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1.
Eur Spine J ; 33(4): 1391-1397, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38451374

RESUMO

PURPOSE: We aimed to evaluate the effect of cervical disc herniation (CDH) and lumbar disc herniation (LDH) on female sexual functioning before and after surgical intervention. METHODS: The current study was conducted from February 2022 to February 2023. A total of 100 sexually active female patients in their reproductive phase who were diagnosed with CDH and LDH based on physical examination and previous magnetic resonance imaging (MRI) results, as well as 50 healthy females, were enrolled. The female subjects were evaluated using the validated Arabic version of the female sexual function index (ArFSFI), a 0 to 10 visual analogue scale (VAS), the Oswestry disability index (ODI) and Beck's depression index (BDI). RESULTS: The baseline ArFSFI domains and total scores were greatest in the controls, followed by the CDH group. The ArFSFI domains and total scores were greatest in the control group, followed by the postoperative ArFSFI domains and total scores in the cervical group. The variations in satisfaction, pain, and overall ArFSFI ratings were significant across research groups. The difference in desire, arousal, lubrication, and orgasm was substantial in the lumbosacral group, but there were no significant changes between the cervical and control groups. Postoperatively, ArFSFI domains and overall scores improved in both of the cervical and lumbar groups. Both research groups' ODI score and grade improved after surgery. Finally, both groups' BDI score and grade improved after surgery. CONCLUSION: Female sexual dysfunctions caused by CDH and LDH improved considerably after surgery.


Assuntos
Discotomia Percutânea , Deslocamento do Disco Intervertebral , Humanos , Feminino , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Estudos Prospectivos , Resultado do Tratamento , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Discotomia/métodos , Estudos Retrospectivos , Discotomia Percutânea/métodos
2.
Nord J Psychiatry ; 78(2): 95-102, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37905346

RESUMO

PURPOSE: Individuals with depression exhibit significantly higher levels of systemic inflammation than those without depression, particularly among those with atypical depression. However, this association has been less convincing at the population level among individuals without a formal depression diagnosis but with suggestive symptoms. Our aim was to clarify this association. MATERIALS AND METHODS: In a large birth cohort sample of the Finnish general population, we examined the cross-sectional association between high-sensitivity C-reactive protein (hsCRP) levels in venous blood samples and atypical/non-atypical depressive symptoms using the Beck Depression Inventory-II to screen 5443 middle-aged participants. RESULTS: As expected, depressive symptoms associated to elevated hsCRP-levels compared to non-depressed. Participants with the atypical subtype of depressive symptoms (n = 84) had an odds ratio (OR) of 2.59 (95% CI 1.40-4.81) for elevated hsCRP levels compared to the non-depressed group. Similarly, our findings indicate that participants with non-atypical symptoms (n = 440) also showed an OR of 1.42 (95% CI 1.05-1.92) when compared to the non-depressed group (n = 4919). CONCLUSIONS: These results provide additional support for previous research linking depression and inflammation and add to the field with a unique and sizeable study population. Furthermore, the current results support the notion that different types of depressive symptoms may be associated with inflammatory markers in slightly different ways.


Assuntos
Proteína C-Reativa , Depressão , Humanos , Pessoa de Meia-Idade , Biomarcadores , Coorte de Nascimento , Proteína C-Reativa/análise , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Finlândia/epidemiologia , Inflamação/epidemiologia
3.
J Foot Ankle Surg ; 2024 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-39033846

