Amyloid-Lowering Monoclonal Antibodies for the Treatment of Early Alzheimer's Disease.

Alzheimer's disease (AD) is the leading cause of dementia worldwide. Numerous biomarker studies have clearly demonstrated that AD has a long asymptomatic phase, with the development of pathology occurring at least 2 decades prior to the development of any symptoms. These pathological changes include a stepwise development of amyloid-ß (Aß) plaques, followed by tau neurofibrillary tangles and subsequently extensive neurodegeneration in the brain. In this review, we discuss the first class of drugs intended to be disease modifying to be approved by the US Food and Drug Administration (FDA) for AD-anti-Aß monoclonal antibodies-and the scientific rationale with which they were developed.

Systematic review and meta-analysis suggest that the duration of Kangaroo mother care has a direct impact on neonatal growth.

AIM: A 2016 Cochrane review showed that Kangaroo mother care (KMC) had a moderate impact on preterm growth, with high heterogeneity among studies. This systematic review and meta-analysis considered new evidence on KMC, particularly the duration. METHOD: Databases were searched for papers published in English, French, Spanish and Portuguese up to 2017. Randomised controlled trials (RCT) of preterm or low birth weight infants were included if they compared growth between KMC and conventional care. Anthropometric measures were related to duration. RESULTS: We identified 1368 papers, and 13 RCTs covering 743 KMC infants and 718 controls met the selection criteria. Infants held in KMC for at least 6 h/d gained more weight than the controls, with a mean difference of 8.99 g/d (95% confidence interval 8.14-9.84, I2  = 0%). This difference persisted between 2 and 6 h/d and disappeared with 2 hours or less. When we used g/kg/d, the weight gain was higher when the duration was at least 8 h/d. Only babies who received 6 h/d gained more length and head circumference. CONCLUSIONS: The effect of the KMC on growth was directly related to the duration.

Systematic review and meta-analysis suggest that Kangaroo position protects against apnoea of prematurity.

AIM: The aim of this study was to determine whether the Kangaroo position decreased apnoea events in preterm newborns compared with conventional care in incubator. METHODS: We conducted a systematic review of clinical trials published in English, French, Spanish and Portuguese. A comprehensive literature search was realised until 2017. The main outcome was apnoea events. Data were extracted and combined in a fixed-effects model. The quality of the evidence was assessed according to the GRADE framework (grading the quality of evidence and the strength of recommendations). RESULTS: Four original clinical trials were selected. These trials were conducted in India and Nepal, between 2005 and 2016. The systematic review comprised 416 preterm newborns. Three studies were randomised controlled trials and one was quasi-experimental. Meta-analysis showed a statistically significant reduction in apnoea episodes (relative risk [RR] 0.41; 95% confidence interval [CI] 0.22, 0.78). The result remained significant when only the three clinical trials were analysed (RR 0.43; 95% CI 0.23, 0.83). Quality analysis indicated moderate quality because of lack of an appropriate method of randomisation in one study. CONCLUSION: The Kangaroo position could have protective effect against apnoea events in preterm infants, decreasing the associated risk of death or long-term disability.

Up and Down the Blind Alley: Population Divergence with Scant Gene Flow in an Endangered Tropical Lineage of Andean Palms (Ceroxylon quindiuense Clade: Ceroxyloideae).

Given the geographical complexity of the Andes, species distributions hold interesting information regarding the history of isolation and gene flow across geographic barriers and ecological gradients. Moreover, current threats to the region's enormous plant diversity pose an additional challenge to the understanding of these patterns. We explored the geographic structure of genetic diversity within the Ceroxylon quindiuense species complex (wax palms) at a regional scale, using a model-based approach to disentangle the historical mechanisms by which these species have dispersed over a range encompassing 17° of latitude in the tropical Andes. A total of 10 microsatellite loci were cross-amplified in 8 populations of the 3 species comprising the C. quindiuense complex. Analyses performed include estimates of molecular diversity and genetic structure, testing for genetic bottlenecks and an evaluation of the colonization scenario under approximate Bayesian computation. We showed that there was a geographical diversity gradient reflecting the orogenetic pattern of the northern Andes and its end at the cordilleras facing the Caribbean Sea. A general pattern of diversity suggests that the cordilleras of Colombia have served as historical recipients of gene flow occurring only scantly along the northern Andes. We provided evidence of important isolation between the largest populations of this complex, suggesting that both historical constraints to dispersal but also current anthropogenic effects might explain the high levels of population structuring. We provide a list of advisable measures for conservation stakeholders.

