RÉSUMÉ
AIMS: Childhood adversities (CAs) predict heightened risks of posttraumatic stress disorder (PTSD) and major depressive episode (MDE) among people exposed to adult traumatic events. Identifying which CAs put individuals at greatest risk for these adverse posttraumatic neuropsychiatric sequelae (APNS) is important for targeting prevention interventions. METHODS: Data came from n = 999 patients ages 18-75 presenting to 29 U.S. emergency departments after a motor vehicle collision (MVC) and followed for 3 months, the amount of time traditionally used to define chronic PTSD, in the Advancing Understanding of Recovery After Trauma (AURORA) study. Six CA types were self-reported at baseline: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and bullying. Both dichotomous measures of ever experiencing each CA type and numeric measures of exposure frequency were included in the analysis. Risk ratios (RRs) of these CA measures as well as complex interactions among these measures were examined as predictors of APNS 3 months post-MVC. APNS was defined as meeting self-reported criteria for either PTSD based on the PTSD Checklist for DSM-5 and/or MDE based on the PROMIS Depression Short-Form 8b. We controlled for pre-MVC lifetime histories of PTSD and MDE. We also examined mediating effects through peritraumatic symptoms assessed in the emergency department and PTSD and MDE assessed in 2-week and 8-week follow-up surveys. Analyses were carried out with robust Poisson regression models. RESULTS: Most participants (90.9%) reported at least rarely having experienced some CA. Ever experiencing each CA other than emotional neglect was univariably associated with 3-month APNS (RRs = 1.31-1.60). Each CA frequency was also univariably associated with 3-month APNS (RRs = 1.65-2.45). In multivariable models, joint associations of CAs with 3-month APNS were additive, with frequency of emotional abuse (RR = 2.03; 95% CI = 1.43-2.87) and bullying (RR = 1.44; 95% CI = 0.99-2.10) being the strongest predictors. Control variable analyses found that these associations were largely explained by pre-MVC histories of PTSD and MDE. CONCLUSIONS: Although individuals who experience frequent emotional abuse and bullying in childhood have a heightened risk of experiencing APNS after an adult MVC, these associations are largely mediated by prior histories of PTSD and MDE.
Sujet(s)
Trouble dépressif majeur , Troubles de stress post-traumatique , Adulte , Humains , Adolescent , Jeune adulte , Adulte d'âge moyen , Sujet âgé , Troubles de stress post-traumatique/épidémiologie , Troubles de stress post-traumatique/étiologie , Troubles de stress post-traumatique/diagnostic , Trouble dépressif majeur/psychologie , Dépression/psychologie , Enquêtes et questionnaires , Véhicules motorisésRÉSUMÉ
BACKGROUND: Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time. METHODS: As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors. RESULTS: Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants. CONCLUSIONS: The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.
Sujet(s)
Dépression , Troubles de stress post-traumatique , Humains , Enfant , Dépression/psychologie , Troubles anxieux , Anxiété/épidémiologie , Troubles de stress post-traumatique/épidémiologie , Troubles de stress post-traumatique/diagnostic , Ethnies/psychologieRÉSUMÉ
Reward positivity (RewP) is an EEG component reflecting reward-prediction errors. Using multilevel models, we measured single-trial RewP amplitude from trial-to-trial, while reward and prediction varied during learning. Sixty participants completed a category-learning task in either engaging or sterile conditions with the RewP time-locked to feedback. Sequential analysis of single-trial RewP showed its relationship to current and previous accuracy, and the probability of changing one's response to subsequent stimuli. Simulations show these effects can be explained in detail by the dynamics of participants' expectations according to principles of reinforcement learning. The single-trial RewP findings were consistent with previous literature linking RewP to reward-prediction error under reinforcement-learning theory. In contrast, the aggregate RewP was unrelated to the engagement manipulation or to delayed retention performance. Thus the present results provide a detailed computational account how RewP relates to acute adaptation, but suggest RewP plays little role in long-term learning.
