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Jeffrey T Colket - One of the best experts on this subject based on the ideXlab platform.
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the eight item treatment outcome post traumatic stress disorder scale a brief measure to assess treatment outcome in post traumatic stress disorder
International Clinical Psychopharmacology, 1997Co-Authors: Jonathan R T Davidson, Jeffrey T ColketAbstract:This preliminary report describes a new brief interview based assessment of post-traumatic stress disorder using an 8-item treatment-outcome post-traumatic stress disorder scale (TOP-8). The TOP-8 was developed from a larger post-traumatic stress disorder evaluation scale based on items which occurred frequently in the population and which responded substantially to treatment across time. The 8 resultant items were drawn from all three symptom clusters for post-traumatic stress disorder, and showed an improved ability to detect drug versus placebo differences in comparison with the original scale. The eight-item treatment-outcome post-traumatic stress disorder scale also correlated significantly with a self-rated measure of post-traumatic stress disorder and distinguished at a highly significant level between responders and non-responders on an independently judged Clinical Global Impressions measure. The results of this study are discussed and future directions suggested.
Rajamannar Ramasubbu - One of the best experts on this subject based on the ideXlab platform.
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lamotrigine treatment for post stroke pathological laughing and crying
Clinical Neuropharmacology, 2003Co-Authors: Rajamannar RamasubbuAbstract:: Pathologic laughing and crying (PLC) is a common distressing and socially disabling condition in stroke patients. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have been increasingly recognized as the treatment of choice for pathologic crying (PC). However, little is known about etiologies and other treatment options for various clinical manifestations of PLC. This case report illustrates the beneficial effect of lamotrigine, a novel antiepileptic drug with antidepressant and mood-stabilizing properties in post-stroke PLC. A 60-year-old woman developed PLC after an ischemic stroke affecting the left frontal and temporal lobes. She was treated with lamotrigine initially at the dose of 50 mg a day, which was gradually increased to 100 mg a day over a 4-week period. There was a significant and rapid recovery in both laughing and crying components of PCL with lamotrigine treatment. The symptoms of pathologic laughing have shown a better response to lamotrigine than PC. Controlled investigations are needed to evaluate the beneficial as well as the differential effects of lamotrigine on PLC.
Alastair J Flint - One of the best experts on this subject based on the ideXlab platform.
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pharmacological treatment of post stroke pathological laughing and crying
Journal of Psychiatry & Neuroscience, 2007Co-Authors: Peter Giacobbe, Alastair J FlintAbstract:A 60-year-old man with left-sided limb weakness after a stroke was referred for assessment and treatment of depression. The patient reported that, after his stroke 2 weeks ago, he has been crying “for no reason” several times a day. He described that the crying spells last several seconds and cannot be resisted. The patient denies depressed mood or symptoms consistent with a mood disorder. On examination, stereotyped paroxysms of crying lasting 5–10 seconds were noted during the interview, incongruent to any emotional themes discussed. The patient was diagnosed with pathological crying and was started on citalopram 10 mg orally at night. On follow-up, he reported that his crying spells stopped within days of initiating the selective serotonin reuptake inhibitor (SSRI) medication. Pathological laughing and crying (PLC) is one of the most common poststroke affective disorders. The cardinal feature of this disorder is a markedly lowered threshold for exhibiting affective behaviour (crying, laughing or both) that is out of proportion to underlying feelings of happiness or sadness. At an extreme, the expression of affect is completely incongruous to the reported underlying emotional experience. Pure pathological crying is by far the most common presentation, representing approximately 80% of cases of post-stroke PLC. Estimates of the prevalence of PLC vary from 7% to up to 48.5% of stroke survivors, with a greater prevalence found in inpatient populations and during the acute post-stroke period. Although it is important to consider the presence of a depressive episode in people who present with excessive emotionality, most people with PLC do not have a diagnosable mood disorder, and many do not manifest depressive symptoms at all. The etiology of PLC is unknown. Converging lines of evidence suggest that monoaminergic neurotransmission is altered in those who develop PLC after a stroke. Four double-blind, placebo-controlled treatment trials of antidepressant drugs in the treatment of PLC have been reported in the English literature. In pooled data of 93 people from these placebo-controlled trials of nortriptyline, fluoxetine, sertraline and citalopram, 96% of patients who received antidepressant medication demonstrated a greater than 50% reduction in the number of crying episodes at the end of the treatment trials, compared with 27.5% of patients who received placebo, yielding a number needed to treat (NNT) of 1.5. Antidepressants have been shown to reduce the frequency and severity of crying or laughing episodes after a stroke, often within days, rather than the weeks typically expected before antidepressant effects are seen. SSRIs should be regarded as the first-line choice when treating poststroke PLC, given the greater tolerability of SSRIs and their lower propensity to have effects on the cardiovascular system, compared with tricyclic antidepressant drugs. The doses of the SSRI medications that were effective in treating PLC in the studies described above (fluoxetine 20 mg, sertraline 50 mg and citalopram 10–20 mg) are at the low end of the therapeutic range used for treating depression. Case reports suggest that bupropion, mirtazapine, venlafaxine and lamotrigine may be effective for PLC in people who cannot tolerate, or do not respond to, SSRIs. There are limited data to guide clinicians on how long patients should remain on treatment. For most stroke patients, the natural history of PLC is for the symptoms to gradually improve over time. However, it is estimated that 10%–15% of people continue to manifest symptoms a year after a stroke. Reports have suggested that PLC can reemerge after discontinuing the antidepressant drug, whereas reinstatement of the medication leads to swift amelioration of these symptoms. The need for long-term treatment needs to be evaluated on an individual basis. Peter Giacobbe, MD Alastair Flint, MB Department of Psychiatry University of Toronto Department of Psychiatry University Health Network Toronto Rehabilitation Institute Toronto, Ont.
