Validation of the Beck Depression Inventory for a Portuguese-speaking Chinese community in Brazil

The objective of the present study was to investigate the psychometric properties and cross-cultural validity of the Beck Depression Inventory (BDI) among ethnic Chinese living in the city of São Paulo, Brazil. The study was conducted on 208 community individuals. Reliability and discriminant analysis were used to test the psychometric properties and validity of the BDI. Principal component analysis was performed to assess the BDI's factor structure for the total sample and by gender. The mean BDI score was lower (6.74, SD = 5.98) than observed in Western counterparts and showed no gender difference, good internal consistency (Cronbach's alpha 0.82), and high discrimination of depressive symptoms (75-100%). Factor analysis extracted two factors for the total sample and each gender: cognitive-affective dimension and somatic dimension. We conclude that depressive symptoms can be reliably assessed by the BDI in the Brazilian Chinese population, with a validity comparable to that for international studies. Indeed, cultural and measurement biases might have influenced the response of Chinese subjects.

Late-life depression, heart failure and frontal white matter hyperintensity: a structural magnetic resonance imaging study

The relevance of the relationship between cardiac disease and depressive symptoms is well established. White matter hyperintensity, a bright signal area in the brain on T2-weighted magnetic resonance imaging scans, has been separately associated with cardiovascular risk factors, cardiac disease and late-life depression. However, no study has directly investigated the association between heart failure, major depressive symptoms and the presence of hyperintensities. Using a visual assessment scale, we have investigated the frequency and severity of white matter hyperintensities identified by magnetic resonance imaging in eight patients with late-life depression and heart failure, ten patients with heart failure without depression, and fourteen healthy elderly volunteers. Since the frontal lobe has been the proposed site for the preferential location of white matter hyperintensities in patients with late-life depression, we focused our investigation specifically on this brain region. Although there were no significant group differences in white matter hyperintensities in the frontal region, a significant direct correlation emerged between the severity of frontal periventricular white matter hyperintensity and scores on the Hamilton scale for depression in the group with heart failure and depression (P = 0.016, controlled for the confounding influence of age). There were no significant findings in any other areas of the brain. This pattern of results adds support to a relationship between cardiovascular risk factors and depressive symptoms, and provides preliminary evidence that the presence of white matter hyperintensities specifically in frontal regions may contribute to the severity of depressive symptoms in cardiac disease.

Cardiopulmonary bypass alters the pharmacokinetics of propranolol in patients undergoing cardiac surgery

The pharmacokinetics of propranolol may be altered by hypothermic cardiopulmonary bypass (CPB), resulting in unpredictable postoperative hemodynamic responses to usual doses. The objective of the present study was to investigate the pharmacokinetics of propranolol in patients undergoing coronary artery bypass grafting (CABG) by CPB under moderate hypothermia. We evaluated 11 patients, 4 women and 7 men (mean age 57 ± 8 years, mean weight 75.4 ± 11.9 kg and mean body surface area 1.83 ± 0.19 m²), receiving propranolol before surgery (80-240 mg a day) and postoperatively (10 mg a day). Plasma propranolol levels were measured before and after CPB by high-performance liquid chromatography. Pharmacokinetic Solutions 2.0 software was used to estimate the pharmacokinetic parameters after administration of the drug pre- and postoperatively. There was an increase of biological half-life from 4.5 (95% CI = 3.9-6.9) to 10.6 h (95% CI = 8.2-14.7; P < 0.01) and an increase in volume of distribution from 4.9 (95% CI = 3.2-14.3) to 8.3 l/kg (95% CI = 6.5-32.1; P < 0.05), while total clearance remained unchanged 9.2 (95% CI = 7.7-24.6) vs 10.7 ml min-1 kg-1 (95% CI = 7.7-26.6; NS) after surgery. In conclusion, increases in drug distribution could be explained in part by hemodilution during CPB. On the other hand, the increase of biological half-life can be attributed to changes in hepatic metabolism induced by CPB under moderate hypothermia. These alterations in the pharmacokinetics of propranolol after CABG with hypothermic CPB might induce a greater myocardial depression in response to propranolol than would be expected with an equivalent dose during the postoperative period.

