Target symptoms for fluvoxamine in old age depression

INTRODUCTION: Old age depression is difficult to treat. It is presumed that the underlying biochemical mechanism differs from that of depression of younger age. Clinical manifestations also differ, as elderly people manifest more irritability, anxiety, conduct and cognitive disorders than pessimism or guilt. Response to treatment is believed to be poorer than in younger patients. METHOD: Fifty patients, with a mean age of 66.65, suffering from major depression or dysthymia according to DSM-IV criteria, took part in the study. Their mean HDRS score was 16.77. They were prescribed 100 mg of fluvoxamine daily. Half of them returned 3 months later for reassessment by GDS, HDRS, MMSE, CAMCOG and FRSSD. RESULTS: Mean changes in scores were: GDS, -3.14 +/- 10.86; MMSE, -0.96 +/- 3.34; CAMCOG, +1.59 +/- 8.95; and FRSSD -3 +/- 4.96; statistically significant differences were found for GDS and FRSSD scores. All patients manifested residual symptoms. CONCLUSION: Fluvoxamine improved elderly patients suffering from geriatric depression, particularly in respect of depressive thought content (GDS) and impairment in everyday activities (FRSSD). When cognitive impairment due to depression was present, response to treatment was greater. Severely depressed patients showed a greater response to treatment, but also more severe residual symptoms. (Int J Psych Clin Pract 2000; 4:127-134) 3.17 +/- 4.06; HDRS,     

Comparing the Personality Traits of Patients with an Eating Disorder versus a Dual Diagnosis

Abstract

Objectives: This cross-sectional study explored personality traits of individuals receiving treatment in a private clinic for an eating disorder (ED) compared to those receiving treatment for a dual diagnosis (DD; defined as an addiction to illegal drugs and/or alcohol along with a mental illness, in this case an ED). The aims of this study were to: (a) assess the personality profiles and differentiating traits between the ED and DD groups, (b) analyze differences in personality traits of restrictive ED versus bingeing ED profiles, and lastly (c) compare the individuals Temperament and Character Inventory-Revised (TCI-R) results to their personality clusters as per the Diagnostic and Statistical Manual of Mental Disorders – 5^th edition (DSM-5). Methods: The TCI-R is a self-report questionnaire consisting of seven scales, each with their own subscales, which provide a fuller understanding of each temperament and character trait evaluated. This questionnaire was given to patients (n?=?67) receiving treatment at a private institute specialized in eating disorders in Barcelona, Spain and the surrounding areas, along with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-II (BDI-II), and the Barratt Impulsiveness Scale-11 (BIS-11). These subsequent questionnaires were given as they are often found to be comorbidities of ED. Results: The ED group (n?=?41), regarding the TCI-R scales, showed higher scores in harm avoidance (HA), reward dependence (RD), persistence (P), cooperativeness (C) and self-directedness (SD). Whereas, the DD (n?=?26) group, showed higher scores in novelty seeking (NS) and self-transcendence (ST). Also, there was a significant positive correlation between the DD group and the extravagance (NS3) subscale of novelty seeking across models. When comparing the two ED groups, the restrictive profile (RP) to the bingeing profile (BP), there were significant negative correlations in the TCI-R subscales of dependence (RD4) and perfectionism (P4) whereas there were positive correlations in the TCI-R subscale of responsibility (SD1). Conclusions: These results support previous studies and help to appraise differences in personality traits between specific groups in a clinical setting.     

A validated HPLC method for the simultaneous determination of naftidrofuryl oxalate and its degradation product (metabolite), naftidrofuryl acid: applications to pharmaceutical tablets and biological samples

A simple, sensitive, and selective reverse phase‐high performance liquid chromatography (RP‐HPLC) method was developed and validated for the simultaneous determination of naftidrofuryl oxalate (NF) and its hydrolytic degradation product (metabolite), naftidrofuryl acid (NFA). Chromatographic separation was achieved on Spheri‐5 RP‐C8 (5 µm) (220 × 4.6 mm i.d.) column using a mobile phase composed of acetonitrile, 0.05 M sodium acetate and triethylamine (40 : 60 : 0.1, by volume) adjusted to pH 5.5 using glacial acetic acid. The mobile phase was pumped at flow rate 1.5 ml/min. The UV detector was set at 225 nm and quantification of the analytes was based on measuring the peak areas. The method was proved to be accurate and precise with linearity ranges of 0.1–25 and 0.2–25 µg ml^‐1 for NF and NFA, respectively. The limits of detection were 0.03 and 0.04 µg ml^‐1 for NF and NFA, respectively. The method was applied to serve three goals: (1) stability‐indicating assay of the parent drug NF in its pharmaceutical formulation, (2) determination of the degradation product NFA down to a level of 0.005% in the presence of large excess of the parent drug, and (3) drug monitoring of naftidrofuryl and its metabolite, naftidrofuryl acid, in human plasma/urine samples taken from a healthy volunteer treated with 200 mg oral dose of naftidrofuryl oxalate. The proposed method proved to be accurate, precise, and reliable in all these application fields. Copyright © 2012 John Wiley & Sons, Ltd.     

