[The moderating effect of dispositional mindfulness in the relationship between depressive symptoms, borderline personality traits and suicidal ideation among young adults]. / L'effet modérateur de la pleine conscience dispositionnelle dans la relation entre symptomatologie dépressive, troubles de la personnalité limite et idéations suicidaires chez le jeune adulte.

OBJECTIVES: The aim of the study was to evaluate the influence of dispositional mindfulness on suicidal ideation and its moderating effect on the relationships between depressive symptoms and borderline personality traits, and suicidal ideation. METHODS: A sample of 1034 students from France (818 women, mean age=20.1±2; 216 men, mean age=20.6±2.2) completed the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), assessing dispositional mindfulness, the Patient Health Questionnaire-9 (PHQ-9) assessing depression symptoms; the borderline personality disorder scale of the Personality Disorder Questionnaire-4th Edition (PDQ-4), and the three-item scale measuring suicidal ideation proposed by Garrison et al. (1991). RESULTS: At least occasional wish to kill oneself was reported by 11% of men and 10% of women. Thirty-eight percent of men and 47% of women had moderate to severe depressive symptoms (P<.001). The mean borderline personality traits score for women was higher than for men (33.44±10.56 versus 31.48±10.35; P=.02), and the mean dispositional mindfulness score for men was higher than for women (77.99±12.3 versus 73.4±12.1; P<.001). In order to explore the role of mindfulness as a moderator between depressive symptoms/borderline traits and the wish to kill oneself, multiple regression analyses were performed separately by gender according to the method of Hayes (2013). To assess whether the presence of dispositional mindfulness decreased the risk for persons with depressive symptoms/borderline personality traits to have suicidal ideation, the effect of the interaction between these disorders and dispositional mindfulness was tested by introducing in a second regression the cross product of these two variables. To assert moderation we had to observe that the interaction explained an additional part of the variance of suicidal ideation. For men, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 32% of the variance of suicidal ideation (R2=.32, s.e.=1.42). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (ß=-.26; t=-4.48, P<.001), accounting for an additional 6% of the variance of suicidal ideation (R2=.38, s.e.=1.36). For women, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 25% of the variance of suicidal ideation (R2=.25, s.e.=1.29). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had slightly decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (ß=-.16; t=-5.34, P<.001), accounting for an additional 3% of the variance of suicidal ideation (R2=.28, s.e.=1.26). For men, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 23% of the variance of suicidal ideation (R2=.23, s.e.=1.51). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (ß=-.27; t=-4.68, P<.001), accounting for an additional 7% of the variance of suicidal ideation (R2=.30, s.e.=1.44). For women, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 24% of the variance of suicidal ideation (R2=.24, s.e.=1.30). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores remained the same. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (ß=-.19; t=-6.30, P<.001) accounting for an additional 3% of the variance of suicidal ideation (R2=.27, s.e.=1.27). CONCLUSIONS: Dispositional mindfulness appeared to be a moderator between depressive symptoms/borderline personality traits and the wish to kill oneself in both genders. This finding is relevant for prevention and therapy and suggests that mindfulness may be important and useful to reduce suicidal ideation and prevent suicidal attempts in young adults.

Aging: a barrier to renutrition? Nutritional and immunologic evidence in rats.

BACKGROUND: Previous reports suggest that correcting the malnourished state is more difficult in elderly people than in younger ones and that protein requirements may be higher in elderly than in younger adults. OBJECTIVE: The aim of this study was to establish whether malnourished old rats respond to protein-supplemented nutritional repletion as do young adult rats. DESIGN: Adult (3 mo old) and old (22 mo old) rats were submitted to dietary restriction programs that induced similar metabolic and nutritional alterations. Malnourished adult and old rats were then killed (R groups) or refed for 1 wk with a high-protein diet (HPD; 23% protein) or a very-high-protein diet (VHPD; 27% protein). Control groups at both ages were fed ad libitum throughout the experiment. Effects of food repletion were evaluated in terms of protein metabolism, intestinal histomorphometry, and nonspecific immune status. RESULTS: In adult rats, HPD sufficed to increase body weight and restore basal values of liver weight and protein content (P: < 0.01 compared with the R adult group), nitrogen balance (P: < 0.01 compared with the R adult group), and hydrogen peroxide production by polymorphonuclear neutrophils and monocytes (P: < 0.01 compared with the R group); VHPD had no supplementary effect except on nitrogen balance. In old rats, HPD was less effective and greater benefit was observed with VHPD in terms of body weight gain (10%; P: < 0.01 compared with the old group fed HPD), albuminemia, muscle weight and protein content, plasma arginine concentration, and hydrogen peroxide production by stimulated polymorphonuclear neutrophils and monocytes compared with the old R group (P: < 0.01). CONCLUSION: Aging is a significant variable affecting the response to nutritional support.

Hematological recovery and peripheral blood progenitor cell mobilization after induction chemotherapy and GM-CSF plus G-CSF in breast cancer.

