2C). Because basal and apical rotation differently responded according to the severity of aortic stiffness, the increase in basal-to-apical twist was attenuated in the 19 patients with PWV > 1700 cm/s. In the remaining 51 patients with PWV ≤ 1700 cm/s, PWV significantly correlated with both apical rotation (r = 0.461, p < 0.001) and basal-to-apical twist (r = 0.488, p < Inhibitors,research,lifescience,medical 0.001) (Fig. 2B). E/E' ratio was related to old age (r = 0.582, p < 0.001),

high systolic blood check details pressure (r = 0.246, p = 0.040), wide pulse pressure (r = 0.33, p = 0.001) and large LV mass index (r = 0.387, p = 0.001). In addition, E/E’ ratio was associated with the reduced longitudinal ε (r = 0.329, p = 0.005), systolic longitudinal SRE Inhibitors,research,lifescience,medical (r = 0.440, p < 0.001), diastolic longitudinal SRE (r = -0.401, p < 0.001) and basal-to-apical twist (β = -0.208, p = 0.030). Intra- and interobserver variabilities were 7 ± 5%

and 10 ± 7% in longitudinal ε. Those of radial and circumferential ε were 12 ± 9% and 13 ± 11%, and, 11 ± 8% and 13 ± 9%, respectively. In basal-to-apical twist, Inhibitors,research,lifescience,medical intra- and interobserver variability were measured as 8 ± 6% and 11 ± 8%. Discussion The major findings of this study are: 1) PWV significantly correlated with echocardiographic parameters of abnormal myocardial relaxation and high LV filling pressure; 2) PWV also correlated with the indicators of regional myocardial Inhibitors,research,lifescience,medical function, including global longitudinal ε and early diastolic SRE; 3) Although there were positive correlations between PWV and basal rotation and basal-to-apical twist, the increase in the

apical rotation and basal-to apical twist, was attenuated in patients with PWV > 1700 cm/s. Vascular stiffening causes arterial pulse pressure to widen and affects mechanical vascular stimulation by Inhibitors,research,lifescience,medical increasing pulsatile shear and pressure. Chronic vascular stiffness increases the speed and magnitude of reflected waves, amplifying late systolic pressure and, thus, systolic load on the LV. This chronic vascular alteration is coupled with an increase in ventricular end-systolic stiffness.1-3) Although chronic systolic ventricular-arterial coupling maintains stroke work, it also predisposes to adverse effects including a high sensitivity 4-Aminobutyrate aminotransferase to change in volume, change in myocardial perfusion patterns and reduction in systolic reserve.9),10) These adverse effects are thought to play a role in the pathophysiology of heart failure in patients with normal EF.4) Because heart ejecting into a stiffer arterial system generates the higher end-systolic pressure for the net stroke volume, the greater energy may be required for a given level of ejected flow.11) As a result, chronic ejection into a stiffer vasculature induces structural and functional changes in myocardium, even at the similar level of mean arterial pressure.

9 The main risk factors for CVT include prethrombotic conditions such as protein C and S deficiency, factor V Leiden, prothrombin and methylene tetrahydrofolate reductase mutation,

oral contraceptive pills, pregnancy, malignancy, infection, and head injury. Three major signs and symptoms of CVT are isolated intracranial hypertension (characterized by headache, vomiting and papillary edema), focal syndromes such as seizure and focal neurological deficits, and encephalopathy characterized by stupor and coma.10 Headache is the most common symptom of CVT. It is more common in females than in males. Headache onset is gradual and usually Inhibitors,research,lifescience,medical localized. The site of headache is not closely related to the localization of the involved sinuses.11 Sometimes headache is accompanied by aura-like migraine headache. The cornerstone of APS treatment is anticoagulation with heparin or warfarin. Currently, new generations of anticoagulants like pradaxa and xarelto are available as well. Alternative agents, especially in catastrophic conditions are Inhibitors,research,lifescience,medical prostacyclins, glucocorticoids, rituximab, and thrombolytic drugs like streptokinase or tissue plasminogen activator inhibitor.12 Tissue plasminogen activator inhibitor is a thrombolytic agent Inhibitors,research,lifescience,medical that was approved by FDA for the treatment of ischemic stroke. It binds to fibrin in thrombotic clot, and then converts

plasminogen to plasmin. There are not randomized clinical trials comparing systemic and local thrombolytic therapies.13 Death (15%), and intracranial and extracranial hemorrhage are the Inhibitors,research,lifescience,medical major side effects of treatment with tissue plasminogen activator inhibitor. There are