An efficient method for gene knock‐down by RNA interference in human skin mast cells

Mast cells (MCs) from human skin have been notoriously resistant to gene manipulation, and a method to knock‐down gene expression in in situ differentiated MCs is highly desired. The Dharmacon Accell^® transfection system proved successful on several “difficult‐to‐transfect” cells. In the present work, we therefore tested this method on skin‐derived MCs using different siRNA entities. The siRNA was readily taken up, followed by pronounced, specific reduction of gene and protein expression. Hence, we present the first efficient technique for the manipulation of gene expression in primary skin MCs ex vivo, which combines high transfection rates with retained cell viability.     

Increased serum sFas,sTRAIL, and reduced sFasL in juvenile-onset systemic lupus erythematosus

Clinical Rheumatology - The aims of this study were to assess serum Fas, FasL, TRAIL, and Bcl-2 levels in patients with juvenile-onset systemic lupus erythematosus (JSLE) and to evaluate their...     

Influence of breast cancer opportunistic screening on aesthetic surgical outcome: A single‐center retrospective study in Switzerland

The aim of this retrospective study is to compare the surgical aesthetic outcome and breast cancer (BC) characteristics in patients with BC detected either by opportunistic screening or clinical diagnosis. 262 women undergoing surgery for BC between 2009 and 2012 were included. The following features were compared in the two groups of patients: (1) age at diagnosis; (2) family history of BC; (3) histology type; (4) tumor diameter; (5) local staging, and (6) type of surgical treatment. In 92/262 (35.1%) cases BC was detected by screening and 170/262 (64.9%) had clinical diagnosis. A positive family history and ductal carcinoma in situ diagnosis were more frequent in patients with clinical diagnosis (P = .001 and P < .0001 respectively). Mean maximum diameter of invasive cancers was significantly greater in symptomatic patients (P < .001). Breast conserving surgery was performed in 76/92 (82.6%) patients with screening and 115/170 (67.6%) with clinical diagnosis. Mastectomy was performed in 16/92 (17.4%) patients with screening and 55/170 (32.3%) with clinical diagnosis. Mastectomy was more frequent in patients with clinical diagnosis of BC (P = .010). No significant group differences were found regarding the other features. This study demonstrated that in opportunistic screening, breast conserving surgery may be applied in a higher number of cases compared to patients presenting with clinical diagnosis, thereby improving life quality of these patients.     

A commentary on methodological issues in stroke caregiver research: lessons learned from three RESCUE intervention studies

Stroke caregivers represent a distinct population and require unique considerations when conducting intervention research. Unfortunately, there are few published recommendations for conducting intervention trials with stroke caregivers. Thus, the goal of this paper is to provide foundational guidance for stroke caregiving researchers. We describe lessons learned from three trials of the RESCUE intervention to illustrate methodological issues in stroke caregiver research. We identify challenges encountered while conducting a clinical demonstration project, pilot study, and multi-site randomized controlled trial of a problem-solving and skills-building stroke caregiver intervention. We use our research experiences to exemplify or enhance understanding of each issue and describe the strategies we employed to overcome these obstacles. We present issues related to and recommendations for study design, theoretical frameworks, eligibility criteria, recruitment and retention, human subjects protection, intervention design, treatment fidelity, outcome measures, and qualitative methods. Identifying approaches to circumvent methodological challenges can help advance research on and implementation of stroke caregiver programs.     

Variation in Inflammatory Response during Pneumococcal Infection Is Influenced by Host-Pathogen Interactions but Associated with Animal Survival

Inflammation is a crucial part of innate immune responses but, if imbalanced, can lead to serious clinical conditions or even death. Cytokines regulate inflammation, and studies report their impact on clinical outcome. However, host and pathogen genetic backgrounds influence cytokine production, making it difficult to evaluate which inflammatory profiles (if any) relate to improved prognosis. Streptococcus pneumoniae is a common human pathogen associated with asymptomatic nasopharyngeal carriage. Infrequently, it can lead to a wide range of diseases with high morbidity and mortality rates. Studies show that both pneumococcal serotype and host genetic background affect the development of disease and contribute to variation in inflammatory responses. In this study, we investigated the impact of the host and pneumococcal genetic backgrounds on pulmonary cytokine responses and their relationship to animal survival. Two inbred mouse strains, BALB/c and CBA/Ca, were infected with 10 pneumococcal strains, and the concentrations of six pulmonary cytokines were measured at 6 h and 24 h postinfection. Collected data were analyzed by principal-component analysis to identify whether there is any pattern in the observed cytokine variation. Our results show that host-pneumococcus combination was at the core of observed variation in cytokine responses, yet the resulting cytokine profile discriminated only between survivors and fatalities but not mouse or pneumococcal strains used during infection. Therefore, our results indicate that although alternative inflammatory profiles are generated during pneumococcal infection, a common pattern emerged, which determined the clinical outcome of pneumococcal infections.     

Stem Cells, Including a Population of Very Small Embryonic-Like Stem Cells, are Mobilized Into Peripheral Blood in Patients After Skin Burn Injury

Background  

Developmentally early cells, including hematopoietic stem progenitor cells (HSPCs), as well as very small embryonic-like stem cells (VSELs), are mobilized into peripheral blood (PB) in response to tissue and organ injury (e.g., heart infarct or stroke).