Comparison of desipramine and citalopram treatments for depression in Parkinson's disease: A double‐blind,randomized, placebo‐controlled study

Depression is one of the most common psychiatric disturbances in Parkinson's disease (PD). Recent reviews have highlighted the lack of controlled trials and the ensuing difficulty in formulating recommendations for antidepressant use in PD. We sought to establish whether antidepressants provide real benefits and whether tricyclic and selective serotonin reuptake inhibitor (SSRI) antidepressants differ in their short‐term efficacy, because the time to onset of therapeutic benefit remains an important criterion in depression. The short‐term efficacy (after 14 and 30 days) of two antidepressants (desipramine, a predominantly noradrenergic reuptake inhibitor tricyclic and citalopram, a SSRI) was assessed in a double‐blind, randomized, placebo‐ controlled study of 48 nondemented PD patients suffering from major depression. After 14 days, desipramine prompted an improvement in the Montgomery Asberg Depression Rating Scale (MADRS) score, compared with citalopram and placebo. Both antidepressants produced significant improvements in the MADRS score after 30 days. Mild adverse events were twice as frequent in the desipramine group as in the other groups. A predominantly noradrenergic tricyclic antidepressant induced a more intense short‐term effect on parkinsonian depression than did an SSRI. However, desipramine's lower tolerability may outweigh its slight short‐term clinical advantage. © 2008 Movement Disorder Society     

Prevalence of Asthma and Other Childhood Allergies in Brazilian Schoolchildren

We determined the prevalence of asthma, rhinitis, and eczema among Brazilian children using the standardized protocol of the International Study on Asthma and Allergies in Childhood (ISAAC) to facilitate the comparison of our results with other studies using the ISAAC methodology. We conducted a cross-sectional study from June to October 1994 to determine the prevalence of asthma, rhinitis, and eczema in 5182 school children aged 7-8 years and 13-14 years residing in the Brazilian towns of Santa Maria and Itabira (iron-mining cities located in Minas Gerais). Parents completed questionnaires at their child's school in the presence of trained interviewers. The cumulative prevalence of doctor-diagnosed asthma was 4.6% for all ages with no significant difference between the age groups. In general, there was a higher prevalence of symptoms in the younger age group than the older. The prevalence of wheezing in the previous 12 months was 14.3% (7-8 years old) and 9.3% (13-14 years old) (p ≤ 0.01), of chronic cough in the previous 12 months was 25.6% (7-8 years old) and 22.1% (13-14 years old) (p ≤ 0.01), and of nighttime cough in the previous 12 months was 22.3% (7-8 years old) and 19.4% (13-14 years old) (p ≤ 0.05). Overall the prevalences of asthma and wheezing symptoms in the previous 12 months were higher for boys than girls (5.2% vs. 3.9% for asthma, p ≤ 0.01, and 13.2% vs. 10.6% for wheezing, p ≤ 0.01, respectively). These results suggest that asthma-related respiratory illnesses affect a substantial part of the childhood population in Itabira and Santa Maria, Minas Gerais. Some factors such as male gender and younger age may be associated with an increase risk for chronic respiratory symptoms. Prevalences of asthma and allergic diseases in these Brazilian cities on the basis of self-reporting of symptoms and of one's medical history may more accurately portray the true prevalence of asthma than the use of medical records.     

Remission of autoimmune hepatitis during pregnancy: a report of two cases

Abstract: Little is known about the evolution of autoimmune hepatitis (AIH) during pregnancy. Some authors reported worsening of the liver disease during pregnancy, whereas others reported stable conditions. We present two untreated patients who had remission of the autoimmune hepatitis in the second half of their pregnancies. One of the patients exhibited this phenomenon twice during two consecutive pregnancies. We speculate that the immunosuppressive effect of pregnancy induced remission of the autoimmune hepatitis in our patients.     

Emerging technologies and perspectives for nutrition research in European Union 7th Framework Programme

Nutrition trends in Europe are driven by taste, health and convenience. The possibilities of research using new technologies and tools such as nutrigenomics, imaging techniques, nanotechnology, bioinformatics, cognitive sciences, innovative processes are very promising to support these nutrition trends and in particular their health aspects. This is supported by European Union research. The opportunities offered in the 7th Framework Programme (FP7), among other innovations, will contribute to the general aim of improving nutrition policy as well as improving products from the food industry in accordance with the Lisbon strategy to create employment and improve the quality of life of the European citizens.     