Liat Birnhack - One of the best experts on this subject based on the ideXlab platform.
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quality criteria for desalinated water and introduction of a novel cost effective and advantageous post treatment process
Desalination, 2008Co-Authors: Liat Birnhack, Roni Penn, Ori LahavAbstract:In many places desalinated water is becoming a significant component of the overall water supply. Notwithstanding its superior quality, un-stabilized desalinated water may be corrosive to water distribution systems, and mixing such water with other water sources in the distribution system can result in corrosion of metallic constituents and in “red water” events. To date, no explicit quality criteria for desalinated water can be found in the literature. In this work, such criteria are discussed from various perspectives, including chemical stability, bio-stability, effect on wastewater treatment, water palatability, health and economic effects, and Post-Treatment engineering considerations. The first part of the work was carried out for the Committee for the Update of Water Quality Standards, appointed in 2005 by the Israeli Ministry of Health. As a result of the study, the following set of quality criteria was proposed and approved: Alkalinity > 80, 80 < [Ca 2+ ] < 120, 3 < CCPP < 10 (all concentrations in mg/L as CaCO3), and pH < 8.5. The second part of the paper focuses on the implications of the new criteria on the post treatment process. A comparison between existing alternative post treatment processes is presented, and a novel, cost effective and unique post treatment process is introduced. The new process was developed not only to comply with the new criteria in a cost effective way, but also to result in a supply of Mg 2+ ions, which are required in desalinated water for both health and agricultural reasons.
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quality criteria for desalinated water following post treatment
Desalination, 2007Co-Authors: Ori Lahav, Liat BirnhackAbstract:Abstract In 2010 desalinated water is expected to provide approximately 25% of Israel’s fresh water supply. Since desalination is cost-effective only if operated constantly, areas adjacent to the desalination plants may receive unblended desalinated water for prolonged times while other sources are added only at peak demand. Notwithstanding that desalinated water is of superior quality, it is widely accepted that soft waters may be corrosive to water distribution systems, and that soft waters mingling with other sources can cause a variety of adverse effects, namely metal corrosion and red water events. Despite this, no unambiguous quantitative criteria have been proposed to-date to address the required quality of desalinated water, following the post treatment stage. In this paper the water quality criteria are considered from various angles (chemical stability, bio-stability, effect on wastewater treatment, water palatability, health and economic effects, and Post-Treatment engineering considerations) and the following set of quality criteria for desalinated water is suggested: Alkalinity > 80, 80
Ori Lahav - One of the best experts on this subject based on the ideXlab platform.
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quality criteria for desalinated water and introduction of a novel cost effective and advantageous post treatment process
Desalination, 2008Co-Authors: Liat Birnhack, Roni Penn, Ori LahavAbstract:In many places desalinated water is becoming a significant component of the overall water supply. Notwithstanding its superior quality, un-stabilized desalinated water may be corrosive to water distribution systems, and mixing such water with other water sources in the distribution system can result in corrosion of metallic constituents and in “red water” events. To date, no explicit quality criteria for desalinated water can be found in the literature. In this work, such criteria are discussed from various perspectives, including chemical stability, bio-stability, effect on wastewater treatment, water palatability, health and economic effects, and Post-Treatment engineering considerations. The first part of the work was carried out for the Committee for the Update of Water Quality Standards, appointed in 2005 by the Israeli Ministry of Health. As a result of the study, the following set of quality criteria was proposed and approved: Alkalinity > 80, 80 < [Ca 2+ ] < 120, 3 < CCPP < 10 (all concentrations in mg/L as CaCO3), and pH < 8.5. The second part of the paper focuses on the implications of the new criteria on the post treatment process. A comparison between existing alternative post treatment processes is presented, and a novel, cost effective and unique post treatment process is introduced. The new process was developed not only to comply with the new criteria in a cost effective way, but also to result in a supply of Mg 2+ ions, which are required in desalinated water for both health and agricultural reasons.
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quality criteria for desalinated water following post treatment
Desalination, 2007Co-Authors: Ori Lahav, Liat BirnhackAbstract:Abstract In 2010 desalinated water is expected to provide approximately 25% of Israel’s fresh water supply. Since desalination is cost-effective only if operated constantly, areas adjacent to the desalination plants may receive unblended desalinated water for prolonged times while other sources are added only at peak demand. Notwithstanding that desalinated water is of superior quality, it is widely accepted that soft waters may be corrosive to water distribution systems, and that soft waters mingling with other sources can cause a variety of adverse effects, namely metal corrosion and red water events. Despite this, no unambiguous quantitative criteria have been proposed to-date to address the required quality of desalinated water, following the post treatment stage. In this paper the water quality criteria are considered from various angles (chemical stability, bio-stability, effect on wastewater treatment, water palatability, health and economic effects, and Post-Treatment engineering considerations) and the following set of quality criteria for desalinated water is suggested: Alkalinity > 80, 80