[Depression and Anxiety Disorders and Associated Factors in the Adolescent Colombian Population, 2015 National Mental Health Survey]. / Trastornos depresivos y de ansiedad y factores asociados en la población de adolescentes colombianos, Encuesta Nacional de Salud Mental 2015.

INTRODUCTION: There was a prevalence of mental disorders of 17% in adolescents in the past year. These tended to be chronic and their appearance at this age is associated with a worse prognosis than those in adulthood. OBJECTIVES: To determine the prevalence and mental factors associated with major depression and anxiety disorders. METHODS: Data were obtained from the IV National Mental Health Survey representing 5 regions. A structured computerised survey was conducted using the Computer Assisted Personal Interview-Composite International Diagnostic Interview-Adolescent Version (CAPI-CIDI-A), focused on the most common depression and anxiety disorders. It included a sample of 1754 adolescents between 12 and 17 years old. RESULTS: The prevalence of any disorder at some point in life was 7.2% (95%CI, 5.8-8.9). The most common disorder corresponded to social phobia manifested sometime in life in 4.8% (95%CI, 3.7-6.2). Less frequent were panic disorder in girls (0.2%; 95% CI, 0.1-1.0) and other bipolar disorders in boys (0.2%; 95%CI, 0.1-0.7). Among the associated factors of suffering from any disorder were, being female (OR=2.1), having little family support (OR=2.0), having witnessed at least one traumatic event (OR=2.6), and having had a previous suicide attempt (OR=3.4). Participation in at least one group was a protective factor (OR=0.5). CONCLUSIONS: Mental disorders of anxiety and depression represent a major burden of disease for Colombia.

[Depression and Anxiety Disorders and Associated Factors in the Adult Colombian Population, 2015 National Mental Health Survey]. / Trastornos depresivos y de ansiedad y factores asociados en la población adulta colombiana, Encuesta Nacional de Salud Mental 2015.

INTRODUCTION: Mental disorders are the first causes of disability adjusted life years (DALY), contributing with the 7.4%. This value increases as the DALYs of the transmittable diseases decrease. OBJECTIVES: To determine the prevalence and associated factors of the major depressive and anxious disorders. METHODS: Data obtained from the IV Mental Health Survey with representation from 5 regions. A computerised interview was conducted, focusing on the most frequent anxiety and depressive disorders, using the CIDI CAPI 3.0. A sample of 10,870 adults over 18 years old was obtained. RESULTS: The lifetime prevalence of any of these disorders is 10.1% (95% CI: 8.8-11.5) in the population between 18 and 44 years, and of 7.7% (95% CI: 6.5-9.1) in those older than 45 years. The prevalence in the last 12 months was 5.1% (95% CI: 4.3-6.0) in the younger group, and 2.3% (95% CI: 1.8-3.0) in the older group. Of the people with evaluated mental disorders, 17.6% (95% CI: 13.1-23.4) had 2 or more disorders, a comorbidity that is more common in the female population (20.4%, 95% CI: 14.2-28.3) than in males (13.5%, 95% CI: 7.9-22.0). Major depressive disorder is the most prevalent of the disorders, with a lifetime prevalence of 4.3% (95% CI: 3.7-5.0). After adjusting in a multivariate model, being divorced or widowed (OR=1.3), previous suicide attempt (OR=3.3), and having 6 or more features of border-line personality, were associated with an increased risk of presenting with any of the studied disorders. CONCLUSIONS: Anxiety and depressive mental disorders are an important health burden in Colombia.

