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The benefits of lithium for BD and CDLinks between genetics and psychosis in use of psychedelics [ABSTRACT FROM AUTHOR]

Background: Lithium therapy during bipolar disorder is associated with an increased risk of chronic kidney disease (CKD) that is slowly progressive and undetectable at early stages. We aimed at identifying kidney image texture features as possible imaging biomarkers of decreased measured glomerular filtration rate (mGFR) using radiomics of T2‐weighted magnetic resonance imaging (MRI). Methods: One hundred and eight patients treated with lithium were evaluated including mGFR and kidney MRI, with T2‐weighted sequence single‐shot fast spin‐echo. Computed radiomic analysis was performed after kidney segmentation. Significant features were selected to build a radiomic signature using multivariable Cox analysis to detect an mGFR <60 ml/min/1.73 m². The texture index was validated using a training and a validation cohort. Results: Texture analysis index was able to detect an mGFR decrease, with an AUC of 0.85 in the training cohort and 0.71 in the validation cohort. Patients with a texture index below the median were older (59 [42–66] vs. 46 [34–54] years, p =.001), with longer treatment duration (10 [3–22] vs. 6 [2–10] years, p =.02) and a lower mGFR (66 [46–84] vs. 83 [71–94] ml/min/1.73m², p <.001). Texture analysis index was independently and negatively associated with age (β = −.004 ± 0.001, p <.001), serum vasopressin (−0.005 ± 0.002, p =.02) and lithium treatment duration (−0.01 ± 0.003, p =.001), with a significant interaction between lithium treatment duration and mGFR (p =.02). Conclusions: A renal texture index was developed among patients treated with lithium associated with a decreased mGFR. This index might be relevant in the diagnosis of lithium‐induced renal toxicity. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the repair bond strength of three different 5‐year water‐aged and non‐aged computer‐aided design/computer‐aided manufacturing (CAD/CAM) ceramics (leucite‐reinforced, lithium disilicate, and feldspathic ceramic) on which four different surface treatments (bur‐grinding, sandblasting, acid‐etching, and laser irradiation) have been applied with composite resin. Note that 360 ea. samples have been attained from CAD/CAM blocks. Each CAD/CAM ceramic has been randomly separated into two sub‐groups depending on aging procedure. The designed 5‐year water‐aged and non‐aged samples have been separated into four sub‐groups. Ceramic surfaces were repaired then the samples have been placed into shear test device. Three‐way variance analysis has been used in the comparison of the repair bond strengths depending on the ceramic type, surface treatment, and aging. Results have revealed that the repair bond strength values show differences depending on CAD/CAM ceramic type, surface treatment, and the aging of the surface (p <.001). While the aged and laser‐irradiated feldspathic CAD/CAM ceramics showing the highest shear bond strength, the lowest shear bond strength values were in aged and bur‐grinded feldspathic CAD/CAM ceramics. Irradiation with erbium chromium: yttrium scandium gallium garnet (Er,Cr:YSGG) laser has significantly increased the repair bond strength in leucite‐reinforced and feldspathic CAD/CAM ceramics, acid‐etching is suggested surface treatment for the lithium disilicate CAD/CAM ceramics. [ABSTRACT FROM AUTHOR]

Furthermore, early Ab immunoassays methods targeted different virus epitopes, mainly anti-nucleocapsid Ab. Comparison of anti-SARS-CoV-2 S1 Receptor-Binding Domain antibody immunoassays in health care workers before and after the BNT162b2 mRNA vaccine. Keywords: antibody immunoassays; harmonization; NIBSC 20/136; SARS-CoV2; WHO standardization EN antibody immunoassays harmonization NIBSC 20/136 SARS-CoV2 WHO standardization 274 279 6 05/12/22 20220501 NES 220501 Introduction Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the etiological agent of the Coronavirus Disease 2019 (COVID-19). [Extracted from the article]

