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Efficacy of depression treatments, including adjunctive antipsychotic treatment, has not been explored for patients with worsening symptoms after antidepressant therapy (ADT).
This post-hoc analysis utilized pooled data from 3 similarly designed, randomized, double-blind, placebo-controlled trials that assessed the efficacy, safety, and tolerability of adjunctive aripiprazole in patients with major depressive disorder with inadequate response to ADT. The studies had 2 phases: an 8-week prospective ADT phase and 6-week adjunctive (aripiprazole or placebo) treatment phase. This analysis focused on patients whose symptoms worsened during the prospective 8-week ADT phase (worsening defined as >0% increase in Montgomery–Åsberg Depressive Rating Scale [MADRS] Total score). During the 6-week, double-blind, adjunctive phase, response was defined as ≥50% reduction in MADRS Total score and remission as ≥50% reduction in MADRS Total score and MADRS score ≤10.
Of 1065 patients who failed to achieve a response during the prospective phase, 160 exhibited worsening of symptoms (ADT-Worseners), and 905 exhibited no change/reduction in MADRS scores (ADT-Non-worseners). Response rates for ADT-Worseners at endpoint were 36.6% (adjunctive aripiprazole) and 22.5% (placebo). Similarly, response rates at endpoint for ADT-Non-worseners were 37.5% (adjunctive aripiprazole) and 22.5% (placebo). Remission rates at endpoint for ADT-Worseners were 25.4% (adjunctive aripiprazole) and 12.4% (placebo). For ADT-Non-worseners, remission rates were 29.9% (adjunctive aripiprazole) and 17.4% (placebo).
These results suggest that adjunctive aripiprazole is an effective intervention for patients whose symptoms worsen during antidepressant monotherapy. The results challenge the view that benefits of adjunctive therapy with aripiprazole are limited to partial responders to ADT.
Low cycle fatigue (LCF) behavior of polycrystalline NiAl was investigated near the monotonic brittle-to-ductile transition temperature (BDTT) at plastic strain ranges of 0.5 and 1.0%. Between 600 and 700 K, NiAl exhibited rapid hardening for the first few cycles followed by a stress plateau and a subsequent return to hardening. Slip traces were observed on the gage surfaces of most LCF specimens using scanning electron microscopy (SEM). The fatigue properties in this intermediate temperature range (600 to 700 K) were found to be a logical transition between previously reported ambient and elevated temperature properties. Transmission electron microscopy (TEM) confirmed that the dislocations had typical <100> Burgers vectors. A cellular dislocation structure began developing before saturation was achieved. This structure transformed at longer lives to elongated cells and eventually to veins of dislocation tangles. The resulting dislocation morphology did not change from 600 to 700 K, but the dislocation density decreased noticeably.
Methods have been devised for preparation of composite hydroxylapatite (HA)-plaster of Paris (PP) implants for augmentation of edentulous alveolar ridges. These implants may be used to correct bony defects, deficiencies, and related contour abnormalities. The HA-PP implants are customized to exactly conform to the underlying bony architecture. They can either be preformed and sterilized for later use or made directly or indirectly at surgery. In addition to maintaining the desirable biological, chemical and mechanical properties of HA, the HA-PP implant provides complete containment of the HA particles in the desired implant shape. The PP also contributes to an enhanced bony healing response and the HA-PP implant is very biocompatible.
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