data showing that for CVT treatment local thrombolytic agents are more effective than systemic heparin anticoagulation. There are few case reports about tissue plasminogen activator inhibitor injection in the treatment of APS.14 Given the APS pathogenesis and presence of impaired fibrinolysin system in this KPT-330 supplier disease, we will probably Inhibitors,research,lifescience,medical see some changes in treatment strategy of this syndrome in the future.15 Conclusion The present case was lupus-induced secondary APS that was diagnosed first time in pregnancy. The main problem of the case was CVT. Due to early diagnosis and intervention with tissue plasminogen activator inhibitor her general condition improved and she has no major problems. Conflict of Interest: None declared
Nerve root compression in the lumbar disk syndrome Ribonucleotide reductase is a common cause of acute, chronic and recurrent low back pain accompanied by radiating pain to the lower extremity superimposed by sensory motor impairment.1 Most patients with disk-induced radicolopathy respond to conservative management. When radiculopathy occurs, several features including pain distribution, reflex changes, distribution of weakness and sensory alteration provide reliable information to enable a clinician to localize the level of disk protrusion or root irritation.

1999]. In another series of investigations PSDEP appeared to relate to a global hierarchic dimension of psychopathology that comprises depressive symptoms at the lowest level of the hierarchy, specific neurotic symptoms at a higher level and psychotic symptoms at the highest level [Surtees and Kendell, 1979]. The symptoms of the nonpsychotic part of this hierarchy correspond to Inhibitors,research,lifescience,medical the symptoms found in the hierarchic global dimension of Emotional Dysregulation [Goekoop and Zwinderman, 1994]. These findings support the usefulness of a

multidimensional assessment of nonpsychotic psychopathology to control for relations with PSDEP that could be explained by relations with the nonpsychotic admixture of that subcategory. We also searched for potentially Belinostat supplier confounding effects on the concentration of plasma NE of current antipsychotic, antidepressant Inhibitors,research,lifescience,medical and benzodiazepine treatment and their dosages, type of antidepressant drug, smoking habit, sex, age, duration of the disease and inpatient or outpatient treatment. Smoking may immediately affect Inhibitors,research,lifescience,medical peripheral sympathetic activity [Grassi et al. 1994], and long-term smoking may increase the NE concentration [Christensen and Jensen, 1995].

Long-term treatment with a tricyclic drug, at least 100 mg, has been found to increase plasma NE concentration [Veith et al. 1994], while plasma NE has been found to be nonsignificantly decreased in patients with major depressive disorder treated with selective serotonin reuptake inhibitors (SSRIs) [Barton et al. 2007]. As far as we know, this method of analysing the plasma NE concentration as a potential biomarker of PSDEP, controlling for several confounding effects, has

not been used before. Inhibitors,research,lifescience,medical Since in our previous study [Goekoop et al. 2011] we did not analyse the effect of antidepressant drug type, we reanalysed the correlation between plasma NE and AVP in PSDEP. Antipsychotic Inhibitors,research,lifescience,medical drug dose was used as an additional confounder in these analyses as it correlates positively with the concentration of plasma AVP [Goekoop et al. 2006]. In summary, we hypothesize the plasma concentration of NE to be increased in PSDEP compared with non-PSDEP, and the correlation between plasma NE and plasma AVP still to be present when accounting for several potentially confounding effects. Methods Methisazone Subjects We reanalysed the data from the same patient sample in which we previously found support for the HAR and ANA subcategories of depression [Goekoop and Wiegant, 2009] and a general vasopressinergic theory of depression [Goekoop et al. 2010]. All patients fulfilled DSM-IV criteria [American Psychiatric Association, 1994] for major depression and scored at least 20 on the MADRS [Montgomery and Asberg, 1979]. The 78 patients with complete NE data were selected from 89 patients who were initially included, 9 with PSDEP and 69 with non-PSDEP.