RESUMO

This study addresses the challenges faced by diabetic patients undergoing lower extremity amputation due to diabetic foot, particularly focusing on the implications for wound healing and early mortality. The wounds at the amputation stump may necessitate multiple surgical interventions. The aim is to identify prognostic factors associated with these outcomes, shedding light on the complexities surrounding the postamputation phase. A prospective study was conducted on 39 diabetic patients who underwent lower extremity amputation due to diabetic foot between 2021 and 2022. Comprehensive preoperative data, encompassing parameters such as blood count, erythrocyte sedimentation rate, C-reactive protein, procalcitonin, hemoglobin A1c, albumin, protein, transferrin, ferritin levels, age, gender, body mass index, smoking habits, dialysis, revascularization, duration of surgery, and the use of tourniquet during the procedure were meticulously recorded. Additionally, cognitive performance and depression status were assessed preoperatively using the Mini-Mental State Examination (MMSE) and Beck Depression Inventory (BDI), respectively. A follow-up period of 3 months postsurgery allowed for the comparison of patients who developed infections at the amputation stump with those who did not, as well as the distinction between patients who survived and those who succumbed to mortality. The study revealed that the use of a tourniquet during surgery significantly increased the risk of infection (p = .027), and higher BDI scores were associated with increased risks of both infection (AUC = 0.814) and mortality (AUC = 0.769), with cut-off scores of 24.0 and 23.5 predicting these outcomes with high sensitivity and specificity, respectively. Additionally, lower MMSE scores were associated with increased short-term postoperative mortality. There were no statistically significant differences between the groups in parameters such as complete blood count, ESR, CRP, procalcitonin, HbA1c, albumin, total protein, transferrin, ferritin levels, age, gender, BMI, smoking, dialysis, revascularization, and surgery duration. This investigation highlights the significance of considering tourniquet usage during amputation, preoperative depression status, and cognitive function in patients who undergo amputation due to diabetic foot. The use of a tourniquet during surgery is a significant risk factor for infection, and elevated BDI scores are strong predictors of both infection and mortality in patients undergoing amputations. The findings underscore the importance of a multidisciplinary neuropsychiatric evaluation preoperatively to enhance patient care and outcomes.

4.
Ann Bot ; 2023 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-37970962

RESUMO

BACKGROUND AND AIMS: The successful plant Fallopia x bohemica presents interesting capacities for the control of soil nitrogen cycle at the adult stage, named the biological denitrification inhibition (BDI). BDI strategy allows the plant, through the production of secondary metabolites (procyanidins), to compete with denitrifying microbial community and to divert, to its benefit, the nitrate from soil. This study aims to analyze whether seedlings of F. x bohemica, can implement BDI at the seedling stage. We also determined whether soil nitrogen availability influence the implementation of BDI and seedling growth. METHODS: We sowed achenes of F. x bohemica in soils representing a nitrogen gradient (6 treatments) and harvested seedlings after twenty and forty days of growth. The denitrification and related microbial communities (i.e., functional gene abundances of nirK and nirS), soil parameters (nitrate content and humidity) and plant performances (biomass, growth and root morphology) were determined. KEY RESULTS: On soil without nitrogen addition, BDI was observed after twenty days of growth, whereas a stimulation of denitrification was found after forty days. The increase of soil N content had few effects on activity and structure of soil denitrifying community and on the plant biomasses or the relative growth rates. Correlations between plant and microbial parameters were observed after 20 days of growth reflecting early and strong chemical interactions between plants and denitrifying community, which decreased with plant growth after 40 days. CONCLUSIONS: This study shows that an early in the first weeks of growth, and then to a change to a root conservative strategy after 40 days. This switch to a conservative strategies involved resource storage, an altered allocation to aboveground and belowground parts and an investment in fine roots. It now seems clear that this storage strategy starts very young with an early BDI establishment, allowing this clonal plant exceptional storage and multiplication capacities.

5.
Eur J Nutr ; 62(7): 2709-2721, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37247076

RESUMO

PURPOSE: With the escalating social pressures, there has been a continuous rise in the prevalence of depression among the population, leading to substantial healthcare burdens. Moreover, conventional pharmacological interventions still exhibit certain limitations. Therefore, the primary objective of this study is to systematically evaluate the clinical efficacy of probiotics in the treatment of depression. METHODS: Randomized controlled trials of probiotics in treating depressive symptoms were retrieved from Pubmed, Cochrane Library, Web of Science, Wan Fang database, and CNKI between the establishment of the database and March 2022. The primary outcome was Beck's depression rating scale (BDI) scores, while the secondary outcomes were depression scores on the DASS-21 scale, biochemical indicators (IL-6, NO, and TNF-α levels), and adverse events. In addition, Revman 5.3 was used for Meta-analysis and quality evaluation, and Stata 17 was used for the Egger test and Begg's test. A total of 776 patients, including 397 and 379 patients in the experimental and control groups, respectively, were included. RESULTS: The total BDI score of the experimental group was lower than that of the control group (MD = - 1.98, 95%CI - 3.14 to - 0.82), and the score of DASS (MD = 0.90, 95%CI - 1.17 to 2.98), the IL-6 level (SMD = - 0.55, 95%CI - 0.88 to - 0.23), the NO level (MD = 5.27, 95% CI 2.51 to 8.03), and the TNF-α level (SMD = 0.19, 95% CI - 0.25 to 0.63). CONCLUSION: The findings substantiate the therapeutic potential of probiotics in mitigating depressive symptoms by significantly reducing Beck's Depression Inventory (BDI) scores and alleviating the overall manifestation of depression.