Combined effects of fasting and alanine on liver function recovery after cold ischemia

The effect of donor nutritional status on hepatic function recovery after cold ischemia is still debated. We demonstrated previously that a 48-h fast diminished the survival rate of liver-transplanted rats and that the deleterious effect of fasting was prevented by infusion of alanine to the recipient at reperfusion. Whether the duration of fasting influenced the protective effect of alanine and whether this effect was metabolic were not known, and the elucidation of these questions is the aim of this study. The effect on hepatic function recovery of fasting periods of 24 h, 48 h and 72 h prior to cold ischemia were studied in a model of isolated, perfused rat liver. After a cold-ischemic time of 24 h in University of Wisconsin (UW) solution at 4 degrees C, livers were reperfused for 3 h. The combined effect of alanine (8 mM) infusion at liver reperfusion was evaluated for each prior fasting period. The addition of pyruvate (8 mM), a metabolic intermediary of alanine, was only tested in the 72-h fasting group. The evaluation criteria were: liver weight after reperfusion, release of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) in the perfusate, bile production, vascular resistance and liver histology after reperfusion. The enzyme release at reperfusion was significantly higher when livers were harvested from rats submitted to a 48-h fast (ALT) or a 72-h fast (ALT, AST, LDH), as compared to those from fed rats. Vascular resistance was increased in 72-h fasted livers. An addition of alanine (8 mM) at reperfusion lowered the release of AST, ALT and LDH. This effect was more obvious when the fasting duration was increased. By contrast, the addition of pyruvate at reperfusion did not improve the recovery of livers submitted to a 72-h fasting period before preservation. A long fasting period is deleterious as compared to feeding; however, this effect can be compensated by infusion of alanine at reperfusion. The mechanism involved is not metabolic. In a clinical setting, the infusion of alanine to the recipient at reperfusion may be a convenient way to compensate for donor undernutrition, especially after a long stay in an intensive care unit.     

Drug-metabolizing enzyme activities in the liver and intestine of rats exposed to DDT: effects of vitamin A status

One-half of a group (deficient group) of male Wistar rats which received a daily intake of 50 IU of vitamin A/kg of body weight, and one-half of a second group (normal group), which received 500 IU of the same substance, were treated by intragastric intubation with 40 mg of DDT/day/kg body weight. Rats were killed after 5 or 12 days of exposure to DDT. The liver vitamin A contents indicated a different rate of storage depending on the amount of vitamin A. DDT increased the relative liver weight and decreased hepatic vitamin A storage in both groups; it induced benzo(a)pyrene hydroxylase (AHH) and glutathione-S-transferase (GST) activities in both organs and cytochrome P 450 only in the liver. At both ages, no change was noted in the cytochrome P450 content in the liver and intestine, whereas enzymatic activities, unchanged in the liver, were significantly modified in the intestine and included a reduction in AHH activity, an increase in UDP-glucuronosyl transferase (UDPGT) and GST activities. Vitamin A deficiency had no effect on AHH and UDPGT activities nor on the cytochrome P 450 content in the liver or intestine. However, it significantly increased the GST activity in the intestine, but not in the liver.     

Altered interpretation of neck proprioceptive signals in persons with subclinical recurrent neck pain.

OBJECTIVE: To evaluate whether subjects with subclinical recurrent neck pain have an altered interpretation of neck proprioceptive signals. DESIGN: A comparative group design. SUBJECTS: Twelve subjects with recurrent neck pain and 12 control subjects. METHODS: The shoulder, head, trunk and whole-body position were measured under the following conditions: active and passive elevation and depression of the right shoulder and vibration of the trapezius muscle. RESULTS: During passive shoulder movements both groups moved their head in the opposite direction (p<0.05). During passive elevation subjects with recurrent neck pain showed a significant over-appraisal of shoulder position. Both groups responded similarly to active movements. Subjects with recurrent neck pain and control subjects showed similar trunk and head-to-trunk movements during shoulder movements. Subjects with recurrent neck pain, however, made larger movements compared with healthy subjects (p<0.05). During trapezius muscle vibration similar whole-body movements were found in both groups. CONCLUSION: These results show a modified interpretation of neck proprioceptive signals in subjects with recurrent neck pain and may reflect an offset in the egocentric reference frame or a decreased capacity to switch between reference frames. Better insight into these mechanisms might lead to better evaluation and treatment of subjects with recurrent neck pain and to a reduction in recurrent episodes.     

Treatment of bone metastases of prostate cancer with strontium-89 chloride: efficacy in relation to the degree of bone involvement

This retrospective study evaluated the toxicity and efficacy of strontium-89 chloride (Metastron, Amersham) in 94 patients with painful bone metastases of prostate cancer (117 injections of 150 MBq) and compared the efficacy of treatment in patients with moderate and extensive bone involvement. The predictive value of flare response with regard to analgesic response was also studied. High-grade leukothrombopenias were observed after only 5% of injections. An improvement in quality of life was obtained in 65% of cases, a decrease in pain in 78% (31% complete response) and a reduction of analgesics in 60%. Efficacy was significantly better for pain decrease (P=0.005) and reduction of analgesics (P=0.018), and response was significantly longer (P<0.0035) in patients with moderate than in patients with extensive bone involvement. The flare response observed in 23% of cases was not predictive of pain response (P=0.919) or reduction of analgesics (P=0.353). A second dose prolonged analgesia in three-quarters of cases without any apparent increase in toxicity. These results confirm the benefit of ⁸⁹Sr chloride for the treatment of metastatic bone pain and suggest that internal radiotherapy should be started earlier. A bone scan could be proposed at the time of hormonal escape resulting in bone pain, and internal radiotherapy could be initiated when several metastatic foci exist, even if only one is painful. In this way, pain-free follow-up could be prolonged, and the transition to other therapeutic approaches, particularly opioids, delayed.