Sujet(s)
Adaptation psychologique/physiologie , Apprentissage/physiologie , , Récompense , Adulte , Électroencéphalographie , Potentiels évoqués/physiologie , Femelle , Humains , Mâle , Analyse multiniveaux , Analyse et exécution des tâches , Jeune adulteRÉSUMÉ
INTRODUCTION: The objective of the study was to evaluate the accuracy of two- and three-dimensional (2D, 3D) transthoracic echocardiography (TTE), 2D transesophageal echocardiography, and computed tomography angiography (CTA) compared with cardiac magnetic resonance imaging (CMR) in normal dogs and to assess repeatability of 2D and 3D TTE for the assessment of left ventricular (LV) and left atrial (LA) dimensions. ANIMALS: The study was performed on six healthy dogs. MATERIALS AND METHODS: Transthoracic echocardiography, transesophageal echocardiography, CTA, and CMR were performed on each dog. Right ventricular (RV) and LV volumes (in systole and diastole), ejection fraction (EF), and LA and right atrial (RA) volumes were assessed. Repeatability and intrarater and interrater measurements of variability were quantified by average coefficient of variation (CV) for 2D and 3D TTE. RESULTS: No clinically relevant differences in LV volume were detected between CMR and all modalities. Importantly, 3D TTE had the lowest CV (6.45%), correlated with (rs = 0.62, p = 0.01), and had the highest overlap in distribution with CMR (OVL >80%). Left ventricular EF and LA size via CTA compared best with CMR and RV and RA volumes were best estimated by 3D TTE. Assessment of LV and LA volumes via 3D TTE had moderate repeatability (15-21%) compared with LV M-mode measurements and 2D LA-to-aortic ratio (<10%), respectively. For LV size, interrater CV for 3D TTE (19.4%) was lower than 2D TTE (23.1%). CONCLUSIONS: Measurements of LV, RV, and RA volumes via 3D TTE and LA volume and LV EF assessed by CTA compared best with CMR. Three-dimensional echocardiography had lower interrater and intrarater CV compared with 2D TTE.
Sujet(s)
Chiens/anatomie et histologie , Échocardiographie tridimensionnelle/médecine vétérinaire , Échocardiographie transoesophagienne/médecine vétérinaire , Échocardiographie/médecine vétérinaire , Coeur/imagerie diagnostique , Imagerie par résonance magnétique/médecine vétérinaire , Tomodensitométrie/médecine vétérinaire , Animaux , Femelle , Atrium du coeur/imagerie diagnostique , Ventricules cardiaques/imagerie diagnostique , Reproductibilité des résultatsRÉSUMÉ
There is a need to identify new and more effective treatments for posttraumatic stress disorder (PTSD). Allopregnanolone and its stereoisomer pregnanolone (together termed ALLO) are metabolites of progesterone that positively and allosterically modulate GABA effects at GABAA receptors, thereby reducing anxiety and depression. Previous research revealed that women with PTSD had low cerebrospinal fluid (CSF) ALLO levels and a low ratio of ALLO to the allopregnanolone precursor 5α-DHP, consistent with deficient activity of the ALLO synthetic enzyme 3α-hydroxysteroid dehydrogenase (3α-HSD). The current study examined ALLO and the ratio of ALLO to 5α-DHP in plasma at rest and in response to psychophysiological stressors in trauma-exposed, medication-free women with and without PTSD. Participants were examined twice in random order during the early follicular phase (eFP) and mid-luteal phase (mLP) of the menstrual cycle. Plasma neurosteroids were measured using gas chromatography-mass spectrometry. Results indicate that the ALLO to 5α-DHP ratio in plasma increases between the eFP and mLP. In addition, women with PTSD have a lower ratio of ALLO to 5α-DHP than trauma-exposed healthy women, as well as blunted increases in this ratio in response to a moderately stressful laboratory procedure, i.e., differential fear conditioning, across the menstrual cycle. Clinically feasible testing for 3α-HSD dysfunction is critical to translating this line of research into clinical care. Measurement of this ratio in plasma could facilitate patient stratification in clinical treatment trials, as well as precision medicine targeting of treatments that address ALLO synthesis deficits in women with PTSD.