Assuntos
Depressão , Probióticos , Humanos , Depressão/terapia , Interleucina-6 , Fator de Necrose Tumoral alfa , Ensaios Clínicos Controlados Aleatórios como Assunto , Probióticos/uso terapêutico
6.
Epilepsy Behav ; 148: 109410, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37832220

RESUMO

BACKGROUND: Depression, a common mental problem frequently detected in people with epilepsy (PWE), is a major factor that decreases the quality of life of PWE. The cognitive behavioral therapy (CBT) is the most commonly used non-pharmacological treatment for depressive disorders. The CBT for PWE with depression has not yet been studied in Korea. This study aimed to evaluate the effects of the CBT on depression in PWE in Korea. METHOD: This study included 16 PWE with depression who received CBT and 30 control PWE with depression who did not receive CBT. The mean number of CBT sessions per patient was 7.2 in the CBT group. The Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire-9 (PHQ-9) were administered before and after CBT sessions in the CBT group, whereas PHQ-9 was performed at baseline and follow-up in the control group. The difference in PHQ-9 and BDI-II scores were analyzed between the pre- and post-CBT periods in the CBT group. The difference between baseline and follow-up PHQ-9 scores was compared in the control group. RESULTS: There was no significant difference in baseline variables between the CBT and control groups. The PHQ-9 score significantly decreased after the CBT sessions in the CBT group (pre-CBT PHQ-9 = 13.56 vs. post-CBT PHQ-9 = 8.56) but it did not change in the control group (Baseline PHQ-9 = 13.83 vs. follow-up PHQ-9 = 14.67). Twelve PWE had undergone four or more CBT sessions with pre-CBT and post-CBT BDI-II. The BDI-II score significantly decreased after CBT sessions (pre-CBT BDI-II = 30.75 vs. post-CBT BDI-II = 21.5). The CBT decreased the sub-field scores of cognitive and physical-emotional factors as well as suicidal ideation, but the score of sleep problems did not significantly improve. The CBT did not significantly change the seizure frequency. CONCLUSION: The CBT significantly improved depression in Korean PWE. Therefore, it can be considered a treatment tool for depression in PWE. However, a study with more patients and a fixed number of CBT sessions is recommended to generalize this effect.


Assuntos
Terapia Cognitivo-Comportamental , Epilepsia , Psicoterapia de Grupo , Humanos , Qualidade de Vida , Questionário de Saúde do Paciente , Epilepsia/complicações , Epilepsia/terapia , Resultado do Tratamento
7.
Surg Endosc ; 37(7): 5752-5759, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37365396

