-
1.
Early Experience with Modified Dose Nirmatrelvir/Ritonavir in Dialysis Patients with Coronavirus Disease 2019.
Hiremath, S, Blake, PG, Yeung, A, McGuinty, M, Thomas, D, Ip, J, Brown, PA, Pandes, M, Burke, A, Sohail, QZ, et al
Clinical journal of the American Society of Nephrology : CJASN. 2023;(4):485-490
-
-
Free full text
-
Abstract
BACKGROUND Nirmatrelvir/ritonavir was approved for use in high-risk outpatients with coronavirus disease 2019 (COVID-19). However, patients with severe CKD were excluded from the phase 3 trial, and the drug is not recommended for those with GFR <30 ml/min per 1.73 m 2 . On the basis of available pharmacological data, we developed a modified low-dose regimen of nirmatrelvir/ritonavir 300/100 mg on day 1, followed by 150/100 mg daily from day 2 to 5. In this study, we report our experience with this modified dose regimen in dialysis patients in the Canadian province of Ontario. METHODS We included dialysis patients who developed COVID-19 and were treated with the modified dose nirmatrelvir/ritonavir regimen during a 60-day period between April 1 and May 31, 2022. Details of nirmatrelvir/ritonavir use and outcomes were captured manually, and demographic data were obtained from a provincial database. Data are presented with descriptive statistics. The principal outcomes we describe are 30-day hospitalization, 30-day mortality, and required medication changes with the modified dose regimen. RESULTS A total of 134 dialysis patients with COVID-19 received nirmatrelvir/ritonavir during the period of study. Fifty-six percent were men, and the mean age was 64 years. Most common symptoms were cough and/or sore throat (60%). Medication interactions were common with calcium channel blockers, statins being the most frequent. Most patients (128, 96%) were able to complete the course of nirmatrelvir/ritonavir, and none of the patients who received nirmatrelvir/ritonavir died of COVID-19 in the 30 days of follow-up. CONCLUSIONS A modified dose of nirmatrelvir/ritonavir use was found to be safe and well tolerated, with no serious adverse events being observed in a small sample of maintenance dialysis patients.
-
2.
Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity.
Chi, X, Liang, K, Chen, ST, Huang, Q, Huang, L, Yu, Q, Jiao, C, Guo, T, Stubbs, B, Hossain, MM, et al
International journal of clinical and health psychology : IJCHP. 2021;21(3):100218
-
-
-
Free full text
Plain language summary
Recent research has showed that the prevalence of insomnia, depressive and anxiety symptoms among Chinese middle school students was 21.90%, 43.70% and 37.40%, respectively, during the COVID-19 period. The aims of this study were: (1) to explore the prevalence of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19 outbreak; (2) to investigate associations of socio-demographic factors and COVID-fear with insomnia, depressive and anxiety symptoms; (3) to investigate associations of nutrition and physical activity with insomnia, depressive and anxiety symptoms after adjusting socio-demographic factors and COVID-fear. This study included 1,794 students (males n= 56.20% and females n= 43.80%) aged 15 and 18 years. Results indicate that prevalence of insomnia, depressive and anxiety symptoms was high in the participating cohort. The highest prevalence was among female participants, left behind children and students with higher COVID-fear. Both better nutritional status, moderately and highly active physical activity levels were protective factors for depression and anxiety, while highly active physical activity level was significantly associated with lower level of insomnia symptoms. Authors conclude by emphasising on the important role of psychology counsellors in schools, health authorities and educators to carry out early psychological interventions.
Abstract
Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19. METHOD Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety. RESULTS The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms. CONCLUSIONS These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise. Los problemas de salud mental son comunes en adolescentes y están influenciados por eventos estresantes. Se evaluó prevalencia y correlatos de síntomas de insomnio, depresión y ansiedad en adolescentes chinos durante el COVID-19. Método: En mayo de 2020 se realizó un estudio transversal (N = 1.794 adolescentes, edad media = 15,26) mediante una encuesta en línea para recopilar datos sociodemográficos, miedo relacionado con COVID-19, nutrición, actividad física (AF) y síntomas de insomnio, depresión y ansiedad. Resultados: La prevalencia de síntomas de insomnio, depresión y ansiedad fue del 37,80%, 48,20% y 36,70%, respectivamente. Modelos lineales generalizados revelaron que mujeres, niños abandonados y estudiantes con más miedo al COVID-19 tendían a informar síntomas de insomnio, depresión y ansiedad simultaneamente. Después de ajustar los factores sociodemográficos y el miedo al COVID-19, mejor estado nutricional y AF moderadamente activa se asociaron con niveles más bajos de síntomas de depresión y ansiedad, mientras que AF muy activa se asoció con niveles más bajos de insomnio, síntomas depresivos y de ansiedad. Conclusiones: Se debe prestar más atención a la salud psicológica de los adolescentes mientras se combate el COVID-19. Para promover su salud mental, los educadores deben ayudarles a desarrollar un estilo de vida saludable con una dieta equilibrada y ejercicio regular.
