Clinical differences between suicidal and nonsuicidal depressed children and adolescents

OBJECTIVE: To examine the clinical symptoms and comorbid psychiatric disorders of depressed children and adolescents with and without clinically significant suicidal ideation. METHOD: Children and adolescents aged 7 to 17 years with current DSM-III-R major depressive disorder (MDD) (N = 135) were recruited between January 1987 and April 2002. Current MDD symptoms and lifetime comorbid psychiatric disorders were assessed using either a combination of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Epidemiologic and -Present Episode versions or the -Present Lifetime version. Thirty-two percent (N = 43) of the depressed subjects were classified as suicidal (at least suicidal ideation with a plan). RESULTS: Depressed suicidal youth presented with a more severe episode (p = .001) and a poorer functional status (p = .019), were more hopeless (p = .001), and presented more frequently with insomnia (p = .011). There was an interaction between suicide x sex x pubertal status for severity of MDD (p = .013), the presence of hopelessness (p < .001), poor functional status (p = .023), and comorbidity with a lifetime history of any disruptive behavior (p = .019). Among pre-pubertal depressed males, suicidal boys had significantly increased severity of MDD (p = .025) and poorer functional status (p = .044) than non-suicidal boys. Among postpubertal depressed females, suicidal girls were more frequently hopeless (p = .008) and presented an increased severity of MDD (p = .022) and more frequent lifetime history of any disruptive behavior (p = .03) when compared with nonsuicidal girls. CONCLUSION: There appears to be a sex difference for some clinical features, particularly hopelessness, among depressed suicidal children and adolescents. Whether hopelessness is a sex-specific characteristic of depressed suicidal children and adolescents requires further study.     

Increase in inflammatory cytokines in median nerves in a rat model of repetitive motion injury

We examined cytokines in rat median nerves following performance of a high repetition reaching and grasping task at a rate of 8 reaches/min for up to 8 weeks. IL-1alpha, IL-1beta, TNF-alpha, IL-6 and IL-10 were analyzed by immunohistochemistry. Double-labeling immunohistochemistry for ED1, a marker of phagocytic macrophages, was also performed. We found increased immunoexpression of IL-6 by week 3, increases in all 5 cytokines by week 5. This response was transient as all cytokines returned to control levels by 8 weeks of performance of a high repetition negligible force task. Cytokine sources included Schwann cells, fibroblasts and phagocytic macrophages (ED1-immunopositive). These findings suggest that cytokines are involved in the pathophysiology of repetitive motion injuries in peripheral nerves.     

Chemosensitizers in drug transport mechanisms involved in protozoan resistance

The emergence and spread of antiparasitic drug resistance pose a severe and increasing public health threat. Failures in prophylaxis or those in treatment with quinolines, hydroxynaphtoquinones, sesquiterpenic lactones, antifolate drugs, arsenic and antimony containing drugs sulfamides induce reemergence of parasitic-related morbidity and mortality. Resistance is often associated with alteration of drug accumulation into parasites, which results from a reduced uptake of the drug, an increased efflux or, a combination of the two processes. Resistance to quinolines, artemisinin derivatives and arsenicals and expression of an active efflux mechanism are more or less correlated in protozoa like Plasmodium spp., Leishmania spp., and Trypanosoma spp. Various parasite candidate genes have been proposed to be involved in drug resistance, each concerned in membrane transport. Genes encoding membrane glycoproteins, orthologue to the P-glycoproteins identified in MDR human cancer cells, have been described in these resistant pathogens in addition to various membrane proteins involved in drug transport. Several compounds have demonstrated, in the past decade, promising capability to reverse the drug resistance in parasite isolates in vitro, in animal models and for human malaria. These drugs belong to different pharmacological classes such as calcium channel blockers, tricyclic antidepressants, antipsychotic calmodulin antagonists, histamine H1-receptor antagonists, analgesic antipyretic drugs, non-steroidal anti-inflammatory drugs, and to different chemical classes such as synthetic surfactants, alkaloids from plants used in traditional medicine, pyrrolidinoaminoalkanes and derivatives, and anthracene derivatives. Here, are summarized the molecular bases of antiparasitic resistance emphasizing recent developments with compounds acting on trans-membrane proteins involved in drug efflux or uptake.     

Randomised study of tegafur and oral leucovorin versus intravenous 5-fluorouracil and leucovorin in patients with advanced colorectal cancer

This randomised, open-label trial compared oral tegafur (FT)/leucovorin (LV) with the intravenous bolus 5-fluorouracil (5-FU)/LV as first-line chemotherapy for advanced colorectal cancer (CRC). Patients were randomised to receive oral FT 750 mg/m2/day for 21 days and LV 15 mg/m2 every 8 h in cycles repeated every 28 days (n=114), or intravenous LV 20 mg/m2 followed by 5-FU 425 mg/m2 daily for 5 days every 4 weeks for 2 cycles, and later every 5 weeks (n=123). Response rate was significantly higher in the FT/LV arm (27%, 95% CI 19-35) than in the 5-FU/LV arm (13%, 95% CI 7-19) (p<0.004). The median time to progression was 5.9 months (95% CI, 5.3-6.5; FT/LV arm) and 6.2 months (95% CI, 5.4-6.9; 5-FU/LV arm). Median overall survival was 12.4 months (95% CI, 10.3-14.5 months; FT/LV arm) and 12.2 months (95% CI, 8.9-15.7 months; 5-FU/LV arm) (p=n.s.; hazard ratio FT/LV:5-FU/LV=1.02). 5-FU/LV showed a higher incidence of grade 3/4 neutropenia (4.1 vs. 0%). Non-hematological toxicities showed similar incidences in the two treatment arms. Oral FT/LV was more active than IV 5-FU/LV in terms of objective response rate with similar overall survival, and with a favorable toxicity profile. This makes FT/LV a valid alternative to the IV 5-FU schedule in CRC patients.     