Objectives: Although lithium renal effects have been extensively investigated, prevalence rates of chronic kidney disease (CKD) in lithium‐treated patients vary. Our aim was to provide prevalence estimates and related moderators. Methods: We performed a systematic review in PubMed/Embase until November 01, 2021, conducting a random effects meta‐analysis of studies evaluating CKD prevalence rates in lithium‐treated patients calculating overall prevalence ±95% confidence intervals (CIs). Meta‐regression analyses included sex, age, body mass index, smoking, hypertension, diabetes, cardiovascular disease, lithium‐treatment dose, duration, and blood levels. Subgroup analyses included sample size, diagnoses, and study design. Pooled odds ratios (OR) were estimated for studies including patients receiving nonlithium treatment. Study quality was assessed using the Newcastle–Ottawa scale. Results: Five, nine, and six trials were rated as high, fair, and low quality, respectively. In 20 studies (n = 25,907 patients), we estimated an overall prevalence of 25.5% (95% CI = 19.8–32.2) of impaired kidney function; despite lack of differences (p = 0.18), prevalence rates were higher in elderly samples than mixed samples of elderly and nonelderly (35.6%, 95% CI = 21.4–52.9, k = 2, n = 3,161 vs. 25.1%, 95% CI = 19.1–31.3, k = 18, n = 22,746). Prevalence rates were associated with longer lithium treatment duration (p = 0.04). Cross‐sectional studies provided lower rates than retrospective studies (14.5%, 95% CI = 13.5–15.5, k = 6, n = 4,758 vs. 29.5%, 95% CI = 22.1–38.0, k = 12, n = 17,988, p < 0.001). Compared with 722,529 patients receiving nonlithium treatment, the OR of impaired kidney function in 14,187 lithium‐treated patients was 2.09 (95% CI = 1.24–3.51, k = 8, p = 0.005). Conclusions: One‐fourth of patients receiving long‐term lithium may develop impaired kidney function, although research suffers from substantial heterogeneity between studies. This risk may be twofold higher compared with nonlithium treatment and may increase for a longer lithium treatment duration. [ABSTRACT FROM AUTHOR]

Background: Lithium is a first-line pharmacotherapy for the treatment of bipolar disorder, but long-term use is associated with nephrotoxicity. However, as dialysis effectively eliminates lithium, it remains a pharmacotherapeutic option for patients on dialysis. This systematic review seeks to evaluate the dosing, safety, efficacy, and monitoring of lithium in patients receiving dialysis. Method: A PubMed database search performed May 5th, 2020, identified 535 article titles. After exclusion criteria were applied, a total of 15 articles were included in this systematic review. Results: In 18 patients receiving dialysis, lithium was primarily used for the treatment of mood disorders. The majority of patients received 300–900 mg lithium carbonate thrice-weekly following dialysis, but several alternative lithium salts and dosing strategies were utilized. The pharmacokinetic properties of lithium in dialysis are not well understood and can be complicated by a serum lithium "rebound effect" following dialysis, due to a two-compartment volume of distribution. Additionally, presence of residual diuresis in some patients may be reason to administer lithium more frequently than thrice-weekly following dialysis. Lithium was shown to be an effective pharmacotherapy in all patients, with many demonstrating rapid improvement after drug initiation. Five patients experienced an adverse event on lithium, but only one patient required lithium discontinuation. Conclusion: Lithium may be used in patients on dialysis, with close monitoring of pre-dialysis serum lithium concentrations for at least two weeks after treatment initiation, followed by a lower frequency after stabilization to ensure therapeutic concentrations and reduce toxicity risk. [ABSTRACT FROM AUTHOR]

Sporadic Creutzfeld Jakob Disease is a rare disease with diagnostic challenges. While there is very little human data regarding this disease, some studies have indicated that certain medications may be useful in slowing its progression. Case study data implies psychiatric and cognitive symptoms preceding the diagnosis. This single case report presents a 68-year-old male with suspected late-onset bipolar disorder, later found to have sporadic Creutzfeld Jakob Disease. The patient was treated with lithium for this purported bipolar disorder. Approximately 2 years later, the patient met the Center for Disease Control (CDC) diagnostic criteria for prion disease following a rapid decline in cognition. This case provides an example of a medical mimic of bipolar disorder in the geriatric population. [ABSTRACT FROM AUTHOR]