Effects of type of physical exercise and leisure activities on the depression scores of obese Brazilian adolescent girls

Several studies have indicated that depressive states may lead to hypokinesia with diminished metabolic rate and energy use. Hypokinesia associated with certain eating behaviors may lead to an unfavorable energy balance that can contribute to the emergence and prevalence of obesity among children and adults. The purpose of the present study was to examine the possibility of reducing depression inventory scores in female adolescents with third-degree obesity while testing the effectiveness of different exercise programs in reducing anxiety and depression scores. The sample consisted of 40 female subjects (mean age 16 ± 1.56 years) divided into 4 groups (aerobic training, anaerobic training, leisure activities, and control). Subjects had a body mass index of 95% or more in relation to the 50th percentile. The aerobic program consisted of three ergometric bicycle sessions per week over a 3-month period (12 weeks) and the activities were prescribed after determining the anaerobic ventilatory threshold (VO2 threshold). Anaerobic training was based on the Wingate anaerobic power test. The leisure program consisted of a varied range of activities (games, exercises, etc.). A nutritionist interviewed the members of these two groups and the control group every week in order to adapt them to the nutritional guidelines proposed for the study. The study showed that all three programs (aerobic exercise, anaerobic exercise and leisure activities) were effective in reducing body mass. However, we found a significant reduction when analyzing the depression scores only for aerobic exercise (18.9 ± 9.33 to 10.6 ± 9.56 or 43.9%) but no significant alterations for anaerobic exercise (11.36 ± 5.23 to 9.63 ± 4.78 or 15.22%) and leisure (17.28 ± 7.55 to 15.07 ± 7.54 or 12.78%), thus indicating that in principle this type of activity could be included to improve emotional well-being of obese adolescent girls.

Effect of Erythrina velutina and Erythrina mulungu in rats submitted to animal models of anxiety and depression

Erythrina velutina (EV) and Erythrina mulungu (EM), popularly used in Brazil as tranquilizing agents, were studied. The effects of acute and chronic oral treatment with a water:alcohol extract of EV (7:3, plant grounded stem bark; acute = 100, 200, 400 mg/kg; chronic = 50, 100, 200 mg/kg) were evaluated in rats (N = 11-12) submitted to the elevated T-maze (for avoidance and escape measurements) model of anxiety. This model was selected for its presumed capacity to elicit specific subtypes of anxiety disorders recognized in clinical practice: avoidance has been related to generalized anxiety and escape to panic. Additionally, animals were treated with the same doses of EV and EM (water:alcohol 7:3, inflorescence extract) and submitted to the forced swim test for the evaluation of antidepressant activity (N = 7-10). Both treatment regimens with EV impaired elevated T-maze avoidance latencies, without altering escape, in a way similar to the reference drug diazepam (avoidance 1, mean ± SEM, acute study: 131.1 ± 45.5 (control), 9.0 ± 3.3 (diazepam), 12.7 ± 2.9 (200 mg/kg), 28.8 ± 15.3 (400 mg/kg); chronic study: 131.7 ± 46.9 (control), 35.8 ± 29.7 (diazepam), 24.4 ± 10.4 (50 mg/kg), 29.7 ± 11.5 (200 mg/kg)). Neither EV nor EM altered measurements performed in the forced swim test, in contrast to the reference drug imipramine that significantly decreased immobility time after chronic treatment. These results were not due to motor alterations since no significant effects were detected in an open field. These observations suggest that EV exerts anxiolytic-like effects on a specific subset of defensive behaviors which have been associated with generalized anxiety disorder.

