Black sheep get the blues: A psychobiological model of social rejection and depression

Major life events involving social rejection are strongly associated with onset of depression. To account for this relation, we propose a psychobiological model in which rejection-related stressors elicit a distinct and integrated set of cognitive, emotional, and biological changes that may evoke depression. In this model, social rejection events activate brain regions involved in processing negative affect and rejection-related distress (e.g., anterior insula, dorsal anterior cingulate cortex). They also elicit negative self-referential cognitions (e.g., “I’m undesirable,” “Other people don’t like me”) and related self-conscious emotions (e.g., shame, humiliation). Downstream biological consequences include upregulation of the hypothalamic-pituitary-adrenal axis, sympathetic-adrenal-medullary axis, and inflammatory response. Pro-inflammatory cytokines play an important role in this process because they induce a constellation of depressotypic behaviors called sickness behaviors. Although these changes can be short-lived, sustained inflammation may occur via glucocorticoid resistance, catecholamines, sympathetic innervation of immune organs, and immune cell aging. This response also may be moderated by several factors, including prior life stress, prior depression, and genes implicated in stress reactivity.     

Neutrophilic airway inflammation is a main feature of induced sputum in nonatopic asthmatic children

Background:  Asthma phenotypes are well described among children. However, there are few studies comparing airway inflammation in different clinical presentations of pediatric asthma. We tested the hypothesis that nonatopic asthma is associated with a predominant noneosinophilic inflammation in the airways, as assessed by induced sputum. The objective of this study was to evaluate the cytological characteristics of induced sputum (IS) in atopic (AA), nonatopic asthmatics (NAA) and nonatopic nonasthmatic children (NANA).
Methods:  Of 90 selected children, 77 met eligibility criteria for performing IS and were classified as: AA, n  = 28, NAA, n  = 29 and NANA, n  = 19. Subjects answered to a set of ISAAC-based questions and were skin-tested for common aeroallergens. A defined series of exclusion criteria was applied.
Results:  Induced sputum was obtained from 54 (70.1%) subjects (21 AA, 20 NAA and 13 NANA). Demographic data and mean FEV₁ were similar in the three groups. The proportion of eosinophils [median, inter quartile range (IQR)] was significantly higher in the sputum of AA [(6.0.)12)] compared with NAAs [0 (2)] and NANAs [0 (1)], P  < 0.001. The proportion of children with sputum eosinophilia (eos > 3%) was also significantly higher in AA (71.4%) when compared with NAA (28.6%); none of the NANA had sputum eosinophilia. Nonatopic asthmatic children had significantly higher proportions and absolute number of neutrophils than AA and controls.
Conclusions:  The results suggest that nonatopic children present IS with a cell pattern that is predominantly neutrophilic while eosinophilia is the hallmark of airway inflammation in the majority of atopic wheezing children not treated with inhaled steroids.     

First‐time pregnant women’s experience of the decision‐making process related to completing or terminating pregnancy – a phenomenological study

Scand J Caring Sci; 2011; 25; 169–175
Pregnant and ambivalent. First‐time pregnant women’s experience of the decision‐making process related to completing or terminating pregnancy – a phenomenological study Every year about 30 000 women in Norway become unexpectedly pregnant and have to decide whether to complete or terminate the pregnancy. Few studies have been performed of these women’s experiences. The aim of this qualitative study was to get new and more extensive information regarding women’s experiences relating to their considerations of whether to terminate a pregnancy in the first trimester. In‐depth interviews with four participants between 25 and 32 years were conducted. None of them had previously given birth or had had an abortion. Each woman was interviewed twice during a period of 2 weeks. The first interview took place between 7 and 11 weeks into the pregnancy. None of the women had reached a decision on whether to complete or terminate the pregnancy. All the women described an increased awareness of their body and a struggle to make ‘the right decision’. They described a desire for autonomy as well as a need for understanding and acknowledgement from significant others and health care providers. They experienced a tension between their pregnant body and the surrounding world, between their own body and the foetus and between their own choice and the opinions of others. One consequence of a woman’s right to choose can be an unwanted loneliness or giving in to other people’s choices. There is consequently a need for professionals who are able to exercise skilled judgement and who are aware of their own power in the relationship so as to assure that the pregnant woman does in fact makes her own decision.     

冠脉造影剂肾病水化干预护理探讨

造影剂（Contrast media,CM）是应用最广泛的心血管药物之一。造影剂在心血管冠脉介入领域中的主要作用就是增强放射显影的对比度,提供有用的诊疗信息。含碘造影剂有一定的肾毒性,严重时可以导致造影剂肾病,后果不能低估。以往对造影剂肾病的认识不是很高,