Background: Novel antidepressive substances are challenging the explanations for the mechanisms of action of traditional psychopharmacology.
Objective: What could be the shared effects of various antidepressants and in this context what role do extrapharmacological factors, such as the body and environment, play?
Material And Method: The available literature on clinical and preclinical data for assumed combined active factors of serotonergic psychedelic drugs, (es)ketamine, monoaminergic antidepressants and zuranolone are presented and the influence of context factors on the individual mechanisms of action is discussed.
Results: There are many indications that classical and novel pharmacological approaches could share similar mechanisms of action in the treatment of depression.
Background And Objectives: Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item.
Methods: A systematic review was performed to identify the impact of each single ERAS item on RC outcomes.
: Quality assurance in data collection is essential as data quality directly impacts the accuracy and reliability of outcomes. In the context of early detection of prostate cancer, improving data completeness is a key focus for enhancing patient care. This study aimed to evaluate the effectiveness of a data-driven feedback tool, visualized through a dashboard, in improving the completeness of data collection by healthcare professionals.
View Article and Find Full Text PDFBackground: Immune checkpoint inhibitors (ICIs) are an important therapeutic pillar in metastatic urothelial carcinoma (mUC). The occurrence of immune-related adverse events (irAEs) appears to be associated with improved outcomes in observational studies. However, these associations are likely affected by immortal time bias and do not represent causal effects.
View Article and Find Full Text PDFThe application of psychedelics in psychiatry and psychotherapy is increasingly the subject of scientific evaluation and discussion in national and international professional and general society, and, internationally, has already been partly applied in the clinical setting. The manuscript provides a basic description of the state of the art regarding evidence and clinical issues; law, ethics and economics are addressed; therapeutic qualification of potential users and a potentially clinical embedding in psychiatry are discussed, taking into consideration current challenges. Thus, the discussion will cover the circumstances under which the application of psychedelics might have a potential to broaden the spectrum of treatments in certain psychiatric conditions, particularly in the context of chronicity and treatment resistance to current methods.
View Article and Find Full Text PDFBackground: Treatment with so-called psychedelic drugs, including psilocybin, lysergic acid diethylamide (LSD), and others, is among the most promising recent developments in psychiatry. This review focuses on psilocybin, a substance found in all mushrooms of the genus Psilocybe, because the largest amount of available evidence relates to this drug.
Methods: This review is based on pertinent publications (since 1969) that were retrieved by a selective search carried out in August 2024 in the PubMed and ScienceDirect databases employing the keywords "psilocybin" AND "long-term effects" AND "mental disorders", with an emphasis on randomized, controlled clinical trials (RCTs).
Objectives: To investigate changes in quality of life (QoL) up to 8 years after radical cystectomy (RC) and compare QoL after RC with a gender- and age-matched Dutch normative population. Furthermore, we aimed to identify patient characteristics associated with QoL and QoL trajectories after RC.
Patients And Methods: Patients with bladder cancer were invited to complete QoL questionnaires at 3-month intervals in the first year and yearly thereafter.
Cerebral arterial and venous flow (A/V) classification is a key parameter for understanding dynamic changes in neonatal brain perfusion. Currently, transfontanellar ultrasound Doppler imaging is the reference clinical technique able to discriminate between A/V using vascular indices such as resistivity index (RI) or pulsatility index (PI). However, under conditions of slow arterial and venular flow, small signal fluctuations can lead to potential misclassifications of vessels.
View Article and Find Full Text PDFBackground: The underlying mechanism for the association between sleep restriction (SR) and unfavorable cognitive outcomes in children and adolescents remains unclear. This study aimed to understand the effect of 5-night experimental SR on magnetic resonance imaging (MRI) measurements of cerebrovascular reactivity (CVR) and cognitive function in adolescents.
Methods: This randomized crossover study compared two sleep conditions, SR and Control Sleep (CS) in a home setting.
The Tol-Pal proteins stabilize the outer membrane during cell division in many Gram-negative bacteria, including . Pal is an outer membrane lipoprotein that can bind peptidoglycan. It accumulates at the septum during division by a mobilization-and-capture mechanism.
View Article and Find Full Text PDFContext: Adjuvant immune checkpoint inhibitors (ICIs) have recently emerged as guideline-recommended treatments of high-risk muscle-invasive urothelial carcinoma (MIUC). However, there is limited evidence regarding the optimal candidates and the differential efficacy of adjuvant ICI regimens.
Objective: To synthesize and compare the efficacy and safety of adjuvant ICIs for high-risk MIUC using updated data from phase III randomized controlled trials.
