Brofaromine in major depressed patients: a controlled clinical trial versus imipramine and open follow-up of up to one year.

In an 8-week controlled double-blind clinical trial with a total of 216 patients Brofaromine was found to be superior to Imipramine with regard to efficacy (Hamilton Depression Scale, von Zerssen self-rating scale, global evaluation) and tolerability (adverse experiences, global evaluation). Mean daily dosages were 93.1 mg/day in the Brofaromine group and 92 mg/day in the Imipramine Group. No tyramine reduced diet had to be observed. Long-term efficacy and tolerability also proved to be good in an open follow-up in the Brofaromine group.     

Student health in various periods of a year from one birthday to the following one

Human health varies in different seasons. There is an individual yearly health cycle (IYHC). The authors examined variations in working capacity (WC), stress inclination (SI), immunity (salivary IgA), biological age (BA), and integral health index (IHI) in 157 apparently healthy students in different months and terms of an individual year--from one birthday to the next one. SI was estimated by several methods. Variations in cardiac rhythm, mathematical problem solution-induced changes in cardiac rhythm and blood pressure, colour preferences (after Lusher), anxiety (after Taylor) and the number of nerve rings of the iris. In young men, the second term of IVHC, i.e. months 4 to 6 of their birthday, was the best for health and the fourth term was the worst. In the last term (months 10 to 12), the mean IHI was 30% lower than that in the second term; elevated blood pressure was found in 30.3% of the students, WC and salivary IgA showed the lowest values and SI and BA did the highest ones. In the girls, these changes were less pronounced and the first term was the best. The association of these individual yearly health variations with birth stress described by H. Lagercrantz and T. Slotkin (1986) is discussed.     

Age-related changes in the haematology of young koalas (Phascolarctos cinereus) up to one year old

Haematology and biochemistry of captive pouch young and back young koalas from 165 days to one year old were studied. Distinct changes with age were observed. Packed cell volume, haemoglobin, erythrocyte count, MCV and total plasma protein where lowest in the youngest animals less than 180 days old. Reticulocytes were highest in this age group. Haematological values differed from those of adult animals. Lymphocytosis occurred, especially between 210–330 days of age. Intense erythropoiesis was indicated by reticulocytosis and the presence of erythrocyte granular inclusions, anisocytosis and poikilocytosis on blood films, particularly up to 330 days of age. Microcytosis present on blood films throughout the study period could not be explained by iron deficiency.     

The Danish PET/depression project: PET findings in patients with major depression.

BACKGROUND: It is hypothesized from previous positron emission tomography (PET) studies of patients with major depression that dysfunction of regions of the limbic system and the frontal lobes in close connection with the basal ganglia is involved in the pathophysiology of major depression. METHODS: By means of PET and 15O labelled radioactive water we determined an index of the neuronal activity by mapping the cerebral blood flow distribution of 42 unselected in-patients suffering from moderate to severe depression and 47 healthy controls controlling for age and gender. The PET maps were co-registered to magnetic resonance images of the anatomy of the brain. RESULTS: The functions-of-interest analysis revealed significant gender differences in cerebral blood flow and changes in the relative distribution of the blood with increasing age. The patients had increased activity of the hippocampus and the cerebellum compared to the healthy controls when corrected for these confounders and the influence of antidepressant medication. Furthermore, data in the Danish Psychiatric Central Register showed that the patients studied were representative of the population of depressed patients admitted to the hospital during the study period. CONCLUSION: Our main finding is increased blood flow to the hippocampus, even when controlling for a number of confounders. This is in accordance with a rapidly expanding literature suggesting an important role for this structure in major depression.     

