Episodes In People Research Articles

Validation of the Italian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)

The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was developed for the rapid detection of a major depressive episode in people with epilepsy. It has been proven to be a user‐friendly screening instrument. This study describes the development, validation, and psychometric properties of the Italian version of the NDDI-E. A consecutive sample of 120 outpatients with epilepsy has been assessed using the M.I.N.I. Plus version 5.0.0 and the NDDI-E. All patients had no major difficulties in understanding or answering the questions of the Italian version. Cronbach's alpha coefficient was 0.851. Receiver operating characteristic analysis showed an area under the curve of 0.943 (CI95%=0.902–0.985; SE 0.021; p<0.001), a cut off score of 13, a sensitivity of 86.2%, a specificity of 89%, a positive predictive value of 71.4%, and a negative predictive value of 95.3%.

Factores asociados a las estancias anormalmente prolongadas en las hospitalizaciones por insuficiencia cardiaca en España

Background. Heart failure is a process of high prevalence that causes repeated hospital admissions with increased health care costs. The aim of this article is to describe and characterize the cases with long stays due to this syndrome, identifying associated factors wherever possible. Methods. An historical cohort of all the episodes of people over 45 years with a diagnosis of heart failure admitted in the Spanish Public Health System in the period 1997-2007. Source: 808,229 episodes classified as Diagnosis Related Groups 127 and 544 according to the Minimum Basic Data provided by the Institute for Health Information. We assessed sociodemographic variables (age, gender, region), clinical variables (comorbidities, complications, type of admission and discharge) and management variables (length of stay, type of hospital readmissions). An abnormally prolonged stay (APS) was defined as one exceeding the 90th percentile (14 and 16 days, respectively); we built a logistic regression model to assess their possible associated factors. Results. Eleven point four percent (11.4%) presented abnormally prolonged stays, showing lower mean age and increased number of diagnoses and procedures, readmissions and mortality than the non-abnormally prolonged stay group. Anemia, kidney failure, pulmonary embolism or stroke as well as readmission and scheduled admission were associated with increased likelihood of APS. Conclusion. It is possible to define a comorbidities and sociodemographic profile to assess the likelihood of a prolonged hospital stay, but given the nature of administrative database the model’s discriminative ability is quite discreet.

How Basal Insulin Analogs Have Changed Diabetes Care

How Basal Insulin Analogs Have Changed Diabetes Care

Elective admissions: the journey for the person with diabetes

Elective admissions: the journey for the person with diabetes

Estimating number-needed-to-treat to avoid hypoglycaemic episodes in people with type 2 diabetes: a post-hoc analysis of a prospective randomized controlled trial comparing once-daily insulin glargine with twice-daily NPH insulin

Estimating number-needed-to-treat to avoid hypoglycaemic episodes in people with type 2 diabetes: a post-hoc analysis of a prospective randomized controlled trial comparing once-daily insulin glargine with twice-daily NPH insulin

Digest

Digest

Factor VIII--Baxter: rAHF-PFM, recombinant anti-haemophilic factor--protein-free method, recombinant factor VIII--protein-free.

Baxter Healthcare is developing a next-generation recombinant factor VIII for the treatment of haemophilia A that is produced using a totally protein-free manufacturing process. By excluding proteins or raw materials derived from human or animal sources in the final product, the risk of transmission of potentially infectious agents is removed. All of the recombinant factor VIII products currently on the market incorporate proteins or raw materials derived from either human or animal sources, as part of the nutrients required for the cells to produce the protein. Baxter has exclusive rights to Quadrant Healthcare's factor VIII stabilisation technology. Quadrant received 1 million US dollars under the agreement, and was to receive milestone payments in excess of 2 million US dollars, together with royalties on sales should a new factor VIII product using Quadrant's technology reach the market. In December 2000, Quadrant Healthcare was acquired by Elan Drug Delivery (Elan Corporation), which continued to develop the proprietary formulation and stabilisation technologies of Quadrant. In July 2003, the newly formed company Quadrant Technologies acquired Elan Drug Delivery from Elan Corporation and renamed it Quadrant Drug Delivery. In July 2003, the US FDA approved the use of ADVATE for the prevention and control of bleeding episodes in people with haemophilia A. At the Bear Stearns 16th Annual Healthcare Conference held in September 2003, Baxter reported that ADVATE was launched in August 2003 in the US. A pivotal phase III clinical trial of this recombinant factor VIII therapy, initiated in 89 previously untreated patients with haemophilia A, has been completed at sites in the US, UK, Sweden, France, Belgium, Germany, Denmark and Italy. This trial compared the pharmacokinetics, tolerability and immunogenicity of this therapy with Baxter's currently marketed recombinant factor VIII preparation, Recombinate trade mark. The first clinical data that were presented on this agent at the XXV International Congress of the World Federation of Hemophilia meeting indicate that Baxter's next-generation recombinant factor VIII is bioequivalant with Recombinate trade mark. The two agents should have comparable efficacy. A Marketing Authorisation Application (MAA) was submitted to the EU EMEA and regulatory filings were made in Canada in September 2002. The submission was made via the centralised procedure. Should the new-generation product reach the market, Baxter will continue to offer Recombinate trade mark as well as plasma-derived factor VIII products. Preliminary study results announced in July 2003 show that factor VIII therapy was effective in controlling bleeding episodes in patients with severe and moderately severe haemophilia A who were previously treated, or had undergone surgery.

Depressive episodes in adults with learning disabilities

AbstractObjective:In view of the Royal College of Psychiatrists Defeat Depression campaign, to review the existing literature on depressive episodes in people with learning disabilities.Methods:Review of all papers identified to cover this area. Papers were identified by Medline search and also by direct checking of the contents in the preceding five years of eight key learning disabilities journals, the British Journal of Psychiatry, Psychiatric Bulletin and bibliography in Current Opinions in Psychiatry. Papers about children or odd ‘depressive’ symptoms (rather than the syndrome of depression) were excluded.Findings:For over a century it has been recognised that depression can occur in people with learning disabilities. However, the number of studies in this area is very limited. There remain many unanswered questions, such as those of prevalence, clinical presentation and diagnostic criteria, associated social factors, and the evaluation of treatments. Suitable rating scales have yet to be evaluated or devised. The authors propose diagnostic criteria for future use.Conclusions:Research in this important area is very limited. Advances are yet to be made in the clinical assessment and management of the illness.