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1.
PLoS One ; 16(2): e0247280, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33630906

RESUMO

BACKGROUND: The long-term clinical and physiological consequences of COVID-19 infection remain unclear. While fatigue has emerged as a common symptom following infection, little is known about its links with autonomic dysfunction. SARS-CoV-2 is known to infect endothelial cells in acute infection, resulting in autonomic dysfunction. Here we set out to test the hypothesis that this results in persistent autonomic dysfunction and is associated with post-COVID fatigue in convalescent patients. METHODS: We recruited 20 fatigued and 20 non-fatigued post-COVID patients (median age 44.5 years, 36/40 (90%) female, median time to follow up 166.5 days). Fatigue was assessed using the Chalder Fatigue Scale. These underwent the Ewing's autonomic function test battery, including deep breathing, active standing, Valsalva manoeuvre and cold-pressor testing, with continuous electrocardiogram and blood pressure monitoring, as well as near-infrared spectroscopy-based cerebral oxygenation. 24-hour ambulatory blood pressure monitoring was also conducted, and patients completed the generalised anxiety disorder-7 questionnaire. We assessed between-group differences in autonomic function test results and used unadjusted and adjusted linear regression to investigate the relationship between fatigue, anxiety, and autonomic test results. RESULTS: We found no pathological differences between fatigued and non-fatigued patients on autonomic testing or on 24-hour blood pressure monitoring. Symptoms of orthostatic intolerance were reported by 70% of the fatigued cohort at the time of active standing, with no associated physiological abnormality detected. Fatigue was strongly associated with increased anxiety (p <0.001), with no patients having a pre-existing diagnosis of anxiety. CONCLUSIONS: These results demonstrate the significant burden of fatigue, symptoms of autonomic dysfunction and anxiety in the aftermath of COVID-19 infection, but reassuringly do not demonstrate pathological findings on autonomic testing.


Assuntos
/patologia , Ansiedade/fisiopatologia , Sistema Nervoso Autônomo/patologia , Pressão Sanguínea , /psicologia , Eletrocardiografia , Fadiga/fisiopatologia , Frequência Cardíaca , Humanos , Pessoa de Meia-Idade
2.
Soc Work Public Health ; 36(2): 194-204, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33413035

RESUMO

This study aims to determine the effect on depression of elderly people's anxiety levels in quarantine during the COVID-19 pandemic. This is a descriptive study, in which data were collected using the online survey method, an introductory information form, a semistructured data form for COVID-19, the Trait Anxiety Inventory, and the Geriatric Depression Scale. Data were collected during the period when a curfew was imposed for the elderly. Data were analyzed using a structural equation model. According to the structural equation model, anxiety was determined as a predictor of depression. The anxiety levels of the elderly who were 65-74 years old, female, single; had insufficient knowledge about the pandemic; and had not encountered a similar outbreak before considered that family relationships were affected negatively so they became lonely and reported that they became bored, exhausted, and distressed during the pandemic, which increased their depression levels. Anxiety affects depression in the elderly. Therefore, it is recommended to provide them with appropriate psychological support interventions and understandable information about the pandemic so that their anxiety and depression levels can be reduced during the pandemic.


Assuntos
Ansiedade/fisiopatologia , Ansiedade/psicologia , Depressão , Quarentena/psicologia , Idoso , Bases de Dados Factuais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Pandemias , Índice de Gravidade de Doença , Distribuição por Sexo
3.
Int J Mol Sci ; 22(1)2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33466445

RESUMO

The lack of effective disease-modifying therapeutics to tackle Alzheimer's disease (AD) is unsettling considering the actual prevalence of this devastating neurodegenerative disorder worldwide. Intermittent hypoxic conditioning (IHC) is a powerful non-pharmacological procedure known to enhance brain resilience. In this context, the aim of the present study was to investigate the potential long-term protective impact of IHC against AD-related phenotype, putting a special focus on cognition and mitochondrial bioenergetics and dynamics. For this purpose, six-month-old male triple transgenic AD mice (3×Tg-AD) were submitted to an IHC protocol for two weeks and the behavioral assessment was performed at 8.5 months of age, while the sacrifice of mice occurred at nine months of age and their brains were removed for the remaining analyses. Interestingly, IHC was able to prevent anxiety-like behavior and memory and learning deficits and significantly reduced brain cortical levels of amyloid-ß (Aß) in 3×Tg-AD mice. Concerning brain energy metabolism, IHC caused a significant increase in brain cortical levels of glucose and a robust improvement of the mitochondrial bioenergetic profile in 3×Tg-AD mice, as mirrored by the significant increase in mitochondrial membrane potential (ΔΨm) and respiratory control ratio (RCR). Notably, the improvement of mitochondrial bioenergetics seems to result from an adaptative coordination of the distinct but intertwined aspects of the mitochondrial quality control axis. Particularly, our results indicate that IHC favors mitochondrial fusion and promotes mitochondrial biogenesis and transport and mitophagy in the brain cortex of 3×Tg-AD mice. Lastly, IHC also induced a marked reduction in synaptosomal-associated protein 25 kDa (SNAP-25) levels and a significant increase in both glutamate and GABA levels in the brain cortex of 3×Tg-AD mice, suggesting a remodeling of the synaptic microenvironment. Overall, these results demonstrate the effectiveness of the IHC paradigm in forestalling the AD-related phenotype in the 3×Tg-AD mouse model, offering new insights to AD therapy and forcing a rethink concerning the potential value of non-pharmacological interventions in clinical practice.


