Wittlinnet8805

AEs were reported in 136 (49.1%) patients; most were mild in severity. The most common AEs were increased weight (13.4%), somnolence (8.3%), nasopharyngitis (4.0%), and headache (4.0%). Mean weight increase from baseline in patients completing 52 weeks of treatment was 1.86 kg, a 2.79% increase. No clinically significant changes in mean laboratory parameters were observed. Mean (SD) changes from baseline to week 52 in PANSS total score and CGI-S score were -16.2 (15.41) and -0.9 (0.92), respectively (both P less then 0.001). DISCUSSION OLZ/SAM was generally well tolerated with a safety profile that supports long-term treatment. During this 52-week extension study, there were improvements in schizophrenia symptoms. FUNDING ACKNOWLEDGEMENTS This study was funded by Alkermes, Inc.INTRODUCTION Major depressive disorder (MDD) is a global long-term condition and is the leading cause for disability in most countries. The objective of this study was to evaluate individual items of the PHQ-9 and SDS to show differences by treatment arm over the course of treatment. METHODS The TRANSFORM-2 study (NCT02418585) was a Phase 3 short-term trial that evaluated efficacy and safety of flexible esketamine nasal spray (56 mg or 84 mg) doses in combination with newly initiated oral antidepressant (ESK+AD) vs oral AD + placebo nasal spray (AD+PBO) in patients with treatment resistant depression (TRD). The study population, men and women aged 18-64 years, who met the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 diagnostic criteria for single-episode or recurrent MDD, but excluded subjects with suicidal ideation/intent to act within 6 months prior to study. Patient reported outcomes (PROs) were integrated to evaluate the patient perspective of treatment using instruments capturing concment difference (95% CI) was -4.0 (-6.28; -1.64). Change in PHQ-9 total score from baseline to Day 28 numerically favored treatment with ESK+AD. The LS mean difference (95%CI) was -2.4 (-4.18; -0.69). Most patients experienced improvement on all PHQ-9 items and more patients experienced greater improvement in the ESK+AD treatment arm compared to the AD+PBO arm (odds ratio range 1.367-2.767; favoring ESK+AD). Improvements were seen across all items of the Sheehan Disability Scale (odds ratio range from 1.994 - 3.378; favoring ESK+AD). CONCLUSIONS This study shows that while the magnitude of improvement varied on individual items, ESK+AD treatment leads to greater symptom improvement across the multiple symptoms included in the PHQ-9 and SDS compared to the AD+PBO. This assists interpretation of the total scores generated by these PRO measures since total scores on the two measures was not driven by a single item. FUNDING ACKNOWLEDGEMENTS Study was funded by Janssen Global Services, LLC.OBJECTIVES To investigate the current response to psychopharmacology and transcranial magnetic stimulation (TMS) in Pacific Islander adolescents with Major Depressive Disorder (MDD). BACKGROUND 40-60% of youth with Major Depressive Disorder (MDD) have a limited response to current treatment protocols and require either (a) medications with a wider side effect profile, (b) intensive psychosocial programs that interfere with school, and/or (c) publicly spurned options (electroconvulsive therapy). Such results are tempered further when working with Pacific Islanders, as such youth and families have shown in multiple studies. The aversion to such standard treatment is concerning, as Native Hawaiian adolescents have a higher risk of suicide than other adolescents in Hawaii (12.9/100,000 youth per year). With this in mind, the investigators wondered how a novel, non-pharmacological approach to depression treatment in children, transcranial magnetic stimulation (TMS), would fair. METHODS 2 literature searches (utilingaging in a pilot study to evaluate the performance of TMS for the treatment of MDD in Native Hawaiian and other Pacific Islander adolescents aged 12-17; we are planning on then progressing on to a sham-controlled RCT in a larger sample size of the same population to test its efficacy in not just Pacific Islanders, but all youth. FUNDING ACKNOWLEDGEMENTS no funding.PURPOSE OF THE STUDY To present a case about a 12 year old with a movement disorder to educate the community about an uncommon side effect of a commonly utilized class of psychiatric medications. Simple statement of methods Patient was seen in the context of a consultation-liaison psychiatry capacity during the first author's general psychiatry residency. Information was obtained from an electronic medical record and interviews with other physicians that treated the patient. Research about the patient's supposed diagnosis was conducted using a PubMed + OneSearch searches and articles were obtained under the guidance of a certified hospital librarian. RESULTS/DISCUSSION Withdrawal Emergent Dyskinesia is an uncommon, but debilitating condition that can occur after a rapid discontinuation/dosage change of a neuroleptic. This condition has been documented sparsely in the literature; more literature exists regarding its presence in children than in adults. The condition lasts for 2-3 months and resolves spontaneously in ~90% of cases. The literature that is available suggests (1) avoiding neuroleptic use in children if possible, (2) tapering off antipsychotics slowly, (3) using benzodiazepines and/or beta-blockers to treat symptoms of this condition, and (4) restarting the neuroleptic if symptoms do not improve. CONCLUSION Withdrawal Emergent Dyskinesia is an uncommon, poorly studied, debilitating condition that can occur after a rapid discontinuation/dosage change of a neuroleptic. Future research efforts could be focused on (a) the prevalence of neuroleptic withdrawal symptoms in both adults and children, (b) the