RESUMO

BACKGROUND: According to the National Clinical Database of Japan, the incidence of bile duct injury (BDI) during laparoscopic cholecystectomy has hovered around 0.4% for the last 10 years and has not declined. On the other hand, it has been found that about 60% of BDI occurrences are due to misidentifying anatomical landmarks. However, the authors developed an artificial intelligence (AI) system that gave intraoperative data to recognize the extrahepatic bile duct (EHBD), cystic duct (CD), inferior border of liver S4 (S4), and Rouviere sulcus (RS). The purpose of this research was to evaluate how the AI system affects landmark identification. METHODS: We prepared a 20-s intraoperative video before the serosal incision of Calot's triangle dissection and created a short video with landmarks overwritten by AI. The landmarks were defined as landmark (LM)-EHBD, LM-CD, LM-RS, and LM-S4. Four beginners and four experts were recruited as subjects. After viewing a 20-s intraoperative video, subjects annotated the LM-EHBD and LM-CD. Then, a short video is shown with the AI overwriting landmark instructions; if there is a change in each perspective, the annotation is changed. The subjects answered a three-point scale questionnaire to clarify whether the AI teaching data advanced their confidence in verifying the LM-RS and LM-S4. Four external evaluation committee members investigated the clinical importance. RESULTS: In 43 of 160 (26.9%) images, the subjects transformed their annotations. Annotation changes were primarily observed in the gallbladder line of the LM-EHBD and LM-CD, and 70% of these shifts were considered safer changes. The AI-based teaching data encouraged both beginners and experts to affirm the LM-RS and LM-S4. CONCLUSION: The AI system provided significant awareness to beginners and experts and prompted them to identify anatomical landmarks linked to reducing BDI.


Assuntos
Traumatismos Abdominais , Doenças dos Ductos Biliares , Ductos Biliares Extra-Hepáticos , Colecistectomia Laparoscópica , Humanos , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Inteligência Artificial , Ductos Biliares Extra-Hepáticos/cirurgia , Ducto Cístico , Ductos Biliares/lesões
8.
BMC Psychiatry ; 23(1): 548, 2023 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-37507656

RESUMO

BACKGROUND: Quantifying depression mainly relies on the use of depression scales, and understanding their factor structure is crucial for evaluating their validity. METHODS: This post-hoc analysis utilized prospectively collected data from a naturalistic study of 1014 inpatients with major depression. Confirmatory and exploratory factor analyses were performed to test the psychometric abilities of the Hamilton Depression Rating Scale, the Montgomery Asberg Depression Rating Scale, and the self-rated Beck Depression Inventory. A combined factor analysis was also conducted including all items of all scales. RESULTS: All three scales showed good to very good internal consistency. The HAMD-17 had four factors: an "anxiety" factor, a "depression" factor, an "insomnia" factor, and a "somatic" factor. The MADRS also had four factors: a "sadness" factor, a neurovegetative factor, a "detachment" factor and a "negative thoughts" factor, while the BDI had three factors: a "negative attitude towards self" factor, a "performance impairment" factor, and a "somatic" factor. The combined factor analysis suggested that self-ratings might reflect a distinct illness dimension within major depression. CONCLUSIONS: The factors obtained in this study are comparable to those found in previous research. Self and clinician ratings are complementary and not redundant, highlighting the importance of using multiple measures to quantify depression.


Assuntos
Transtorno Depressivo Maior , Pacientes Internados , Humanos , Reprodutibilidade dos Testes , Transtorno Depressivo Maior/diagnóstico , Ansiedade , Transtornos de Ansiedade , Escalas de Graduação Psiquiátrica , Psicometria
9.
Int J Med Sci ; 20(7): 951-957, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37324195

RESUMO

Objectives: Empty nose syndrome (ENS), a complication resulting from surgical procedures on turbinate tissue, is characterized by paradoxical nasal obstruction with wide nasal airways. Patients with ENS often also experience psychiatric symptoms, and psychiatric disorder detection remains dependent on subjective evaluation. Objective biomarkers for mental status assessment in patients with ENS are unestablished. This study aimed to evaluate the role of serum interleukin-6 (IL-6) levels in the mental status of patients with ENS. Methods: Overall, 35 patients with ENS who underwent endonasal submucosal implantation surgery were prospectively included in the study. The Sino-Nasal Outcome Test-25 (SNOT-25), Empty Nose Syndrome 6-item Questionnaire (ENS6Q), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) were used to assess the physical and psychiatric symptoms of these patients preoperatively, and 3, 6, and 12 months postoperatively. Serum IL-6 levels were analyzed 1 day before surgery. Results: All subjective assessments significantly improved 3 months after surgery and plateaued at 12 months. Patients with higher serum preoperative IL-6 levels tended to experience more severe depression. Regression analysis showed that a preoperative serum IL-6 level > 1.985 pg/mL was significantly correlated with severe depression status in patients with ENS (odds ratio = 9.76, p = 0.020). Conclusions: ENS patients with higher preoperative serum IL-6 levels were more likely to have severe depressive burden. Since more suicidal thoughts or attempts were noted in these patients, timely treatment plan for patients with high levels of serum IL-6 is crucial and may consider psychotherapy after surgical treatment.