-
3.
Longer-term open-label study of adjunctive riluzole in treatment-resistant depression.
Sakurai, H, Dording, C, Yeung, A, Foster, S, Jain, F, Chang, T, Trinh, NH, Bernard, R, Boyden, S, Iqbal, SZ, et al
Journal of affective disorders. 2019;:102-108
-
-
Free full text
-
Abstract
BACKGROUND While riluzole has been investigated for the treatment of depression, little is known about its longer-term efficacy and optimal treatment duration in treatment-resistant depression (TRD). The objective of this study is to characterize the longer-term outcome of adjunctive riluzole therapy for TRD in an open-label extension of an 8-week acute treatment trial. METHODS The data from 66 patients with TRD who received adjunctive riluzole in a 12-week open-label extension phase were analyzed. Response rates (⩾50% reduction in the Mongomery-Asberg Depression Rating Scale [MADRS] score), relapse rates (a MADRS score of ⩾22 in patients who had previously achieved response), and adverse events were examined in patients who had achieved response at the end of the acute phase and those who had not. RESULTS Among acute phase responders, the maintained response rate was 66.7% (8/12) and the relapse rate was 8.3% (1/12). In acute phase non-responders, the response rate was 24.1% (13/54). The most commonly reported adverse event was fatigue (9.1%). Three cases were considered serious adverse events; vomiting (n = 1), shortness of breath (n = 1), and aborted suicide attempt (n = 1). LIMITATIONS This longer-term study was open-label and uncontrolled. The sample size was relatively small. CONCLUSIONS Longer-term adjunctive riluzole appears relatively well tolerated and beneficial for maintaining previous response. Additionally, approximately one fourth of patients who did not respond to 8-week antidepressant treatment might respond if treated with riluzole for 12 weeks. Those findings warrant further investigation because adjunctive riluzole could represent an option for treatment of depression when standard antidepressants have failed.
-
4.
Efficacy of dexamethasone versus bevacizumab on regression of hard exudates in diabetic maculopathy: data from the BEVORDEX randomised clinical trial.
Mehta, H, Fraser-Bell, S, Yeung, A, Campain, A, Lim, LL, Quin, GJ, McAllister, IL, Keane, PA, Gillies, MC
The British journal of ophthalmology. 2016;(7):1000-1004
Abstract
OBJECTIVE To report the effect of bevacizumab versus dexamethasone on hard exudates (HEX) in diabetic macular oedema (DME). DESIGN Post hoc analysis of 24-month data from the Randomised clinical trial of BEVacizumab OR DEXamethasone for diabetic macular oedema (BEVORDEX) phase 2 multicentre randomised clinical trial. Eyes with centre-involving DME resistant to or unlikely to benefit from macular laser therapy were included. Eyes were randomly assigned to bevacizumab every 4 weeks or Ozurdex dexamethasone implant (DEX) every 16 weeks, both as required. The 68 eyes from 48 patients that completed 24-month follow-up were analysed. Two masked graders assessed extent and location of HEX on baseline, 12-month and 24-month foveal-centred colour fundus photographs using validated grading software. RESULTS Macular HEX was present in 60% of study eyes. Of these, 21 eyes were treated with DEX and 20 eyes with bevacizumab. Both treatments led to reduction in area of macular HEX at 12 months and 24 months. There was greater regression of HEX from the foveal centre in DEX-treated eyes (median change +890 µm, IQR=1040 µm) than bevacizumab-treated eyes (median change +7.0 µm, IQR=590 µm) at 12 months (p=0.04) but the difference was no longer statistically significant (p=0.10) by 24 months (DEX +1400 µm, IQR=1590 µm; bevacizumab +20 µm, IQR=2680 µm). Reassuringly, no study eye developed HEX at the foveal centre, a visually devastating consequence of diabetic maculopathy. CONCLUSIONS Bevacizumab and DEX were effective in reducing area of HEX in eyes with DME. DEX provided more rapid regression of HEX from the foveal centre although bevacizumab-treated eyes started to catch up by 24 months. Distance from the foveal centre as well as total area of macular HEX should be assessed when evaluating treatments for foveal-threatening HEX. TRIAL REGISTRATION NUMBER NCT01298076; Post-results.
-
5.
The basis of antagonistic pleiotropy in hfq mutations that have opposite effects on fitness at slow and fast growth rates.