Trastornos depresivos y de ansiedad y factores asociados en la población adulta colombiana, Encuesta Nacional de Salud Mental 2015 / Depression and Anxiety Disorders and Associated Factors in the Adult Colombian Population, 2015 National Mental Health Survey

Resumen Introducción: Las enfermedades mentales son la primera causa de años vividos con discapacidad, contribuyen al 7,4% de los años de vida ajustados por discapacidad y esto aumenta en la medida en que disminuyen los producidos por enfermedades transmisibles. Objetivos: Determinar la prevalencia y los factores asociados a los principales trastornos mentales depresivos y ansiosos. Métodos: Datos obtenidos de la IVEncuesta Nacional de Salud Mental con representatividad de cinco regiones. Se realiza una encuesta estructurada computarizada con el CIDI-CAPI 3.0, centrada en los más frecuentes trastornos depresivos y ansiosos. Se tomó una muestra de 10.870 adultos mayores de 18 años. Resultados: La prevalencia de cualquiera de estos trastornos alguna vez en la vida es del 10,1%, (intervalo de confianza del 95% [IC95%], 8,8%-11,5%) de las personas de 18-44 años y el 7,7% (IC95%, 6,5%-9,1%) de los mayores de 45 años. En los últimos 12 meses, el 5,1% (IC95%, 4,3%-6,0%) del grupo más joven y el 2,3% (IC95%, 1,8%-3,0%) del de más edad. De las personas con alguno de los trastornos mentales medidos, el 17,6% (IC95%, 13,1%-23,4%) presentan dos o más trastornos; es más frecuente la comorbilidad en mujeres (20,4%; IC95%, 14,2%-28,3%) que en varones (13,5%; IC95%, 7,9%-22,0%). El trastorno depresivo mayor es el más prevalente de los trastornos, con una prevalencia de vida del 4,3% (IC95%, 3,7%-5,0%). Entre los factores asociados a cualquier trastorno, se encontró en el modelo multivariable que estar separado, viudo o divorciado (odds ratio [OR] = 1,3), el intento de suicidio previo (OR = 3,3) y tener seis o más rasgos de personalidad limítrofe (OR = 2,7) incrementan el riesgo de sufrirlos. Conclusiones: Los trastornos mentales de ansiedad y depresión suponen una importante carga de enfermedad para Colombia.

Abstract Introduction: Mental disorders are the first causes of disability adjusted life years (DALY), contributing with the 7.4%. This value increases as the DALYs of the transmittable diseases decrease. Objectives: To determine the prevalence and associated factors of the major depressive and anxious disorders. Methods: Data obtained from the IV Mental Health Survey with representation from 5 regions. A computerised interview was conducted, focusing on the most frequent anxiety and depressive disorders, using the CIDI CAPI 3.0. A sample of 10,870 adults over 18 years old was obtained. Results: The lifetime prevalence of any of these disorders is 10.1% (95% CI: 8.8-11.5) in the population between 18 and 44 years, and of 7.7% (95% CI: 6.5-9.1) in those older than 45 years. The prevalence in the last 12 months was 5.1% (95% CI: 4.3-6.0) in the younger group, and 2.3% (95% CI: 1.8-3.0) in the older group. Of the people with evaluated mental disorders, 17.6% (95% CI: 13.1-23.4) had 2 or more disorders, a comorbidity that is more common in the female population (20.4%, 95% CI: 14.2-28.3) than in males (13.5%, 95% CI: 7.9-22.0). Major depressive disorder is the most prevalent of the disorders, with a lifetime prevalence of 4.3% (95% CI: 3.7-5.0). After adjusting in a multivariate model, being divorced or widowed (OR = 1.3), previous suicide attempt (OR = 3.3), and having 6 or more features of border-line personality, were associated with an increased risk of presenting with any of the studied disorders. Conclusions: Anxiety and depressive mental disorders are an important health burden in Colombia.