A pulsed electric field (PEF) is a technology used for microbial inactivation in food and beverages. This study aimed to examine the effect of PEF treatment on microbial inactivation and quality parameters in Thai orange juice (TOJ). The results showed that PEF and conventional thermal pasteurization (CTP) can be performed for inactivation of Staphylococcus aureus and Escherichia coli in TOJ. A 5-log reduction was obtained after 10 pulses of PEF treatment when using and electrical field strength of 30 kV cm−1, and the microbial inactivation by the PEF treatment resulted from the electroporation more than the temperature. Moreover, PEF treatment affects the quality parameters less than CTP. Moreover, PEF treatment did not affect the TOJ quality parameters such as pH, commission international de l'eclairage (CIE), viscosity, and total soluble solid (TSS), but saved vitamin C and all sugar and all mineral (sucrose, glucose, fructose, sodium, lithium, potassium, magnesium, and calcium) values more than CTP treatment. [ABSTRACT FROM AUTHOR]

At the beginning of the pandemic, we observed that lithium carbonate had a positive effect on the recovery of severely ill patients with COVID-19. Lithium is able to inhibit the replication of several types of viruses, some of which are similar to the SARS-CoV-2 virus, increase the immune response and reduce inflammation by preventing or reducing the cytokine storm. Previously, we published an article with data from six patients with severe COVID-19 infection, where we proposed that lithium carbonate could be used as a potential treatment for COVID-19. Now, we set out to conduct a randomized clinical trial number EudraCT 2020–002008–37 to evaluate the efficacy and safety of lithium treatment in patients infected with severe SARS-CoV-2. We showed that lithium was able to reduce the number of days of hospital and intensive care unit admission as well as the risk of death, reduces inflammatory cytokine levels by preventing cytokine storms, and also reduced the long COVID syndromes. We propose that lithium carbonate can be used to reduce the severity of COVID-19. [ABSTRACT FROM AUTHOR]

Misshaped red blood cells (RBCs), characterized by thorn-like protrusions known as acanthocytes, are a key diagnostic feature in Chorea-Acanthocytosis (ChAc), a rare neurodegenerative disorder. The altered RBC morphology likely influences their biomechanical properties which are crucial for the cells to pass the microvasculature. Here, we investigated blood cell deformability of five ChAc patients compared to healthy controls during up to 1-year individual off-label treatment with the tyrosine kinase inhibitor dasatinib or several weeks with lithium. Measurements with two microfluidic techniques allowed us to assess RBC deformability under different shear stresses. Furthermore, we characterized leukocyte stiffness at high shear stresses. The results showed that blood cell deformability–including both RBCs and leukocytes - in general was altered in ChAc patients compared to healthy donors. Therefore, this study shows for the first time an impairment of leukocyte properties in ChAc. During treatment with dasatinib or lithium, we observed alterations in RBC deformability and a stiffness increase for leukocytes. The hematological phenotype of ChAc patients hinted at a reorganization of the cytoskeleton in blood cells which partly explains the altered mechanical properties observed here. These findings highlight the need for a systematic assessment of the contribution of impaired blood cell mechanics to the clinical manifestation of ChAc. [ABSTRACT FROM AUTHOR]

The crystal structures of the lithium aluminosilicate minerals of the Li2O–Al2O3–SiO2 (LAS) system (Li1−xAl1−xSi1+xO4 system for 0.0 ≤ x ≤ 1.0), and bikitaite were determined by X-ray diffraction (XRD) in literature, suggesting several possible lattice models for each of the crystallized phases, because of the intrinsic experimental difficulties of this technique. Here, we correlate powder XRD patterns with Rietveld refinement of cell parameters and magic angle sample spinning multinuclear magnetic resonance (NMR) spectra, including 29Si, 27Al, 7Li, and 6Li spectroscopy at 7.05 T, 9.4 T, and 20 T. The aim is to select appropriate lattice models from short-range order schemes in the lithium aluminosilicate phases, from natural minerals and synthetic crystals from the crystallization of amorphous gel precursors by a ceramic route and also by hydrothermal high-pressure experiments. Solid solutions were found in α-quartz and α-cristobalite up to x ≥ 0.75, and in β-eucryptite and β-spodumene for 0.0 ≤ x ≤ 1.0, when the ceramic synthesis is at work. The local structures of these intermediate members of the β-eucryptite and β-spodumene solid-solution series have 29Si NMR spectra consistent with the Loewenstein's rule, i.e., they have short-range order but are strictly non-periodic structures. However, β-eucryptite LiAlSiO4 end-member has a short-range structure compatible with the long-range order of the P6422 symmetry, when the crystallization is produced at hydrothermal conditions. The local structure of α-spodumene LiAlSi2O6 is consistent with the C2/c model. α-eucryptite LiAlSiO4 shows a short-range structure as that suggested by the R-3 lattice model. Petalite LiAlSi4O10 has a local structure compatible with the P2/a space group. Finally, the 29Si NMR spectra of bikitaite LiAlSi2O6·H2O indicate a short-range structure well-suited with the P1 symmetry. These results are consistent with the Ostwald's rule of stages, forming a order-disorder sequence of increasing long-range order from the starting fully disordered solid gels, through crystalline pseudoperiodic structures in non-stoichiometric solid solution crystals that respect the Lowenstein's rule, up to fully ordered crystals with short-range structures from NMR close to the long-range structures by XRD, as in the stoichiometric compounds found in some natural minerals. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the long-term effects of lithium treatment on white blood cell (WBC) count, serum creatinine, and thyroid-stimulating hormone (TSH) levels in children and adolescents with bipolar disorder (BD) and non-BD in a Turkish children and adolescent sample. Methods: The study is based on retrospective chart review. Children and adolescent patients with BD and non-BD prescribed lithium in a mental health and neurological disorders hospital between 2012 and 2017 were included in the study. Data were collected from the electronic medical files. Laboratory values for WBC count, serum creatinine, and TSH levels at baseline within the week before the onset of lithium, and at 1st, 3rd, 6th, and 12th month of treatment were recorded. Results: A total of 143 patients (82 females, 61 males; 100 BD, 43 non-BD) aged 9-18 were included. Non-BD diagnoses were psychotic and schizoaffective disorders, unipolar depression, attention-deficit/hyperactivity disorder, conduct disorder, severe mood dysregulation syndrome, borderline personality disorder, and autism. Mean age of the participants were 15.90 ± 1.16 years for the bipolar group and 14.88 ± 1.79 years for the nonbipolar group. Patients with BD reported more adverse effects. There was a statistically significant increase in WBC counts and TSH levels at any time point. A statistically significant elevation in serum creatinine was found at 3rd and 12th month of treatment. During the course of lithium treatment, WBC counts exceeded 13,000 in 14 (9.8%) patients, and TSH levels exceeded 5.5 mU/L in 41 patients (28.6%). Twenty-one (14.68%) patients were started on thyroxin replacement. Basal TSH levels and duration of the lithium treatment were higher in the participants with TSH levels exceeding 5.5 mU/L. Lithium maximum dose, lithium blood level, basal TSH level, and duration of treatment were higher in the participants receiving thyroxin replacement. No patients had serum creatinine levels exceeding the normal reference values. Conclusion: Our study suggests that lithium is a generally safe and tolerable agent for children and adolescents with BD and non-BD; however, close monitoring of thyroid functions particularly in patients with a higher basal TSH level and longer duration of lithium use is important. [ABSTRACT FROM AUTHOR]