It is apparent that human and murine B cells take up IgE-antigen complexes via CD23 and present antigenic peptides via MHC class II stimulating CD4+ T cells. TNP-(trinitrophenyl-) specific IgE linked to BSA or OVA and injected into mice results in 100-fold enhanced IgG antibody responses as compared to either IgE or BSA or OVA injected alone; the enhanced antibody effects are completely dependent on CD23 [217, 218]. In addition, the coexpression of CD23 with DC-SIGN further suggests that antigen presentation and stimulation of antigens is possible

between the cross-talk of these two receptors. Hence, targeting CD23 is a novel Inhibitors,research,lifescience,medical ABT-869 cell line vaccine strategy for stimulating CD4+ T-cell immune responses. 8. Conclusions A promising strategy to improve the immunogenicity of antigens is “antigen targeting.” DCs are unique in their ability to present antigen to naive

T cells and, hence, play a major role in Inhibitors,research,lifescience,medical initiating immune responses. Characterization of DC receptors aid in the understanding of the mechanism underlying their potent antigen presenting capacity. A major challenge for vaccine design is targeting antigens to DCs Inhibitors,research,lifescience,medical in vivo, facilitating cross-presentation, and conditioning the microenvironment for Th1- and Th2-type immune responses. We have analysed numerous DC cell surface receptors, which function in inducing cellular responses and individually each shows promise as targets for vaccine design against cancer. More recently there has been an upsurge of information regarding toll-like receptor (TLR) targeting

and stimulation of DCs via TLR. It is clear that in mice, use of TLR ligands to activate DCs stimulates Inhibitors,research,lifescience,medical effective cellular immune responses and activation of DCs. However, no substantial TLR-targeting vaccine Inhibitors,research,lifescience,medical trials have been completed in humans and it remains to be determined whether TLR targeted approach will result in significant benefits in humans as those seen in mice. Furthermore, targeting antigens to chemokine receptors [1] on DCs (CCR1, CCR2, CXCR4, CCR5, CCR6, and CXCR1) generates enhanced immune responses in vitro and in vivo. Furthermore, bacterial toxins, DC binding peptides and internalization no peptide (Int) also target antigens to DCs; however, the targeting does not involve receptor targeting. It is clear that receptor targeting of antigens is a promising new approach for cancer immunotherapy studies.
The public health burdens from ocular diseases/disorders are enormous. It is estimated that about 9.1 million American adults have one of the major retinal degenerations such as diabetic retinopathy, glaucoma, and macular degeneration. While the annual cost of adult vision problems in the US is approximately $51.4 billion including the direct medical cost, loss of productivity and other costs to caregivers and healthcare payers [1, 2].

The automatic thresholding function (the same for all the images) used by Image J divides the image into visual signal (shade of grey to black) and background (white) and provides a numerical readout of area of the visual signal. In addition to image analysis of the maximal vibration energy frame, numerical maximal inspiratory Inhibitors,research,lifescience,medical vibration energy analysis was performed [4]. This analysis is not dependent on the image and allows total vibration energy to be compared before and after GSK2606414 research buy clinical improvement. Respiratory sound

generated vibration signals have very high signal intensity when compared to usual background noise and combined with the orientation of the sensor, allow pulmonary Inhibitors,research,lifescience,medical airflow to be the dominant signal in the

gray-scale distribution. High energy artifacts from background noise due to patient movement against matrix framework or from sudden loud noises in the environment are occasionally encountered and easily identified Inhibitors,research,lifescience,medical in the image. These images were excluded from the analysis. Statistical Analysis Wilcoxon signed rank test for paired and unpaired data (SPSS 11.5, SPSS Inc., Chicago, IL, USA) was used to analyze the data. Median and interquartile range (IQR) and mean ± standard deviation (SD) are reported. A pre-study Inhibitors,research,lifescience,medical power calculation was not possible due to unknown size of effect of pulmonary edema and treatment on amount and distribution of vibration energy. A p value less than 0.05 was considered statistically significant. Results Patients A total of 23 consecutive CHF patients with shortness of breath at rest were enrolled in the study. Follow-up studies

were obtained on the day of discharge following clinical improvement of CHF symptoms (no shortness of breath) and were not obtained for 4 patients due to timing of their discharge. In addition to the improvement of CHF symptoms such as shortness of breath, physical examination Inhibitors,research,lifescience,medical findings documented by the physicians were also used as objective measures of clinical improvement. All patients were discharged on the recommendation of the treating physician. The average hospital stay for CHF patients without and with REPE was 2.9 ± 1.6 days and 3.4 ± 1.4 days respectively (p > 0.05). CHF patients without and with REPE had a negative click here fluid balance during treatment of 1736 ± 945 ml/day and 1871 ± 763 ml/day, respectively (P > 0.05). Vibration energy images Chest radiographs and vibration energy images for healthy volunteers and CHF patients on admission and after clinical improvement are shown in Figure ​Figure2.2. The images of healthy volunteers encompassed the entire imaging field and were symmetric (Figure ​(Figure2A).2A).