Synthesis and schistosomicidal activity of new substituted thioxo-imidazolidine compounds

Synthesis and physico-chemical properties of 3-benzyl-5-(4-fluoro-benzylidene)-1-methyl-2-thioxo-imidazolidin-4-ones, 5-benzylidene-3-(4-nitro-benzyl)-2-thioxo-imidazolidin-4-ones and 4-acridin-9-ylmethylene-1-benzyl-5-thioxo-imidazolidin-2-ones compounds are described. These thioxo-imidazolidine derivatives were prepared by alkylation and condensation with 4-fluoro-benzaldehyde or nucleophilic Michael addition with cyanoacrylates. The schistosomicidal activity of 3-benzyl-5-(4-fluoro-benzylidene)-1-methyl-2-thioxo-imidazolidin-4-one compounds was evaluated.     

Hematologic response to four weeks of intermittent hypobaric hypoxia in highly trained athletes

We investigated changes induced by four weeks of intermittent hypobaric hypoxia (IHH) at a simulated altitude of 4000-5500 m in highly trained athletes. Serum erythropoietin increased significantly (p<0.001) after the sessions of IHH, but reticulocyte and red cell parameters did not. Our IHH protocol stimulated endogenous erythropoietin secretion without producing the subsequent erythropoietic response.     

Comparison of two physical activity questionnaires in obese subjects: the NUGENOB study

PURPOSE: Simple instruments are needed to assess habitual physical activity (PA) in obese subjects. In a multicenter European obesity project, we tested whether PA assessments by two questionnaires were correlated and similarly associated to selected obesity-related variables. METHODS: A total of 757 obese subjects (75% female; age 37.1 [7.9] yr, BMI 35.5 [4.9] kg.m(-2), mean [SD]) completed the Baecke questionnaire (assessing work, sport, and nonsport leisure activity) and the short last 7-d version of the International Physical Activity Questionnaire (IPAQ; assessing vigorous, moderate-intensity, walking activity, and sitting). We assessed percent body fat (bioimpedance), waist circumference, and fasting plasma concentrations of glucose, insulin, leptin, and FFA. Insulin sensitivity was assessed by the HOMA index for insulin resistance (HOMAIR). RESULTS: Using the IPAQ, only about one third of men and women were classified as insufficiently active. Total habitual PA assessments by the Baecke and IPAQ were significantly related (Spearman rho = 0.51 in total sample, P < or = 0.0001, with adjustment for age, gender, and center). Using principal component analysis, we built two uncorrelated indices corresponding to general obesity (determined by high body fat and leptin) and abdominal obesity (determined by high waist circumference and HOMAIR). PA scores from both questionnaires were negatively related to general and abdominal obesity indices, except for abdominal obesity with the IPAQ in men. CONCLUSIONS: Total PA assessments by the two questionnaires were found to correlate significantly, and the general pattern of associations of PA with general obesity was similar for the two questionnaires. However, the IPAQ may capture less of the relationships between PA and abdominal obesity than the Baecke, especially in men. Reporting of habitual PA in obese subjects with the IPAQ warrants further evaluation against objective assessment methods.     

Epidemic asthma in Barcelona: an evaluation of new strategies for the control of soybean dust emission

BACKGROUND: Asthma attacks and mortality due to inhalation of soybean antigens in Barcelona have been well documented. Strict protective measures in the unloading process were established in 1998 to avoid the release of soybean dust into the atmosphere. The present study was undertaken to assess the effectiveness of these latest environmental measures, and, if effective, to recommend their implementation in the many harbours where soybean is unloaded. METHODS: Levels of soybean aeroallergen were analysed daily during a period of 5 years and 2 months in a total of 1,854 samples, 125 from the pre-intervention period and 1,729 from the postintervention period. Additionally, the number of asthma admissions to the emergency rooms of the city's three largest hospitals was recorded. Asthma patients attended at home by the public home emergency service and judicial autopsies registering asthma deaths were also investigated. RESULTS: The mean concentration of soybean aeroallergen was 159 U/m(3) in the pre-intervention period and 39 U/m(3) in the postintervention period (p < 0.0001). Significant differences in postintervention aeroallergen concentrations were found between days of soybean unloading (42 U/m(3)) and days of no unloading (33 U/m(3)), with p < 0.0001. No significant relationship was found between concentrations of environmental soybean aeroallergens and the number of emergency room admissions for asthma. CONCLUSIONS: Implementation of stricter protective measures in silos for the soybean unloading process has reduced the concentration of soybean dust in the atmosphere and evidences the effectiveness of the measures adopted.