Trastornos depresivos y de ansiedad y factores asociados en la población de adolescentes colombianos, Encuesta Nacional de Salud Mental 2015 / Depression and Anxiety Disorders and Associated Factors in the Adolescent Colombian Population, 2015 National Mental Health Survey

Resumen Introducción: La prevalencia de trastornos mentales entre los adolescentes es del 17% en el último año. Dichos trastornos tienden a ser crónicos y su aparición a esta edad se asocia a un peor pronóstico que las que aparecen en la edad adulta. Objetivos: Determinar la prevalencia y los factores asociados a los principales trastornos mentales depresivos y ansiosos de los adolescentes. Métodos: Datos obtenidos de la Encuesta Nacional de Salud Mental 2015 con representatividad de 5 regiones. Se realiza una encuesta estructurada computarizada con el CIDI-CAPI adolescentes, centrada en los más frecuentes trastornos depresivos y ansiosos. Se tomó una muestra de 1.754 adolescentes entre 12 y 17 años. Resultados: La prevalencia de cualquier trastorno alguna vez en la vida es del 7,2%, (intervalo de confianza del 95% [IC95%], 5,8-8,9). El trastorno más frecuente fue la fobia social, que se manifestó alguna vez en la vida en un 4,8% (IC95%, 3,7-6,2); los menos frecuentes fueron el trastorno de pánico en las mujeres (0,2%; IC95%, 0,1-1,0) y otros trastornos bipolares en los varones (0,2%; IC95%, 0,1-0,7). De los factores asociados a sufrir cualquier trastorno, se encontró: ser mujer (odds ratio [OR] = 2,1), tener poco apoyo familiar (OR = 2,0), haber presenciado al menos un evento traumático (OR = 2,6) y haber hecho un intento de suicidio (OR = 3,4). Como factor protector, se encontró la participación en por lo menos un grupo (OR = 0,5). Conclusiones: Los trastornos mentales de ansiedad y depresión representan una importante carga de enfermedad para Colombia.

Abstract Introduction: There was a prevalence of mental disorders of 17% in adolescents in the past year. These tended to be chronic and their appearance at this age is associated with a worse prognosis than those in adulthood. Objectives: To determine the prevalence and mental factors associated with major depression and anxiety disorders. Methods: Data were obtained from the IV National Mental Health Survey representing 5 regions. A structured computerised survey was conducted using the Computer Assisted Personal Interview-Composite International Diagnostic Interview-Adolescent Version (CAPI-CIDI-A), focused on the most common depression and anxiety disorders. It included a sample of 1754 adolescents between 12 and 17 years old. Results: The prevalence of any disorder at some point in life was 7.2% (95%CI, 5.8-8.9). The most common disorder corresponded to social phobia manifested sometime in life in 4.8% (95%CI, 3.7-6.2). Less frequent were panic disorder in girls (0.2%; 95% CI, 0.1-1.0) and other bipolar disorders in boys (0.2%; 95%CI, 0.1-0.7). Among the associated factors of suffering fromany disorderwere, being female (OR = 2.1), having little family support (OR = 2.0), having witnessed at least one traumatic event (OR = 2.6), and having had a previous suicide attempt (OR = 3.4). Participation in at least one group was a protective factor (OR = 0.5). Conclusions: Mental disorders of anxiety and depression represent a major burden of disease for Colombia.

Visual rating and volumetric measurement of medial temporal atrophy in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort: baseline diagnosis and the prediction of MCI outcome.