Mechanical stimulation is commonly used in cartilage tissue engineering for enhancing tissue formation and improving the mechanical properties of resulting engineered tissues. However, expanded chondrocytes tend to dedifferentiate and lose expression of their primary cilia, which is necessary for chondrocyte mechanotransduction. As treatment with lithium chloride (LiCl) can restore passaged chondrocytes in monolayer, in this study, we investigated whether this approach would be effective in 3D culture and restore chondrocyte mechanosensitivity. Chondrocytes at different passages (P0 to P2) were treated with 0–50 mM LiCl for 24 h, with different pre-culture durations (0 to 4 days). The primary cilia incidence and length were measured in α-tubulin-stained images. Treated chondrocytes were cultured with or without dynamic compression to evaluate the effect of LiCl-induced primary cilia expression on matrix synthesis by mechanically stimulated chondrocytes. LiCl treatment of chondrocytes in 3D agarose culture increased primary cilia incidence and length, with significant increases in incidence and length using 50 mM LiCl compared to other concentrations (P < 0.05). This effect was further optimized by including a 4-day pre-culture prior to the 24-h 50 mM LiCl treatment. Importantly, LiCl-induced primary cilia expression increased chondrocyte mechanosensitivity. When stimulated with dynamic compression, LiCl-treated P1 chondrocytes increased collagen (1.4-fold, P < 0.1) and proteoglycan (1.5-fold, P < 0.05) synthesis compared to untreated, unstimulated cells. The LiCl treatment method described here can be used to restore primary cilia in passaged chondrocytes, transforming them into a mechanosensitive cell source for cartilage tissue engineering. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate the fracture resistance and fracture patterns of single implant‐supported crowns with different prosthetic designs and materials. Materials and Methods: One hundred and forty‐four identical crowns were fabricated from zirconia‐reinforced lithium silicate (ZLS), leucite‐based (LGC), and lithium disilicate (LDS) glass‐ceramics, reinforced composite (RC), translucent zirconia (ZR), and ceramic‐reinforced polyetheretherketone (P). These crowns were divided into 3 subgroups according to restoration design: cementable crowns on a prefabricated titanium abutment, cement‐retained crown on a zirconia‐titanium base abutment, and screw‐cement crown (n = 8). After adhesive cementation, restorations were subjected to thermal‐cycling and loaded until fracture. The fracture patterns were evaluated under a stereomicroscope. Statistical analysis was performed by using 2‐way ANOVA/Bonferroni multiple comparison post hoc test (α = 0.05). Results: For each prosthetic design, ZR presented the highest fracture resistance (p ≤ 0.005). Other than the differences with ZLS and RC for screw‐cement crowns (p > 0.05) and RC for crowns on zirconia‐titanium base abutments (p > 0.05), LGC showed the lowest fracture resistance. P endured higher loads than LDS (p < 0.001), except for the crowns on zirconia‐titanium base abutments (p > 0.05). Cementable crowns presented the highest fracture resistance (p < 0.001), other than LGC and LDS. The differences between LGC crowns (p > 0.05) or LDS crowns on prefabricated titanium and zirconia‐titanium abutments were nonsignificant (p = 0.133). Fragmented crown fracture was predominant in most of the restorations. Screw and abutment fractures were observed in ZR screw‐cement crowns, and all P crowns were separated from the abutments. Conclusions: Restorative material and restoration design affect the fracture resistance and fracture pattern of implant‐supported single‐unit restorations. Clinicians may restore single‐unit implants in premolar sites with the materials and prosthetic designs tested in the present study. [ABSTRACT FROM AUTHOR]

Purpose: To determine the fracture resistance of chairside computer‐aided design and computer‐assisted manufacturing (CAD/CAM) lithium disilicate full coverage crowns and two different designs of overlay restorations for premolars. Materials and Methods: CAD/CAM lithium disilicate (IPS e.max CAD for CEREC/HT A1 C14, Ivoclar Vivadent) restorations (15 specimens/group) with 1.5 mm occlusal thickness and 1.0 mm chamfer were designed and fabricated with a chairside CAD/CAM system (CEREC, Dentsply Sirona). The restorations were prepared in three different designs: (1) full coverage crowns, (2) overlays with the margin located 2 mm above the gingiva, and (3) overlays with the margin located 4 mm above the gingiva. Restorations were cemented using conventional resin luting cement (Multilink, Ivoclar Vivadent) with primer system (Monobond Plus, Ivoclar Vivadent) to resin printed dies, load cycled (2,000,000 load cycles at 1 Hz with 275 N force), and then finally loaded with a steel indenter until failure. Scanning electron microscopy observations of fractured surfaces were also conducted. Group results were analyzed with one‐way analysis of variance, and the medians were evaluated independently with Kruskal‐Wallis. Results: The fracture force of CAD/CAM lithium disilicate restorations was significantly different (p < 0.001) depending on the design of the restoration. Full coverage crowns showed significantly higher force to fracture (1018.8 N) than both types of overlays (p = 0.002 for overlay 2.0 mm and p < 0.001 for overlay 4.0 mm above gingiva). Among the two overlays, the restoration with the margin located 2 mm above the gingiva showed significantly higher fracture force (813.8 N) than the overlay with margin at 4 mm above the gingiva (436.1 N; p < 0.001). The fracture appearance of the crowns was much more complex than that of the overlay restorations. Conclusions: Full coverage chairside CAD/CAM lithium disilicate premolar crown showed higher fracture resistance than overlay restorations. Overlays with the margin located 2 mm above the margin demonstrated higher resistance than those with the margin located 4 mm above the gingiva. [ABSTRACT FROM AUTHOR]

