Factors Influencing Report of Common Mental Health Problems Among Psychologically Distressed Adults

This study investigates the sociodemographic factors associated with self-report of common mental problems by the psychologically distressed in order to gain insight into the profile of the population subgroups least likely to receive mental health support whenever needed. Data from the 2006–2008 french National Survey on Health, Health Care and Insurance, were used, measuring psychological distress based on the Mental Health Inventory MHI-5. The patterns associated with education, employment situation and living arrangement were investigated in a sample of 11,543 subjects aged 30–54 years. Men with lower educational level were found to be doubly disadvantaged, as they were more subjected to distress than those with higher educational level and at the same time less likely to report common mental problems whenever distressed. While in both genders subjects not living with a spouse and non-employed subjects were also more subjected to distress, they were more likely than the others to report common mental problems in presence of distress. The findings were discussed in terms of living conditions, stigma, mental health literacy and help-seeking behaviour. Mental health promotion programmes should aim at educating the public, and particularly men and the lower educated public, on the signs of distress and their significance.     

In vivo differential susceptibility of sensory neurons to rabies virus infection

There is controversy with regard to the entry pathway of the rabies virus (RABV) into the central nervous system (CNS). Some authors have suggested that the virus inoculated at the periphery is captured and transported to CNS only by motor neurons; however, it has been reported that dorsal root ganglia (DRG) sensory neurons capture and transport the virus to the spinal cord (SC) and then to the brain. It is probable that preferences for one pathway or another depend on the site of inoculation and the post-infection time. Therefore, in the present study, we evaluated different vertebral segments and post-infection times, along with the location, number, and subpopulation of sensory neurons susceptible to infection after inoculating RABV in the footpads of adult mice. It was noted that the virus inoculated in the footpad preferentially entered the CNS through the large-sized DRG sensory neurons, while infection of the motor neurons occurred later. Further, it was found that the virus was dispersed in spinal cord trans-synaptically through the interneurons, arriving at both sensory neurons and contralateral motor neurons. In conclusion, we observed that RABV inoculated in the plantar footpad is captured preferentially by large sensory neurons and is transported to the DRG, where it replicates and is spread to the SC using transynaptic jumps, infecting sensory and motor neurons at the same level before ascending to the brain.     

Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study

Background

Perioperative short-term outcomes could be improved after totally robotic Roux-en-Y gastric bypass (TR-RYGBP) compared with conventional laparoscopic gastric bypass.

Methods

This is a nonrandomized controlled prospective study (N = 200) to evaluate perioperative short-term outcomes. The primary endpoint was to investigate risk factors for 30-day surgical complications.

Results

Mean total operative time was shorter in patients who underwent TR-RYGBP (130 vs 147 minutes; P < .0001). However, postoperative surgical complications rate (13% vs 1%; P = .001), and mean overall hospital stay (9.3 vs 6.7 days; P < .0001) were higher after TR-RYGBP. By multivariate analysis, robotic surgery (hazard ratio [HR] = 15.1; 95% confidence interval [CI], 2.8 to 280; P = .01), and conversion to laparotomy (HR = 18.8; 95% CI, 1.7 to 250.8; P = .014) were independent risk factors for 30-day surgical complications.

Conclusions

Although robotic gastric bypass reduces mean operative time, TR-RYGBP is associated with an increased postoperative surgical complications rate and longer hospitalization.     

Postural coordination modes and transition: dynamical explanations

While research to date has been successful in quantifying postural behaviour, this paper examines the causes of transition between postural coordination mode using dynamical variables and, by inference, efficient control strategies underlying postural behaviour. To this end, six subjects in bipedal stance were instructed to maintain a constant distance between their head and a visual target that oscillated along the line of sight. Within sessions, participants were exposed to gradual changes in increasing target motion frequency. Kinematic results showed a sudden transition between in-phase and anti-phase postural coordination modes in visual target tracking. The dynamical analysis pointed out that (1) the center of pressure (CoP) position parameter is a crucial parameter in the determination of the adopted coordination mode, (2) the change occurred in response to limits bordered by the system: the interaction between equilibrium constraints (A/P displacements of CoP), physiological limits (net joint moments) support the emergence of different postural behaviours and, (3) finally, the anti-phase mode presents a better distribution of muscular moment between hip and ankle joints and is more effective to achieve high frequency oscillations with limited CoP displacements.     

BURDEN 2020—Burden of disease in Germany at the national and regional level

Background

Evidence-based policy measures need non-interest-guided information about the health status of a population and the diseases that affect the population the most. In such cases, a national burden of disease study can provide reliable insights at the regional level.

Aim

This article presents the potential of the BURDEN 2020 project and its expected outcome for Germany at the national and regional level.

Methods

The BURDEN 2020 project uses several indicators including years of life lost (YLL) to cover the impact of mortality and years lived with disability (YLD) to cover morbidity. The sum of both is the measure of population health called disability adjusted life years (DALY).

Results

The study ranks individual diseases and risk factors based on their impact on population health. The burden of disease approach is assumed to be sensitive to subnational differences and may generate immediate benefits for regional planning. The BURDEN 2020 study will pilot a national burden of disease study for Germany that will later be transformed into a continuous data processing and visualization tool. This is done by using, modifying and supplementing the methodology employed by the Global Burden of Disease (GBD) study to better fit the needs of health policy in Germany. This study is aimed at calculating the disease burden for up to 17 preselected diseases. Furthermore, the estimates of burden of disease are attributed to a selected set of risk factors.

Conclusion

The Burden 2020 study will provide the results of a new, health-related data processing system to the public. This includes a noninterest-guided presentation of the burden of disease (DALY) in Germany at the national and regional level.

     

Effect of pharmacist care on medication adherence and cardiovascular outcomes among patients post-acute coronary syndrome: A systematic review

Background

The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting.

Neoadjuvant targeted molecular therapies in patients undergoing nephrectomy and inferior vena cava thrombectomy: is it useful?

Objective

To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management.

Methods

We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick’s classification.

Results

Before TMT, thrombus level was staged I for 1 (7 %), II for 10 (72 %) and III (21 %) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1–5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43 %) patients had a measurable decrease, 6 (43 %) had no change, and 2 (14 %) had an increase in the thrombus. One patient (7 %) had a downstage of thrombus level, 12 (85 %) had stable thrombi, and 1 (7 %) had an upstage. Regarding primary tumor, 7 (50 %), 5 (36 %) and 2 (14 %) patients had a decrease, stabilization and an increase in tumor size, respectively.

Conclusion

Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi.