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Contributors
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- By Ghazi Al-Rawas, Vazken Andréassian, Tianqi Ao, Stacey A. Archfield, Berit Arheimer, András Bárdossy, Trent Biggs, Günter Blöschl, Theresa Blume, Marco Borga, Helge Bormann, Gianluca Botter, Tom Brown, Donald H. Burn, Sean K. Carey, Attilio Castellarin, Francis Chiew, François Colin, Paulin Coulibaly, Armand Crabit, Barry Croke, Siegfried Demuth, Qingyun Duan, Giuliano Di Baldassarre, Thomas Dunne, Ying Fan, Xing Fang, Boris Gartsman, Alexander Gelfan, Mikhail Georgievski, Nick van de Giesen, David C. Goodrich, Hoshin V. Gupta, Khaled Haddad, David M. Hannah, H. A. P. Hapuarachchi, Hege Hisdal, Kamila Hlavčová, Markus Hrachowitz, Denis A. Hughes, Günter Humer, Ruud Hurkmans, Vito Iacobellis, Elena Ilyichyova, Hiroshi Ishidaira, Graham Jewitt, Shaofeng Jia, Jeffrey R. Kennedy, Anthony S. Kiem, Robert Kirnbauer, Thomas R. Kjeldsen, Jürgen Komma, Leonid M. Korytny, Charles N. Kroll, George Kuczera, Gregor Laaha, Henny A. J. van Lanen, Hjalmar Laudon, Jens Liebe, Shijun Lin, Göran Lindström, Suxia Liu, Jun Magome, Danny G. Marks, Dominic Mazvimavi, Jeffrey J. McDonnell, Brian L. McGlynn, Kevin J. McGuire, Neil McIntyre, Thomas A. McMahon, Ralf Merz, Robert A. Metcalfe, Alberto Montanari, David Morris, Roger Moussa, Lakshman Nandagiri, Thomas Nester, Taha B. M. J. Ouarda, Ludovic Oudin, Juraj Parajka, Charles S. Pearson, Murray C. Peel, Charles Perrin, John W. Pomeroy, David A. Post, Ataur Rahman, Liliang Ren, Magdalena Rogger, Dan Rosbjerg, José Luis Salinas, Jos Samuel, Eric Sauquet, Hubert H. G. Savenije, Takahiro Sayama, John C. Schaake, Kevin Shook, Murugesu Sivapalan, Jon Olav Skøien, Chris Soulsby, Christopher Spence, R. ‘Sri’ Srikanthan, Tammo S. Steenhuis, Jan Szolgay, Yasuto Tachikawa, Kuniyoshi Takeuchi, Lena M. Tallaksen, Dörthe Tetzlaff, Sally E. Thompson, Elena Toth, Peter A. Troch, Remko Uijlenhoet, Carl L. Unkrich, Alberto Viglione, Neil R. Viney, Richard M. Vogel, Thorsten Wagener, M. Todd Walter, Guoqiang Wang, Markus Weiler, Rolf Weingartner, Erwin Weinmann, Hessel Winsemius, Ross A. Woods, Dawen Yang, Chihiro Yoshimura, Andy Young, Gordon Young, Erwin Zehe, Yongqiang Zhang, Maichun C. Zhou
- Edited by Günter Blöschl, Technische Universität Wien, Austria, Murugesu Sivapalan, University of Illinois, Urbana-Champaign, Thorsten Wagener, University of Bristol, Alberto Viglione, Technische Universität Wien, Austria, Hubert Savenije, Technische Universiteit Delft, The Netherlands
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- Book:
- Runoff Prediction in Ungauged Basins
- Published online:
- 05 April 2013
- Print publication:
- 18 April 2013, pp ix-xiv
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10 - Chronic Graft versus Host Disease Pharmacology
- from PART II - CLINICAL MANAGEMENT
- Edited by Georgia B. Vogelsang, The Johns Hopkins University School of Medicine, Steven Z. Pavletic, National Cancer Institute, Bethesda, Maryland
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- Book:
- Chronic Graft Versus Host Disease
- Published online:
- 26 August 2009
- Print publication:
- 20 April 2009, pp 101-116
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Summary
This chapter focuses on the pharmacology, pharmacokinetics, drug interactions, and toxicity of commonly utilized immunosuppressive agents in the management of chronic graft versus host disease (cGVHD). The agents selected for review within this chapter include the corticosteroids, the calcineurin inhibitors, mycophenolate mofetil, thalidomide, and sirolimus. Table 10.1 summarizes additional pharmacologic agents that have been utilized for the systemic management of cGVHD.
CORTICOSTEROIDS
Corticosteroids and, most notably, prednisone are generally considered the mainstay and drug of choice for the initial treatment of cGVHD. Prednisone has utility as a single agent in the initial therapy of cGVHD, particularly in standard risk patients and in combination therapy with a calcineurin inhibitor, such as cyclosporine, for high-risk patients. The clinical application of prednisone in the treatment of cGVHD is summarized in Chapter 12.
Pharmacology
Corticosteroids impact an extensive number of physiologic functions within the body including carbohydrate, protein, and lipid metabolism; maintenance of fluid and electrolyte balance; and preservation of a variety of organ systems including the cardiovascular, immune, skeletal muscle, renal, endocrine, and nervous systems. Corticosteroids are classified according to their relative potencies in sodium retention (i.e., mineralocorticoid activity) and their effects on glucose or carbohydrate metabolism (i.e., glucocorticoid activity). The potency of a corticosteroid to impact glucose metabolism closely parallels those for anti-inflammatory activity (refer to Table 10.2).
Mental capacity in psychiatric patients: Systematic review
- David Okai, Gareth Owen, Hugh McGuire, Swaran Singh, Rachel Churchill, Matthew Hotopf
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- Journal:
- The British Journal of Psychiatry / Volume 191 / Issue 4 / October 2007
- Published online by Cambridge University Press:
- 02 January 2018, pp. 291-297
- Print publication:
- October 2007
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Background
Mental capacity is central to legal and ethical debates on the use of compulsion in psychiatry.
AimsTo describe the clinical epidemiology of mental incapacity in patients with psychiatric disorders, including interrater reliability of assessments, frequency in the psychiatric population and associations of mental incapacity.
MethodCross-sectional studies of capacity to consent to treatment for psychiatric patients were systematically reviewed from Medline, EMBASE and PsycInfo databases. Information on the reliability of assessments, frequency and associations of mental incapacity was extracted.
ResultsOut of 37 papers reviewed, 29 different capacity assessment tools were identified. Studies were highly heterogeneous in their measurement and definitions of capacity. Interrater reliabilities between tools were high. Studies indicate incapacity is common (median 29%) but the majority of psychiatric in-patients are capable of making treatment decisions. Psychosis, severity of symptoms, involuntary admission and treatment refusal were the strongest risk factors for incapacity.
ConclusionsMental capacity can be reliably assessed. The majority of psychiatric in-patients have capacity, and socio-demographic variables do not have a major impact but clinical ones do.