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Psychiatry Research Apr 1986A study of weight change in subjects treated with imipramine was performed on recurrent depressive outpatients. The patients (n = 52) were treated with imipramine...
A study of weight change in subjects treated with imipramine was performed on recurrent depressive outpatients. The patients (n = 52) were treated with imipramine (200-250 mg/day) and psychotherapy for 16 weeks. Each individual was weighed upon entry to the study (drug-free) and then weekly thereafter for 16 weeks. Of the 44 women (85%) and 8 men (15%) in the study, 60% of the total group had a weight gain or loss less than 5 pounds (mean = 1.1 pounds) over this time. A weight gain of 6-10 pounds was observed in 19% of subjects, while 9% of the group gained 11-15 pounds. Only 6% (3 subjects) gained more than 15 pounds. Three subjects (6%) lost 6-10 pounds. No correlations were observed between a change in weight and the subject's age, sex, prior weight, or response to medication.
Topics: Adult; Aged; Appetite; Body Weight; Depressive Disorder; Female; Humans; Imipramine; Male; Middle Aged
PubMed: 3714910
DOI: 10.1016/0165-1781(86)90074-0 -
The Medical Journal of Australia Oct 1969
Topics: Female; Humans; Mastectomy; Prostheses and Implants
PubMed: 5351055
DOI: 10.5694/j.1326-5377.1969.tb107406.x -
Clinical Infectious Diseases : An... Jun 2015Weight gain after antiretroviral therapy (ART) initiation is common, but its implication for mortality is unknown. We evaluated weight change in the first year after ART...
BACKGROUND
Weight gain after antiretroviral therapy (ART) initiation is common, but its implication for mortality is unknown. We evaluated weight change in the first year after ART initiation and its association with subsequent mortality.
METHODS
Human immunodeficiency virus-infected patients from the Veterans Aging Cohort Study (VACS) who initiated ART between 2000 and 2008, with weight recorded at baseline and 1 year later, were followed another 5 years for mortality. Baseline body mass index (BMI) was classified as underweight (<18.5 kg/m(2)), normal (18.5-24.9 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (≥30 kg/m(2)). We used multivariable Cox models to assess mortality risk with adjustment for disease severity using the VACS Index.
RESULTS
The sample consisted of 4184 men and 127 women with a mean age of 47.9 ± 10.0 years. After 1 year of ART, median weight change was 5.9 pounds (2.7 kg) (interquartile range, -2.9 to 17.0 pounds, -1.3 to 7.7 kg). Weight gain after ART initiation was associated with lower mortality among underweight and normal-weight patients. A minimum threshold of 10- to 19.9-pound (4.5 to 9.0 kg) weight gain was beneficial for normal-weight patients (hazard ratio, 0.56; 95% confidence interval, .41-.78), but there was no clear benefit to weight gain for overweight/obese patients. Baseline weight, CD4 cell count status, and hemoglobin level were strongly associated with weight gain. Risk for weight gain was higher among those with greater disease severity, regardless of weight at initiation.
CONCLUSIONS
The survival benefits of weight gain after ART initiation are dependent on starting BMI. Weight gain after ART is associated with lower mortality for those who are not initially overweight.
Topics: Adult; Anti-Retroviral Agents; Body Mass Index; Body Weight; Female; HIV Infections; HIV-1; Humans; Male; Middle Aged; Overweight; Prospective Studies; Veterans; Weight Gain; Weight Loss
PubMed: 25761868
DOI: 10.1093/cid/civ192 -
Food Chemistry Jun 2018The aim of the present study was to investigate the ability of MIR and texture analyzer to evaluate the quality of pound cake samples produced with palm oil and rapeseed...
The aim of the present study was to investigate the ability of MIR and texture analyzer to evaluate the quality of pound cake samples produced with palm oil and rapeseed oil throughout storage. The MIR spectra analyzed by using principal component analysis (PCA) showed a clear separation of pound cakes as a function of the storage time and the nature of the used oil in the recipe. By applying partial least square regression (PLSR), excellent prediction was obtained for hardness (R = 0.91; RPD = 2.26), while an approximate qualitative prediction was found for springiness (R = 0.73; RPD = 2.07), cohesiveness (R = 0.67; RPD = 1.31) and resilience (R = 0.65; RPD = 1.24). It could be concluded that the MIR spectroscopy could be used as a rapid and non-destructive technique for monitoring texture of pound cakes throughout storage as well as for the prediction of their hardness.