Assuntos
Doença de Alzheimer/fisiopatologia , Transtornos Cognitivos/fisiopatologia , Cognição/fisiologia , Metabolismo Energético/fisiologia , Hipóxia/fisiopatologia , Camundongos Transgênicos/fisiologia , Mitocôndrias/fisiologia , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Precursor de Proteína beta-Amiloide/metabolismo , Animais , Ansiedade/metabolismo , Ansiedade/fisiopatologia , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Transtornos Cognitivos/metabolismo , Modelos Animais de Doenças , Hipóxia/metabolismo , Masculino , Camundongos , Camundongos Transgênicos/metabolismo , Mitocôndrias/metabolismo
4.
Int J Mol Sci ; 22(2)2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33477830

RESUMO

The forced swim stress test (FST) is widely used for screening pharmacological or non-pharmacological strategies with potential antidepressant activities. Recent data have suggested that repeated FST for five consecutive days (i.e., 5d-RFSS) could be used to generate a robust depressive-like phenotype in mice. However, the face, construct, and predictive validities of 5d-RFSS have been recently challenged. This study took advantage of recent findings showing that mice vulnerability to anxiety is enhanced when animals are stressed during the dark phase, to provide new insight into the relevance of this model. Our results showed a progressive increase in time of immobility in 5d-RFSS mice relative to control non-stressed animals (sham). Three weeks later, we noticed that 5d-RFSS mice injected with the vehicle compound (Veh) still exhibited a high level of immobility in the FST whereas this behavior was reversed by the antidepressant drug amitriptyline (AMI). However, 5d-RFSS/Veh and 5d-RFSS mice/AMI mice showed normal performances in the open field, the novelty suppressed feeding and the tail suspension tests. Despite this lack of generalized behavioral deficits, an impairment of different parameters characterizing the hypothalamic-pituitary-adrenal (HPA) axis reactivity was evidenced in 5d-RFSS mice/Veh but not in 5d-RFSS mice/AMI. Despite anomalies in the HPA axis, the activity of the central serotonergic system remained unaffected in 5d-RFSS mice relative to controls. From our results, it is suggested that learned immobility does not replicate the broad spectrum of depressive symptoms observed in other chronic models of depression such as the unpredictable chronic mild stress (UCMS) model, the chronic social defeat stress (CSDS) model or chronic corticosterone (CORT) exposure but its influence on the HPA axis is remarkable. Further experiments are warranted to makes this model suitable for modelling depression and therefore refine its translational applicability.


Assuntos
Ansiedade/tratamento farmacológico , Corticosterona/farmacologia , Transtorno Depressivo/tratamento farmacológico , Estresse Psicológico/tratamento farmacológico , Animais , Antidepressivos/farmacologia , Ansiedade/fisiopatologia , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/patologia , Comportamento Animal/efeitos dos fármacos , Transtorno Depressivo/patologia , Modelos Animais de Doenças , Humanos , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Sistema Hipotálamo-Hipofisário/patologia , Camundongos , Fenótipo , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Sistema Hipófise-Suprarrenal/patologia , Estresse Psicológico/patologia , Natação
5.
Arch Pediatr ; 28(2): 136-140, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33446428

RESUMO

OBJECTIVES: Besides infectious pneumonia and death risks, the COVID-19 pandemic has prompted negative psychological impacts on communities, especially on people with chronic diseases. We aimed to evaluate COVID-19 and sickle cell disease (SCD)-related experiences, and the clinical course during the outbreak, to measure anxiety levels of adolescent and young adult patients with homozygous SCD, to analyze the correlations between their COVID-19 experiences and anxiety levels and painful episodes. METHODS: In this cross-sectional study, 47 patients aged between 14 and 24 years responded to a descriptive instrument and the State-Trait Anxiety Inventory. Clinical features requiring hospitalization for the same period (between March 10 and May 10) of two sequential years were compared. RESULTS: Sixty-six percent of the patients had at least one negative COVID-19 experience of dizziness, sleep disturbance, tonic immobility, appetite loss or nausea/abdominal distress. The number of negative COVID-19 experiences was correlated with the state anxiety score, the trait anxiety score, and the number of painful episodes (ρ=0.552, P<0.001; ρ=0.529, P<0.001; ρ=0.448, P=0.002, respectively). Both median state anxiety and trait anxiety scores were below the cut-off scores indicating significant clinical symptoms. The number of hospitalizations requiring vaso-occlusive crisis management and blood/exchange transfusion were similar for the same period of two sequential years, 2019 and 2020. CONCLUSION: These descriptive and correlation findings are the first reported on COVID-19-related anxiety in SCD patients. To develop screening and support strategies for mental health needs in pandemic times, further SCD studies should be conducted.