Although there have never been as many recognized potential targets for drug therapy in psychiatric disease

as at present, there has been no major progress in terms of marketed agents revolutionizing therapy. The partial cloning of the human genome now allows us to PF299 chemical structure define the total number of receptors in the human genome (for example, about, 48 nuclear receptors, about 750 receptors coupled to G proteins). This is a definitive statement defining the future, and perhaps eventually the limits, of drug discovery. One of us (M. Spedding) is chairman of the Nomenclature Committee for the International Union of Inhibitors,research,lifescience,medical Pharmacology (NC-IUPHAR), which has the mission of classifying Inhibitors,research,lifescience,medical these receptors. Hie sequences of the receptors coupled to G proteins (GPCRs) have now been defined, and the olfactory receptors and pseudogenes separated, leaving several hundred known or orphan receptors that may be drug targets. However, screening for agonists and antagonists, and then proceeding to clinical trials to test whether a certain hypothesis works,

is one of the most expensive experiments known to man! Furthermore, the main reason for Inhibitors,research,lifescience,medical the failure of new drugs when they get into clinical trials is not pharmacokinetics or toxic side effects, but lack of efficacy (Figure 1.) Figure 1. Reasons for stopping clinical development of 121 compounds from 7 British companies (B. Cox, personal communication). Reproduced

from reference 21: Sebban C, Tesolin-Decros S, Ciprian-Ollivier J, Perret L, Spedding M. Effects of phencydidine (PCP) Inhibitors,research,lifescience,medical and … This lack of efficacy means that either the original hypothesis of why the drug should work in man was wrong or – and this is more likely – that the tests performed in animals where the drug was active did not measure the same parameters as the tests in phase 1 or 2 clinical trials Inhibitors,research,lifescience,medical (which, in turn, may not reflect, the disease situation). As there are now hundreds of potential targets from the human genome, and most compounds going into man appear not, to be effective, what can be done? oxyclozanide The response by much of the pharmaceutical industry is to push up screening of new targets by high-throughput testing of chemical libraries on new receptors (or other potential targets), eliminating targets that do not yield active results in disease models (frequently based on transgenic animals), and then taking promising compounds into the clinic for abbreviated “proof of concept” testing in man. However, it is not always possible to have proof of concept, testing that reflects the situation in diverse patient populations. An alternative approach is to benefit from the breakthroughs made in basic research in brain function over the last few years to study the pathology in man, and then construct new animal models which better mimic the disease state.

A P value less than 0.05 was considered statistically significant. Results Compared with control group, the study group had shorter duration of invasive mechanical ventilation, non-invasive mechanical ventilation time, total mechanical ventilation time, total hospital stay (P<0.01). There are significant differences between these two groups in re-intubation rate, VAP occurred in the number of case, hospital mortality rate in 28 days (P<0.05). Three in the study group died

Inhibitors,research,lifescience,medical selleck because of exacerbation of respiratory muscle fatigue and no improvement of patients’ condition by the non-invasive mechanical ventilation. Of the three cases, two died of MODS, and one died of discontinuation treatment. Eleven in the control group died because of MODS. Of the eleven cases, five died of refusing endotracheal intubation, and two died of discontinuation treatment. 23 people in the control group were survived by using endotracheal intubation again. (Table ​(Table11) Inhibitors,research,lifescience,medical Table 1 Some medical indices in study and control groups Discussion Weaning from mechanical ventilation for COPD patients is a challenge in clinic for a long time, because of long course of diseases, recurrent cough and wheeze with infection in COPD patients, which

lead to respiratory muscle fatigue. Inhibitors,research,lifescience,medical In addition, balance of normal flora was inevitably destroyed as a result of using antibiotics long term, and influenced the body’s digestion and absorption. Patients will in high emergency condition when exacerbations, and then muscular atrophy will happen, even if it is timely to add exogenous proteins, it can’t change organization protein consumption of their own, so mal-nutrition is common in most of COPD patients. Inhibitors,research,lifescience,medical For those patients who have weaning difficulties, they will get pulmonary infection aggravated even though infection is controlled, because of respiratory muscles fatigue and weakness, sputum drained difficultly, obstructed airways repeatedly. It is well known that during long-term mechanical ventilation, due to implementation of an invasive artificial Inhibitors,research,lifescience,medical airway, ventilator associated pneumonia Electron transport chain (VAP) requiring repeated treatment often occurs. The