In order to determine the effect of GM-CSF plus G-CSF in combination in breast cancer patients receiving an effective induction regimen, we compared hematological recovery and peripheral blood progenitor cell (PBPC) mobilization according to colony-stimulating factor (CSF) support. Forty-three breast cancer patients were treated by TNCF (THP-doxorubicin, vinorelbine, cyclophosphamide, fluorouracil, D1 to D4) with CSF support: 11 patients received GM-CSF (D5 to D14); 16 patients G-CSF (D5 to D14) and 16 patients GM-CSF (D5-D14) plus G-CSF (D10-D14). Between two subsequent cycles, progenitor cells were assessed daily, from D13 to D17. The WBC count was similar for patients receiving G-CSF alone or GM-CSF plus G-CSF, but significantly greater than that of patients receiving GM-CSF alone (P<0.001). The GM-CSF plus G-CSF combination led to better PBPC mobilization, with significantly different kinetics (P<0.001) and optimal mean values of CFU-GM, CD34+ cells and cells in cycle, at D15 compared to those obtained with G-CSF or GM-CSF alone. The significantly greater PBPC mobilization obtained with a CSF combination by D15 could be of value for PBPC collection and therapeutic reinjection after high-dose chemotherapies.

Phagocyte functions in stressed rats: comparison of modulation by glutamine, arginine and ornithine 2-oxoglutarate.

The effects of diets supplemented with 6.8 mmol.day-1.kg-1 glutamine, arginine or ornithine 2-oxoglutarate [ornithine alpha-ketoglutarate (OKG), a precursor of both glutamine and arginine] on phagocyte functions [i.e. H2O2 production by leucocytes and secretion of tumour necrosis factor alpha (TNFalpha) by stimulated macrophages] of stressed rats were studied. The relationship between the immunological effects of these amino acids and their plasma and tissue (muscle and intestine) concentrations was also explored. The catabolic model used consisted of injections of dexamethasone (DEX; 1.5 mg.day-1.kg-1) for 5 days. As previously described, DEX suppressed TNFalpha secretion in stimulated macrophages. Supplementation with arginine or OKG, but not glutamine, was able to counteract the DEX effect on TNFalpha secretion. Glutamine, arginine and OKG supplementation increased H2O2 production by monocytes and polymorphonuclear neutrophils from DEX-treated rats. All DEX-treated rats showed plasma and muscle glutamine depletion and also a decrease in the concentration of arginine in the gastrocnemius. Supplementation with glutamine, arginine or OKG was not able to counteract these depletions. It was concluded that glutamine, arginine and OKG improve phagocyte responses during stress, and that glutamine depletion is not necessarily associated with dysimmunity, since no correlation between glutamine tissue pools and the immune state was observed.

Successful blood stem cell collection and transplant in children weighing less than 25 kg.

Peripheral blood stem cells (PBSCs) were collected for autotransplantation in 20 children (median age 4 years, range 0.5-10 years) weighing < 25 kg (median 14.5 kg, range 6.8-24 kg) with various malignant diseases: leukemias and lymphomas (n = 6), solid tumours (n = 14). Cytaphereses were carried out after standard chemotherapy (n = 10), mobilizing high-dose chemotherapy (n = 9) or radiotherapy alone (n = 1). In 13 children PBSCs were harvested after haematopoietic growth factor (HGF) administration. PBSCs were collected using a continuous flow blood separator (Cobe Spectra). In 13 patients access was through a central catheter with peripheral venous return, in 4 patients access was through a central catheter with return through a femoral catheter; one patient had femoral catheter access with peripheral venous return and two patients had both access and return through peripheral veins. For 19 patients the extracorporeal line was primed with red blood cells. The median blood flow rate was 13.8 ml/min (range 7-22 ml/min). Sixty-six procedures (mean 3.3/patient, range 1-4) were performed with a mean total collection time of 8.5 h. The median number of granulocyte-macrophage colony-forming units (CFU-GM) collected was 37.7 x 10(4)/kg (mean 107 x 10(4)/kg, range 1.05-882 x 10(4)/kg). The number of CFU-GM collected per procedure in children with HGF was 7.8-fold higher than in children without HGF (median 20.4 versus 2.6 x 10(4) CFU-GM/kg body weight, respectively). There were no consistent effects on peripheral blood counts except on platelet counts which decreased following each procedure (median decrease in platelet count was 36%).(ABSTRACT TRUNCATED AT 250 WORDS)

Neoadjuvant chemotherapy in 126 operable breast cancers.

126 patients with non-inflammatory operable breast cancer, who otherwise would have undergone modified radical mastectomy (MRM), were treated by induction chemotherapy. Before treatment, every patient had a local and general assessment, and pathological or cytological evidence of malignancy. Patients received, every 3 weeks, the same treatment with doxorubicin, vincristine, cyclophosphamide, 5-fluorouracil (AVCF); methotrexate was added in 80 cases (AVCFM). Tumour shrinkage greater than 50% was documented in 105 (83%) of the 126 women. A higher objective response rate was obtained in aneuploid or high S phase tumours, especially in the patients treated with methotrexate. After chemotherapy, 41 patients were then treated by radiotherapy alone after complete or sub-complete response; 64 had a residual tumour that could be treated by conservative surgery and radiotherapy. Only 19 had MRM and radiotherapy. Histopathological complete remission was documented in 1 case; isolated residual tumour cells were found in 5 patients. Thus primary chemotherapy enhanced the possibility of breast conservation in up to 83% of the cases in a series in which most would have been otherwise subjected to a MRM because of tumour size.