Assuntos
Anemia Falciforme/psicologia , Ansiedade/etiologia , /psicologia , Adolescente , Anemia Falciforme/fisiopatologia , Ansiedade/diagnóstico , Ansiedade/fisiopatologia , Estudos Transversais , Progressão da Doença , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Turquia , Adulto Jovem
6.
J Ethnopharmacol ; 265: 113337, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32890709

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: In the Indian system of medicine, Withania somnifera (L.) Dunal, Hemidesmus indicus (R.Br.), Aegle marmelos (L.) Correa, Emblica officinalis Gaertn, Ocimum sanctum (L.) has been mentioned as a remedy for the treatment of anxiety related disorders. Based on their folklore use, a polyherbal combination was derived for the management of anxiety. AIM OF THE STUDY: The present study is aimed to find the best polyherbal combination (PHC), in terms of its pharmacological action, out of two PHC, namely PHC1 and PHC3, prepared based on the previous studies conducted and to carry out the pharmacokinetic (PK) study of the best combination (PHC3). MATERIALS AND METHODS: Pharmacological activities include elevated plus maze model and hole-board test for anti-anxiety screening, gamma amino-butyric acid (GABAA) measurement in brain tissues and superoxide dismutase, lipid peroxidation and reduced glutathione measurement for anti-oxidant screening. RESULTS: PHC3 (100 mg/kg) produced statistically significant (p < 0.05) effect on all the pharmacological outcome measures when compared to alprazolam standard. Therefore, it was chosen for PK study. PK study was carried out using Liquid Chromatography Mass Spectroscopy technique with respect to Withaferin-A. PK parameters such as maximum plasma concentration (Cmax), 16.78 ± 5.32 ng/mL; time of maximum concentration (Tmax), 18 ± 0.12min; half-life (T1/2) 61.20 ± 9.87min; mean residual time (MRT), 7.53 h s; area under the concentration versus time curve (AUC0-1), 1678 ± 34.13 ng/mL; area under the concentration versus time curve from zero to infinity (AUC0-∞), 1705 ± 28.87 ng/mL; total clearance (CL), 290.67 ± 15.89 mL/min and volume of distribution (Vd) 0.054 L were calculated. CONCLUSIONS: The results of the studies revealed that PHC3 possessed significant anxiolytic, anti-oxidant activities and enhanced expression of GABAA mediated inhibition when compared to PHC1. Withaferin-A in PHC3 exhibited a rapid oral absorption in rat plasma. The findings of this study greatly help to provide useful evidence for the development of suitable formulation using PHC3.


Assuntos
Ansiolíticos/farmacologia , Ansiedade/tratamento farmacológico , Extratos Vegetais/farmacologia , Withania/química , Alprazolam/farmacologia , Animais , Ansiolíticos/isolamento & purificação , Ansiolíticos/farmacocinética , Antioxidantes/isolamento & purificação , Antioxidantes/farmacocinética , Antioxidantes/farmacologia , Ansiedade/fisiopatologia , Área Sob a Curva , Modelos Animais de Doenças , Glutationa/metabolismo , Meia-Vida , Índia , Masculino , Extratos Vegetais/química , Extratos Vegetais/farmacocinética , Ratos , Ratos Sprague-Dawley , Distribuição Tecidual , Vitanolídeos/isolamento & purificação , Vitanolídeos/farmacologia
7.
PLoS Comput Biol ; 16(12): e1008484, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33315893

RESUMO

Recent neurocomputational theories have hypothesized that abnormalities in prior beliefs and/or the precision-weighting of afferent interoceptive signals may facilitate the transdiagnostic emergence of psychopathology. Specifically, it has been suggested that, in certain psychiatric disorders, interoceptive processing mechanisms either over-weight prior beliefs or under-weight signals from the viscera (or both), leading to a failure to accurately update beliefs about the body. However, this has not been directly tested empirically. To evaluate the potential roles of prior beliefs and interoceptive precision in this context, we fit a Bayesian computational model to behavior in a transdiagnostic patient sample during an interoceptive awareness (heartbeat tapping) task. Modelling revealed that, during an interoceptive perturbation condition (inspiratory breath-holding during heartbeat tapping), healthy individuals (N = 52) assigned greater precision to ascending cardiac signals than individuals with symptoms of anxiety (N = 15), depression (N = 69), co-morbid depression/anxiety (N = 153), substance use disorders (N = 131), and eating disorders (N = 14)-who failed to increase their precision estimates from resting levels. In contrast, we did not find strong evidence for differences in prior beliefs. These results provide the first empirical computational modeling evidence of a selective dysfunction in adaptive interoceptive processing in psychiatric conditions, and lay the groundwork for future studies examining how reduced interoceptive precision influences visceral regulation and interoceptively-guided decision-making.