Clinical and psychosocial factors associated with the outcome of unipolar major depression: a one year prospective study

BACKGROUND: The role of psychosocial and clinical variables in the prediction of major depression is controversial. In a previous paper, we obtained a one-year predictive multivariate model of non-remission for major depression, based on the presence of a personality disorder, a low self-esteem and a low satisfaction with social support. OBJECTIVES: To evaluate more in depth both personality disorders and psychosocial variables as predictors of outcome. METHODS: A prospective study on 57 consecutive outpatients with major depressive episodes were followed-up monthly during one year. Clinical and psychosocial variables were registered, including personality (DSM-IV criteria and IPDE structured interview), previous quality of life, self-esteem, social support and dyadic adjustment. Remission was defined as a HDS score less than 8. Univariate and multivariate (logistic regression) analyses were applied. RESULTS: 68% of the patients reached remission at 12 months. Personality disorder (diagnosed clinically but not according to IPDE), and previous quality of life were the variables more consistently associated to remission at 12 months. Among follow-up variables, remission at 3 months was strongly associated with remission. CONCLUSIONS: Our findings confirm the importance of the clinical diagnosis of personality disorder in the major depression outcome. However, more studies are needed to clarify the divergence between clinical and structured interview guided diagnosis. With the exception of quality of life, psychosocial variables had a weak and non consistent relationship with outcome.     

Age-related changes in the haematology of young koalas (Phascolarctos cinereus) up to one year old

Haematology and biochemistry of captive pouch young and back young koalas from 165 days to one year old were studied. Distinct changes with age were observed. Packed cell volume, haemoglobin, erythrocyte count, MCV and total plasma protein where lowest in the youngest animals less than 180 days old. Reticulocytes were highest in this age group. Haematological values differed from those of adult animals. Lymphocytosis occurred, especially between 210–330 days of age. Intense erythropoiesis was indicated by reticulocytosis and the presence of erythrocyte granular inclusions, anisocytosis and poikilocytosis on blood films, particularly up to 330 days of age. Microcytosis present on blood films throughout the study period could not be explained by iron deficiency.     

Decreased levels of circulating IL-21 in HIV-infected AIDS patients: correlation with CD4+ T-cell counts

IL-21 is a relatively newly discovered multifunctional and pleiotropic cytokine. It is produced primarily by CD4(+) T cells, the principal targets of the virus, and therefore this cytokine has special relevance to HIV infection. Here we show for the first time that serum levels of this cytokine are significantly reduced in HIV-infected AIDS patients and correlate significantly with their CD4(+) T-cell counts. These data suggest that the cytokine levels could act as a valuable biomarker for the progression of AIDS.     

Immunologic tools to decipher efficacy of BCG immunotherapy in advanced breast cancer: a one year follow up study

We report the clinical outcome of conventional therapy and BCG immunisation therapy for 40 patients with advanced breast carcinoma. The clinical outcome was better for the 20 patients receiving BCG immunisation therapy. All patients were assessed for cell mediated immunologic competence before starting treatment and after completion of treatment. Thereafter they were followed for one year. Those patients who showed good local response to BCG vaccination before starting therapy had better prognosis, and those for whom anergy to PPD and DNCB could be reversed by BCG immunotherapy showed clinical improvement. Another interesting finding was that IgA was the predominating immunoglobulin located in normal breast tissue and benign breast tumours while IgG was deposited in most of the malignant breast tumour. This indicated that malignant tumours of the breast jeopardise the secretory immune system of the mammary gland.     

Prevention of depression in subclinically depressed adults: follow-up effects on the 'Coping with Depression' course

BACKGROUND: People with subclinical depressive symptoms are at increased risk of depressive disorder, little is known on the prevention of depressive disorder in this population. This study evaluates the long-term preventive effects of an effective depression treatment, the Coping with Depression (CWD) course. This paper describes the effect of the CWD course on the incidence of depressive episodes and depressive symptoms, and explores whether the initial level of symptoms and gender has differential intervention effects. METHODS: Participants (N=104) were adults with subclinical depressive symptoms, who were randomly assigned to either a preventive group course condition, the 'Coping with Depression' course, or to an assessment-and-advice-only control group condition. Follow-up results were measured 6 and 12 months after completion of the course. RESULTS: The CWD course showed to be effective in preventing depressive symptomatology but there was no evidence that the course prevented depressive disorder. 25% of the control group and 27.3% of the course group developed a depressive disorder within a year. Initial depressive symptomatology moderated the outcomes: only participants with low initial symptomatology appeared to benefit in the long term from course participation. CONCLUSIONS: The CWD course is effective as a treatment for subclinical depression. Preventive effects are restricted to participants with initially low depression levels. Therefore, this subgroup should be targeted in future depression-prevention practices and in future prevention studies.     