OBJECTIVE: This study aims to determine the clinical utility of visual ratings and volumetric measurements of medial temporal atrophy among subjects from the Alzheimer's Disease Neurorimaging Initiative (ADNI) cohort. METHODS: A sample of 189 subjects from the ADNI, Phase 1 (ADNI-1), was chosen as follows: 49 cognitively normal (CN), 89 with mild cognitive impairment (MCI), and 50 with Alzheimer's disease (AD). Structural MRI images were downloaded from the ADNI website, and a visual rating system (VRS) was used to obtain semi-quantitative ratings of the hippocampus (HPC) and entorhinal cortex (ERC). VRS ratings and FreeSurfer measures of the HPC and ERC were used to predict (i) baseline diagnosis and (ii) progression to AD among subjects with MCI at baseline. RESULTS: VRS and FreeSurfer measures of ERC were equivalent in classifying subjects at baseline, but FreeSurfer measures of HPC were superior to VRS measures for classifying CN versus MCI subjects. VRS and FreeSurfer measures of both HPC and ERC were significant predictors of progression from MCI to AD. However, VRS ratings of ERC were superior to other MRI measures. MCI subjects with minimal ERC atrophy by VRS had a threefold lower progression rate to AD at 3.2 years compared with those with mild, moderate, or severe atrophy (23% vs 63%, 69%, and 87%, respectively). CONCLUSIONS: Visual ratings of HPC and ERC provide useful information to a physician in a clinical setting. Visual ratings of ERC may be especially useful in following patients with MCI.

Mapping EST-derived SSRs and ESTs involved in resistance to bacterial blight in Manihot esculenta.

Cassava (Manihot esculenta Crantz) is a major root crop widely grown in the tropics. Cassava bacterial blight, caused by Xanthomonas axonopodis pv. manihotis (Xam), is an important disease in Latin America and Africa resulting in significant losses. The preferred control method is the use of resistant genotypes. Mapping expressed sequence tags (ESTs) and determining their co-localization with quantitative trait loci (QTLs) may give additional evidence of the role of the corresponding genes in resistance or defense. Twenty-one EST-derived simple sequence repeats (SSRs) were mapped in 16 linkage groups. ESTs showing similarities with candidate resistance genes or defense genes were also mapped using strategies such as restriction fragment length polymorphisms, cleaved amplified polymorphic sequences, and allele-specific primers. In total, 10 defense-related genes and 2 bacterial artificial chromosomes (BACs) containing resistance gene candidates (RGCs) were mapped in 11 linkage groups. Two new QTLs associated with resistance to Xam strains CIO121 and CIO151 were detected in linkage groups A and U, respectively. The QTL in linkage group U explained 61.6% of the phenotypic variance and was associated with an RGC-containing BAC. No correlation was found between the new EST-derived SSRs or other mapped ESTs and the new or previously reported QTLs.

Prevalencia de depresión y factores asociados con ella en la población colombiana / The prevalence of and factors associated with depression in Colombia

OBJETIVOS: Analizar la prevalencia del síndrome depresivo y los factores asociados con la depresión en Colombia entre los años 2000 y 2001. MÉTODOS: Para este estudio descriptivo de corte transversal se aplicó una encuesta entre noviembre de 2000 y enero de 2001 a 1 116 adultos de 18 años de edad o más de uno u otro sexo que residían en viviendas particulares seleccionadas mediante un muestreo representativo nacional polietápico, estratificado según el grado de urbanización del área incluida en el muestreo. La depresión se clasificó en breve, subclínica o clínica (leve, moderada o grave) en los 30 días y los 12 meses previos a la entrevista. Se calcularon las frecuencias simples y estratificadas por la edad y el sexo, y los intervalos de confianza de 95 por ciento (IC95 por ciento) de más de 500 variables. La asociación de las variables seleccionadas con episodios depresivos se evaluó mediante un modelo de regresión logística con múltiples variables. RESULTADOS: De las personas estudiadas, 10,0 por ciento (IC95 por ciento: 9,2 a 10,7) presentaron algún episodio depresivo en los 12 meses previos a la encuesta y 8,5 por ciento (IC95 por ciento: 7,8 a 9,2) sufrieron alguno durante el último mes. Hubo una mayor proporción de mujeres con depresión en ambos períodos. Más de 50 por ciento de los episodios fueron moderados, tanto en hombres como en mujeres, y las mayores prevalencias se encontraron en las personas mayores de 45 años. Los factores asociados con la depresión en el último mes fueron ser mujer, considerar el estado de salud propio como regular o malo, sufrir de dolores o molestias, tener dificultades en las relaciones interpersonales, consumir marihuana o sustancias adictivas, medicamentos estimulantes o calmantes, tener dependencia del alcohol, o estar desempleado con discapacidad. CONCLUSION: La depresión es una afección frecuente en Colombia. Se deben poner en marcha medidas dirigidas a reducir el riesgo de depresión, especialmente en mujeres y en personas mayores de 45 años de edad.