Assuntos
Ansiedade/fisiopatologia , Teorema de Bayes , Simulação por Computador , Depressão/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/fisiopatologia , Magreza/fisiopatologia , Adulto Jovem
8.
Mayo Clin Proc ; 95(11): 2487-2498, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33153636

RESUMO

In light of the coronavirus disease 2019 pandemic, we explore the role of stress, fear, and the impact of positive and negative emotions on health and disease. We then introduce strategies to help mitigate stress within the health care team, and provide a rationale for their efficacy. Additionally, we identify strategies to optimize patient care and explain their heightened importance in today's environment.


Assuntos
Infecções por Coronavirus/psicologia , Medo/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Relações Profissional-Paciente , Estresse Psicológico/etiologia , Adaptação Psicológica , Ansiedade/etiologia , Ansiedade/fisiopatologia , Ansiedade/prevenção & controle , Estado Terminal , Medo/fisiologia , Saúde Global , Humanos , Relações Interpessoais , Saúde Mental , Saúde do Trabalhador , Pandemias , Resiliência Psicológica , Estresse Psicológico/fisiopatologia , Estresse Psicológico/prevenção & controle
9.
Maturitas ; 141: 1-8, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33036697

RESUMO

OBJECTIVE: Our study aims to investigate the differences in insomnia between Chinese and Western women during menopause to fill the gaps in the research on menopause in Chinese women, and to examine the premenopausal factors predictive of moderate to severe insomnia during menopause. STUDY DESIGN: This is a longitudinal cohort study conducted in an urban Chinese community with a total of 458 participants. MAIN OUTCOME MEASURES: Presence of insomnia symptoms (trouble falling asleep, waking up early); vasomotor symptoms; anxiety and depression assessed by the Hospital Anxiety and Depression Scale; and menopausal stages. RESULTS: Multivariable analysis showed that compared with that in premenopause, the prevalence of trouble falling asleep was significantly higher in menopausal transition (P = 0.029) and postmenopause (P < 0.001), and the prevalence of early-morning awakenings also significantly increased in menopausal transition (P = 0.003) and postmenopause (P = 0.011). In multivariable analysis anxiety (P = 0.022) and depression (P = 0.005) were independently and significantly positively associated with trouble falling asleep. Anxiety (P < 0.001), depression (P = 0.018), and levels of follicle stimulating hormone (P-0.031) were independently and significantly positively associated with trouble falling asleep. Women who experienced insomnia in premenopause had a significantly higher risk of moderate to severe insomnia in menopausal transition (P = 0.003) and postmenopause (P = 0.047) than those who did not. CONCLUSION: This study showed that the prevalence of sleep disturbance significantly increased during and after menopause. Women with anxiety and depression had a higher risk of insomnia. Difficulty in sleep initiation in the premenopausal period was a strong predictor of moderate to severe insomnia at menopausal transition and postmenopause.


Assuntos
Ansiedade/fisiopatologia , Depressão/fisiopatologia , Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Sono , Adulto , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Estudos de Coortes , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Estudos Longitudinais , Menopausa/fisiologia , Pessoa de Meia-Idade , Perimenopausa , Pós-Menopausa , Pré-Menopausa , Prevalência , Fatores de Risco , Transtornos do Sono-Vigília
10.
Epilepsy Behav ; 112: 107396, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32911299

RESUMO

BACKGROUND: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. METHODS: This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. RESULTS: One hundred patients were included, 52% women, mean age 42.4 years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; p = 0.008) and a prior higher seizure frequency (OR: 12.4; p = 0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; p = 0.03) and recent adjustment of antiepileptics (OR: 0.07; p = 0.01) acted as protecting factors. CONCLUSIONS: A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.


Assuntos
Anticonvulsivantes/uso terapêutico , Ansiedade/fisiopatologia , Infecções por Coronavirus , Epilepsia/fisiopatologia , Pandemias , Pneumonia Viral , Estresse Psicológico/fisiopatologia , Adolescente , Adulto , Ansiedade/psicologia , Betacoronavirus , Depressão/fisiopatologia , Depressão/psicologia , Progressão da Doença , Epilepsia/tratamento farmacológico , Epilepsia/psicologia , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Convulsões/fisiopatologia , Privação do Sono/fisiopatologia , Espanha , Estado Epiléptico/fisiopatologia , Estresse Psicológico/psicologia
11.
PLoS One ; 15(9): e0238457, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911486