Sujet(s)
Prégnanolone/métabolisme , Progestérone/métabolisme , Troubles de stress post-traumatique/physiopathologie , 5alpha-Dihydroprogestérone/métabolisme , Adulte , Femelle , Phase folliculaire , Agents GABA , Humains , Hydroxysteroid dehydrogenases/métabolisme , Phase lutéale , Cycle menstruel , Agents neuromédiateurs/analyse , Agents neuromédiateurs/sang , Agents neuromédiateurs/métabolisme , Prégnanolone/analyse , Prégnanolone/sang , Récepteurs GABA/métabolisme , Récepteurs GABA-A/métabolisme , Troubles de stress post-traumatique/métabolismeRÉSUMÉ
The Psychiatric Genomics Consortium-Posttraumatic Stress Disorder group (PGC-PTSD) combined genome-wide case-control molecular genetic data across 11 multiethnic studies to quantify PTSD heritability, to examine potential shared genetic risk with schizophrenia, bipolar disorder, and major depressive disorder and to identify risk loci for PTSD. Examining 20 730 individuals, we report a molecular genetics-based heritability estimate (h2SNP) for European-American females of 29% that is similar to h2SNP for schizophrenia and is substantially higher than h2SNP in European-American males (estimate not distinguishable from zero). We found strong evidence of overlapping genetic risk between PTSD and schizophrenia along with more modest evidence of overlap with bipolar and major depressive disorder. No single-nucleotide polymorphisms (SNPs) exceeded genome-wide significance in the transethnic (overall) meta-analysis and we do not replicate previously reported associations. Still, SNP-level summary statistics made available here afford the best-available molecular genetic index of PTSD-for both European- and African-American individuals-and can be used in polygenic risk prediction and genetic correlation studies of diverse phenotypes. Publication of summary statistics for â¼10 000 African Americans contributes to the broader goal of increased ancestral diversity in genomic data resources. In sum, the results demonstrate genetic influences on the development of PTSD, identify shared genetic risk between PTSD and other psychiatric disorders and highlight the importance of multiethnic/racial samples. As has been the case with schizophrenia and other complex genetic disorders, larger sample sizes are needed to identify specific risk loci.
Sujet(s)
Schizophrénie/génétique , Troubles de stress post-traumatique/génétique , Adulte , /génétique , Trouble bipolaire/génétique , Études cas-témoins , Trouble dépressif majeur/génétique , Femelle , Prédisposition génétique à une maladie/génétique , Étude d'association pangénomique , Humains , Mâle , Adulte d'âge moyen , Hérédité multifactorielle/génétique , Polymorphisme de nucléotide simple , Facteurs de risque , Caractères sexuels , Facteurs sexuels , /génétiqueRÉSUMÉ
BACKGROUND: Recent studies have implicated inflammatory processes in the pathophysiology of posttraumatic stress disorder (PTSD). C-reactive protein (CRP) is a widely-used measure of peripheral inflammation, but little is known about the genetic and epigenetic factors that influence blood levels of C-reactive protein (CRP) in individuals with PTSD. METHODS: Participants were 286 U.S. military veterans of post-9/11 conflicts (57% with current PTSD). Analyses focused on single nucleotide polymorphisms (SNPs) in the CRP gene and DNA methylation at cg10636246 in AIM2-a locus recently linked to CRP levels through results from a large-scale epigenome-wide association study. RESULTS: PTSD was positively correlated with serum CRP levels with PTSD cases more likely to have CRP levels in the clinically-elevated range compared to those without a PTSD diagnosis. Multivariate analyses that controlled for white blood cell proportions, genetic principal components, age and sex, showed this association to be mediated by methylation at the AIM2 locus. rs3091244, a functional SNP in the CRP promoter region, moderated the association between lifetime trauma exposure and current PTSD severity. Analyses also revealed that the top SNPs from the largest genome-wide association study of CRP conducted to date (rs1205 and rs2794520) significantly interacted with PTSD to influence CRP levels. CONCLUSIONS: These findings provide new insights into genetic and epigenetic mechanisms of inflammatory processes in the pathophysiology of PTSD and point to new directions for biomarker identification and treatment development for patients with PTSD.