Topics: Food Analysis; Food Storage; Principal Component Analysis; Quality Control; Spectrophotometry, Infrared; Spectroscopy, Fourier Transform Infrared
PubMed: 29478549
DOI: 10.1016/j.foodchem.2018.01.122 -
Fertility and Sterility Nov 2003To determine the cost of achieving pregnancy with different gonadotropin preparations. (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
OBJECTIVE
To determine the cost of achieving pregnancy with different gonadotropin preparations.
DESIGN
Cost-minimization analysis of a prospective randomized clinical trial.
SETTING
Twenty-two centers in six countries.
PATIENT(S)
Women 18 to 36 years of age with infertility for more than 1 year who were undergoing IVF or ICSI.
INTERVENTION(S)
Highly purified hMG or recombinant FSH.
RESULT(S)
Mean cost of achieving an ongoing pregnancy. The mean cost per patient treatment cycle was estimated to be pound 2423 with highly purified hMG (95% CI, pound 2356 to pound 2495) and pound 2745 with recombinant FSH (95% CI, pound 2658 to pound 2830). The ongoing pregnancy rate was 22% with highly purified hMG and 19% with recombinant FSH. The cost per ongoing pregnancy was pound 10781 with highly purified hMG (95% CI, pound 9056 to pound 12919) and pound 14284 with recombinant FSH (95% CI, pound 11883 to pound 17891).
CONCLUSION(S)
Highly purified hMG and recombinant FSH are equally effective, but highly purified hMG is less expensive per cycle. Using highly purified hMG instead of recombinant FSH would translate into a 13% increase in the number of cycles that could be offered.
Topics: Adult; Clinical Trials, Phase III as Topic; Cost Control; Cost-Benefit Analysis; Drug Costs; Female; Fertility Agents, Female; Fertilization in Vitro; Follicle Stimulating Hormone; Health Resources; Humans; Menotropins; Multicenter Studies as Topic; Pregnancy; Randomized Controlled Trials as Topic; Recombinant Proteins; Sperm Injections, Intracytoplasmic; Treatment Outcome
PubMed: 14607557
DOI: 10.1016/s0015-0282(03)02185-x -
The British Journal of Psychiatry : the... Mar 2003There is a lack of data on the cost-effectiveness of relapse prevention in depression. (Clinical Trial)
Clinical Trial Randomized Controlled Trial
BACKGROUND
There is a lack of data on the cost-effectiveness of relapse prevention in depression.
METHOD
A total of 158 subjects with partially remitted major depression despite adequate clinical treatment were randomly allocated to cognitive therapy in addition to antidepressants and clinical management v. antidepressants and clinical management alone. Relapse rates and health care resource utilisation were measured prospectively over 17 months.
RESULTS
Cumulative relapse rates in the cognitive therapy group were significantly lower than in the control group (29% v. 47%). The incremental cost incurred in subjects receiving cognitive therapy over 17 months (pound sterling 779; 95% CI pound sterling 387- pound sterling 1170) was significantly lower than the overall mean costs of cognitive therapy (pound sterling 1164; 95% CI pound sterling 1084- pound sterling 1244). The incremental cost-effectiveness ratio ranged from pound sterling 4328 to pound sterling 5027 per additional relapse prevented.
CONCLUSIONS
In individuals with depressive symptoms that are resistant to standard treatment, adjunctive cognitive therapy is more costly but more effective than intensive clinical treatment alone.
Topics: Adult; Aged; Antidepressive Agents; Chronic Disease; Cognitive Behavioral Therapy; Combined Modality Therapy; Confidence Intervals; Cost-Benefit Analysis; Depressive Disorder; Female; Health Resources; Humans; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Secondary Prevention; Treatment Outcome
PubMed: 12611785
DOI: 10.1192/bjp.182.3.221 -
The Journal of Prosthetic Dentistry 1951
Topics: Dental Prosthesis; Dentures; Esthetics; Humans; Phonetics; Speech
PubMed: 14814654
DOI: 10.1016/0022-3913(51)90085-6 -
Brain Sciences Nov 2022Activities of daily living consist of accurate, coordinated movements, which require the upper limbs to constantly interact with environmental loads. The magnitude of...