RESUMO

Anxiety and depression are common among patients with chronic physical illnesses and have a significant impact on morbidity, quality of life, and health service utilisation. Psychological treatment of anxiety and depression has small to moderate efficacy in this group and is not commonly based on a model of causal mechanisms. A novel approach to understanding and improving mental health outcomes in physical illnesses is needed. One approach may be to explore the role of metacognitive beliefs which are reliably associated with anxiety and depression in individuals with mental health difficulties. The current systematic review aimed to evaluate the contribution of metacognitive beliefs to anxiety and depression across physical illnesses. Systematic searches were conducted on Web of Science, PsychINFO, MEDLINE, Embase, and CINAHL of studies published between 1997 and January 2019. 13 eligible studies were identified that in sum comprised 2851 participants. Metacognitive beliefs were found to have reliable, moderate, positive and significant associations with anxiety and depression symptoms across a range of physical illnesses. There appeared to be commonality and some specificity in the relationships. Negative metacognitive beliefs concerned with uncontrollability and danger of worry were associated with both anxiety and depression across all physical illnesses assessed, whilst more specific associations emerged for individual medical conditions where positive beliefs about worry, cognitive confidence and cognitive self-consciousness were unique correlates. Negative metacognitive beliefs of uncontrollability and danger significantly and positively predicted symptoms of anxiety and depression after controlling for factors including age, gender, disease factors and cognition (illness perceptions and intolerance of uncertainty). The results suggest that the metacognitive model of psychological disorder is applicable to psychological symptoms of anxiety and depression across a range of chronic medical conditions, implying that metacognitive therapy might be helpful in improving outcomes in multiple morbidities that involve poor mental and medical health.


Assuntos
Metacognição/fisiologia , Aptidão Física/psicologia , Adulto , Ansiedade/fisiopatologia , Ansiedade/psicologia , Cognição , Depressão/fisiopatologia , Depressão/psicologia , Emoções , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Modelos Psicológicos , Qualidade de Vida , Inquéritos e Questionários
12.
Proc Natl Acad Sci U S A ; 117(40): 25116-25127, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-32958652

RESUMO

The ventromedial prefrontal cortex (vmPFC) is a key brain structure implicated in mood and anxiety disorders, based primarily on evidence from correlational neuroimaging studies. Composed of a number of brain regions with distinct architecture and connectivity, dissecting its functional heterogeneity will provide key insights into the symptomatology of these disorders. Focusing on area 14, lying on the medial and orbital surfaces of the gyrus rectus, this study addresses a key question of causality. Do changes in area 14 activity induce changes in threat- and reward-elicited responses within the nonhuman primate, the common marmoset, similar to that seen in mood and anxiety disorders? Area 14 overactivation was found to induce heightened responsivity to uncertain, low-imminence threat while blunting cardiovascular and behavioral anticipatory arousal to high-value food reward. Conversely, inactivation enhanced the arousal to high-value reward cues while dampening the acquisition of cardiovascular and behavioral responses to a Pavlovian threat cue. Basal cardiovascular activity, including heart rate variability and sympathovagal balance, which are dysfunctional in mood and anxiety disorders, are insensitive to alterations in area 14 activity as is the extinction of conditioned threat responses. The distinct pattern of dysregulation compared to neighboring region area 25 highlights the heterogeneity of function within vmPFC and reveals how the effects of area 14 overactivation on positive and negative reactivity mirror symptoms of anhedonia and anxiety that are so often comorbid in mood disorders.


Assuntos
Ansiedade/diagnóstico por imagem , Mapeamento Encefálico , Callithrix/fisiologia , Córtex Pré-Frontal/diagnóstico por imagem , Animais , Ansiedade/fisiopatologia , Condicionamento Clássico/fisiologia , Frequência Cardíaca/fisiologia , Humanos , Imagem por Ressonância Magnética , Córtex Pré-Frontal/fisiologia , Recompensa
13.
PLoS One ; 15(9): e0238514, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32877438

RESUMO

Chronotype is a circadian phenotype expressed in the preference of individuals to perform their activities and sleep in specific phases along the day. The objective of the study was to identify anxiety levels, quality of sleep and different chronotypes of university students and investigate their possible relationships. This is a cross-sectional study with a quantitative approach, in which 103 undergraduate students answered the Morningness-Eveningness Questionnaire (MEQ) the State and Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI). There is a relationship between chronotype, quality of sleep and anxiety in the investigated population. Evening chronotype students showed higher anxiety status and have poor sleep quality when compared with morning chronotype students. The high occurrence of anxiety levels and poor sleep quality in evening students may be a consequence of high academic demand in a shift incompatible with the phase delay of the circadian timing system of these individuals.