Sujet(s)
Protéine C-réactive/génétique , Méthylation de l'ADN , Protéines de liaison à l'ADN/génétique , Troubles de stress post-traumatique/génétique , Adulte , Protéine C-réactive/métabolisme , Femelle , Étude d'association pangénomique , Humains , Inflammation/génétique , Inflammation/métabolisme , Mâle , Polymorphisme de nucléotide simple , Troubles de stress post-traumatique/sang , Anciens combattantsRÉSUMÉ
The negative long-term effects of mild traumatic brain injury (mTBI) have been a growing concern in recent years, with accumulating evidence suggesting that mTBI combined with additional vulnerability factors may induce neurodegenerative-type changes in the brain. However, the factors instantiating risk for neurodegenerative disease following mTBI are unknown. This study examined the link between mTBI and brain-derived neurotrophic factor (BDNF) genotype, which has previously been shown to regulate processes involved in neurodegeneration including synaptic plasticity and facilitation of neural survival through its expression. Specifically, we examined nine BDNF single-nucleotide polymorphisms (SNPs; rs908867, rs11030094, rs6265, rs10501087, rs1157659, rs1491850, rs11030107, rs7127507 and rs12273363) previously associated with brain atrophy or memory deficits in mTBI. Participants were 165 white, non-Hispanic Iraq and Afghanistan war veterans between the ages of 19 and 58, 110 of whom had at least one mTBI in their lifetime. Results showed that the BDNF SNP rs1157659 interacted with mTBI to predict hippocampal volume. Furthermore, exploratory analysis of functional resting state data showed that rs1157659 minor allele homozygotes with a history of mTBI had reduced functional connectivity in the default mode network compared to major allele homozygotes and heterozygotes. Apolipoprotein E (APOE) was not a significant predictor of hippocampal volume or functional connectivity. These results suggest that rs1157659 minor allele homozygotes may be at greater risk for neurodegeneration after exposure to mTBI and provide further evidence for a potential role for BDNF in regulating neural processes following mTBI.
Sujet(s)
Lésions encéphaliques/génétique , Lésions encéphaliques/anatomopathologie , Facteur neurotrophique dérivé du cerveau/génétique , Hippocampe/anatomopathologie , Commotion de l'encéphale/génétique , Commotion de l'encéphale/anatomopathologie , Génotype , Hippocampe/physiopathologie , Humains , Tests neuropsychologiques , Polymorphisme de nucléotide simple/génétique , RisqueRÉSUMÉ
Demographic data for Elkhorn coral, Acropora palmata, and in situ water temperature data from seven upper Florida Keys (USA) reefs revealed three warm thermal stress events between 2010 and 2016. During a mild bleaching event in 2011, up to 59% of colonies bleached, but no mortality resulted. In both 2014 and 2015, severe and unprecedented bleaching was observed with up to 100% of colonies bleached. A. palmata live tissue cover declined by one-third following the 2014-2015 events. Colony mortality of mildly- and non-bleached colonies did not differ but increased significantly with more severe bleaching. Increased bleaching prevalence corresponded to maximum daily average water temperatures above 31.3°C. However, the cumulative days with daily average exceeding 31.0°C provided a better predictor of bleaching response. The bleaching response of surviving colonies in 2015 was not consistent with acclimatization as most individual colonies bleached at least as badly as in 2014.
Sujet(s)
Anthozoa , Espèce en voie de disparition , Acclimatation , Animaux , Anthozoa/physiologie , Récifs de corail , Floride , Stress physiologique , TempératureRÉSUMÉ
Foundation species such as redwoods, seagrasses and corals are often long-lived and clonal. Genets may consist of hundreds of members (ramets) and originated hundreds to thousands of years ago. As climate change and other stressors exert selection pressure on species, the demography of populations changes. Yet, because size does not indicate age in clonal organisms, demographic models are missing data necessary to predict the resilience of many foundation species. Here, we correlate somatic mutations with genet age of corals and provide the first, preliminary estimates of genet age in a colonial animal. We observed somatic mutations at five microsatellite loci in rangewide samples of the endangered coral, Acropora palmata (n = 3352). Colonies harboured 342 unique mutations in 147 genets. Genet age ranged from 30 to 838 years assuming a mutation rate of 1.195-04 per locus per year based on colony growth rates and 236 to 6500 years assuming a mutation rate of 1.542-05 per locus per year based on sea level changes to habitat availability. Long-lived A. palmata genets imply a large capacity to tolerate past environmental change, and yet recent mass mortality events in A. palmata suggest that capacity is now being frequently exceeded.
