In light of the large number of studies published since the 2004 update of Schizophrenia Patient Outcomes Research Team psychopharmacological treatment recommendations, we conducted an extensive literature review to determine whether the current psychopharmacological treatment recommendations required revision and whether there was sufficient evidence to warrant new treatment recommendations for prespecified outcomes of interest. We reviewed over 400 articles, which resulted in 16 treatment recommendations: the revision of 11 previous treatment recommendations and 5 new treatment recommendations. Three previous treatment recommendations were eliminated. There were 13 interventions and/or outcomes for which there was insufficient evidence for a treatment recommendation, and a statement was written to summarize the current level of evidence and identify important gaps in our knowledge that need to be addressed. In general, there was considerable consensus among the Psychopharmacology Evidence Review Group and the expert consultants. Two major areas of contention concerned whether there was sufficient evidence to recommend specific dosage ranges for the acute and maintenance treatment of first-episode and multi-episode schizophrenia and to endorse the practice of switching antipsychotics for the treatment of antipsychotic-related weight gain. Finally, there continue to be major gaps in our knowledge, including limited information on (1) the use of adjunctive pharmacological agents for the treatment of persistent positive symptoms or other symptom domains of psychopathology, including anxiety, cognitive impairments, depressive symptoms, and persistent negative symptoms and (2) the treatment of co-occurring substance or medical disorders that occur frequently in individuals with schizophrenia.

/pdf/the-2009-schizophrenia-port-psychopharmacological-treatment-1d2t1b8i1l.pdf

The 2009 Schizophrenia PORT Psychopharmacological Treatment Recommendations and Summary Statements

The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures.

Cancer is still one of the major causes of mortality in both developing and developed countries. At present, in spite of intensive interventions, a large number of patients suffer from poor prognosis. Therefore, the effort for finding new anticancer agents with better efficacy and lesser side effects has been continued. According to the traditional recommendations and experimental studies, numerous medicinal plants have been reported to have anticancer effect. Also antiproliferative, pro-apoptotic, anti-metastatic and anti-angiogenic effects of several phytochemicals have been shown in in vitro experiments or animal studies. However, only a small number have been tested in cancerous patients and limited evidence exists for their clinical effectiveness. Also, regarding some phytochemicals, only beneficial effects on cancer-related symptoms or on quality of life have been reported and no positive results exist for their antitumor actions. This review was focused on the phytochemicals whole beneficial effects on various types of cancer have been supported by clinical trials. Based on the literature review, curcumin, green tea, resveratrol and Viscum album were the satisfactory instances of clinical evidence for supporting their anticancer effects. The main findings of these phytochemicals were also summarized and discussed.

http://ajp.mums.ac.ir/pdf_3872_5e294c5136a484546facad3dc24c9613.html

Cancer therapy with phytochemicals: evidence from clinical studies.

BACKGROUND Debate continues about the comparative benefits and harms of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) in treating schizophrenia. PURPOSE To compare the effects of FGAs with those of SGAs in the treatment of adults aged 18 to 64 years with schizophrenia and related psychosis on illness symptoms, diabetes mellitus, mortality,tardive dyskinesia, and a major metabolic syndrome. DATA SOURCES English-language studies from 10 electronic databases to March 2012, reference lists of relevant articles, and gray literature. STUDY SELECTION Randomized trials for efficacy and cohort studies at least 2 years in duration for adverse events. DATA EXTRACTION Two independent reviewers extracted data from 114 studies involving 22 comparisons and graded the strength of evidence for primary outcomes as insufficient, low, moderate, or high using the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SYNTHESIS Few differences of clinical importance were found for core illness symptoms; lack of precision in effect estimates precluded firm conclusions for many comparisons. Moderate-strength evidence showed a clinically important benefit of haloperidol over olanzapine for improving positive symptoms, but the benefit was scale-dependent: It was seen when the Scale for the Assessment of Positive Symptoms was used but not when the Positive and Negative Syndrome Scale (PANSS) was used. Moderate-strength evidence showed a clinically important benefit of olanzapine over haloperidol in improving negative symptoms when the PANSS and the Scale for the Assessment of Negative Symptoms were used. Low-strength evidence showed no difference in mortality for chlorpromazine verus clozapine or haloperidol versus aripiprazole,increased incidence of the metabolic syndrome for olanzapine versus haloperidol (risk differences, 2% and 22%), and higher incidence of tardive dyskinesia for chlorpromazine versus clozapine (risk differences, 5% and 9%). Evidence was insufficient to draw conclusions for diabetes mellitus. LIMITATIONS All studies had high or unclear risk of bias. Length of study follow-up was often too brief to adequately measure adverse events. Medication comparisons, dosage, and outcome measurement were heterogenous for head-to-head comparisons. Selective patient populations limit generalizability. CONCLUSION Clear benefits of FGAs versus SGAs for treating schizophrenia remain inconclusive because of variation in assessing outcomes and lack of clinically important differences for most comparisons. The strength of evidence on safety for major medical events is low or insufficient. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality.

