These results support a biphasic model of changes in AD, which could affect the selection of patients for clinical trials and the use of magnetic resonance imaging as a surrogate marker of disease modification.

Background: Authors are required to describe in their manuscripts ethical approval from an appropriate committee and how consent was obtained from participants when research involves human participants. Objective: To assess the reporting of these protections for several study designs in general medical journals. Design: A consecutive series of research papers published in the Annals of Internal Medicine, BMJ, JAMA, Lancet and The New England Journal of Medicine between February and May 2003 were reviewed for the reporting of ethical approval and patient consent. Ethical approval, name of approving committee, type of consent, data source and whether the study used data collected as part of a study reported elsewhere were recorded. Differences in failure to report approval and consent by study design, journal and vulnerable study population were evaluated using multivariable logistic regression. Results: Ethical approval and consent were not mentioned in 31% and 47% of manuscripts, respectively. 88 (27%) papers failed to report both approval and consent. Failure to mention ethical approval or consent was significantly more likely in all study designs (except case-control and qualitative studies) than in randomised controlled trials (RCTs). Failure to mention approval was most common in the BMJ and was significantly more likely than in The New England Journal of Medicine. Failure to mention consent was most common in the BMJ and was significantly more likely than in all other journals. No significant differences in approval or consent were found when comparing studies of vulnerable and non-vulnerable participants. Conclusion: The reporting of ethical approval and consent in RCTs has improved, but journals are less good at reporting this information for other study designs. Journals should publish this information for all research on human participants.

Effective interventions for drug abusing adolescents are underutilized. Using an interrupted time series design, this study tested a multicomponent, multi-level technology transfer intervention developed to train clinical staff within an existing day treatment program to implement multidimensional family therapy (MDFT), an evidence-based adolescent substance abuse treatment. The sample included 10 program staff and 104 clients. MDFT was incorporated into the program and changes were noted in the program environment, therapist behavior, and in most (e.g., drug abstinence, and out of home placements) but not all (e.g., drug use frequency) client outcomes. These changes remained after MDFT supervision was withdrawn. (Am J Addict 2006;15:102-112) Science-based, effective therapies have been developed to treat adolescent drug abuse, 1 but the practice of these treatments in community drug treatment clinics remains the exception rather than the rule. 2 This continuation of the research-practice divide is particularly troubling given what we are learning about the standard treatment that is available for most drug involved adolescents. Most adolescent treatment programs in standard community-based programs are plagued by high drop out rates, service fragmentation, and failure to address youths' multiple problems. For instance, a national multi-site evaluation of teen drug abuse treatment programs, found only 27% of youth completing outpatient therapy, and, according to these data the use of hard drugs increased over the course of treatment.3 Providers are unable to meet the needs of substance abusing youth with multiple problems, including those with comorbid disorders and legal involvement. These circumstances have commanded the attention of policy makers, managed care organizations, third-party payers, and local, state, and federal funding agencies to expedite the movement of research-based adolescent drug treatments to community settings. 4 But dire need does not mean that the task is simple. Transporting research-based therapies to non-research environments is complex and difficult. 5 We have learned a great deal about the challenges of this kind of work. Although effective, characteristics of the models themselves and provider factors interact to create formidable obstacles to adoption of science-based treatments. Treatments developed for research purposes are not generally designed to accommodate to the features of community clinics. Therapists in community clinics typically handle large caseloads, and do not receive clinical supervision that addresses their clinical development. Although interested in new therapies that could enhance their skill and effectiveness, community clinicians feel overburdened, and have few incentives or opportunities to learn manual-guided treatments. Systemic factors are at play as well. Community-based treatment programs rarely have an organizational structure, the financial resources and=or reimbursement system to implement new treatments.Still, solutions, or at least recommenda...

This review summarizes the up-to-date and comprehensive information on compounds from endophytes fungi from 1995 to 2011 that relates to 313 compounds isolated from endophytic microorganisms, together with the botany, phytochemistry, pharmacology and toxicology, and discusses possible trends and the scope for future research of endophytes.

One of the major challenges of medical sciences has been finding a reliable compound for the pharmacological treatment of Alzheimer’s disease (AD). As most of the drugs directed to a variety of targets have failed in finding a medical solution, natural products from Ayurvedic medicine or nutraceutical compounds emerge as a viable preventive therapeutics’ pathway. Considering that AD is a multifactorial disease, nutraceutical compounds offer the advantage of a multitarget approach, tagging different molecular sites in the human brain, as compared with the single-target activity of most of the drugs used for AD treatment. We review in-depth important medicinal plants that have been already investigated for therapeutic uses against AD, focusing on a diversity of pharmacological actions. These targets include inhibition of acetylcholinesterase, β-amyloid senile plaques, oxidation products, inflammatory pathways, specific brain receptors, etc., and pharmacological actions so diverse as anti-inflammatory, memory enhancement, nootropic effects, glutamate excitotoxicity, anti-depressants, and antioxidants. In addition, we also discuss the activity of nutraceutical compounds and phytopharmaceuticals formulae, mainly directed to tau protein aggregates mechanisms of action. These include compounds such as curcumin, resveratrol, epigallocatechin-3-gallate, morin, delphinidins, quercetin, luteolin, oleocanthal, and meganatural-az and other phytochemicals such as huperzine A, limonoids, azaphilones, and aged garlic extract. Finally, we revise the nutraceutical formulae BrainUp-10 composed of Andean shilajit and B-complex vitamins, with memory enhancement activity and the control of neuropsychiatric distress in AD patients. This integrated view on nutraceutical opens a new pathway for future investigations and clinical trials that are likely to render some results based on medical evidence.