Assuntos
Transtorno Depressivo , Obstrução Nasal , Doenças Nasais , Humanos , Interleucina-6 , Doenças Nasais/etiologia , Doenças Nasais/cirurgia , Doenças Nasais/diagnóstico , Obstrução Nasal/cirurgia , Obstrução Nasal/complicações , Obstrução Nasal/psicologia , Síndrome
10.
IEEE Sens J ; 23(2): 898-905, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36913222

RESUMO

Ambient intelligence plays a crucial role in healthcare situations. It provides a certain way to deal with emergencies to provide the essential resources such as nearest hospitals and emergency stations promptly to avoid deaths. Since the outbreak of Covid-19, several artificial intelligence techniques have been used. However, situation awareness is a key aspect to handling any pandemic situation. The situation-awareness approach gives patients a routine life where they are continuously monitored by caregivers through wearable sensors and alert the practitioners in case of any patient emergency. Therefore, in this paper, we propose a situation-aware mechanism to detect Covid-19 systems early and alert the user to be self-aware regarding the situation to take precautions if the situation seems unlikely to be normal. We provide Belief-Desire-Intention intelligent reasoning mechanism for the system to analyze the situation after acquiring the data from the wearable sensors and alert the user according to their environment. We use the case study for further demonstration of our proposed framework. We model the proposed system by temporal logic and map the system illustration into a simulation tool called NetLogo to determine the results of the proposed system.

11.
Psychol Med ; 52(10): 1875-1882, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-33138872

RESUMO

BACKGROUND: The Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory (BDI-II) and the Generalised Anxiety Disorder Assessment (GAD-7) are widely used in the evaluation of interventions for depression and anxiety. The smallest reduction in depressive symptoms that matter to patients is known as the Minimum Clinically Important Difference (MCID). Little empirical study of the MCID for these scales exists. METHODS: A prospective cohort of 400 patients in UK primary care were interviewed on four occasions, 2 weeks apart. At each time point, participants completed all three questionnaires and a 'global rating of change' scale (GRS). MCID estimation relied on estimated changes in symptoms according to reported improvement on the GRS scale, stratified by baseline severity on the Clinical Interview Schedule (CIS-R). RESULTS: For moderate baseline severity, those who reported improvement on the GRS had a reduction of 21% (95% confidence interval (CI) -26.7 to -14.9) on the PHQ-9; 23% (95% CI -27.8 to -18.0) on the BDI-II and 26.8% (95% CI -33.5 to -20.1) on the GAD-7. The corresponding threshold scores below which participants were more likely to report improvement were -1.7, -3.5 and -1.5 points on the PHQ-9, BDI-II and GAD-7, respectively. Patients with milder symptoms require much larger reductions as percentage of their baseline to endorse improvement. CONCLUSIONS: An MCID representing 20% reduction of scores in these scales, is a useful guide for patients with moderately severe symptoms. If treatment had the same effect on patients irrespective of baseline severity, those with low symptoms are unlikely to notice a benefit. FUNDING: Funding. National Institute for Health Research.


Assuntos
Depressão , Atenção Primária à Saúde , Humanos , Depressão/epidemiologia , Depressão/terapia , Depressão/diagnóstico , Estudos Longitudinais , Estudos Prospectivos , Reino Unido
12.
BMC Neurol ; 22(1): 117, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35331161