Antipsychotics in adults with schizophrenia: comparative effectiveness of first-generation versus second-generation medications: a systematic review and meta-analysis.

https://academicworks.medicine.hofstra.edu/cgi/viewcontent.cgi?article=5059&context=articles

Tardive dyskinesia risk with first- and second-generation antipsychotics in comparative randomized controlled trials: a meta-analysis.

Hypothesis. Withania somnifera is an herb with antioxidant, anti-inflammatory, anticancer, antistress, and adaptogenic properties. Previous studies have shown its antistress effects in animals. Tra...

https://journals.sagepub.com/doi/pdf/10.1177/1534735412464551

Effect of Withania somnifera (Ashwagandha) on the Development of Chemotherapy-Induced Fatigue and Quality of Life in Breast Cancer Patients:

Effects of polyethylene-grafted maleic anhydride (PE-g-MA) on tensile properties, morphology and water absorption of LDPE/ Thermoplastic sago starch (TPSS) blends were studied. TPSS was prepared by mixing starch (65 wt. %) and glycerol (35 wt. %) and stored overnight at room temperature. The mixture then was melt-compounded using a heated 2 roll-mills at 150°C for 10 minutes. LDPE/TPSS blends with different TPSS loadings, with and without the addition of PE-g-MA were prepared by using a Haake Rheomix mixer at 150°C. All mixing were carried out for 10 minutes at a rotor speed of 50 rpm. Tensile test specimens were cut out from the compression molded sheets. Results indicated that the mixing torque of LDPE/TPSS blends reduced with increasing TPSS loading. The tensile strength and elongation at break of LDPE/TPSS/PE-g-MA blends were greater than LDPE/TPSS blends particularly at higher TPSS loadings. The interfacial properties between LDPE and TPSS were improved after PE-g-MA addition as evident from the tens...

Effects of PE-g-MA on Tensile Properties, Morphology and Water Absorption of LDPE/Thermoplastic Sago Starch Blends

Remitted Male Schizophrenia Patients with Sexual Dysfunction

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT



• Many studies raise serious questions about the prescribing appropriateness and prescription quality. However, there is a lack of a single measure that will capture all facets of prescription quality.



• Evaluation of prescriptions was usually based on expert judgement of practitioners.



• Definition of prescription quality, reference model, validity and reliability of the measurement tools, and other data such as the number, type and severity of diagnosis of patients were usually insufficient or lacking.



WHAT THIS STUDY ADDS



• The Prescription Quality Index (PQI) was developed with a strong structural foundation and was able to capture the clinical, clerical and legal requirement of a prescription.



• Extensive psychometric testing was performed on the PQI and the new tool demonstrated acceptable validity and reliability.



• The PQI has been shown to be a valid, reliable and responsive tool to measure quality of prescriptions in chronic diseases.



AIMS

The aims were to develop and validate a new Prescription Quality Index (PQI) for the measurement of prescription quality in chronic diseases.



METHODS

The PQI were developed and validated based on three separate surveys and one pilot study. Criteria were developed based on literature search, discussions and brainstorming sessions. Validity of the criteria was examined using modified Delphi method. Pre-testing was performed on 30 patients suffering from chronic diseases. The modified version was then subjected to reviews by pharmacists and clinicians in two separate surveys. The rater-based PQI with 22 criteria was then piloted in 120 patients with chronic illnesses. Results were analysed using SPSS version 12.0.1



RESULTS

Exploratory principal components analysis revealed multiple factors contributing to prescription quality. Cronbach's α for the entire 22 criteria was 0.60. The average intra-rater and inter-rater reliability showed good to moderate stability (intraclass correlation coefficient 0.76 and 0.52, respectively). The PQI was significantly and negatively correlated with age (correlation coefficient −0.34, P < 0.001), number of drugs in prescriptions (correlation coefficient −0.51, P < 0.001) and number of chronic diseases/conditions (correlation coefficient −0.35, P < 0.001).



CONCLUSIONS

The PQI is a promising new instrument for measuring prescription quality. It has been shown that the PQI is a valid, reliable and responsive tool to measure quality of prescription in chronic diseases.

/pdf/development-and-validation-of-a-new-prescription-quality-51i5a5h53g.pdf

Hasanah Che Ismail

Papers

Effect of Withania somnifera (Ashwagandha) on the Development of Chemotherapy-Induced Fatigue and Quality of Life in Breast Cancer Patients:

Effects of PE-g-MA on Tensile Properties, Morphology and Water Absorption of LDPE/Thermoplastic Sago Starch Blends

Remitted Male Schizophrenia Patients with Sexual Dysfunction

Development and validation of a new Prescription Quality Index

AOS14 Phase II clinical study of combination chemotherapy with herb Withania somnifera (ashwagandha) in breast cancer