complete neurochemical and neurobiological pathogenesis of WED, and (c) the differences in terms of diagnosis and treatment between dyskinesias associated with both neuroleptic use and/or withdrawal. In addition, the existence of such a condition is yet another reason to reconsider off-label use of neuroleptics to treat behavioral symptoms in the absence of clear psychiatric indications for their use.OBJECTIVE To describe the initial results of implementing pharmacogenomics testing in a community-based psychiatry practice and potential impacts on medication management. METHOD Retrospective chart review of prospectively maintained medical records of all adult patients with pharmacogenomics results from 9/01/2017 to 6/30/2019 under the care of psychiatrist and clinical pharmacist. RESULTS A total of 51 patients met inclusion criteria. A total of 7 pharmacokinetic genes and, due to changes in the test report over time, a range of 6-10 pharmacodynamic genes relevant to psychotropic medications were evaluated per patient. Every patient had genetic variations, with an average of 6.1 per patient (range 3-9; SD= 1.5). Patients were taking an average of 3.6 (range 1-8; SD=1.7) psychiatric medications at the time of the genetic test, to treat an average of 5 psychiatric conditions (range 1-9; SD=2.2). An average of 1.2 (range 0-4; SD=1.0) gene-drug interactions were uncovered per patient. Following review by psychiatrist and pharmacist, medication adjustments resulted in patients remaining on an average of 3.6 psychiatric medications, but decreasing the average number of gene-drug interactions per patient to 0.8 (range 0-3, SD=0.8). DISCUSSION The large number of genetic variations observed per patient is consistent with previous findings 1-2. The decrease in number of gene-drug interactions following testing demonstrates the practical utility of pharmacogenomics information to guide medication therapy. This study did not examine outcomes such as improvement in psychiatric condition or reduction in medication adverse effects; however, these endpoints have been evaluated in other trials 3-4. CONCLUSIONS Pharmacogenomics testing presents an opportunity for a personalized medicine approach in a community-based psychiatry practice.The production of tilapia Oreochromis spp. is rapidly growing throughout the world, but atypical motile aeromonad septicemia (MAS) is a current threat to the tilapia farming industry. The etiological agent of this disease is usually Aeromonas hydrophila. Mortality rates due to MAS are frequently high, resulting in a devastating negative impact on this industry worldwide; therefore, proper control measures regarding both prevention and treatment are necessary. Although vaccines against MAS for tilapia are available, their effectiveness is entirely dependent on the specific strain of problematic bacteria. Until now, whole-cell inactivated A. hydrophila vaccines for tilapia have exhibited the highest level of protection over live attenuated and recombinant vaccines. Among the various vaccine administration systems, only intraperitoneal (i.p.) injections of the A. hydrophila vaccine into tilapia were found to provide prominent immune protection. Vaccine efficacy was primarily measured by using the i.p. injection challenge model and estimating the relative percent survival of the immunized tilapia. Freund's incomplete adjuvant showed to be the most effective for tilapia MAS vaccines. In this review, multiple factors that directly or indirectly influence the efficacy of MAS vaccines for tilapia (adjuvants, challenge models, immunization doses and duration, and size of vaccinated fish) are discussed. © 2020 American Fisheries Society.Kynurenic acid (KYNA) is a compound derived from the tryptophan catabolic pathway. Antioxidant and neuroprotective properties have been confirmed for KYNA, which makes it an interesting and important metabolite of biomedical significance. In the present study the yeast Yarrowia lipolytica was tested for KYNA biosynthesis. The results showed that Y. lipolytica strain S12 is able to produce KYNA in high concentrations (up to 21.38 μg/ml in culture broth and 494.16 μg/g CDW in biomass) in optimized conditions in medium supplemented with tryptophan. Different conditions of culture growth, including the source of carbon, its concentration and pH value of the medium, as well as the influence of an inhibitor or precursor of KYNA synthesis, were analyzed. The obtained data confirmed the presence of KYNA metabolic pathway in the investigated yeast. To our best knowledge, this is the first study that reports KYNA production in the yeast Y. lipolytica in submerged fermentation. This article is protected by copyright. All rights reserved.BACKGROUND Scurvy, the disease resulting from vitamin C deficiency, is perceived as being rare and occurring predominantly in the past. However, scurvy continues to exist and may be encountered in children with medical/developmental conditions and/or restricted diet. Diagnosis can be challenging given the perceived rarity of the condition and nonspecific symptoms, including gingival disease. METHODS We present a series of two cases of scurvy in which the affected children presented to medical attention with dental complaints. Additional cases of scurvy are described, based on the literature review of case reports/series published in the last 10 years. RESULTS Literature review yielded 77 relevant case reports published in the English language since 2009. Most affected children had a previous diagnosis of a medical or developmental condition (especially autism spectrum disorder). Intraoral features (gingival swelling, pain, and bleeding) were noted in most of the identified cases of scurvy. Improvement in the oral features of scurvy occurred within days of vitamin C therapy initiation.