Predictors of response to antidepressants in women with postpartum depression: a systematic review

Archives of Women's Mental Health - Antidepressants are the mainstay of drug treatment for moderate or severe postpartum depression. Knowledge of predictors of response could help optimize...     

Improved physical function and physical activity in older adults following a community-based intervention: Relationships with a history of depression

The purpose of this study was to explore the relationship of a history of depression with moderate physical activity and physical function before and after a physical activity intervention of congregate meal participants in senior centers from all 12 Georgia Area Agencies on Aging (AAA). Participants were a convenience sample of older adults (n=376, mean age=76 years, 82% female, 64% Caucasian, 36% African American, 22% a history of depression). The physical activity intervention included educator-led chair exercises that incorporated balls and bands. Pre- and post-tests assessed moderate physical activity and physical function. At the pre-test, a history of depression was not related to moderate physical activity or physical function. Following the intervention there were significant increases in both moderate physical activity and physical function, but a history of depression was a negative predictor of improvements in physical activity when controlled for site, demographics, and health-related conditions. These results provide an evidence base for the effectiveness of this intervention in improving moderate physical activity and physical function in a community setting, but additional efforts may be needed to improve the impact of this type of intervention among older adults with a history of depression.     

Decreased resistance to Listeria monocytogenes in mice following vanadate exposure: effects upon the function of macrophages

We have previously demonstrated that ammonium metavanadate has a broad immunomodulating effect in mice after subchronic exposure. Because host resistance to pathogenic Listeria monocytogenes and in vitro phagocytic activity of harvested peritoneal macrophages (PEM) were strongly affected by vanadate treatment, we investigated the effect of vanadate on the functional role of resident PEM in active listeriosis in the mouse. Vanadium treatment results in altered patterns of clearance of the organism from the peritoneal cavity, liver and spleen. The total in vitro phagocytic uptake of Listeria by PEM was consistently decreased as a function of infection period. Similarly, intracellular killing of Listeria was decreased although the PEM from the vanadate-treated and control mice were more bacteriostatic than bactericidal. Population distributions of Listeria within infected PEM were not affected by host pretreatment with vanadate. Vanadate exposure interferes with both the uptake and ultimate intraphagolysosomal killing of Listeria. These results were expected in light of our previous studies of the effects of vanadate on PEM superoxide production, and hexose monophosphate shunt and glutathione redox cycle activity. The results provide additional information for the development of a mechanism to explain why workers exposed to vanadium-containing dusts have increased susceptibility to bacterial respiratory diseases.     

Mg2+ administered up to twenty-four hours following reperfusion prevents ischemic damage of the Ca1 neurons in the rat hippocampus

Inductively coupled plasma emission spectrometry analysis was applied to determine ischemia-induced changes of Mg2+ and Ca2+ in vulnerable regions of rat brain. This method can provide an accurate quantification and lower detection limits, as compared to atomic absorption spectrophotometry or several other methods. In the hippocampus, Mg2+ content significantly increases 24 h following 20 min of ischemia, followed by a gradual decrease between 48 and 72 h. Ca2+ accumulation was found at 48 and 72 h. At the cell membrane, Mg2+ plays a role as an endogenous calcium channel blocker of both the receptor-operated and voltage-dependent gates and, in the mitochondria, Mg2+ inhibits Ca2+ uptake processes. We propose that the mobilization of Mg2+ after 24 h reperfusion may counteract the process of ischemia-induced neuronal damage and that decreases of Mg2+ may be correlated with the degree of brain injury. However, in the natural concentration of Mg2+, the counteraction may not be sufficient for a neuroprotective effect. Therefore, after 24 h reperfusion, an artificial enhancement of Mg2+ is necessary for neuroprotection. In order to test the above hypothesis, MgCl2, (50 mM) was administered directly to the CA1 sector of the rat hippocampus before and at various intervals following 20 min of ischemia. Pyramidal cells were evaluated seven days later and neuronal density was determined. Consistent with the hypothesis, a neuroprotective effect was observed, even when MgCl2 was administered 24 h, but not 48 h, after the ischemic episode.     