Assuntos
Ansiedade/fisiopatologia , Ritmo Circadiano/fisiologia , Sono/fisiologia , Estudantes , Universidades , Feminino , Humanos , Modelos Lineares , Masculino , Inquéritos e Questionários , Adulto Jovem
14.
J Stroke Cerebrovasc Dis ; 29(9): 105082, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807479

RESUMO

BACKGROUND: There is relatively limited information on the risk factors and outcome of new onset Poststroke Anxiety (PSA) in Low- and Middle-Income Countries. We estimated incidence, cumulative incidence, risk factors and outcome of new onset anxiety in the first year of stroke among African stroke survivors. METHODS: We analyzed the dataset of a completed clinical trial comprising patients enrolled to test an intervention designed to improve one-year blood pressure control among recent (≤ one month) stroke survivors in Nigeria. Anxiety was measured using the Hospital Anxiety and Depression Scale. Outcomes were assessed using the modified Rankin Scale (mRS), Community screening instrument for dementia (CSID) and Health Related Quality of Life in Stroke Patients (HRQOLISP-26). RESULTS: Among 322 stroke survivors who were free of anxiety at baseline, we found a one-year cumulative incidence of 34% (95% CI = 28.6-39.3). Rates were 36.2% (95% CI =29.6-42.7) for men and 29.2% (95% CI =19.9-38.3) for women. In multivariate Cox regression analyses, haemorrhagic stroke type was associated with higher risk of new onset PSA (Hazard Ratio=1.52, 95% CI =1.01-2.29). New onset PSA was independently associated with cognitive [(mean difference (MD) in CSID scores=1.1, 95% C.I=0.2, 1.9)] and motor decline (MD in mRS scores= -0.2, 95% C.I= -0.4, -0.02), as well as poorer quality of life overtime (MD in total HRQOLISP-26 scores=3.6, 95% C.I=1.0, 6.2). CONCLUSION: One in 3 stroke survivors in Nigeria had PSA at one year. Clinicians in SSA should pay special attention to survivors of haemorrhagic stroke as they are at higher risk of incident anxiety and therefore its consequences.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Ansiedade/psicologia , Hemorragias Intracranianas/psicologia , Acidente Vascular Cerebral/psicologia , Idoso , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/fisiopatologia , Cognição , Avaliação da Deficiência , Emoções , Feminino , Humanos , Incidência , Hemorragias Intracranianas/diagnóstico , Hemorragias Intracranianas/etnologia , Hemorragias Intracranianas/fisiopatologia , Masculino , Pessoa de Meia-Idade , Atividade Motora , Nigéria/epidemiologia , Prognóstico , Qualidade de Vida , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/fisiopatologia , Inquéritos e Questionários , Fatores de Tempo
15.
Thorac Cancer ; 11(10): 2983-2986, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32790028

RESUMO

The current coronavirus disease 2019 (COVID-19) pandemic is associated with a heavy burden on the mental and physical health of patients, regional healthcare resources, and global economic activity. Many patients with lung cancer are thought to be affected by this situation. Therefore, in this study, we aimed to evaluate the impact of COVID-19 pandemic on lung cancer treatment scheduling. We retrospectively reviewed the medical records of lung cancer patients who were undergoing anticancer treatment at the National Hospital Organization Kyoto Medical Center (600 beds) in Kyoto, Japan, between 1 March 2020 and 31 May 2020. After the medical records were reviewed, the patients were assigned to one of two groups, depending on whether their lung cancer treatment schedule was delayed. We assessed the characteristics, types of histopathology and treatment, and the reason for the delay. A total 15 (9.1%) patients experienced a delay in lung cancer treatment during the COVID-19 pandemic. Patients with a treatment delay received significantly more immune checkpoint inhibitor (ICI) monotherapy than patients without a treatment delay (P = 0.0057). On the contrary, no patients receiving molecular targeted agents experienced a treatment delay during the COVID-19 pandemic period (P = 0.0027). The treatments of most of the patients were delayed at their request. We determined that 9.1% lung cancer patients suffered anxiety and requested a treatment delay during the COVID-19 pandemic. Oncologists should bear in mind that patients with cancer have more anxiety than expected under unprecedented circumstances such as the COVID-19 pandemic.


Assuntos
Ansiedade/psicologia , Infecções por Coronavirus/psicologia , Neoplasias Pulmonares/psicologia , Pneumonia Viral/psicologia , Tempo para o Tratamento , Idoso , Idoso de 80 Anos ou mais , Ansiedade/fisiopatologia , Betacoronavirus/patogenicidade , Protocolos Clínicos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Japão , Pulmão/fisiopatologia , Pulmão/virologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/fisiopatologia , Neoplasias Pulmonares/virologia , Masculino , Registros Médicos , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Estudos Retrospectivos
16.
J Occup Environ Med ; 62(10): 783-787, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32769803

RESUMO

OBJECTIVE: To describe nurses' mental health status during the Covid-19 outbreak and to explore the factors that might accentuate the negative consequences on their mental health. METHODS: We conducted an online survey to evaluate demographic variables, working conditions, family dynamics, and mental health variables in nurses working in healthcare settings, in Portugal, during the Covid-19 outbreak. RESULTS: Portuguese nurses presented higher depression, anxiety and stress levels, when compared to the Portuguese general population, during the outbreak. Overall, nurses who did not consider the quantity and quality of personal protective equipment as adequate presented significantly higher levels of depression, anxiety, and stress. CONCLUSIONS: Our results suggest that nurses' mental health status seems to be particularly affected by the Covid-19 outbreak and that some modifiable elements might accentuate the impacts on their mental health.