Sujet(s)
Anthozoa/génétique , Génétique des populations , Animaux , Caraïbe , Analyse de mutations d'ADN , Écosystème , Floride , Longévité , Répétitions microsatellitesRÉSUMÉ
Methylation of the SKA2 (spindle and kinetochore-associated complex subunit 2) gene has recently been identified as a promising biomarker of suicide risk. Based on this finding, we examined associations between SKA2 methylation, cortical thickness and psychiatric phenotypes linked to suicide in trauma-exposed veterans. About 200 trauma-exposed white non-Hispanic veterans of the recent conflicts in Iraq and Afghanistan (91% male) underwent clinical assessment and had blood drawn for genotyping and methylation analysis. Of all, 145 participants also had neuroimaging data available. Based on previous research, we examined DNA methylation at the cytosine-guanine locus cg13989295 as well as DNA methylation adjusted for genotype at the methylation-associated single nucleotide polymorphism (rs7208505) in relationship to whole-brain cortical thickness, posttraumatic stress disorder symptoms (PTSD) and depression symptoms. Whole-brain vertex-wise analyses identified three clusters in prefrontal cortex that were associated with genotype-adjusted SKA2 DNA methylation (methylation(adj)). Specifically, DNA methylation(adj) was associated with bilateral reductions of cortical thickness in frontal pole and superior frontal gyrus, and similar effects were found in the right orbitofrontal cortex and right inferior frontal gyrus. PTSD symptom severity was positively correlated with SKA2 DNA methylation(adj) and negatively correlated with cortical thickness in these regions. Mediation analyses showed a significant indirect effect of PTSD on cortical thickness via SKA2 methylation status. Results suggest that DNA methylation(adj) of SKA2 in blood indexes stress-related psychiatric phenotypes and neurobiology, pointing to its potential value as a biomarker of stress exposure and susceptibility.
Sujet(s)
Protéines chromosomiques nonhistones/génétique , Méthylation de l'ADN/génétique , Polymorphisme de nucléotide simple/génétique , Cortex préfrontal/anatomopathologie , Troubles de stress post-traumatique/génétique , Troubles de stress post-traumatique/prévention et contrôle , Adulte , Dépression/étiologie , Femelle , Études d'associations génétiques , Génotype , Humains , Guerre d'Irak (2003-2011) , Modèles linéaires , Mâle , Neuroimagerie , Échelles d'évaluation en psychiatrie , Troubles de stress post-traumatique/complications , Anciens combattants , Jeune adulteRÉSUMÉ
Rising sea levels and temperature will be dominant drivers of coastal Everglades' foundation communities (i.e., mangrove forests, seagrass/macroalgae, and coral reefs) by 2060 based on a climate change scenario of +1.5 °C temperature, +1.5 foot (46 cm) in sea level, ±10 % in precipitation and 490 ppm CO2. Current mangrove forest soil elevation change in South Florida ranges from 0.9 to 2.5 mm year(-1) and would have to increase twofold to fourfold in order to accommodate a 2060 sea level rise rate. No evidence is available to indicate that coastal mangroves from South Florida and the wider Caribbean can keep pace with a rapid rate of sea level rise. Thus, particles and nutrients from destabilized coastlines could be mobilized and impact benthic habitats of southern Florida. Uncertainties in regional geomorphology and coastal current changes under higher sea levels make this prediction tentative without further research. The 2060 higher temperature scenario would compromise Florida's coral reefs that are already degraded. We suggest that a new paradigm is needed for resource management under climate change that manages coastlines for resilience to marine transgression and promotes active ecosystem management. In the case of the Everglades, greater freshwater flows could maximize mangrove peat accumulation, stabilize coastlines, and limit saltwater intrusion, while specific coral species may require propagation. Further, we suggest that regional climate drivers and oceanographic processes be incorporated into Everglades and South Florida management plans, as they are likely to impact coastal ecosystems, interior freshwater wetlands and urban coastlines over the next few decades.
