Pregnancy outcome following maternal exposure to mirtazapine: a multicenter, prospective study.

This multicenter, observational prospective cohort study addresses the risk associated with exposure to mirtazapine during pregnancy. Pregnancy outcomes after exposure to mirtazapine were compared with 2 matched control groups: (1) exposure to any selective serotonin reuptake inhibitor (SSRI, control subjects with a psychiatric condition) and (2) no exposure to medication known to be teratogenic or any antidepressant (general control subjects). Data were collected by members of the European Network of Teratology Information Services between 1995 and 2011. Observations from 357 exposed pregnancies were compared with 357 pregnancies from each control group. The rate of major birth defects between the mirtazapine and the SSRI group did not differ significantly (4.5% vs 4.2%; odds ratio [OR], 1.1; 95% confidence interval [95% CI], 0.5-2.3; P = 0.9). A trend toward a higher rate of birth defects in the mirtazapine group compared with general control subjects (4.5% vs 1.9%; OR, 2.4; 95% CI, 0.9-6.3; P = 0.08) reached statistical significance after exclusion of chromosomal or genetic anomalies (4.1% vs 1.3%; OR, 3.3; 95% CI, 1.04-10.3; P = 0.03), but this difference became again nonsignificant if cases of exposure not comprising the first trimester were excluded from the analysis (3.4% vs 1.9%; OR, 1.8; 95% CI, 0.6-5.0; P = 0.26). The crude miscarriage rate did not differ significantly between the mirtazapine, the SSRI, and the general control groups (12.1% vs 12.0% vs 9.3%; P = 0.44). However, a higher rate of elective pregnancy termination was observed in the mirtazapine group compared with SSRI and general control subjects (7.8% vs 3.4% vs 5.6%; P = 0.03). This study did not observe a statistically significant difference in the rate of major birth defects after first-trimester exposure between mirtazapine, SSRI-exposed, and nonexposed pregnancies. A marginally higher rate of birth defects was, however, observed in the mirtazapine and SSRI groups compared with the low rate of birth defects in our general control subjects. Overall pregnancy outcome after mirtazapine exposure was similar to that of the SSRI-exposed control group.

Tie Strength and Family Formation : which Personal Relationships are Influential ?

Based on the analysis of qualitative interviews in western Germany, we argue that personal relationships have a strong impact on individuals' family formation processes and fertility intentions. We identify persons who influence individuals' fertility choices. Strong ties, such as those among core family members (i.e., parents and siblings), are an important contributing factor, but we are also able to show that weak ties, such as those among colleagues, and acquaintances need to be considered when examining social influence on family formation processes. Apart from single network partners, we have identified influential groups of persons. Such groups serve as a comparative standard regarding the timing of having one's first child and subsequent children.

Was bringt die Masern-Passivimpfung nach Exposition? [What is the value of measles passive vaccination after exposure?].

In der Schweiz, wie in vielen anderen Ländern, ist die Durchimpfungsrate zu tief, um die Verbreitung von Masern zu stoppen. Es kommt immer wieder zu Masern-Ausbrüchen. Die Gabe von Immunglobulinen (Passivimpfung) ist für nicht-immune Personen gedacht, die Kontakt zu Masernvirus-Ausscheidern hatten. Sie wird in der Schweiz für Hochrisiko-Personen wie z.B. schwangere Frauen, immunsupprimierte Personen und Säuglinge <6 Monate ohne nachgewiesene Immunität empfohlen. Schätzungen über die Wirksamkeit der Passivimpfung variieren; es wurde keine minimalwirksame Dosierung festgelegt. Ziel dieses Reviews war, die Wirksamkeit und Sicherheit einer intramuskulären oder intravenösen Gabe von Immunglobulinen zur Masern-Prophylaxe nach Exposition jedoch vor Symptombeginn bei für Masern empfänglichen Personen zu untersuchen.

Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample.

This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.

Prenatal Exposure to DEHP Affects Spermatogenesis and Sperm DNA Methylation in a Strain-Dependent Manner.

