Cytochrome P450 and ABCB1 genetics: association with quetiapine and norquetiapine plasma and cerebrospinal fluid concentrations and with clinical response in patients suffering from schizophrenia. A pilot study.

Variability in response to atypical antipsychotic drugs is due to genetic and environmental factors. Cytochrome P450 (CYP) isoforms are implicated in the metabolism of drugs, while the P-glycoprotein transporter (P-gp), encoded by the ABCB1 gene, may influence both the blood and brain drug concentrations. This study aimed to identify the possible associations of CYP and ABCB1 genetic polymorphisms with quetiapine and norquetiapine plasma and cerebrospinal fluid (CSF) concentrations and with response to treatment. Twenty-two patients with schizophrenia receiving 600 mg of quetiapine daily were genotyped for four CYP isoforms and ABCB1 polymorphisms. Quetiapine and norquetiapine peak plasma and CSF concentrations were measured after 4 weeks of treatment. Stepwise multiple regression analysis revealed that ABCB1 3435C > T (rs1045642), 2677G > T (rs2032582) and 1236C > T (rs1128503) polymorphisms predicted plasma quetiapine concentrations, explaining 41% of the variability (p = 0.001). Furthermore, the ABCB1 polymorphisms predicted 48% (p = 0.024) of the variability of the Δ PANSS total score, with the non-carriers of the 3435TT showing higher changes in the score. These results suggest that ABCB1 genetic polymorphisms may be a predictive marker of quetiapine treatment in schizophrenia.

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, for the year ended June 30, 2004

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, for the year ended June 30, 2004

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30, 2005

Report of recommendations to the Iowa Department of Education, Division of Vocational Rehabilitation Services, June 30

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

OBJECTIVE: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. DESIGN: Cost-utility analysis alongside a randomized controlled trial. SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain. METHODS: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. RESULTS: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. CONCLUSION: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2004

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2005

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2006

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2009

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2007

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2008

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2010

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2011

Agency Performance Report

Iowa Division of Vocational Rehabilitation Services Performance Report, FY2012

Agency Performance Report