Sujet(s)
Changement climatique , Conservation des ressources naturelles/méthodes , Écosystème , Zones humides , Récifs de corail , Floride , Forêts , Mouvements de l'eauRÉSUMÉ
Post-traumatic stress disorder (PTSD) is associated with elevated risk for a variety of age-related diseases and neurodegeneration. In this paper, we review evidence relevant to the hypothesis that chronic PTSD constitutes a form of persistent life stress that potentiates oxidative stress (OXS) and accelerates cellular aging. We provide an overview of empirical studies that have examined the effects of psychological stress on OXS, discuss the stress-perpetuating characteristics of PTSD, and then identify mechanisms by which PTSD might promote OXS and accelerated aging. We review studies on OXS-related genes and the role that they may have in moderating the effects of PTSD on neural integrity and conclude with a discussion of directions for future research on antioxidant treatments and biomarkers of accelerated aging in PTSD.
Sujet(s)
Vieillissement/physiologie , Dégénérescence nerveuse/physiopathologie , Stress oxydatif/physiologie , Troubles de stress post-traumatique/physiopathologie , Stress psychologique/physiopathologie , Vieillissement/génétique , Animaux , Maladie chronique , Humains , Dégénérescence nerveuse/génétique , Stress oxydatif/génétique , Troubles de stress post-traumatique/génétique , Stress psychologique/génétiqueRÉSUMÉ
BACKGROUND: Published information regarding survival and long-term cardiac remodeling after patent ductus arteriosus (PDA) closure in dogs is limited. OBJECTIVES: To report outcome and identify prognostic variables in dogs with PDA, and to identify risk factors for persistent remodeling in dogs with a minimum of 12 months of follow-up after closure. ANIMALS: Five hundred and twenty client-owned dogs. METHODS: Retrospective review of medical records of 520 dogs with PDA. Outcome was determined by contacting owners and veterinarians. Dogs with PDA closure and ≥ 12 months of follow-up were asked to return for a re-evaluation. RESULTS: In multivariable analysis of 506 dogs not euthanized at the time of diagnosis, not having a PDA closure procedure negatively affected survival (HzR = 16.9, P < .001). In 444 dogs undergoing successful PDA closure, clinical signs at presentation (HzR = 17, P = .02), concurrent congenital heart disease (HD) (HzR = 4.8, P = .038), and severe mitral regurgitation (MR) documented within 24 hours of closure (HzR = 4.5, P = .028) negatively affected survival. Seventy-one dogs with ≥ 12 months follow-up demonstrated a significant reduction in radiographic and echocardiographic measures of heart size (P = 0) and increased incidence of acquired HD (P = .001) at re-evaluation. Dogs with increased left ventricular size and low fractional shortening at baseline were more likely to have persistent remodeling at re-evaluation. CONCLUSIONS AND CLINICAL IMPORTANCE: Patent ductus arteriosus closure confers important survival benefits and results in long-term reverse remodeling in most dogs. Clinical signs at presentation, concurrent congenital HD, and severe MR negatively affect survival. Increased left ventricular systolic dimensions and systolic dysfunction at baseline correlated significantly with persistent remodeling.
Sujet(s)
Maladies des chiens/diagnostic , Persistance du canal artériel/médecine vétérinaire , Animaux , Maladies des chiens/mortalité , Maladies des chiens/physiopathologie , Chiens , Persistance du canal artériel/diagnostic , Persistance du canal artériel/mortalité , Persistance du canal artériel/physiopathologie , Femelle , Mâle , Pronostic , Facteurs de risque , Analyse de survie , Remodelage ventriculaire/physiologieRÉSUMÉ
BACKGROUND: Twin studies of veterans and adults suggest that approximately 30-46% of the variance in post-traumatic stress disorder (PTSD) is attributable to genetic factors. The remaining variance is attributable to the non-shared environment, which, by definition, includes combat exposure. This study used a gene by measured environment twin design to determine whether the effects of genetic and environmental factors that contribute to the etiology of PTSD are dependent on the level of combat exposure. METHOD: The sample was drawn from the Vietnam Era Twin Registry (VETR) and included 620 male-male twin pairs who served in the US Military in South East Asia during the Vietnam War era. Analyses were based on data from a clinical diagnostic interview of lifetime PTSD symptoms and a self-report measure of combat exposure. RESULTS: Biometric modeling revealed that the effects of genetic and non-shared environment factors on PTSD varied as a function of level of combat exposure such that the association between these factors and PTSD was stronger at higher levels of combat exposure. CONCLUSIONS: Combat exposure may act as a catalyst that augments the impact of hereditary and environmental contributions to PTSD. Individuals with the greatest exposure to combat trauma were at increased risk for PTSD as a function of both genetic and environmental factors. Additional work is needed to determine the biological and environmental mechanisms driving these associations.
