The relationship between independent and dependent life events and depression symptoms in Sri Lanka: a twin and singleton study

Social Psychiatry and Psychiatric Epidemiology - Life events have been associated with a variety of mental health conditions including depression. There is a scarcity of research in South Asia...     

Effects of threat context and cardiac sensitivity on fear responding to a 35% CO2 challenge: A test of the context-sensitivity panic vulnerability model

The present study tested several predictions of a context-sensitivity panic vulnerability model emphasizing the interaction between threat context and threat sensitivities. Participants without a history of panic (N = 47) completed both global and domain-specific panic relevant sensitivity measures and were then randomized to undergo a 35% CO₂ inhalation challenge in the presence or absence of a cardiac defibrillator (threat context). As predicted by the model, cardiac sensitivity (but not trait anxiety or anxiety sensitivity) potentiated the effects of the presence of the defibrillator on CO₂ fear responding. Moreover, as predicted by the model, the observed potentiation effects of cardiac sensitivity on CO₂ fear responding were mediated by participants’ threat appraisals connected to the presence of the defibrillator. Theoretical and clinical implications are discussed.     

Effects of Mg2+, pH and PCr on cardiac excitation-metabolic coupling.

A tight coupling between ionic currents, intracellular Ca2+ homeostasis, cytosolic [ADP] and deltaG of ATP hydrolysis underlies the regulation of cardiac cell function. As more experimental detail on the biochemistry and biophysics of these complex processes and their interactions accumulates, the intuitive interpretation of the new findings becomes increasingly impractical. For this reason we developed detailed biophysical model that couples Ca2+ signaling, cell electrophysiology and bioenergetics with the main interactions between phosphorylated species (ATP, ADP, AMP, PCr, Cr, P(i)) and Lewis cytosolic acids (Na+, K+, Mg2+, H+). The results indicate that the increase in free cytosolic Mg2+ (0.2-5 mM) systematically shortens the action potential duration. The analysis suggests that that under physiological conditions a pH decrease accompanied by a free Mg2+ increase tends to counteract an [ADP] increase due to PCr depletion. The model reproduces qualitatively a sequence of events that correlates well with the experimental data.     

Early definition of treatment outcomes after reperfusion therapy for myocardial infarction

AIMS: Early definition of treatment outcomes, including coronary patency and infarct size, after reperfusion therapy for myocardial infarction (MI) is desirable to identify patients requiring further intervention. METHODS AND RESULTS: Patients receiving reperfusion therapy for a first MI had continuous 12-lead ST segment monitoring to document reperfusion and ischaemia time. Infarct size was measured by 12-lead QRS score and radionuclide scintigraphy ((201)Tl single-photon emission computed tomography, SPECT) at 1 week, and left ventricular function by echocardiography at 1 week and 1 month. Resolution of ST elevation accurately detected TIMI 2 or 3 reperfusion (predictive accuracy 93%) in 55 patients undergoing immediate angioplasty, but ST recovery was delayed (17+/-14min) after angiographic reperfusion. A multivariate model, including risk region and ischaemia time, accurately predicted MI size (R(2)=0.80, P<0.00001) in these patients. The same model, prospectively applied on Day 1 to 154 patients receiving thrombolytic therapy, accurately predicted MI size, measured by QRS score (R(2)=0.88, P<0.0000001) and (201)Tl SPECT (R(2)=0.75, P<0.000001) at 1 week for individual patients. Regional myocardial wall motion at 1 month was directly correlated with MI size predicted by the model on Day 1 (r=0.73, P<0.0001). CONCLUSIONS: Use of ST segment monitoring during reperfusion therapy facilitates early prediction of treatment outcomes, including coronary reperfusion, infarct size and ventricular function.     

Inhibition of the T790M gatekeeper mutant of the epidermal growth factor receptor by EXEL-7647.

PURPOSE: Agents inhibiting the epidermal growth factor receptor (EGFR) have shown clinical benefit in a subset of non-small cell lung cancer patients expressing amplified or mutationally activated EGFR. However, responsive patients can relapse as a result of selection for EGFR gene mutations that confer resistance to ATP competitive EGFR inhibitors, such as erlotinib and gefitinib. We describe here the activity of EXEL-7647 (XL647), a novel spectrum-selective kinase inhibitor with potent activity against the EGF and vascular endothelial growth factor receptor tyrosine kinase families, against both wild-type (WT) and mutant EGFR in vitro and in vivo. EXPERIMENTAL DESIGN: The activity of EGFR inhibitors against WT and mutant EGFRs and their effect on downstream signal transduction was examined in cellular assays and in vivo using A431 and MDA-MB-231 (WT EGFR) and H1975 (L858R and T790M mutant EGFR) xenograft tumors. RESULTS: EXEL-7647 shows potent and long-lived inhibition of the WT EGFR in vivo. In addition, EXEL-7647 inhibits cellular proliferation and EGFR pathway activation in the erlotinib-resistant H1975 cell line that harbors a double mutation (L858R and T790M) in the EGFR gene. In vivo efficacy studies show that EXEL-7647 substantially inhibited the growth of H1975 xenograft tumors and reduced both tumor EGFR signaling and tumor vessel density. Additionally, EXEL-7647, in contrast to erlotinib, substantially inhibited the growth and vascularization of MDA-MB-231 xenografts, a model which is more reliant on signaling through vascular endothelial growth factor receptors. CONCLUSIONS: These studies provide a preclinical basis for clinical trials of XL647 in solid tumors and in patients bearing tumors that are resistant to existing EGFR-targeted therapies.     

Role of Fc in Antibody-Mediated Protection from Ricin Toxin

We have studied the role of the antibody (Ab) Fc region in mediating protection from ricin toxicity. We compared the in vitro and in vivo effects of intact Ig and of Fab fragments derived from two different neutralizing Ab preparations, one monoclonal, the other polyclonal. Consistent results were obtained from each, showing little difference between Ig and Fab in terms of antigen binding and in vitro neutralization, but with relatively large differences in protection of animals. We also studied whether importing Ab into the cell by Fc receptors enhanced the intracellular neutralization of ricin toxin. We found that the imported Ab was found in the ER and Golgi, a compartment traversed by ricin, as it traffics through the cell, but intracellular Ab did not contribute to the neutralization of ricin. These results indicate that the Fc region of antibody is important for in vivo protection, although the mechanism of enhanced protection by intact Ig does not appear to operate at the single cell level. When using xenogeneic antibodies, the diminished immunogenicity of Fab/F(ab’)₂ preparations should be balanced against possible loss of protective efficacy.