Activities of daily living consist of accurate, coordinated movements, which require the upper limbs to constantly interact with environmental loads. The magnitude of the load was shown to affect kinematic outcomes in healthy subjects. Moreover, the increase in load facilitates the recovery of motor function in patients with neurological disorders. Although Brodmann Areas 4 and 6 were found to be active during loaded movements, it remains unclear whether stronger activation can be triggered simply by increasing the load magnitude. If such a linear relationship exists, it may provide a basis for the closed-loop adjustment of treatment plans in neurorehabilitation. Fourteen healthy participants were instructed to lift their hands to their armpits. The movements were grouped in blocks of 25 s. Each block was assigned a magnitude of inertial loads, either 0 pounds (bare hand), 3 pounds, or 15 pounds. Hemodynamic fNIRS signals were recorded throughout the experiment. Both channel-wise and ROI-wise analyses found significant activations against all three magnitudes of inertia. The generalized linear model revealed significant increases in the beta coefficient of 0.001673/pound in BA4 and 0.001338/pound in BA6. The linear trend was stronger in BA6 (conditional r = 0.9218) than in BA4 (conditional r = 0.8323).
PubMed: 36421862
DOI: 10.3390/brainsci12111539 -
Health Technology Assessment... Mar 2009This report addressed the question 'What is the clinical and cost-effectiveness of spinal cord stimulation (SCS) in the management of chronic neuropathic or ischaemic... (Review)
Review
OBJECTIVES
This report addressed the question 'What is the clinical and cost-effectiveness of spinal cord stimulation (SCS) in the management of chronic neuropathic or ischaemic pain?'
DATA SOURCES
Thirteen electronic databases [including MEDLINE (1950-2007), EMBASE (1980-2007) and the Cochrane Library (1991-2007)] were searched from inception; relevant journals were hand-searched; and appropriate websites for specific conditions causing chronic neuropathic/ischaemic pain were browsed. Literature searches were conducted from August 2007 to September 2007.
REVIEW METHODS
A systematic review of the literature sought clinical and cost-effectiveness data for SCS in adults with chronic neuropathic or ischaemic pain with inadequate response to medical or surgical treatment other than SCS. Economic analyses were performed to model the cost-effectiveness and cost-utility of SCS in patients with neuropathic or ischaemic pain.
RESULTS
From approximately 6000 citations identified, 11 randomised controlled trials (RCTs) were included in the clinical effectiveness review: three of neuropathic pain and eight of ischaemic pain. Trials were available for the neuropathic conditions failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS) type I, and they suggested that SCS was more effective than conventional medical management (CMM) or reoperation in reducing pain. The ischaemic pain trials had small sample sizes, meaning that most may not have been adequately powered to detect clinically meaningful differences. Trial evidence failed to demonstrate that pain relief in critical limb ischaemia (CLI) was better for SCS than for CMM; however, it suggested that SCS was effective in delaying refractory angina pain onset during exercise at short-term follow-up, although not more so than coronary artery bypass grafting (CABG) for those patients eligible for that surgery. The results for the neuropathic pain model suggested that the cost-effectiveness estimates for SCS in patients with FBSS who had inadequate responses to medical or surgical treatment were below 20,000 pounds per quality-adjusted life-year (QALY) gained. In patients with CRPS who had had an inadequate response to medical treatment the incremental cost-effectiveness ratio (ICER) was 25,095 pounds per QALY gained. When the SCS device costs varied from 5000 pounds to 15,000 pounds, the ICERs ranged from 2563 pounds per QALY to 22,356 pounds per QALY for FBSS when compared with CMM and from 2283 pounds per QALY to 19,624 pounds per QALY for FBSS compared with reoperation. For CRPS the ICERs ranged from 9374 pounds per QALY to 66,646 pounds per QALY. If device longevity (1 to 14 years) and device average price (5000 pounds to 15,000 pounds) were varied simultaneously, ICERs were below or very close to 30,000 pounds per QALY when device longevity was 3 years and below or very close to 20,000 pounds per QALY when device longevity was 4 years. Sensitivity analyses were performed varying the costs of CMM, device longevity and average device cost, showing that ICERs for CRPS were higher. In the ischaemic model, it was difficult to determine whether SCS represented value for money when there was insufficient evidence to demonstrate its comparative efficacy. The threshold analysis suggested that the most favourable economic profiles for treatment with SCS were when compared to CABG in patients eligible for percutaneous coronary intervention (PCI), and in patients eligible for CABG and PCI. In these two cases, SCS dominated (it cost less and accrued more survival benefits) over CABG.