Sujet(s)
Troubles psychiques liés à la guerre/complications , Interaction entre gènes et environnement , Enregistrements , Troubles de stress post-traumatique/étiologie , Troubles de stress post-traumatique/génétique , Anciens combattants/psychologie , Adulte , Maladies chez les jumeaux/étiologie , Maladies chez les jumeaux/génétique , Humains , Mâle , Adulte d'âge moyen , États-Unis , Anciens combattants/statistiques et données numériques , Guerre du VietnamRÉSUMÉ
BACKGROUND: Chagas disease (Trypanosomiasis) is a cause of myocarditis in the southern United States causing cardiac conduction abnormalities, arrhythmias, and heart failure. OBJECTIVES: To report clinical findings and outcome in Chagas positive (CP) dogs requiring pacemaker implantation for bradyarrhythmias. ANIMALS: One hundred and forty-four client-owned dogs requiring pacemaker implantation. METHODS: Retrospective case series. Information regarding history, physical exam, laboratory and diagnostic imaging findings, treatment, and survival were obtained from medical records, with additional follow-up information obtained by contacting referring veterinarians and owners. RESULTS: Of the 144 dogs requiring pacemaker implantation from January 2001 to May 2010, 83 (57.6%) had a Chagas titer performed and 9 (10%) were CP. Concurrent ventricular arrhythmias (odds ratio 1.61, P = .005) or atrioventricular (AV) block (odds ratio 4.18, P < .001) increased the likelihood that a Chagas titer was submitted. Median age for CP dogs was 6.2 years (range, 0.3-10); 7 were male. Bradyarrhythmias included high-grade 2nd or 3rd degree AV block (n = 8) and sinus bradycardia with 1st degree AV block (n = 1); 5 had concurrent ventricular arrhythmias. A positive Chagas titer had a negative impact on survival (hazard ratio 4.04; 95% CI 1.36-12.1, P = .012) with a reported median survival time of 365 days (interquartile range, 84-973 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Bradyarrhythmias can result in clinical signs requiring pacemaker implantation in CP dogs, and although the diagnosis negatively impacts survival, pacemaker therapy is a viable treatment option.
Sujet(s)
Bradycardie/médecine vétérinaire , Cardiomyopathie associée à la maladie de Chagas/médecine vétérinaire , Maladies des chiens/anatomopathologie , Pacemaker/médecine vétérinaire , Animaux , Bradycardie/étiologie , Bradycardie/anatomopathologie , Cardiomyopathie associée à la maladie de Chagas/complications , Cardiomyopathie associée à la maladie de Chagas/anatomopathologie , Maladies des chiens/thérapie , Chiens , Femelle , Modèles logistiques , MâleRÉSUMÉ
We describe the results of the first genome-wide association study (GWAS) of post-traumatic stress disorder (PTSD) performed using trauma-exposed white non-Hispanic participants from a cohort of veterans and their intimate partners (295 cases and 196 controls). Several single-nucleotide polymorphisms (SNPs) yielded evidence of association. One SNP (rs8042149), located in the retinoid-related orphan receptor alpha gene (RORA), reached genome-wide significance. Nominally significant associations were observed for other RORA SNPs in two African-American replication samples-one from the veteran cohort (43 cases and 41 controls) and another independent cohort (100 cases and 421 controls). However, only the associated SNP from the veteran African-American replication sample survived gene-level multiple-testing correction. RORA has been implicated in prior GWAS studies of psychiatric disorders and is known to have an important role in neuroprotection and other behaviorally relevant processes. This study represents an important step toward identifying the genetic underpinnings of PTSD.