RESUMO

BACKGROUND: Few research works have explored female sexual dysfunction (FSD) in patients with Neuromyelitis optica spectrum disorder (NMOSD) which remains an ignored disease symptom. This work aimed to describe the frequency, patterns, and predictors of FSD in a sample of newly diagnosed AQP4-ab seropositive NMOSD patients. METHODS: This case-control study was conducted on 28 seropositive NMOSD patients and 31 age matched healthy controls. All included patients were asked to privately fill and hand back the following questionnaires: female sexual function index questionnaire (FSFI), Beck depression inventory II (BDI) and fatigue severity scale (FSS). Also, Modified Modified Ashworth scale (MMAS) and Expanded disability status scale (EDSS) were applied to all included patients. RESULTS: NMOSD patients had significantly lower total FSFI scores and significantly higher BDI and FSS scores than controls (P < 0.001). FSS scores were negatively correlated with total scores of FSFI as well as desire, lubrication, orgasm, and satisfaction scores. BDI scores was negatively correlated with desire and orgasm scores. The uncorrected visual FS score was negatively correlated with lower total scores of FSFI as well as arousal, orgasm, and satisfaction scores. The pain score was negatively correlated with the scores of the MMAS. The only predictors of FSFI total score were fatigue and visual disability. Visual disability was also a predictor of dysfunction in arousal and satisfaction domains, whereas spasticity in the lower limbs predicted sexual related pain. CONCLUSIONS: Sexual dysfunction in patients with NMOSD is strongly related to fatigue, depression, visual disability, and lower limbs spasticity.


Assuntos
Neuromielite Óptica , Disfunções Sexuais Fisiológicas , Autoanticorpos , Estudos de Casos e Controles , Egito/epidemiologia , Feminino , Humanos , Neuromielite Óptica/complicações , Neuromielite Óptica/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia
13.
Surg Endosc ; 36(10): 7126-7139, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35794500

RESUMO

BACKGROUND: Decades of debate surround the use of intraoperative cholangiography (IOC) during cholecystectomy. To the present day, the role of IOC is controversial as regards decreasing the rate of bile duct injury (BDI). We aimed to review and analyse the available literature on the benefits of IOC during cholecystectomy. METHODS: A systematic literature search was performed until 19 October 2020 in five databases using the following search keys: cholangiogra* and cholecystectomy. The primary outcomes were BDI and retained stone rate. To investigate the differences between the groups (routine IOC vs selective IOC and IOC vs no IOC), we calculated weighted mean differences (WMD) for continuous outcomes and relative risks (RR) for dichotomous outcomes, with 95% confidence intervals (CI). RESULTS: Of the 19,863 articles, 38 were selected and 32 were included in the quantitative synthesis. Routine IOC showed no superiority compared to selective IOC in decreasing BDI (RR = 0.91, 95% CI 0.66; 1.24). Comparing IOC and no IOC, no statistically significant differences were found in the case of BDI, retained stone rate, readmission rate, and length of hospital stay. We found an increased risk of conversion rate to open surgery in the no IOC group (RR = 0.64, CI 0.51; 0.78). The operation time was significantly longer in the IOC group compared to the no IOC group (WMD = 11.25 min, 95% CI 6.57; 15.93). CONCLUSION: Our findings suggest that IOC may not be indicated in every case, however, the evidence is very uncertain. Further good quality research is required to address this question.


Assuntos
Doenças dos Ductos Biliares , Colecistectomia Laparoscópica , Doenças dos Ductos Biliares/cirurgia , Colangiografia , Colecistectomia , Colecistectomia Laparoscópica/efeitos adversos , Humanos , Cuidados Intraoperatórios , Tempo de Internação
14.
Hum Psychopharmacol ; 37(4): e2833, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35089613

RESUMO

OBJECTIVE: We examined the association of serotonin receptor transporter gene polymorphism in patients with MDD with the clinical efficacy of mirtazapine (MZ) and sertraline (ST). METHOD: Newly diagnosed, treatment naïve, 80 MDD patients (aged 18-45) diagnosed using DSM-5 criteria and with Beck's depression inventory score (BDI) score ≥21 were included and randomly divided into two groups of 40 participants and were administered MZ 15-45 mg/day or ST 25-200 mg/day respectively. Patients were followed up for 6 weeks for evaluation of BDI scores. Genotypic evaluation was done and three allele variants were identified based on the polymerase chain reaction fragment sizes: short (S; 486 bp), long (L; 529 bp), or extralong (XL; 612 or 654 bp) and classified into five genotypes: S/S,S/L, L/L, S/XL, and L/XL. RESULT: We found that 32.5% patients belonged to the S/S genotype, suggesting that individuals with the SS genotype are at higher risk of developing MDD. No statistically significant association was seen with ST or MZ groups on the basis of genotypes. Clinically significant improvement was observed with a more than 50% reduction in BDI scores at 6 weeks of treatment with both drugs. CONCLUSION: Identification of risk population can be carried out by genotype testing. Prior genotyping in MDD patients might help to predict a better clinical outcome with antidepressants.