Objective: Sparse data exist on the impact of upper urinary tract (UUT) decompression on the risk of UUT recurrence in patients with bladder cancer (BCa). This study aims to evaluate whether Double J stenting (DJS) can increase the risk of UUT recurrence compared to percutaneous nephrostomy (PCN) placement.
Materials And Methods: We retrospectively analyzed data from 1550 patients with cTa-T3NanyM0 BCa who underwent radical cystectomy (RC) between at 12 tertiary care centers (1990-2020).
Objective: We aim to provide an updated literature overview on patient-reported barriers and facilitators to participation in SDM across different patient groups and healthcare settings to uncover the 'common ground' and to reach for a more generalizable, uniform and inclusive insight in patients' perspective on participation in SDM.
Methodology: We conducted a qualitative meta-summary, using five databases. Search terms were based on the concepts: 'decision-making', 'patient participation', 'patient perceptions' and 'study design' (of patient reporting).
Purpose: There is lack of evidence regarding the indication for re-transurethral resection of bladder tumor (reTURBT) for Ta high grade (HG) non-muscle invasive bladder cancer (NMIBC). This study aims to evaluate the oncological outcomes of patients with TaHG NMIBC to determine the benefit from performing reTURBT.
Methods: We relied on a multicenter cohort of 317 TaHG NMIBC from 12 centers who underwent TURBT and a subsequent complete Bacillus Calmette-Guérin induction from 2009 to 2021.
Despite wide availability of prevention and treatment services, including the ongoing roll-out of pre-exposure prophylaxis (PrEP), the HIV epidemic is not under control in Belgium. Hence, there is a recognized need to improve case finding and early diagnosis to curb the further spread of HIV more effectively. The objective of the present study was to improve insight into the profiles of persons recently infected with HIV-1 and on their prevention trajectory.
View Article and Find Full Text PDFThe European Association of Urology (EAU), National Comprehensive Cancer Network, and European Society for Medical Oncology guidelines recommend PD-L1 and FGFR testing for patients with locally advanced bladder cancer or upper tract urothelial cancer (UTUC) according to specific eligibility criteria; positive results indicate therapy with immune checkpoint inhibitors or erdafitinib, respectively. The EAU guidelines recommend PD-L1 testing for subsequent adjuvant therapy in high-risk UC, and germline DNA sequencing in patients with UTUC positive for DNA mismatch repair alterations.
View Article and Find Full Text PDFObjective: To investigate the influence of statins on the survival outcomes of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adjuvant intravesical bacille Calmette-Guérin (BCG) immunotherapy.
Patients And Methods: A retrospective cohort of consecutive patients with NMIBC who received intravesical BCG therapy from 2001 to 2020 and statins prescription were identified. Overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and progression-free survival (PFS) were analysed between the Statins Group vs No-Statins Group using Kaplan-Meier method and multivariable Cox regression.
Arch Dis Child Fetal Neonatal Ed
September 2024
Rationale: Preterm neonates needing rescue treatments with inotropes and/or inhaled nitric oxide (iNO) (acute critical illnesses, ACIs) in neonatal intensive care units (NICUs) are at high risk of mortality. While targeted neonatal echocardiography consultations (TNE) are increasingly used to guide management, its clinical impact need evaluation.
Objectives: To investigate clinical outcomes in relation to TNE utilisation during episodes of ACIs among preterm neonates.
Background And Objective: Management of low-grade (LG) urothelium-confined (Ta stage) non-muscle-invasive bladder cancer (NMIBC) poses a distinct therapeutic challenge. Transurethral resection of bladder tumor (TURBT), the standard treatment, frequently has to be repeated because of high tumor recurrence rates. This places a considerable strain on both patients and health care infrastructure, underscoring the need for alternative management approaches.
View Article and Find Full Text PDFBackground: Right ventricular (RV) hemodynamic performance determines the prognosis of patients with RV pressure overload. Using ultrafast ultrasound, natural wave velocity (NWV) induced by cardiac valve closure was proposed as a new surrogate to quantify myocardial stiffness.
Objectives: This study aimed to assess RV NWV in rodent models and children with RV pressure overload vs control subjects and to correlate NWV with RV hemodynamic parameters.
Objectives: To explore the educational needs of physicians and residents regarding shared decision making (SDM).
Methods: We conducted eight focus groups with 12 general practitioners (GPs), 14 hospital specialists, 12 hospital specialist residents and 13 GP residents in Belgium. We used thematic analysis to guide data analysis.