Sujet(s)
Prédisposition génétique à une maladie/génétique , Membre-1 du groupe F de la sous-famille-1 de récepteurs nucléaires/génétique , Troubles de stress post-traumatique/génétique , /génétique , Études cas-témoins , Femelle , Étude d'association pangénomique , Humains , Mâle , Adulte d'âge moyen , Polymorphisme de nucléotide simple , /génétiqueRÉSUMÉ
Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) mainly affecting cervids in North America. The accumulation of an abnormal form of host-encoded prion protein (PrP(CWD) ) in the CNS and lymphoid tissues is characteristic of the disease and known to be caused by pathogenic prion proteins (PrP(res) ), which are thought to be transmitted mainly by contact with body fluids, such like saliva. Species known to be naturally infected by CWD include Rocky Mountain elk (Cervus elaphus nelsoni), white-tailed deer (Odocoileus virginianus) and mule deer (Odocoileus hemionus). Recently, large-scale disease eradication or control programs have been attempted to curtail the spread of disease. But reports of diseased free-ranging and farmed cervids in many locations in the USA and Canada are still continuing. The goal of this study was to find sensitive rapid test systems that are reliably able to detect CWD-associated PrP(CWD) in cervids, thereby reviewing an important control tool in case the disease spreads further and reaches Europe. Seven tests, originally developed for the detection of other TSE diseases such as Scrapie and bovine spongiform encephalopathy, including two Western blots, four enzyme-linked immunosorbent assays (ELISAs), and one lateral flow device, were included in this study. All seven tests evaluated were able to detect pathogenic prion proteins (PrP(CWD) ) in Northern American infected animals and distinguish physiologic prion protein (PrP(c) ) in brainstem (obex region) and lymph node samples from North American and European cervids, respectively. However, the specificity and sensitivity of the tests differed significantly. Highly sensitive tests for the detection of prion proteins are an important tool both for the design of effective disease surveillance and control strategies and the safety of the food chain. Thus, this study contributes to the emergency preparedness against CWD.
Sujet(s)
Cervidae , Encéphalopathie spongiforme bovine/diagnostic , Prions/isolement et purification , Tremblante/diagnostic , Maladie du dépérissement chronique/diagnostic , Animaux , Bovins , Colorado/épidémiologie , Europe/épidémiologie , Allemagne/épidémiologie , Sensibilité et spécificité , Maladie du dépérissement chronique/épidémiologie , Wisconsin/épidémiologieRÉSUMÉ
BACKGROUND: Identification of the bacterial organism in dogs with endocarditis is challenging. Human studies have reported the utility of the polymerase chain reaction (PCR) to amplify and identify bacterial nucleic acid from infected valvular tissue and blood. HYPOTHESIS/OBJECTIVES: We hypothesized that PCR using primers designed to amplify the bacterial 16s gene would identify circulating bacteria in dogs with suspected bacterial endocarditis more consistently than standard blood culture techniques. ANIMALS: Eighteen dogs with suspected bacterial endocarditis based upon clinical and echocardiographic findings. Fifteen clinically normal dogs served as negative controls. METHODS: Prospective study of dogs evaluated for suspect endocarditis at 6 veterinary hospitals. A blood sample was drawn from all dogs and evaluated with both a single-sample PCR and standard 3-sample blood culture techniques. RESULTS: Blood culture identified noncontaminant bacteria in 6/18 study animals (33%) and 1 control dog; PCR identified noncontaminant bacteria in 7/18 study animals (39%). There were no study animals in which the 2 tests identified different bacteria (κ = 1.0). However, bacteria were identified by both techniques in only 2/18 study animals. When results from both PCR and blood culture were considered together, a noncontaminant bacterial organism was identified in 11/18 study animals (61%). CONCLUSION AND CLINICAL IMPORTANCE: The results of this study suggest that although single sample PCR with 16s primers was not more sensitive than blood culture for detection of bacteremia in dogs with suspect endocarditis, performing both techniques simultaneously did increase the likelihood of identification of bacteria in blood.