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| 1 | Pharmacologic approaches to treatment resistant depression:Evidences and personal experience显示文摘AIM: To review evidence supporting pharmacological treatments for treatment-resistant depression(TRD) and to discuss them according to personal clinical experience.METHODS: Original studies, clinical trials, systematic reviews, and meta-analyses addressing pharmacological treatment for TRD in adult patients published from 1990 to 2013 were identified by data base queries(Pub Med, Google Scholar e Quertle Searches) using terms: 'treatment resistant depression', 'treatment refractory depression', 'partial response depression', 'non responder depression', 'optimization strategy', 'switching strategy', 'combination strategy', 'augmentation strategy', selective serotonin reuptake inhibitors antidepressants(SSRI), tricyclic antidepressants(TCA), serotonin norepinephrine reuptake inhibitors antidepressants, mirtazapine, mianserine, bupropione, monoamine oxidase inhibitor antidepressant(MAOI), lithium, thyroid hormones, second generation antipsychotics(SGA), dopamine agonists, lamotrigine, psychostimulants, dextromethorphan, dextrorphan, ketamine, omega-3 fatty acids, S-adenosil-L-metionine, methylfolat, pindolol, sex steroids, glucocorticoid agents. Other citations of interest were further identified from references reported in the accessed articles. Selected publications were grouped by treatment strategy:(1) switching from an ineffective antidepressant(AD) to a new AD from a similar or different class;(2) combining the current AD regimen with a second AD from a different class; and(3) augmenting the current AD regimen with a second agent not thought to be an antidepressant itself.RESULTS: Switching from a TCA to another TCA provides only a modest advantage(response rate 9%-27%), while switching from a SSRI to another SSRI is more advantageous(response rate up to 75%). Evidence supports the usefulness of switching from SSRI to venlafaxine(5 positive trials out 6), TCA(2 positive trials out 3), and MAOI(2 positive trials out 2) but not from SSRI to bupropione, duloxetine and mirtazapine. Three reviews demonstrated that the benefits of intraand cross-class switch do not significantly differ. Data on combination strategy are controversial regarding TCA-SSRI combination(positive results in old studies, negative in more recent study) and bupropion-SSRI combination(three open series studies but not three controlled trails support the useful of this combination) and positive regard mirtazapine(or its analogue mianserine) combination with ADs of different classes. As regards the augmentation strategy, available evidences supported the efficacy of TCA augmentation with lithium salts and thyroid hormone(T3), but are conflicting regard the SSRI augmentation with these two drugs(1 positive trial out of 4 for lithium and 3 out of 5 for thyroid hormone). Double-blind controlled studies showed the efficacy of AD augmentation with aripiprazole(5 positive trials out 5), quetiapine(3 positive trials out 3) and, at less extent, of fluoxetine augmentation with olanzapine(3 positive trials out 6), so these drugs received the FDA indication for the acute treatment of TRD. Results on AD augmentation with risperidone are conflicting(2 short term positive trials, 1 short-term and 1 long-term negative trials). Case series and open-label trials showed that AD augmentation with pramipexole or ropinirole, two dopamine agonists, could be an effective treatment for TRD(response rate to pramipexole 48%-74%, to ropinirole 40%-44%) although one recent double-blind placebo-controlled study does not support the superiority of pramipexole over placebo. Evidences do not justify the use of psychostimulants, omega-3 fatty acids, S-adenosil-Lmetionine, methylfolate, pindolol, lamotrigine, and sex hormone as AD augmentation for TRD. Combining the available evidences with our experience we suggest treating non-responders to one SSRI bupropion or mirtazapine trial by switching to venlafaxine, and nonresponders to one venlafaxine trial by switching to a TCA or, if TCA are not tolerated, combining mirtazapine with SSRI or venlafaxine. In non-responders to two or more ADs(including at least one TCA if tolerated) current AD regimen could be augmented with lithium salts(mainly in patients with bipolar depression or suicidality), SGAs(mostly aripiprazole) or DA-agonists(mostly pramipexole). In patients with severe TRD, i.e., non-responders to combination and augmentation strategies as well as to electroconvulsive therapy if workable, we suggest to try a combination plus augmentation strategy.CONCLUSION: Our study identifies alternative effective treatment strategies for TRD. Further studies are needed to compare the efficacy of different strategies in more homogeneous subpopulations. | Antonio Tundo Rocco de Filippis Luca Proietti | 2015 | World Journal of Psychiatry2015，5，3： | 15 |