[The prevalence of and factors associated with depression in Colombia]. / Prevalencia de depresión y factores asociados con ella en la población colombiana.

OBJECTIVES: To analyze the prevalence of depression and the factors associated with it in Colombia in 2000 and 2001. METHODS: For this descriptive cross-sectional study a survey was conducted between November 2000 and January 2001 with 1,116 men and women 18 years of age or older who were living in private homes that were selected through a multistage national representative sampling, stratified according to the degree of urbanization of the area included in the sampling. Depression was classified as brief recurrent depression, subclinical depression, or mild, moderate, or serious clinical depressive episodes in the 30 days and in the 12 months prior to the interview. Simple and stratified frequencies of over 500 variables, along with their 95% confidence intervals (95% CIs), were calculated by age and gender. The association that the selected variables had with depressive episodes was evaluated through a multivariate logistic regression model. RESULTS: Of the persons studied, 10.0% of them (95% CI: 9.2% to 10.7%) had had a depressive episode in the 12 months prior to the survey, and 8.5% (95% CI: 7.8% to 9.2%) had suffered a depressive episode in the preceding month. There was a higher proportion of women with depression in both of the periods. More than 50% of the episodes were moderate, in both men and women. There were higher prevalences of depression in persons older than 45 years. The factors associated with depression in the preceding month were: female gender; considering one's health to be moderate or bad; suffering from pain or discomfort; having difficulties in interpersonal relations; consuming marijuana, addictive substances, stimulants, or tranquilizers; being dependent on alcohol; and being unemployed and unable to work. CONCLUSIONS: Depression is a frequent disorder in Colombia. Measures directed at reducing the risk of depression should be implemented, especially among women and in persons over 45 years old.

Factores asociados al intento de suicidio en la poblacion colombiana / Associated factors in suicide attempts in colombian people

Objetivos: describir y analizar el perfil epidemiológico y los factores asociados al intento de suicidio en una muestra de la población Colombiana. Diseño: análisis secundario de la base de datos de la Primera encuesta nacional de salud mental y consumo de sustancias psicoactivas. Muestra: 25.135 personas fueron encuestadas. Se escogieron 21.988 personas de ambos sexos con edades entre 16 y 60 años, a quienes se les aplicó la escala de Zung para ansiedad y depresión. Se midieron 240 variables independientes. Medida de desenlace principal: reporte de intentos de suicidio en el último año y en la vida. Resultados: la prevalencia para intentos de suicidio en el último año y a través de toda la vida fue de 1,2 por ciento (IC 95 por ciento: 1,06-1,34) y 4,25 por ciento (IC 95 por ciento: 4,25-4,81) respectivamente. Con la técnica de regresión logística para variables policótomas, los intentos de suicidio en el último año estaban asociados con: edades de 16 a 21 años OR = 2,5 (IC 95 por ciento 1,5-4,2), depresión grave OR = 11,8 (5,1-27,3), moderada OR = 5,3 (3,1-9,0) y leve OR = 3,6 (2,4-5,8), niveles moderados y graves de ansiedad OR = 3,4 (1,8-6,7). Se encontraron resultados similares cuando se consideraron los intentos de suicidio a lo largo de la vida. Conclusiones: el intento de suicidio en Colombia tiene una prevalencia similar a la de otros países, la población con mayor riesgo tiene entre 16 y 21 años, presenta depresión o ansiedad, consulta al médico por 'nervios', es objeto de abuso verbal (particularmente en las mujeres) o tiene diferentes valores morales a los de su familia