Pre-treatment waking cortisol response and vulnerability to interferon α induced depression

Depressive disorder is a common consequence of interferon α treatment. An understanding of the aetiological processes involved is evolving. HPA axis abnormalities are clearly described in community depressive disorder and represent vulnerability to depression development. We explored whether pre-treatment HPA axis abnormalities influence depression emergence during interferon α treatment. We examined waking HPA axis response via salivary cortisol sampling in 44 non-depressed, chronic hepatitis C infected patients due to commence standard interferon α treatment. Hamilton depression scales and the structured clinical interview for DSM-IV major depressive disorder status were administered monthly during treatment. Major depressive disorder developed in 26 of 44 subjects during interferon-α treatment. The pre-treatment waking cortisol response over 1 h was significantly greater in the subsequent switch to depression group (F=4.23, p=0.046). The waking cortisol response pre-treatment with interferon α appears greater in those subsequently switching to depressive disorder during treatment. This waking response may join other vulnerability factors for depression emergence in this group. This model could prove a valuable tool in understanding non-iatrogenic depressive disorder in the general population and notably the role of cytokines.     

Comparing Occupation-Based and Repetitive Task Practice Interventions for Optimal Stroke Recovery: A Pilot Randomized Trial

Aims: This pilot randomized comparative study investigated changes in motor performance and indices of neuroplasticity associated with occupation-based intervention and repetitive task practice in the recovery of occupational performance following stroke. Method: Sixteen participants received either occupation-based intervention or repetitive task practice for eight 55-minute sessions. Motor performance was measured by the Fugl Meyer Assessment (FMA), Stroke Impact Scale (SIS), the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scale (GAS). Indices of neuroplastic change were assessed by transcranial magnetic stimulation (TMS). Results: Both occupation-based intervention and repetitive task practice groups demonstrated significant changes on the FMA and the occupation-based group demonstrated significant changes on the GAS goals. Neurophysiological measures showed enlargement in TMS volume maps in the affected hemisphere for both groups. Conclusion: Occupation-based and repetitive task practice interventions can yield similar improvements in chronic stroke.     

Cue Consistency Associated with Physical Activity Automaticity and Behavior

Physical activity is partly regulated by automatic processes such as habits (ie, well-learned responses to cues), but it remains unclear what cues trigger these processes. This study examined the relations of physical activity automaticity and behavior with the consistency of people, activity, routine, location, time, and mood cues present upon initiation of physical activity behavior. Australian adults (N = 1,244, 627 female, M age = 55 years) reported their physical activity automaticity, behavior, and the degree of consistency of these cues each time they start a physical activity behavior. Multiple regression models, which accounted for gender and age, revealed that more consistent routine and mood cues were linked to more physical activity automaticity; whereas more consistent time and people cues were linked to more physical activity behavior. Interventions may more effectively translate into long-lasting physical activity habits if they draw people's attention to the salient cues of time, people, routine, and mood.     

In Vitro Activity of Novel Gyrase Inhibitors against a Highly Resistant Population of Pseudomonas aeruginosa

The activity of five novel gyrase inhibitors was evaluated against 303 nonduplicate Pseudomonas aeruginosa strains collected from 53 North American institutions. The most active compound, GP-2, displayed MIC₅₀ and MIC₉₀ values of 1 and 2 μg/ml, respectively. Cross-resistance to other commercially available antipseudomonal compounds was not evident, as no major change was observed in the gyrase inhibitor MIC distribution when stratified by nonsusceptible phenotypes, including the fluoroquinolones and those isolates classified as multidrug resistant (MDR).     

Efficient Detection of Carbapenemase Activity in Enterobacteriaceae by Matrix-Assisted Laser Desorption Ionization?Time of Flight Mass Spectrometry in Less Than 30 Minutes

The recognition of carbapenemase-producing Enterobacteriaceae (CPE) isolates is a major laboratory challenge, and their inappropriate or delayed detection may have negative impacts on patient management and on the implementation of infection control measures. We describe here a matrix-assisted laser desorption ionization−time of flight (MALDI-TOF)-based method to detect carbapenemase activity in Enterobacteriaceae. After a 20-min incubation of the isolate with 0.5 mg/ml imipenem at 37°C, supernatants were analyzed by MALDI-TOF in order to identify peaks corresponding to imipenem (300 Da) and an imipenem metabolite (254 Da). A total of 223 strains, 77 CPE (OXA-48 variants, KPC, NDM, VIM, IMI, IMP, and NMC-A) and 146 non-CPE (cephalosporinases, extended-spectrum β-lactamases [ESBLs], and porin defects), were tested and used to calculate a ratio of imipenem hydrolysis: mass spectrometry [MS] ratio = metabolite/(imipenem + metabolite). An MS ratio cutoff was statistically determined to classify strains as carbapenemase producers (MS ratio of ≥0.82). We validated this method first by testing 30 of our 223 isolates (15 CPE and 15 non-CPE) 10 times to calculate an intraclass correlation coefficient (ICC of 0.98), showing the excellent repeatability of the method. Second, 43 strains (25 CPE and 18 non-CPE) different from the 223 strains used to calculate the ratio cutoff were used as external controls and blind tested. They yielded sensitivity and specificity of 100%. The total cost per test is <0.10 U.S. dollars (USD). This easy-to-perform assay is time-saving, cost-efficient, and highly reliable and might be used in any routine laboratory, given the availability of mass spectrometry, to detect CPE.