Background: Dementia is the leading cause of death in elderly Western populations. Preventative interventions that could delay dementia onset even modestly would provide a major public health impact. There are no disease-modifying treatments currently available. Lithium has been proposed as a potential treatment. We assessed the association between lithium use and the incidence of dementia and its subtypes. Methods and findings: We conducted a retrospective cohort study comparing patients treated between January 1, 2005 and December 31, 2019, using data from electronic clinical records of secondary care mental health (MH) services in Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), United Kingdom (catchment area population approximately 0.86 million). Eligible patients were those aged 50 years or over at baseline and who had at least 1 year follow-up, excluding patients with a diagnosis of mild cognitive impairment (MCI) or dementia before, or less than 1 year after, their start date. The intervention was the use of lithium. The main outcomes were dementia and its subtypes, diagnosed and classified according to the International Classification of Diseases-10th Revision (ICD-10). In this cohort, 29,618 patients (of whom 548 were exposed to lithium) were included. Their mean age was 73.9 years. A total of 40.2% were male, 33.3% were married or in a civil partnership, and 71.0% were of white ethnicity. Lithium-exposed patients were more likely to be married, cohabiting or in a civil partnership, to be a current/former smoker, to have used antipsychotics, and to have comorbid depression, mania/bipolar affective disorder (BPAD), hypertension, central vascular disease, diabetes mellitus, or hyperlipidemias. No significant difference between the 2 groups was observed for other characteristics, including age, sex, and alcohol-related disorders. In the exposed cohort, 53 (9.7%) patients were diagnosed with dementia, including 36 (6.8%) with Alzheimer disease (AD) and 13 (2.6%) with vascular dementia (VD). In the unexposed cohort, corresponding numbers were the following: dementia 3,244 (11.2%), AD 2,276 (8.1%), and VD 698 (2.6%). After controlling for sociodemographic factors, smoking status, other medications, other mental comorbidities, and physical comorbidities, lithium use was associated with a lower risk of dementia (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.40 to 0.78), including AD (HR 0.55, 95% CI 0.37 to 0.82) and VD (HR 0.36, 95% CI 0.19 to 0.69). Lithium appeared protective in short-term (≤1-year exposure) and long-term lithium users (>5-year exposure); a lack of difference for intermediate durations was likely due to lack of power, but there was some evidence for additional benefit with longer exposure durations. The main limitation was the handling of BPAD, the most common reason for lithium prescription but also a risk factor for dementia. This potential confounder would most likely cause an increase in dementia in the exposed group, whereas we found the opposite, and the sensitivity analysis confirmed the primary results. However, the specific nature of the group of patients exposed to lithium means that caution is needed in extending these findings to the general population. Another limitation is that our sample size of patients using lithium was small, reflected in the wide CIs for results relating to some durations of lithium exposure, although again sensitivity analyses remained consistent with our primary findings. Conclusions: We observed an association between lithium use and a decreased risk of developing dementia. This lends further support to the idea that lithium may be a disease-modifying treatment for dementia and that this is a promising treatment to take forwards to larger randomised controlled trials (RCTs) for this indication. Shanquan Chen and colleagues investigate the association between lithium use and the incidence of dementia and its subtypes. Author summary: Why was this study done?: Dementia is the leading cause of death and disability in elderly Western populations. Preventative interventions that could delay dementia onset even modestly would provide a major public health impact. Lithium has been proposed as a potential treatment, but limited population-level research has been conducted to support the idea that lithium might delay the onset of dementia. What did the researchers do and find?: We identified 548 patients who were exposed to lithium and 29,070 patients who were not exposed to lithium between January 1, 2005 and December 31, 2019, using data from electronic clinical records of secondary care mental health (MH) services in Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK. We assessed the association between lithium use and the incidence of dementia and its subtypes, including Alzheimer disease (AD) and vascular dementia (VD). We found that lithium was associated with a lower risk of receiving a diagnosis of dementia, including a lower risk of being diagnosed with either AD or VD. The extended analysis by the duration of lithium treatment indicated that both short- (≤1-year exposure) and long-term (>5-year exposure) lithium exposure (but not medium term, 1- to 5-year lithium exposure) was associated with decreased incidence of dementia and its subtypes. Power was less for the intermediate durations. There was some evidence for additional benefit with longer exposure durations. What do these findings mean?: Our findings support the possibility that lithium treatment could decrease the risk of developing dementia and supports the need for further randomised controlled trials (RCTs) to test the efficacy of lithium as a disease-modifying drug in dementia. The main limitation is that 73% of the patients in lithium-exposed group had mania/bipolar affective disorder (BPAD), which is a significant risk factor for dementia. Our results were in the opposite direction, however, and were supported by sensitivity analyses. [ABSTRACT FROM AUTHOR]

Objective: Selective reporting impairs the valid interpretation of trials and leads to bias with regards to the clinical evidence. We aimed to examine factors associated with selective reporting in psychopharmacotherapy trials and thus enable solutions to prevent such selective reporting in the future. Methods: We retrieved all registry records of trials investigating medication for depressive, bipolar and psychotic disorders. Multivariate logistic regression was performed with selective reporting as outcome, and funding source, psychiatric disorder, year of study start date, participating centers, and anticipated sample size as explanatory variables, after testing for multicollinearity. Adjusted odds ratios (AOR) were calculated. Two‐sided Fisher exact test was used to compare the proportions of newly added positive primary outcomes with the proportions of positive results in the overall group of primary outcomes. Results: Of 151 included trials (N = 94,303 participants), 21 (14%) showed irregularities between registered and published primary outcomes. Higher odds of such irregularities were associated with non‐industry‐funded RCTs (AOR 5.3; p = 0.014) and trials investigating major depressive disorder (AOR 12.7; p = 0.024) or schizophrenia (AOR 14.5; p = 0.016; Table 1). Conclusion: We demonstrate discrepancies between trial registrations and publications across RCTs investigating debilitating psychiatric disorders, especially in non‐industry funded RCTs. [ABSTRACT FROM AUTHOR]

Background: Patients with bipolar disorder have higher rates of cardiometabolic comorbidities and mortality. Although guidelines emphasize the importance of cardiovascular monitoring, few studies characterized the cardiometabolic risk profile during treatment and their relation to symptomatology and treatment response.Methods: We analyzed data from two similar 24-weeks comparative effectiveness trials, with a combined sample of 770 participants randomized to two different lithium doses, quetiapine (300 mg/day), or standard treatment without lithium. Glucose, lipids and vital signs were measured before and after 24 weeks of treatment. We calculated several cardiovascular risk scores, assessed baseline correlations and compared the four treatment arms via multiple linear regression models.Results: Higher cholesterol and LDL levels were associated with greater depression severity, showing differential correlations to specific symptoms, particularly agitation, low energy and suicidality. Those randomized to quetiapine showed a significant worsening of cardiometabolic markers during the 24-week trial. Neither baseline nor change in lipid levels correlated with differential treatment response.Limitations: Study duration was short from the perspective of cardiometabolic risk markers, and all treatment arms included patients taking adjunct antipsychotics. The trials compared quetiapine to lithium, but not to other medications known to affect similar risk factors.Conclusions: Treatment with 300 mg/day quetiapine for 24 weeks, representing a short and common dose course, resulted in increased cardiometabolic risk markers, emphasizing the importance of monitoring during mood-stabilizing treatment. The symptom-specific associations are in line with previous studies in unipolar depression, suggesting a cardiometabolic-depression link that needs to be further studied in bipolar depression. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the effect of lithium treatment on renal function and to determine influencing factors. In addition, the utility of spot urine protein/creatinine ratio in detection of lithium induced nephropathy was also investigated. Methods: Serum concentrations of lithium, blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), and urinalysis including protein/creatinine ratio were measured in 375 patients using lithium. Results: Patients taking lithium for ≥8 years had higher BUN, creatinine levels, percentage of proteinuria, percentages of stage 2 and 3 chronic kidney disease (CKD); lower urine density and eGFR compared to patients taking lithium <8 years. Urine density was lower in groups with >0.8 and 0.6–0.8 mmol/L lithium level than <0.6 mmol/L. Predictors of CKD were serum level of lithium, dose of lithium, cumulative duration of lithium use, age at onset of illness, and caffeine consumption. Conclusions: Detrimental effects of lithium on renal functions were detected after lithium use for ≥8 years. Proteinuria measured by spot urine protein/creatinine ratio can be detected even when eGFR is >90 ml/min/1.73 m2. Spot urine protein/creatinine ratio, which is a cost‐effective and practical laboratory test, can be used to monitor lithium‐treated patients. [ABSTRACT FROM AUTHOR]