Assuntos
Infecções por Coronavirus/enfermagem , Surtos de Doenças/estatística & dados numéricos , Saúde Mental , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Pneumonia Viral/enfermagem , Fatores Etários , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/fisiopatologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Estresse Ocupacional/prevenção & controle , Pandemias , Pneumonia Viral/epidemiologia , Portugal , Prevalência , Fatores Sexuais
17.
Life Sci ; 261: 118359, 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-32861795

RESUMO

AIMS: The aim of this study is to investigate the anxiolytic activity of perampanel, a non-competitive antagonist of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-type glutamate receptors, which is approved for partial-onset seizures in patients with epilepsy, and its mechanism of action. MAIN METHODS: The anxiolytic activity of perampanel at the doses of 0.25, 0.5, 1, 2, and 4 mg/kg intraperitoneally (i.p.) was investigated in mice using elevated plus-maze, hole-board, and open-field tests. The findings were compared to the anxiolytic activity of gamma-aminobutyric acid type A benzodiazepine (GABAA/BZ) receptor allosteric modulator diazepam (1 mg/kg, i.p.) and AMPA antagonist GYKI-53655 (5 mg/kg, i.p.). The mechanisms of action of perampanel were evaluated by pre-treatment with GABAA/BZ receptor antagonist flumazenil (3 mg/kg, i.p.), serotonin 5-hydroxytryptamine 1A (5-HT1A) antagonist WAY-100635 (1 mg/kg, i.p.), and α2-adrenoreceptor antagonist yohimbine (5 mg/kg, i.p.). KEY FINDINGS: In the elevated plus-maze and open-field tests, perampanel at the dose of 0.5 mg/kg, and in the hole-board test, at the doses of 0.25, 0.5, and 1 mg/kg demonstrated an anxiolytic effect without altering the locomotor activity. The effect of perampanel was comparable to the effect of diazepam. Stimulation of GABAA/BZ and α2-adrenergic receptors contributed to the anxiolytic effect of perampanel, since significant antagonisms were determined in various behavioral parameters by the antagonist pre-treatments. SIGNIFICANCE: AMPA antagonism is believed to provide the determined anxiolytic activity of perampanel. Increased GABAergic tonus induced by AMPA receptor antagonism along with other systems, especially the noradrenergic system, might be involved in the anxiolytic activity.


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Piridonas/uso terapêutico , Animais , Ansiolíticos/farmacologia , Ansiedade/fisiopatologia , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Atividade Motora/efeitos dos fármacos , Piridonas/farmacologia , Receptores Adrenérgicos alfa 2/metabolismo , Receptores de GABA/metabolismo
18.
Nat Commun ; 11(1): 3744, 2020 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-32719346

RESUMO

Epilepsy and autism spectrum disorders (ASD) are two distinct brain disorders but have a high rate of co-occurrence, suggesting shared pathogenic mechanisms. Neuroligins are cell adhesion molecules important in synaptic function and ASD, but their role in epilepsy remains unknown. In this study, we show that Neuroligin 2 (NLG2) knockout mice exhibit abnormal spike and wave discharges (SWDs) and behavioral arrests characteristic of absence seizures. The anti-absence seizure drug ethosuximide blocks SWDs and rescues behavioral arrests and social memory impairment in the knockout mice. Restoring GABAergic transmission either by optogenetic activation of the thalamic reticular nucleus (nRT) presynaptic terminals or postsynaptic NLG2 expression in the thalamic neurons reduces the SWDs and behavioral arrests in the knockout mice. These results indicate that NLG2-mediated GABAergic transmission at the nRT-thalamic circuit represents a common mechanism underlying both epileptic seizures and ASD.


Assuntos
Comportamento Animal , Moléculas de Adesão Celular Neuronais/metabolismo , Epilepsia Tipo Ausência/metabolismo , Epilepsia Tipo Ausência/fisiopatologia , Neurônios GABAérgicos/metabolismo , Rede Nervosa/fisiopatologia , Proteínas do Tecido Nervoso/metabolismo , Transmissão Sináptica , Tálamo/fisiopatologia , Potenciais de Ação , Animais , Ansiedade/fisiopatologia , Eletrodos , Eletroencefalografia , Eletromiografia , Etossuximida , Núcleos Intralaminares do Tálamo/fisiopatologia , Locomoção , Memória , Camundongos Endogâmicos C57BL , Camundongos Knockout
19.
J Intensive Care Med ; 35(8): 818-824, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32633215

