Introduction: During the last decade, a number of meta-analyses questioned the clinically relevant efficacy of antidepressants. Part of the debate concerned the method used in each of these meta-analyses as well as the quality of the data set.
Materials And Methods: The Kirsch data set was analysed with a number of different methods, and eight key questions were tackled. We fit random effects models in both Bayesian and frequentist statistical frameworks using raw mean difference and standardised mean difference scales. We also compare between-study heterogeneity estimates and produce treatment rank probabilities for all antidepressants. The role of the initial severity is further examined using meta-regression methods.
Results: The results suggest that antidepressants have a standardised effect size equal to 0.34 which is lower but comparable to the effect of antipsychotics in schizophrenia and acute mania. The raw HDRS difference from placebo is 2.82 with the value of 3 included in the confidence interval (2.21-3.44). No role of initial severity was found after partially controlling for the effect of structural (mathematical) coupling. Although data are not definite, even after controlling for baseline severity, there is a strong possibility that venlafaxine is superior to fluoxetine, with the other two agents positioned in the middle. The decrease in the difference between the agent and placebo in more recent studies in comparison to older ones is attributed to baseline severity alone.
Discussion: The results reported here conclude the debate on the efficacy of antidepressants and suggest that antidepressants are clearly superior to placebo. They also suggest that baseline severity cannot be utilized to dictate whether the treatment should include medication or not. Suggestions like this, proposed by guidelines or institutions (e.g. the NICE), should be considered mistaken.
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http://dx.doi.org/10.1186/1744-859X-12-26 | DOI Listing |
Pediatr Radiol
January 2025
Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Background: Radiographic skeletal survey plays an important role in the diagnosis of infant abuse. Some practitioners have expressed concerns about the radiation exposure from this examination.
Objective: To utilize state-of-the-art hybrid computational phantoms to more accurately estimate radiation doses of skeletal surveys performed for suspected infant abuse.
Strahlenther Onkol
January 2025
Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Purpose: Recent advancements in imaging, particularly 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET/CT), have improved the detection of involved lymph nodes, thus influencing staging accuracy and potentially treatment outcomes. This study is a post hoc analysis of the GAZAI trial data to evaluate the impact of FDG-PET/CT versus computed tomography (CT) alone on radiation target volumes for involved-site radiotherapy (IS-RT) in early-stage follicular lymphoma (FL).
Methods: All patients in the GAZAI trial underwent pretherapeutic FDG-PET/CT examinations, which were subject to central quality control.
Physiol Res
December 2024
Department of Physiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovak Republic.
Obesity is considered an important factor contributing to the development of atherosclerosis. Inflammation plays a key role in endothelial dysfunction (ED), an initial stage of the atherosclerotic process. Several microRNAs (miRNAs) may play an important role in the inflammatory process, but there is a lack of information about their participation in the early stages of atherosclerosis development in patients with obesity.
View Article and Find Full Text PDFBackground: Transfusion-associated hypotension (TAH) is characterized by the abrupt onset of hypotension immediately after the start of transfusion and usually resolves when transfusion ceases. The pathogenesis of TAH is not yet fully understood.
Methods: A 36-year-old woman underwent exploratory laparotomy and cesarean section due to cervical squamous cell carcinoma.
Transl Vis Sci Technol
January 2025
Department of Biomedical Engineering, Duke University, Durham, NC, USA.
The introduction of optical coherence tomography (OCT) in the 1990s revolutionized diagnostic ophthalmic imaging. Initially, OCT's role was primarily in the adult ambulatory ophthalmic clinics. Subsequent advances in handheld form factors, integration into surgical microscopes, and robotic assistance have expanded OCT's utility and impact outside of its initial environment in the adult outpatient ophthalmic clinic.
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