Aim: The effect of switching from lithium immediate release (Li‐IR) to lithium prolonged release (Li‐PR) on lithium‐induced tremor after 1 and 12 weeks of treatment was evaluated in a randomized, multicenter, open trial, in bipolar patients from the participating sites with a tremor severity ≥2 (Udvalg for Kliniske Undersøgelser [UKU] rating scale) despite optimal lithium titration. Methods: The primary endpoint was the evaluation of tremor by means of the UKU scale after 1 week of treatment. Secondary endpoints included manic Young Mania Rating Scale (YMRS) and depressive symptoms (Montgomery–Asberg Depression Rating Scale), a global assessment of the patient's status (Clinical Global Impression), polyuria/polydipsia (UKU item 3.8) and patient‐reported outcomes. Results: Owing to difficulties in including suitable patients the enrollment phase was closed when 73 patients were randomized. Notwithstanding the lower number of patients, in the modified intention‐to‐treat population (n = 70) the primary endpoint was statistically significant: tremor improved after 1 week in 62.9% in Li‐PR group against 20.0% of patients in Li‐IR group (p =.0006; two‐tailed Fisher's exact test). The difference remained statistically significant after 4 (p =.0031) and 12 weeks (p =.0128). The same analysis performed in the PP population confirmed these results. Among the secondary endpoints, only the factor convenience of the treatment satisfaction questionnaire showed a statistically significant difference between groups. There were no apparent differences in the safety profile of the two formulations. Conclusions: This study is the first comparative documentation of a potential benefit of the prolonged‐release formulation in reducing the symptom tremor, a well‐known adverse effect of lithium therapy. Indeed, the study results should be interpreted taking into account the sample size lower than planned. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the effects of lithium treatment on gene expression and activity of the prefrontal antioxidant enzymes: copper, zinc superoxide dismutase (SOD1), manganes superoxide dismutase (SOD2), catalase (CAT), and glutathione peroxidase (GPx) in animals exposed to chronic restraint stress (CRS). Methods: The investigated parameters were quantified using real-time RT-PCR, Western blot analyses, and assays of enzyme activities. Results: We found that lithium treatment decreased gene expression of SOD2, as well as the activities of SOD1 and SOD2 in chronically stressed rats to the levels found in unstressed animals. However, lithium treatment in animals exposed to CRS increased prefrontal GPx activity to the levels found in unstressed animals. Conclusions: These findings confirm that treatment with lithium induced the modulation of prefrontal antioxidant status in chronically stressed rats. Our results may be very important in biomedical research for understanding the role of lithium in maintaining the stability of prefrontal antioxidant defense system in neuropsychiatric disorders caused by chronic stress. [ABSTRACT FROM AUTHOR]

All ceramic restorations are most extensively used in aesthetic rehabilitations. Lithium disilicate is a glass ceramic material with excellent aesthetic qualities and improved mechanical properties. The improved mechanical properties of this glass ceramic material have extended its clinical indications. With advancements in adhesive bonding mechanisms, retention, strength and aesthetics are considerably improved and enhancing the success of the treatment. This article provides an overview of properties of Lithium disilicate as restorative material and describes versatile application of this material in different clinical situations. [ABSTRACT FROM AUTHOR]

We report two clinical cases assessed in our minor ailment service presenting with symptoms suggestive of common digestive disorders. Both patients were treated with narrow therapeutic index drugs (lithium carbonate and digoxin, respectively). In both cases, medication analysis revealed that referred symptoms might be elicited by these drugs: abdominal discomfort is a frequent adverse reaction in long term treatments with lithium carbonate while in the case of digoxin symptomatology was found to be accompanied by bradycardia. Thus, we propose two different pharmaceutical interventions, one being an urgent general practitioner referral. Pharmacotherapy assessment during minor ailment service, focused on narrow therapeutic index drugs, is a key point in discriminating minor ailments from potential life-threatening situations. [ABSTRACT FROM AUTHOR]