Assuntos
Transtorno Depressivo Maior , Sertralina , Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/genética , Humanos , Mirtazapina/uso terapêutico , Polimorfismo Genético/genética , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Sertralina/uso terapêutico , Resultado do Tratamento
15.
Neurol Sci ; 43(3): 1965-1974, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34528181

RESUMO

Although depressive symptoms are the most common psychiatric comorbidity in epilepsy, they remain underestimated and untreated in a large proportion of patients. The purpose of this study was to evaluate depression severity and related clinical features in people with epilepsy using a well-reliable self-report index of mood, the Beck Depression Inventory-II (BDI-II). One-hundred seventeen adult patients with epilepsy were recruited from a tertiary epilepsy center and completed the BDI-II. A single-item analysis of the 21 questions of the BDI-II was computed and differences between women and men in each depressive symptom were evaluated. Correlation and regression analyses were used to identify clinical features associated with the severity of depression. Results showed gender differences in some items, with women reporting overall higher depression severity than men. The most common symptoms regarded domains of sleeping patterns, tiredness, and loss of energy. Regression evidence suggested that being female, having an epilepsy duration < 10 years, as well as being treated with psychotropic drugs and reporting generalized seizure, were associated with higher depression severity. Despite its cross-sectional nature, this study reinforces the importance of investigating and possibly treating depressive symptoms in adult patients with epilepsy, since they negatively impact well-being, daytime activities, and sleep. Further studies identifying pharmacological and non-pharmacological treatments for depression in epilepsy need to be planned.


Assuntos
Depressão , Epilepsia , Adulto , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Convulsões/complicações
16.
J Adv Nurs ; 78(9): 3025-3033, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35774030

RESUMO

AIMS: This study investigated mental health reactions to dealing with COVID-19 in a population of nurses working in a variety of settings. The study attempted to expand our current understanding of the psychological reactions unique to nurses working during the highly stressful period of the COVID-19 pandemic. DESIGN: The study used an online questionnaire design. METHODS: Nurses were recruited using social media via an electronic link between July and September 2020. Of them, 112 nursing professionals completed the 66-item questionnaire. RESULTS: Significant findings included the presence of moderate or greater levels of anxiety (62%), depression (31%), and posttraumatic stress disorder (15%) and with significantly greater intrusive thoughts and memories for nurses who provided direct patient care than those who did not. Nurses with a prior history of anxiety or depression were found to be at greater risk for psychological distress. Results further highlighted concerns and fears related to coronavirus in both their daily personal and professional lives. CONCLUSION: The use of standard, commonly used, measures of psychological disorders allow for a more precise comparison among studies both for this population at the time of the survey and over a period of time. IMPACT: Suggestions for helping nursing professionals identify nurses at risk and improved ways to cope and deal with adverse psychological effects are discussed.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Adaptação Psicológica , Ansiedade , COVID-19/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Humanos , Pandemias
17.
Mol Biol (Mosk) ; 56(4): 619-627, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35964318

RESUMO

In cells of Escherichia coli, terminal oxidase bd-I encoded by the cydAB gene catalyzes the reduction of O2 to water using hydroquinone as an electron donor. In addition to the cydAB operon, two other genes, cydC and cydD, encoding the heterodimeric ATP-binding cassette-type transporter are essential for the assembly of cytochrome bd-I. It was shown that inactivation of cytochrome bd-I by the introduction of cydB or cydD deletions into the E. coli chromosome leads to supersensitivity of the bacteria to antibiotics of the quinolone and beta-lactam classes. The sensitivity of these mutants to antibiotics is partially suppressed by introduction of a constitutively expressed gene katG under the control of the Ptet promoter into their genome. The increased level of hydrogen sulfide resulting from the introduction of the mstA gene, encoding 3-mercaptopyruvate sulfurtransferase, under the control of the Ptet promoter, leads to the same effect. These data demonstrate the important role of cytochrome bd-I in the defense of bacteria from oxidative stress and bactericidal antibiotics.


