Hospitalizations that require invasive cardiac procedures or support with an intra-aortic balloon pump can be unsettling. This study was undertaken to measure the effect of a music intervention on physiologic and psychological responses of patients on bed rest due to procedural sheaths or an intra-aortic balloon pump. A randomized, two-group, pretest/post-test design was utilized to measure the effect of a 30-minute music intervention on heart rate, blood pressure, respiratory rate, skin temperature, pain perception, and mood states. One hundred forty subjects participated, 65 in the control group and 75 in the treatment group. There were no significant differences between the groups in demographic, clinical, or baseline variables, except for respiratory rate. After the music intervention, there were reductions in blood pressure, respiratory rate, and psychological distress, as measured by the Profile of Mood States (p < 0.05). Music appeared to affect selected physiologic responses and reduce psychological distress in patients on bed rest.
Our study indicates possible advantages of LAI over oral antipsychotic formulation in terms of subjective experience of maintenance treatment in remitted schizophrenic patients. Size and duration of this study need to be expanded in order to produce more solid and generalizable results.
Our preliminary results suggest that the switch from oral to LAI antipsychotic treatment may help to address the subjective core of an optimal and satisfying recovery of psychotic patients. Size and duration of this study need to be expanded in order to produce more solid and generalizable results.
Myocardial uptake of 99Tcm-tetrofosmin in vivo is determined by a combination of flow and metabolic status of myocytes. The accumulation of tetrofosmin in the mitochondria is related to their ability to transduce metabolic energy into electronegative membrane potential. Trimetazidine (TMZ), an anti-ischaemic drug, appears to have a metabolic cytoprotective effect related to mitochondrial function, since it does not induce systemic or coronary haemodynamic changes. In this study, we evaluated the effects of TMZ on tetrofosmin uptake in hypoperfused myocardial regions in patients with coronary artery disease (CAD). Twenty-two patients, 14 with previous myocardial infarction (group A) and eight with a history of angina (group B), with angiographically documented CAD were studied. All patients underwent two tetrofosmin SPET studies at rest, before (baseline) and 1 week after TMZ administration (post-TMZ). On quantitative analysis, 131 segments showed less tetrofosmin uptake at baseline. In these segments, tetrofosmin uptake was 51 +/- 13% at baseline and 55 +/- 15% post-TMZ (P < 0.001 vs control). In the 86 hypoperfused segments of group A, tetrofosmin uptake was 48 +/- 14% at baseline and 52 +/- 17% post-TMZ (P < 0.001 vs control). In the 45 hypoperfused segments of group B, tetrofosmin uptake was 56 +/- 9% at baseline and 60 +/- 10% post-TMZ (P < 0.001 vs control). In the remaining 309 segments, no significant difference in tetrofosmin uptake before and after TMZ was observed. In conclusion, our results suggest that TMZ administration may increase myocardial uptake of tetrofosmin in hypoperfused regions at rest in patients with CAD, based on its metabolic effect.
IntroductionLong acting injectable “depot” preparations of antipsychotic medications have been used as an alternative to oral medication therapy for patients with low adherence to therapy. Nowadays the use of long acting second generation antipsychotic therapy is focused on improving quality of life and patients’ subjective experience of drug therapy.Objectives and aimsTo evaluate the impact of long acting second generation antipsychotic therapy on patients’ psychopathology, quality of life, subjective experience of drug and cognitive performance.Methods20 adult male and female outpatients aged 21-53 attending the Psychiatric Unit of the University of Florence under therapy with oral second generation antipsychotics were recruited and were switched to long acting second generation antipsychotics (Zypadhera, Risperdal depot and Xeplion). Patients were assessed by means of Psychometric Tests, Neurocognitive Tests and blood tests at recruitment, after 6 months and after 12 months.ResultsA first clinical evaluation is indicating an improvement in quality of life especially regarding patients’ subjective experience of drug and a decrease of side effects like sedation and blunted affect. Furthermore, preliminary data show a reduction of bodyweight in patients who initially gained weight during oral antipsychotic therapy.ConclusionsLong acting second generation antipsychotic therapy seems to be a valid alternative in patients who have been stabilized on oral antipsychotics, since it has a similar efficacy and furthermore it offers a better quality of life by reducing side effects of oral antipsycotics.
IntroductionLimited research has been devoted to the subjective impact of switching antipsychotic maintenance treatment (AMT) from oral to LAI formulation in schizophrenia.ObjectiveTo compare LAI AMT with oral AMT in terms of subjective experience of treatment, taking into account the effects on psychopathology.MethodsTwenty outpatients (7 males, mean age 40.55 ± 11.00 years) with remitted schizophrenia treated with either olanzapine or paliperidone and switching from oral to LAI AMT were recruited before the switch (LAI-AMT group). A group of 20 remitted schizophrenic subjects with oral AMT and matched for the main socio-demographic, clinical and treatment variables made up the controls (oral-AMT group). All participants were assessed by means of the PANSS and of the SWN-K at baseline (T0) and after 6 months (T1).ResultsBetween T0 and T1, general psychopathology of the PANSS and all but one of the SWN-K dimensions (except for “social integration”), showed significantly higher percent improvements in the LAI-AMT group compared to the oral-AMT group. After 6 months (T1), the LAI-AMT group showed significantly lower PANSS total and general psychopathology scores, as well as higher mean score of perceived “mental functioning” compared to the oral-AMT group. Item analysis of the general PANSS at T1 showed significant differences between the two groups in anxiety, tension, depression, guilt feelings, poor attention, and active social avoidance.ConclusionsOur data on switching from oral to LAI AMT in remitted schizophrenia suggest a better efficacy of the latter in terms of improvement of general psychopathology and subjective experience of treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction:Long-acting injectable (LAI) antipsychotics have been used as an alternative to oral antipsychotic formulations.Aims:to evaluate the impact of switching to a LAI second-generation antipsychotic (SGA) in terms of changes in patient's psychopathology, subjective experience of drug and quality of life.Methods:18 adult outpatients diagnosed with Schizoaffective disorder (by means of the SCID-I/P) and attending the Psychiatric Unit of the University of Florence were recruited. All patients were under a stabilized therapy with a single oral SGA (either olanzapine or paliperidone) and were switched to its corresponding LAI formulation (olanzapine pamoate or paliperidone palmitate). Patients were assessed by means of the following questionnaires: MADRS, YMRS, PANSS, DAI-10, SWN and SF-36 at enrolment (T0) and after 6 months (T1).Results:A significant reduction was found between T0 and T1 (p<.05) in PANSS total, negative and general psychopathology mean scores, as well as in mean MADRS and YMRS total scores. No difference was found for positive PANSS mean scores. We observed a significant increase of mean DAI-10 and SWN total scores between T0 and T1 (p<.05). A reduction of side effects like sedation and blunted affect between T0 and T1 (p<.05) was confirmed by significant increases in mean SF-36 subscales scores, such as: general health (p<.01) change in health (p<.01) and social integration (p<.05).Conclusions:Treatment with LAI SGAs seems to be a valid alternative in patients with Schizoaffective disorder. Our preliminary data suggest an improvement in patient's subjective experience of pharmacological therapy and health-related quality of life, together with a similar efficacy on psychopathology.
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