CONCLUSIONS
The evidence suggested that SCS was effective in reducing the chronic neuropathic pain of FBSS and CRPS type I. For ischaemic pain, there may need to be selection criteria developed for CLI, and SCS may have clinical benefit for refractory angina short-term. Further trials of other types of neuropathic pain or subgroups of ischaemic pain, may be useful.
Topics: Chronic Disease; Cost-Benefit Analysis; Decision Trees; Electric Stimulation Therapy; Evidence-Based Medicine; Failed Back Surgery Syndrome; Humans; Ischemia; Markov Chains; Neuralgia; Pain; Pain Management; Quality-Adjusted Life Years; Randomized Controlled Trials as Topic; Reflex Sympathetic Dystrophy; Research Design; Sensitivity and Specificity; Spinal Cord; Technology Assessment, Biomedical; Treatment Outcome; United Kingdom
PubMed: 19331797
DOI: 10.3310/hta13170 -
Rheumatology (Oxford, England) Sep 2004In the past, treatment options for ankylosing spondylitis (AS) have been limited, and the introduction of new treatments such as infliximab will have a noticeable impact... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
OBJECTIVES
In the past, treatment options for ankylosing spondylitis (AS) have been limited, and the introduction of new treatments such as infliximab will have a noticeable impact on health-care budgets. The objective of this study was therefore to assess the current burden of the disease and estimate the cost-effectiveness of infliximab treatments.
METHODS
A cross-sectional retrospective observational study of resource consumption and utility related to disease severity was performed in patients who had participated in a population survey between 1992 and 1994 at the University of Bath and patients regularly followed at the Royal National Hospital for Rheumatic Diseases in Bath for up to 9 years. Mean costs and utility were estimated using a regression model including age, gender, disease duration, disease activity and functional status, and disease development was expressed as annual progression of functional disability. Cost-effectiveness of infliximab was modelled using a 3-month placebo-controlled clinical trial with open 1-yr extension in 70 patients, over a total time frame of 2 yr. In the model, costs and utility controlled for disease severity and age from the observational study were assigned to individual patients. The effect of long-term treatment was evaluated in a hypothetical model over 30 yr.
RESULTS
Fifty-seven per cent of patients answered the questionnaires. The mean age was 57 (s.d. 11.2) yr, 74% were male and mean disease duration was 30.2 (11.7) yr. Mean total costs were estimated at pound 6765 (s.d. pound 166). Indirect costs represented 57.9% and non-medical costs such as investments and informal care accounted for 16.5% of total costs. Mean utility was 0.67 (0.21). In the main model, mean costs for untreated patients are estimated at pound 25,128. For the infliximab group, mean costs (excluding treatment) are estimated at pound 17,240, a reduction of 31%. Thus, part of the treatment cost was offset by savings in other resources ( pound 7888), leaving an incremental cost of pound 6214. Treatment increased the number of quality-adjusted live years (QALYs) by 0.175 QALYs, leading to a cost per QALY gained of pound 35,400 for the first year of treatment. When treatment is assumed to continue for the full 2 yr, the cost per QALY is pound 32,800. When infliximab infusions are given every 8 weeks instead of every 6 weeks, the cost per QALY is reduced to pound 17,300. In the long-term model, the cost per QALY is estimated at pound 9600.
CONCLUSIONS
Non-medical costs and production losses dominate costs in AS, and economic evaluation must therefore adopt a societal perspective. The cost of treatment with infliximab is partly offset by reductions in the cost of the disease and patients' quality of life is increased, leading to a cost per QALY gained in the vicinity of pound 30,000 to pound 40,000 in the short term, but potentially below pound 10,000 in the long term.
Topics: Antibodies, Monoclonal; Antirheumatic Agents; Cost of Illness; Cost-Benefit Analysis; Cross-Sectional Studies; Disability Evaluation; Double-Blind Method; Female; Humans; Infliximab; Male; Middle Aged; Models, Economic; Quality of Life; Retrospective Studies; Severity of Illness Index; Spondylitis, Ankylosing
PubMed: 15226514
DOI: 10.1093/rheumatology/keh271