RESUMO

It has been well known for decades that prone positioning (PP) improves oxygenation. However, it has gained widespread acceptance only in the last few years since studies have shown significant survival benefit. Many centers have established prone ventilation in their treatment algorithm for mechanically ventilated patients with severe acute respiratory distress syndrome (ARDS). Physiologically, PP should also benefit awake, non-intubated patients with acute hypoxemic respiratory failure. However, proning in non-intubated (PINI) patients did not gain any momentum until a few months ago when the Coronavirus disease 2019 (COVID-19) pandemic surged. A large number of sick patients overwhelmed the health care system, and many centers faced a dearth of ventilators. In addition, outcomes of patients placed on mechanical ventilation because of COVID-19 infection have been highly variable and often dismal. Hence, increased focus has shifted to using various strategies to prevent intubation, such as PINI. There is accumulating evidence that PINI is a low-risk intervention that can be performed even outside intensive care unit with minimal assistance and may prevent intubation in certain patients with ARDS. It can also be performed safely at smaller centers and, therefore, may reduce the patient transfer to larger institutions that are overwhelmed in the current crisis. We present a case series of 2 patients with acute hypoxemic respiratory failure who experienced significant improvements in oxygenation with PP. In addition, the physiology of PP is described, and concerns such as proning in obese and patient's anxiety are addressed; an educational pamphlet that may be useful for both patients and health care providers is provided.


Assuntos
Ansiedade , Infecções por Coronavirus , Obesidade , Pandemias , Posicionamento do Paciente/métodos , Pneumonia Viral , Decúbito Ventral/fisiologia , Insuficiência Respiratória , Adulto , Ansiedade/fisiopatologia , Ansiedade/prevenção & controle , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/metabolismo , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Humanos , Hipóxia/etiologia , Hipóxia/terapia , Masculino , Obesidade/epidemiologia , Obesidade/fisiopatologia , Consumo de Oxigênio , Oxigenoterapia/métodos , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/metabolismo , Pneumonia Viral/fisiopatologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Respiração Artificial/métodos , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/psicologia , Insuficiência Respiratória/terapia , Resultado do Tratamento
20.
JAMA Netw Open ; 3(7): e2014053, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32609353

RESUMO

Importance: People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. Objective: To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. Design, Setting, and Participants: This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. Main Outcomes and Measures: The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. Results: Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 27.9% (95% CI, 27.5%-28.2%) for depression, 31.6% (95% CI, 31.2%-32.0%) for anxiety, 29.2% (95% CI, 28.8%-29.6%) for insomnia, and 24.4% (95% CI, 24.0%-24.7%) for acute stress. Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 3.27 [95% CI, 1.84-5.80] for patients; 1.53 [95% CI, 1.26-1.85] for family or friends), anxiety (adjusted ORs, 2.48 [95% CI, 1.43-4.31] for patients; 1.53 [95% CI, 1.27-1.84] for family or friends), insomnia (adjusted ORs, 3.06 [95% CI, 1.73-5.43] for patients; 1.62 [95% CI, 1.35-1.96] for family or friends), and acute stress (adjusted ORs, 3.50 [95% CI, 2.02-6.07] for patients; 1.77 [95% CI, 1.46-2.15] for family or friends). Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 1.96 [95% CI, 1.77-2.17] for occupational exposure; 1.42 [95% CI, 1.19-1.68] for Hubei residence), anxiety (adjusted ORs, 1.93 [95% CI, 1.75-2.13] for occupational exposure; 1.54 [95% CI, 1.30-1.82] for Hubei residence), insomnia (adjusted ORs, 1.60 [95% CI, 1.45-1.77] for occupational exposure; 1.20 [95% CI, 1.01-1.42] for Hubei residence), and acute stress (adjusted ORs, 1.98 [95% CI, 1.79-2.20] for occupational exposure; 1.49 [95% CI, 1.25-1.79] for Hubei residence). Both centralized quarantine (adjusted ORs, 1.33 [95% CI, 1.10-1.61] for depression; 1.46 [95% CI, 1.22-1.75] for anxiety; 1.63 [95% CI, 1.36-1.95] for insomnia; 1.46 [95% CI, 1.21-1.77] for acute stress) and home quarantine (adjusted ORs, 1.30 [95% CI, 1.25-1.36] for depression; 1.28 [95% CI, 1.23-1.34] for anxiety; 1.24 [95% CI, 1.19-1.30] for insomnia; 1.29 [95% CI, 1.24-1.35] for acute stress) were associated with the 4 negative mental health outcomes. Being at work was associated with lower risks of depression (adjusted OR, 0.85 [95% CI, 0.79-0.91]), anxiety (adjusted OR, 0.92 [95% CI, 0.86-0.99]), and insomnia (adjusted OR, 0.87 [95% CI, 0.81-0.94]). Conclusions and Relevance: The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19. Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public. These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Distúrbios do Início e da Manutenção do Sono , Estresse Psicológico , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/fisiopatologia , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/fisiopatologia , Feminino , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Entrevista Psiquiátrica Padronizada/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Prevalência , Quarentena/psicologia , Retorno ao Trabalho/psicologia , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/fisiopatologia
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