Maharjan, R, McKenzie, C, Yeung, A, Ferenci, T
Heredity. 2013;(1):10-8
-
-
Free full text
-
Abstract
Mutations beneficial in one environment may cause costs in different environments, resulting in antagonistic pleiotropy. Here, we describe a novel form of antagonistic pleiotropy that operates even within the same environment, where benefits and deleterious effects exhibit themselves at different growth rates. The fitness of hfq mutations in Escherichia coli affecting the RNA chaperone involved in small-RNA regulation is remarkably sensitive to growth rate. E. coli populations evolving in chemostats under nutrient limitation acquired beneficial mutations in hfq during slow growth (0.1 h(-1)) but not in populations growing sixfold faster. Four identified hfq alleles from parallel populations were beneficial at 0.1 h(-1) and deleterious at 0.6 h(-1). The hfq mutations were beneficial, deleterious or neutral at an intermediate growth rate (0.5 h(-1)) and one changed from beneficial to deleterious within a 36 min difference in doubling time. The benefit of hfq mutations was due to the greater transport of limiting nutrient, which diminished at higher growth rates. The deleterious effects of hfq mutations at 0.6 h(-1) were less clear, with decreased viability a contributing factor. The results demonstrate distinct pleiotropy characteristics in the alleles of the same gene, probably because the altered residues in Hfq affected the regulation of expression of different genes in distinct ways. In addition, these results point to a source of variation in experimental measurement of the selective advantage of a mutation; estimates of fitness need to consider variation in growth rate impacting on the magnitude of the benefit of mutations and on their fitness distributions.
-
6.
The effectiveness of a comprehensive mind body weight loss intervention for overweight and obese adults: a pilot study.
Alert, MD, Rastegar, S, Foret, M, Slipp, L, Jacquart, J, Macklin, E, Baim, M, Fricchione, G, Benson, H, Denninger, J, et al
Complementary therapies in medicine. 2013;(4):286-93
Abstract
OBJECTIVES This pilot study evaluated the effectiveness of a comprehensive mind body intervention for weight loss in overweight and obesity and the maintenance of weight loss at 6-month follow-up. DESIGN Thirty-one overweight and obese employees (Body Mass Index (BMI) 28.6-47.9 kg/m²) from a large corporation participated in a 20-week comprehensive mind body intervention targeting weight loss. MAIN OUTCOME MEASURES Weight, BMI, waist and hip circumference, rate pressure product (RPP), blood pressure, fasting blood glucose, cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and psychological variables were collected at baseline, post-intervention, and 6-month follow-up. RESULTS Using linear mixed model analyses, the intervention resulted in significant mean weight loss (-4.3 kg, 95% CI -5.8 to -2.8), decreases in BMI (-1.51, 95% CI -2.1 to -1.0), hip circumference measurement (-4.3 cm, 95% CI -6.9 to -1.5), and triglyceride levels (95% CI -33.1 to -4.8). In 6-month follow-up after intervention, statistically significant improvements in weight, BMI and waist measurement were sustained. Participants also showed positive changes in self-reported psychological indices: food-related disinhibition, and hunger both decreased significantly (p<0.01); general self-efficacy increased (p<0.05); positive affect increased (p<0.001); physical function and self-esteem increased (p<0.01); and measures of health-promoting behaviors on 4 subscales (health responsibility, physical activity, nutrition, and stress management) also showed statistically significant improvements (p<0.001) at post-intervention and 6-month follow-up. CONCLUSIONS This comprehensive mind body intervention showed modest effects on physical, laboratory, and psychological outcomes, both immediately following treatment and at 6-month follow-up, in overweight and obese individuals.
-
7.
Exploring the effectiveness of a comprehensive mind-body intervention for medical symptom relief.
Samuelson, M, Foret, M, Baim, M, Lerner, J, Fricchione, G, Benson, H, Dusek, J, Yeung, A
Journal of alternative and complementary medicine (New York, N.Y.). 2010;(2):187-92
Abstract
OBJECTIVE The objective of this study was to describe possible changes in physical and psychologic symptoms among outpatients completing a 12-week mind-body medical symptom reduction program related to chronic medical conditions. DESIGN The cornerstone of the program is elicitation of the relaxation response, and the curriculum also incorporates trainings on mind-body interactions, cognitive restructuring, nutrition, and physical activity. The Medical Symptom Checklist (MSCL), Health Promoting Lifestyle Profile-II (HPLP-II) and Symptom Checklist-90R (SCL-90-R) were used to assess 331 patients' physical and psychologic symptoms before and after the intervention. RESULTS Significant post-treatment improvements in symptom frequency occurred for 12 individual symptoms on the MSCL, all 6 of the HPLP-II subscales, and 8 of the 9 SCL-90-R subscales from pre- to post-treatment. CONCLUSIONS The results from this uncontrolled study suggest that a comprehensive mind-body intervention program might be useful as a complementary or adjunct therapy for treatment of chronic medical symptoms.
-
8.
Implications of the presence and length of "geographic miss" on restenosis and the edge phenomenon in the INHIBIT trial.
Costantini, CO, Lansky, AJ, Mintz, GS, Shirai, K, Teirstein, PS, Stone, G, Vandertie, L, Proctor, B, Fahy, M, Yeung, A, et al
The American journal of cardiology. 2003;(10):1261-5