Anxiety and depression after coronary artery bypass graft surgery: most get better, some get worse

BACKGROUND: To target interventions, patients at risk for poor outcomes after a cardiac event need to be identified. We investigated trajectories of anxiety and depression after coronary artery bypass graft surgery (CABGS) and identified patients at risk of persistent or worsening anxiety and depression. METHODS: A consecutive sample of 184 patients on the waiting list for CABGS at The Royal Melbourne Hospital completed self-report questionnaires before surgery, and at 2 and 6 months postsurgery. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Growth mixture modelling identified trajectories of anxiety and depression. RESULTS: Two possible trajectories emerged for anxiety, whereas three trajectories emerged for depression. Most patients (92%) followed a trajectory of minor presurgical anxiety that remitted in 6 months after CABGS, with the remainder (8%) following a trajectory of major anxiety that remitted in the same period. Minor remitted depression was also common (72% patients). Two less common depression trajectories indicated worsening or unresolved depression. One trajectory began with major presurgical depression that partially remitted by 6 months (14% patients) and the other began with minor presurgical depression that worsened by 6 months (14% patients). Unpartnered patients, smokers, those with presurgical anxiety, high cholesterol, angina, more severe disease or having repeat CABGS were at increased risk for a poor depression trajectory. CONCLUSION: Although initial anxiety and depression resolved or lessened for most patients, some patients experienced persistent or worsening depression after CABGS. Interventions can be targeted toward 'at risk' patients.     

Elevated IgA and IgM anticardiolipin antibodies in acute Kawasaki disease

There is marked activation of the endothelium and immune system in Kawasaki disease. Anticardiolipin antibodies (aCL) can cause activation of the endothelium. We measured aCL levels in acute Kawasaki disease patients and compared them to other febrile patients to see whether their aCL responses were different. Twenty-one patients with acute Kawasaki disease and 16 patients with an acute febrile illness were recruited. The aCL levels were measured in the sera of febrile patients and in Kawasaki disease patients prior to immunoglobulin therapy. There was no significant difference between the IgG aCL levels (p = 0.87) between the Kawasaki disease and febrile patients. However, the IgM (p = 0.01) and IgA (p = 0.03) aCL were significantly higher in patients with acute Kawasaki disease than in febrile children. Elevation of IgA aCL has been reported in association with other vasculitides and IgA-secreting plasma cells have been demonstrated in the vascular tissue in Kawasaki disease.     

Pharmacokinetics and Pharmacodynamics of Clofazimine in a Mouse Model of Tuberculosis

The antileprosy drug clofazimine has shown potential for shortening tuberculosis treatment; however, the current dosing of the drug is not evidence based, and the optimal dosing is unknown. Our objective was to conduct a preclinical evaluation of the pharmacokinetics and pharmacodynamics of clofazimine in the mouse model of tuberculosis, with the goal of providing useful information on dosing for future studies. Pharmacokinetic parameters were evaluated in infected and uninfected BALB/c mice. Pharmacodynamic parameters were evaluated in Mycobacterium tuberculosis-infected mice that were treated for 12 weeks with one of six different clofazimine dosing regimens, i.e., doses of 6.25, 12.5, and 25 mg/kg of body weight/day and 3 regimens with loading doses. Clofazimine progressively accumulated in the lungs, livers, and spleens of the mice, reaching levels of greater than 50 μg/g in all tissues by 4 weeks of administration, while serum drug levels remained low at 1 to 2 μg/ml. Elimination of clofazimine was extremely slow, and the half-life was dependent on the duration of drug administration. Clofazimine exhibited dose-dependent tissue and serum concentrations. At any dose, clofazimine did not have bactericidal activity during the first 2 weeks of administration but subsequently demonstrated potent, dose-independent bactericidal activity. The antituberculosis activity of clofazimine was dependent on neither the dose administered nor the drug concentrations in the tissues, suggesting that much lower doses could be effectively used for tuberculosis treatment.     

Metal phthalocyanine organic thin-film transistors: changes in electrical performance and stability in response to temperature and environment

Metal phthalocyanines (MPcs) are a widely studied class of materials that are frequently used in organic thin-film transistors (OTFTs), organic photovoltaics (OPVs) and organic light emitting diodes (OLEDs). The stability of these devices and the materials used in their fabrication is important to realize their widespread adoption. Seven P-type MPcs: zinc (ZnPc), magnesium (MgPc), aluminum (AlClPc), iron (FePc), cobalt (CoPc), and titanium (TiOPc) were investigated as the semiconductors in OTFTs under varying temperatures (25 °C to 150 °C) and environmental conditions (air and vacuum, P < 0.1 Pa). Devices using the divalent MPcs (except MgPc) showed significant shifts in threshold voltage and field-effect mobility with rising temperature in both air and vacuum. AlClPc and TiOPc, on the other hand, had more stable electrical properties, making them useful for applications requiring consistent performance. Distinct variations in film morphology as determined by atomic force microscopy may explain the different thermal response between the two groups of MPcs, while thermal gravimetric analysis in air and nitrogen (N₂) provides additional insight into their susceptibility to oxidation at elevated temperature. To demonstrate proof-of-concept thermal sensing under realistic operating conditions, current changes were monitored in response to temperature stimuli using two more sensitive divalent MPcs. This comparative study of the effect of central atom inclusion in MPcs, the resulting material stability and thin-film characteristics will facilitate design of future sensors and other OTFT applications.

A series of metal phthalocyanine based organic thin film transistors were evaluated and their responses to changes in temperature and environmental was determined: the choice of central atom makes a difference.