"Coping with depression": an open study of the efficacy of a group psychoeducational intervention in chronic, treatment-refractory depression

BACKGROUND: Failure to respond to antidepressant medication represents a major clinical problem. Few therapeutic interventions have been shown to benefit such individuals. METHOD: Patients attended a 12-session psychoeducational programme over a period of 10 weeks, with follow-up at 26 weeks. The main outcome measures were the self-report Beck Depression Inventory (BDI-II), the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI) and the EuroQol 5D. RESULTS: Baseline assessments confirmed substantial chronicity and treatment resistance, high symptom burden and poor quality of life in the study cohort. Twenty-six week follow-up data were obtained from 34% of cohort. Completion of the course was associated with clinically significant changes in symptom burden. Sustained remission was achieved by 35% of completers. LIMITATIONS: We did not characterise the cohort using structured clinical interview and did not collect structured, objective ratings of mental health status. There was no control group. There was a high attrition rate and caution must be exercised in interpreting results. CONCLUSIONS: For a proportion of patients with chronic depressive episodes that have not responded to antidepressant treatments, the "Coping with Depression" psychoeducational group may confer sustained and meaningful benefit. Controlled studies are warranted.     

The experience of HIV/AIDS among rural women in the Northwestern United States: A qualitative analysis

The unique experience of HIV/AIDS among rural women in the United States was explored using qualitative interviews with 7 women who are HIV positive. Based on these interviews, eight themes emerged. These included (a) daily powerful emotions, (b) emotional and physical abandonment, (c) romantic betrayal, (d) medical treatment issues, (e) loss and grief, (f) appreciating a good support system, (g) renewed purpose for living, and (h) personal growth and transformation. Results are discussed with regard to future research and practice with rural women with HIV/AIDS, with an emphasis on the importance of social support and counseling opportunities in facilitating women's progress through the emotional process associated with HIV/AIDS diagnosis and treatment. © 2007 Wiley Periodicals, Inc.     

Analysis of the scalp of women with AIDS subjected to autopsy: epithelial,follicular, and immunologic aspects

Hair keeps the scalp warmer and slightly moister than the rest of the skin, which contributes to a favorable environment for mycotic, bacterial, and parasitic infections. It is well established that AIDS makes the patient more susceptible to opportunistic infections and cutaneous manifestations. Because of this, the aim of this study was to analyze scalp fragments of autopsied women with AIDS. Twenty-eight scalp samples of women aged between 18 and 46 years were observed. These women were divided into 2 groups: with AIDS (n = 14) and without AIDS (n = 14). We conducted histochemical (hematoxylin-eosin, Picrosirius, and Verhoeff), morphometric (Image J; National Institutes of Health, Hamilton, ON, Canada and KS-300 Kontron-Zeiss; Kontron Elektronik, Carl-Zeiss, Germany), and immunohistochemical (S-100) analyses of the scalp. In patients with AIDS, epithelial thickness, number of epithelial cell layers, number of immature Langerhans cells in the epidermis, and percentages of elastic fibers in the dermis were significantly lower, whereas telogen hair follicles were significantly higher. The percentage of collagen fibers in the dermis and the diameter of the epithelial cells were smaller in patients with AIDS, without significant difference. AIDS possibly causes immunologic and morphologic alterations in the scalp. This study may establish parameters for better clinical and morphologic diagnostic in patients with AIDS.