Di-(2-ethylhexyl)phtalate (DEHP) is a plasticizer with endocrine disrupting properties found ubiquitously in the environment and altering reproduction in rodents. Here we investigated the impact of prenatal exposure to DEHP on spermatogenesis and DNA sperm methylation in two distinct, selected, and sequenced mice strains. FVB/N and C57BL/6J mice were orally exposed to 300 mg/kg/day of DEHP from gestation day 9 to 19. Prenatal DEHP exposure significantly decreased spermatogenesis in C57BL/6J (fold-change = 0.6, p-value = 8.7*10-4), but not in FVB/N (fold-change = 1, p-value = 0.9). The number of differentially methylated regions (DMRs) by DEHP-exposure across the entire genome showed increased hyper- and decreased hypo-methylation in C57BL/6J compared to FVB/N. At the promoter level, three important subsets of genes were massively affected. Promoters of vomeronasal and olfactory receptors coding genes globally followed the same trend, more pronounced in the C57BL/6J strain, of being hyper-methylated in DEHP related conditions. In contrast, a large set of micro-RNAs were hypo-methylated, with a trend more pronounced in the FVB/N strain. We additionally analyze both the presence of functional genetic variations within genes that were associated with the detected DMRs and that could be involved in spermatogenesis, and DMRs related with the DEHP exposure that affected both strains in an opposite manner. The major finding in this study indicates that prenatal exposure to DEHP can decrease spermatogenesis in a strain-dependent manner and affects sperm DNA methylation in promoters of large sets of genes putatively involved in both sperm chemotaxis and post-transcriptional regulatory mechanisms.

Differential associations of personal and general just-world beliefs with the Five-Factor and HEXACO models of personality.

Recent literature evidences differential associations of personal and general just-world beliefs with constructs in the interpersonal domain. In line with this research, we examine the respective relationships of each just-world belief with the Five-Factor and the HEXACO models of personality in one representative sample of the working population of Switzerland and one sample of the general US population, respectively. One suppressor effect was observed in both samples: Neuroticism and emotionality was positively associated with general just-world belief, but only after controlling for personal just-world belief. In addition, agreeableness was positively and honesty-humility negatively associated with general just-world belief but unrelated to personal just-world belief. Conscientiousness was consistently unrelated to any of the just-world belief and extraversion and openness to experience revealed unstable coefficients across studies. We discuss these points in light of just-world theory and their implications for future research taking both dimensions into account.

Childhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients.

BACKGROUND: Evidence suggests a relationship between exposure to trauma during childhood and functional impairments in psychotic patients. However, the impact of age at the time of exposure has been understudied in early psychosis (EP) patients. METHOD: Two hundred and twenty-five patients aged 18-35 years were assessed at baseline and after 2, 6, 18, 24, 30 and 36 months of treatment. Patients exposed to sexual and/or physical abuse (SPA) were classified according to age at the time of first exposure (Early SPA: before age 11 years; Late SPA: between ages 12 and 15 years) and then compared to patients who were not exposed to such trauma (Non-SPA). The functional level in the premorbid phase was measured with the Premorbid Adjustment Scale (PAS) and with the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS) during follow-up. RESULTS: There were 24.8% of patients with a documented history of SPA. Late SPA patients were more likely to be female (p = 0.010). Comparison with non-SPA patients revealed that: (1) both Early and Late SPA groups showed poorer premorbid social functioning during early adolescence, and (2) while patients with Early SPA had poorer functional level at follow-up with lower GAF (p = 0.025) and lower SOFAS (p = 0.048) scores, Late SPA patients did not. CONCLUSION: Our results suggest a link between exposure to SPA and the later impairment of social functioning before the onset of the disease. EP patients exposed to SPA before age 12 may present long-lasting functional impairment, while patients exposed at a later age may improve in this regard and have a better functional outcome.

Childhood sexual and physical abuse : age at exposure modulates impact on functional outcome in early psychosis patients

Introduction : La littérature suggère un lien entre l'exposition à des expériences traumatiques durant l'enfance et des déficits dans le niveau de fonctionnement chez des patients souffrant de psychose. Par contre, l'impact de l'âge au moment de l'exposition à ces expériences n'a pas été investigué chez des patients dans leur phase précoce de la psychose. Méthodes : Deux cents vingt-cinq patients âgés entre 18 et 35 ans ont été évalués au moment de leur entrée dans un programme thérapeutique spécialisé pour la psychose débutante (TIPP), et après 2, 6, 12, 18, 24, 30 et 36 mois de traitement. Les patients exposés à des abus sexuel et/ou physiques (SPA) ont été classifiés selon l'âge au moment de la première exposition (Early-SPA : avant 11 ans d'âge; Late-SPA : entre 12 et 15 ans d'âge) et ils ont été comparés à des patients qui n'ont jamais été exposés à une telle expérience (Non-SPA). Le niveau de fonctionnement dans la phase premorbide a été mesuré avec la Premorbid Adjustment Scale (PAS) et avec les échelles Global Assessment of Functioning (GAF) et Social and Occupational Functionning Assessment Scale (SOFAS) durant le suivi thérapeutique. Résultats : 24.8 % des patients ont été exposés à SPA. Les patients dans le groupe Late-SPA étaient plus souvent des femmes (p=0.010). Les comparaisons avec les patients dans le groupe Non-SPA ont révélé que : (1) Les patients dans le groupe Early et Late-SPA ont montré un moins bon niveau de fonctionnement social premorbide durant l'adolescence précoce, et (2) alors que les patients dans le groupe Early-SPA ont présenté un moins bon niveau de fonctionnement durant tout le suivi selon les scores de GAF (p=0.025) et SOFAS (p=0.048), les patients dans le groupe Late-SPA n'ont pas montré telles différences avec le groupe non exposé. Conclusion : Nos résultats suggèrent un lien entre l'exposition à SPA et une altération ultérieure de niveau de fonctionnement social, avant l'apparition de la maladie. Les patients dans leur phase précoce de la psychose exposés à SPA avant l'âge de 12 ans ont des altérations fonctionnelles durables, alors que les patients exposés à SPA plus tardivement semblent s'améliorer à ce niveau et montrent une meilleure capacité de récupération.

Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample.

This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.

Anatomical UV Exposure in French Outdoor Workers.

BACKGROUND: Solar ultraviolet has been recognized as the main causative factor for skin cancer and is currently classified as a carcinogenic agent by International Agency for Research on Cancer. METHOD: Results from a previous phone survey conducted in 2012 in France were used to assess exposure conditions to sun among outdoor workers. Satellite data were used in combination with an exposure model to assess anatomical exposure. RESULT: The yearly median exposure of the outdoor worker population is 77  kJ/m2 to 116  kJ/m2. Road workers, building workers, and gardeners are the more exposed. About 70% of the yearly dose estimate is due to the cumulative summer and spring exposures. CONCLUSIONS: This study highlights the role of individual factors in anatomical exposure and ranks the most exposed body parts and outdoor occupations. Prevention messages should put emphasis on spring exposure, which is an important contributor to the yearly dose.

Methylmercury exposure and developmental neurotoxicity

Comment on: Global methylmercury exposure from seafood consumption and risk of developmental neurotoxicity: a systematic review. [Bull World Health Organ. 2014]

Study and modelling of the effect of herbicides pulse exposure on freshwater microalgae

De plus en plus de substances chimiques sont émises et détectées dans l'environnement.Parmi ces substances, on trouve les herbicides qui sont utilisés en agriculture pour luttercontre la présence des mauvaises herbes. Après leur application sur les sols, les herbicidespeuvent être entrainés par les eaux de pluie jusque dans les ruisseaux et les rivières. Lesconcentrations de ces substances varient donc de manière importante dans les systèmesaquatiques en période de pluie ou en période de temps sec. Des pics élevés de concentrationssont suivis de période de concentrations très faibles ou nulles. Les herbicides présents dans lescours d'eau peuvent engendrer des effets toxiques sur les algues et les plantes aquatiques. Orles tests classiques d'écotoxicologie effectués en laboratoire sont réalisés en exposant lesespèces vivantes à des polluants de manière continue. Ils ne permettent donc pas d'évaluer leseffets des concentrations fluctuantes comme celles des herbicides. Le but de cette thèse estd'étudier et de modéliser les effets des concentrations fluctuantes d'herbicide sur les espècesde microalgues vertes Scenedesmus vacuolatus et Pseudokirchneriella subcapitata. Desexpériences en laboratoire ont également été effectuées dans le but de valider le modèle.Quatre herbicides ont été testés. Il s'agit de l'atrazine (utilisé jusqu'à récemment pour lemaïs), du diuron (utilisé dans la vigne), de l'isoproturon (utilisé pour les céréales) et du Smétolachlore(utilisé pour le maïs). Les résultats de ce travail de thèse indiquent que les effetsdes concentrations fluctuantes d'herbicide peuvent être modélisés sur des algues d'eau douce.Le modèle est relativement simple pour les inhibiteurs de la photosynthèse tels que l'atrazine,le diuron ou l'isoproturon. Il nécessite la connaissance de deux paramètres, le taux decroissance de l'algue sans polluant et la courbe dose-réponse pour chaque substance.Cependant, des expériences supplémentaires doivent être réalisées si la substance étudiéeinduit un délai de l'effet et du rétablissement ou si une algue est cultivée avec une autre alguedans le même milieu de croissance. Le modèle pourrait également être adapté pour tenircompte des mélanges de substances. Appliqué pour prédire les effets sur les algues descénarios réels, le modèle montre que les longs pics de concentrations jouent le rôle le plusimportant. Il est donc crucial de les mesurer lors du monitoring des cours d'eau. D'autre part,une évaluation du risque effectuée avec ce modèle montre que l'impact des pics deconcentrations sur les espèces les plus sensibles est total. Cela met en évidence, une fois deplus, l'importance de tenir compte de ces concentrations fluctuantes dans l'évaluation durisque environnemental des herbicides, mais également des autres polluants.