results show that occurring rate of VAP in the study group is obviously lower than those of the control group (P<0.01). The decrease of the incidence rate of VAP can improve the effect of treatment and decrease the medical expenditure. In a way, increasing BMI can reduce dangerous factors of VAP, strengthen the body’s immunity and decrease mortality risk. The results show that 23 people in the control group (BMI<21, but their BMI>21 by enteral nutrition combined with parenteral nutrition in treatment) were survived by using endotracheal intubation again. In this way, we know BMI is important. Pulmonary infection control window (PIC window) will appear early if the antibiotic is administrated reasonably, although the treatment of COPD is a comprehensive process.

In Burris et al. (2008), working memory function was within normal range among veterans

diagnosed with PTSD. However, it is important to note that this domain was measured using the traditional forward digit span task. Compared to the forward digit span, the Backward Digit Span (BDS) task has been shown to load different cognitive processes in that it relies on internal manipulation of mnemonic representations and is not sensitive to the type of information being remembered (Conklin et al. 2000). Brain imaging suggests that the BDS task taxes specific regions of the dorsolateral prefrontal Inhibitors,research,lifescience,medical cortex more heavily than the forward digit span task (Hoshi et al. 2000). The BDS task is sensitive to working memory deficits from neurodegenerative disease, traumatic brain injury, and psychiatric illness (Conklin et al. 2000; Backman et al. 2001; Fork et al. 2005). The current study investigated Inhibitors,research,lifescience,medical neuropsychological functioning associated with combat-related PTSD. We tested

active-duty soldiers with PTSD versus healthy active-duty soldiers on specific components of attention using the ANT and working memory functioning as assessed with a BDS. Metrics of combat experience, depression, anxiety, PTSD, and alcohol consumption were explored as possible mediators of neuropsychological functioning. Materials and Methods Ixazomib Participants Forty-six active-duty U.S. Army Soldiers (36 males) with prior Inhibitors,research,lifescience,medical combat experience voluntarily participated in this cross-sectional study. Participants were recruited via posters Inhibitors,research,lifescience,medical and clinician referral from a garrison PTSD treatment facility. All participants in the PTSD group (n= 23) had received, from a military health provider, an active diagnosis for PTSD (American Psychological Association 2000) as assessed via the Clinician Administered PTSD Scale (CAPS). The diagnosis had to be annotated in Military

Health Service Electronic Medical Record or hard copy of medical record. Individuals were excluded if there existed a comorbid psychiatric diagnosis of a mood disorder, psychotic Inhibitors,research,lifescience,medical disorder (e.g., schizophrenia), or were currently being treated for substance dependency. The control group (n= 23) consisted of soldiers with no PTSD or any other mental health diagnosis, recruited from both patients and staff from different departments at the post Army Medical Center. Nine participants in the PTSD group (43%) reported having received a concussion or mild traumatic brain injury (mTBI) with a PDK4 brief loss of consciousness (LOC) within the last five years. Individuals were excluded if they reported or had documented a moderate-to-severe TBI at any point in their medical history. All participants passed a screening for effort using the Test of Memory Malingering (TOMM) with a cut-off score of less than 45 correct. All participants gave written informed consent and authorization for the health insurance portability and accountability act (HIPAA).

17 Complete ruptures are associated with contrast extravasation into the perineum when rupture of the distal perineal fascia or UGD occurs.13 Figure 5 (A) Partial posterior urethral injury with contrast observed in bladder. (B) Complete urethral injury with starburst pattern of contrast extravasation seen on retrograde urethrogram. Bladder contrast present from previous imaging.