Assuntos
Proteínas de Escherichia coli , Quinolonas , Transportadores de Cassetes de Ligação de ATP/genética , Antibacterianos/farmacologia , Grupo dos Citocromos b , Citocromos/genética , Citocromos/metabolismo , Complexo de Proteínas da Cadeia de Transporte de Elétrons , Escherichia coli/genética , Escherichia coli/metabolismo , Proteínas de Escherichia coli/genética , Oxirredutases/genética , beta-Lactamas
18.
Ocean Coast Manag ; 229: 106330, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36035871

RESUMO

In this study, we use the sample data from Jan 22, 2020 to Jan 21, 2022 to investigate the impacts of added infection number on the volatility of BDI. Under this structure, the control variables (freight rate, Brent crude oil price, container idle rate, port congestion level, global port calls) are added to test whether the information contained in the added infection number is covered. In the GARCH-MIDAS model, we divide the volatility of BDI into the long-term and short-term components, then employ in the least squares regression to empirically test the influences of added infection number on the volatility. From the analysis, we find the added infection numbers effectively impact the BDI volatility. In addition, whether the freight rate, Brent crude oil price, container idle rate, port congestion level, global port calls and other variables are considered alone or at the same time, further the added infection number still significantly influences the volatility of BDI. By studying the ability of the confirmed number to explain the volatility of BDI, a new insight is provided for the trend prediction of BDI that the shipping industry can take the epidemic development of various countries as a reference to achieve the purpose of cost or risk control.

19.
Cogn Behav Pract ; 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-36059862

RESUMO

Remote cognitive and behavioral therapy (CBT) via videoconference has been garnering attention as a means of improving access to CBT for depression, in particular during the coronavirus disease 2019 pandemic. However, there is a lack of evidence supporting its implementation in Japanese clinical settings. This case series aimed to establish preliminary evidence of whether remote CBT can be an effective therapy for major depression in Japanese clinical settings. Five patients who met the diagnostic criteria for major depressive disorder were enrolled and underwent remote CBT via videoconference and face-to-face assessment interviews. The results showed that remote CBT via videoconference improved depressive symptoms, enabling a relatively high level of patient satisfaction and working alliance. Moreover, detailed feedback from our patients showed that continuous monitoring was preferable for increasing treatment engagement. Further research is warranted to test the efficacy and acceptability of remote CBT via videoconference for treating major depression.

20.
J Neural Transm (Vienna) ; 128(9): 1301-1310, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33988765

RESUMO

Posttraumatic stress disorder (PTSD) is a severe mental disorder that can develop after a traumatic event. PTSD has been reported to be associated with activation of the innate immune system, as measured by increased levels of pro-inflammatory cytokines. While it is well known that PTSD patients display increased levels of interleukin 6 (IL-6) when compared with healthy controls, the relationship between cytokine secretion and treatment outcome has been hardly investigated yet. The aim of this study was to assess the potential association of inflammatory activation and therapy outcome in PTSD. Before therapeutic intervention, we applied the Trier Social Stress Test (TSST) as a method to elicit psychosocial stress and an acute inflammatory response. IL-6 levels were measured in blood plasma of PTSD patients at different time points before and after the TSST. Severity of depressive, trauma-related, and somatic symptoms was assessed before and 8 weeks after trauma-focused treatment in a multimodal day clinic setting. We showed that high reactivity of IL-6 to psychosocial stress at the beginning of the therapy was associated with a negative therapy outcome in PTSD, especially regarding depressive symptoms. This study suggests plasma IL-6 reactivity as a potential molecular marker to predict treatment outcome in PTSD.


Assuntos
Interleucina-6 , Transtornos de Estresse Pós-Traumáticos , Citocinas , Humanos , Psicoterapia , Transtornos de Estresse Pós-Traumáticos/terapia , Estresse Psicológico/terapia
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