| 2 | Acute ulcerative jejunal diverticulitis:Case report of an uncommon entity显示文摘Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations.Its reported incidence varies from 0.05% to 6%.Although there is no consensus on the management of asymptomatic jejunal diverticular disease,some complications are potentially life threatening and require early surgical treatment.We report a case of an 88-year-old man investigated for acute abdominal pain with a high biological inflammatory syndrome.Inflammation of multiple giant jejunal diverticulum was discovered at abdominal computed tomography (CT).As a result of the clinical and biological signs of early peritonitis,an emergency surgical exploration was performed.The first jejunal loop showed clear signs of jejunal diverticulitis.Primary segmental jejunum resection with end-to-end anastomosis was performed.Histopathology report confirmed an ulcerative jejunal diverticulitis with imminent perforation and acute local peritonitis.The patient made an excellent rapid postoperative recovery.Jejunal diverticulum is rare but may cause serious complications.It should be considered a possible etiology of acute abdomen,especially in elderly patients with unusual symptomatology.Abdominal CT is the diagnostic tool of choice.The best treatment is emergency surgical management. | Wojciech Staszewicz Michel Christodoulou Stefania Proietti Nicolas Demartines | 2008 | World Journal of Gastroenterology2008，14，40： | 3 |
| 3 | Finding the most vital node of a shortest path显示文摘 | Enrico Nardelli Guido Proietti Peter Widmayer | 2002 | Theoretical Computer Science2002，，1： | 2 |
| 4 | An unusual case of fatty liver in a patient with desmoid tumor显示文摘A desmoid tumor,also known as aggressive fibromatosis,is a rare benign neoplasm that arises from fascial or musculoaponeurotic tissues.It can occur in any anatomical location,most commonly the abdominal wall,shoulder girdle and retroperitoneum.The typical clinical presentation is a painless mass with a slow and progressive invasion of contiguous structures.It is associated with a high local recurrence rate after resection.Many issues regarding the optimal treatment of desmoid tumors remain controversial.Aggressive surgical resection with a wide margin(2-3 cm) remains the gold standard treatment with regard to preserving quality of life.Radiotherapy alone has been shown to be effective for the control of unresectable or recurrent lesions.Desmoid tumors tend to be locally infiltrative,therefore,the fields must be generous to prevent marginal recurrence.The radiation dose appropriate for treating desmoid tumors remains controversial.We present a 25-year-old Caucasian man with local recurrence of a desmoid tumor after repeated surgical resection,treated with radiotherapy.The patient achieved complete tumor regression at 4 mo after radiotherapy,and he is clinically free of disease at 12 mo after the end of treatment,with an acceptable quality of life.The patient developed short bowel syndrome as a complication of second surgical resection.Consequently,radiotherapy might have worsened an already present malabsorption and so led to steatohepatitis. | Francesca De Felice Daniela Musio Rossella Caiazzo Bartolomeo Dipalma Lavinia Grapulin Camilla Proietti Semproni Vincenzo Tombolini | 2012 | World Journal of Gastroenterology2012，18，24： | 2 |
| 5 | Finite-length Anaiysis of Low-density Parity-check Codes on the Binary Erasure Channel显示文摘 | Di C Proietti D | 2002 | IEEE Transaction on Information Theory2002，48，6： | 1 |
| 6 | A faster computation of the most vital edge of a shortest path between two nodes 显示文摘 | NARDELLI E PROIETTI G WIDMAYER P | 2001 | Information Processing Letters2001，79，2： | 1 |
| 7 | Prevention of atelectasis formation during induction of general anesthesia显示文摘 | RUSCA M PROIETTI S SCHNYDER P | 2003 | Anesth Analg2003，97，6： | 1 |
| 8 | Transfusion - transmitted infectious diseases 显示文摘 | Allain JP Stramer SL Carneiro - Proietti AB | 2009 | Biologicals2009，2，： | 1 |
| 9 | A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities显示文摘 | Logroscino CA Proietti L Pola E | 2011 | Eur Spine J2011，20，1： | 1 |
| 10 | Changes in photosynthesis and fruit characteristics in olive in response to assimilate availability显示文摘 | Proietti P | 2003 | Photosynthetica2003，41，4： | 1 |
| 11 | Finding the most vital node of a shortest path显示文摘 | NARDELLI E PROIETTI G WIDMAYER P | 2003 | Theoretical Computer Science2003，296，1： | 1 |
| 12 | Prevention of atelectasis formation during the induction of general anesthesia in morbidly obese patients显示文摘 | COUSSA M PROIETTI S SCHNYDER P | 2004 | Anesth Analg2004，98，5： | 1 |
| 13 | A faster computation of the most vital edge of a shortest path between two nodes显示文摘 | Nardelli E Proietti G Widmyer P | 2001 | Infor- mation Processing Letters2001，79，2： | 1 |
| 14 | Finding the detour-critical edge of a shortest path between nodes 显示文摘 | Nardeui E Proietti G Widmayer P | 1998 | Information Processing Letters1998，67，1： | 1 |
| 15 | Finding the detour critical edge of a shortest path between nodes 显示文摘 | NARDELLI E PROIETTI G WIDMAYER P | 1998 | Information Processing Letters1998，67，1： | 1 |
| 16 | Acute thrombosis of the sinus node artery: arrhythmological implications显示文摘 | Ando G Gaspardone A Proietti I | 2003 | Heart2003，89，： | 1 |
| 17 | Finite-length analysis of low-density parity-check codes on the binary erasure channel 显示文摘 | C Y Di D Proietti I E Telatar T J Richardson R L Urbanke | 2002 | IEEE Trans Inform Theory2002，48，6： | 1 |
| 18 | Type I interfer- on is a powerful inhibitor of in vivo HIV-1 infection and pre- serves human CD4 (+) T cells from virus-induced deple- tion in SCID mice transplanted with human cells 显示文摘 | Lapenta C Santini SM Proietti E | 1999 | Virolo- gy1999，263，1： | 1 |
| 19 | Morbid obesity and postoperative pulmonary atelectasis:an underestimat- ed problem显示文摘 | Eichenberger A Proietti S Wicky S | 2002 | Anesth Analg2002，95，12： | 1 |
| 20 | A faster computation of the most vital edge of a shortest path显示文摘 | Nardelli E Proietti G Widmayer P | 2001 | Information Processing Letters2001，79，2： | 1 |
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