Similar to bladder injuries, a number of classification systems have been developed Inhibitors,research,lifescience,medical to describe urethral injuries based on urethrographic appearance (Table 3,18 Table 4,8 Table 51). Although the actual grades may differ, they convey essentially the same information, differentiating between partial and complete disruptions in the anterior and/or posterior urethra. Table 3 Unified Anatomic Mechanical Classification of Urethral Injuries18 Table 4 Urethral Injury Severity Scale8 Table 5 European Association of Urology Classification of Blunt Anterior and Inhibitors,research,lifescience,medical Posterior Urethral Trauma1 Diagnosis Blood at the meatus is seen in 37% to 93% of posterior urethral tears and in 75% of anterior urethral tears.19,20 Hematuria, the inability to pass urine, and dysuria may be present; however, the amount of hematuria correlates poorly to the severity

Inhibitors,research,lifescience,medical of injury as complete rupture can mean minimal bleeding and small partial tears can result in heavy bleeding. A high-riding prostate is an unreliable sign. Perineal ecchymosis and swelling are seen in urethral injuries as a direct result of trauma to the area or urinary extravasation and blood tracking within the limits of fascial planes (scrotum, perineum, abdominal Inhibitors,research,lifescience,medical wall). In anterior urethral injuries, the acknowledged “butterfly” pattern of bruising is seen when Buck’s fascia is disrupted. The Cisplatin in vitro presence of pelvic trauma should alert clinicians to the possibility of injury. The classic triad of blood at the meatus, inability to void, and a full bladder is uncommon and according

to the Advanced Trauma and Life Support (ATLS) guidelines, Inhibitors,research,lifescience,medical radiographic evaluation should be undertaken if any of the above exists. 21 Examination of the rectum and/or vagina should be performed in all patients with suspected urethral injury related to pelvic fracture or penetrating trauma and can identify associated injuries. In the presence of blood at the meatus, a gentle attempt at catheterization has been shown to be acceptable and successful in up to 50% of patients.1 others It had been previously thought that insertion of a catheter into a torn urethra could result in conversion to a complete injury, disruption and infection of pelvic hematoma, and aggravated prostatic bed bleeding, although supporting evidence is lacking. Catheterization should be performed in situations where the patient is too unstable to have radiographic investigation. If urethral injury is suspected, a retrograde urethrogram should be performed whenever possible.

One large multicenter phase III trial found depressive symptoms in 11% of those receiving pemetrexed.133 Another multicenter study examined a regimen of pemetrexed and cisplatin and found a 14% rate of occurrence.134 Depression has been listed among the adverse reactions to fludarabine, another antimetabolite; however, this has not been reported often during controlled trials that have looked at Inhibitors,research,lifescience,medical its safety and efficacy. Furthermore, one study examining the safety of oral fludarabine

showed a statistically significant improvement in the mean scores of emotions among patients who received this agent.135 Medications that interfere with DNA and RNA synthesis Doxorubicin and daunorubicin are anthracyclic antibiotics that act by binding to DNA and disordering synthesis. Based on animal models, this class of medications is potentially neurotoxic; however, at therapeutic doses in humans these agents do not cross the blood-brain barrier. Depression is not commonly associated with these Inhibitors,research,lifescience,medical agents; nevertheless, one prospective, randomized phase III trial (comparing doxorubicin and daunorubicin for the treatment of Kaposi’s sarcoma), Inhibitors,research,lifescience,medical reported the incidences of depression as 6% and 10%, respectively136 L-Asparaginase (a naturally occurring enzyme that inhibits protein, DNA,

and RNA synthesis in tumor cells by decreasing circulating levels of asparagine) has been associated with assorted psychiatric symptoms (including irritability, depression, and hallucinations). Haskell and colleagues137

reported that up to 31% of patients taking this medication developed CNS abnormalities (most commonly moderate to severe depression associated with personality Inhibitors,research,lifescience,medical disturbances). Ohnuma138 reported that 25% of patients developed mild depression and drowsiness within 1 month of therapy; higher doses were related with more severe symptoms, and discontinuation of it led to the resolution of symptoms.139 Mitotic inhibitors Taxane drugs (ie, paclitaxel and docetaxel) Inhibitors,research,lifescience,medical are mitotic inhibitors that interfere with the normal breakdown of microtubules during cell BIIB057 supplier division. Several studies have found an association between these medications and depressive symptoms. One case report of a woman receiving paclitaxel described the onset of severe depression and suicidal thoughts that remitted following the discontinuation of the drug.140 In a prospective RCT, Fountzilas and associates141 reported worse emotional function in those many receiving paclitaxel as part of a multidrug regimen as compared with those receiving the same regimen without paclitaxel. Finally, in a naturalistic, longitudinal study, Thornton and coworkers142 documented slower psychological recovery and higher rates of depressive symptoms in patients receiving paclitaxel and docetaxel. Biological agents Interleukins Interleukin-2 (IL-2) has been used in the treatment of metastatic renal cancer, melanoma, and other malignancies.