Effekten av situationsbundna faktorer i sexuellt utnyttjande av barn på depression : en metaanalys

Sexuellt utnyttjande av barn (SUB) har påvisats resultera i en mängd negativa utfall, så som depression. Eftersom inte alla som upplevt SUB utvecklar depression har man föreslagit att situationsbundna faktorer, så som offrets ålder när SUB startade, graden av fysisk kontakt, användningen av fysiskt våld i samband med SUB, mängden SUB och relationen mellan offret och förövaren påverkar förhållandet mellan SUB och depression. En metaanalys över den existerande litteraturen om effekten av situationsbundna faktorer på utvecklingen av depression utfördes. Samplets kön användes som modererande variabel i analyserna. Utöver detta utfördes också analyser av publikationsbias. För att inkluderas i metaanalysen skulle studierna vara referentgranskade, skrivna på engelska och undersöka effekten av minst en situationsbunden faktor på insjuknande i depression. Litteratursökningen resulterade i 73 relevanta artiklar. Dessa artiklar undersökte sammanlagt 14 058 individer som utsatts för sexuellt utnyttjande före 18 års ålder. Högre grad av fysisk kontakt, incestuöst SUB (jämfört med icke-incestuöst SUB), användningen av fysiskt våld (jämfört med SUB utan fysisk våld) samt högre frekvens, fler incidenter och längre varaktighet av SUB ökade risken för att insjukna i depression. Resultaten från den föreliggande metaanalysen överensstämmer med tidigare metaanalyser gjorda på situationsbundna faktorers inverkan på hälsoriskbeteende, social kompetens och psykosexuell ångest.

Moderate-term reproducibility of heart rate variability during rest and light to moderate exercise in children

Previous studies have demonstrated the high reproducibility of heart rate variability (HRV) measures in adults while little information exists concerning HRV reproducibility in children. Subsequently, the aim of the current study was to examine the moderate-term reproducibility of heart rate and frequency domain measures of HRV during rest and light to moderate exercise in children. Ten healthy children (6 males, 4 females) aged between 7 and 12 years of age volunteered for this study with HRV recordings obtained during supine rest and three treadmill walking exercise work rates (≤60% maximum heart rate), initially and then 8 weeks later. Differences (P < 0.05) between variables were examined using paired t-tests or Wilcoxon signed rank tests while reliability and reproducibility were examined by intraclass correlation coefficients (ICC), coefficients of variation (CV), and mean bias ratio and ratio limits of agreement (LOA). Heart rate and all measures of HRV at rest and exercise were unchanged after 8 weeks. Significant ICC were documented primarily during rest (0.72-0.85) while weaker relationships (-0.02-0.87) were evident during exercise. A large range of CV was identified during rest (6-33%) and exercise (3-128%) while the ratio LOA were variable and substantial (1.04-2.73). Despite similar HRV over an 8-week period, variable ICC and sizable CV and ratio LOA indicate moderate to poor reproducibility of HRV in children, particularly during light to moderate exercise. Studies examining HRV in children should include age- or maturation stage-matched control participants to address the age-related change in HRV and inadequate HRV reliability.

Synaptic vesicle pool size, release probability and synaptic depression are sensitive to Ca2+ buffering capacity in the developing rat calyx of Held

The calyx of Held, a specialized synaptic terminal in the medial nucleus of the trapezoid body, undergoes a series of changes during postnatal development that prepares this synapse for reliable high frequency firing. These changes reduce short-term synaptic depression during tetanic stimulation and thereby prevent action potential failures during a stimulus train. We measured presynaptic membrane capacitance changes in calyces from young postnatal day 5-7 (p5-7) or older (p10-12) rat pups to examine the effect of calcium buffer capacity on vesicle pool size and the efficiency of exocytosis. Vesicle pool size was sensitive to the choice and concentration of exogenous Ca2+ buffer, and this sensitivity was much stronger in younger animals. Pool size and exocytosis efficiency in p5-7 calyces were depressed by 0.2 mM EGTA to a greater extent than with 0.05 mM BAPTA, even though BAPTA is a 100-fold faster Ca2+ buffer. However, this was not the case for p10-12 calyces. With 5 mM EGTA, exocytosis efficiency was reduced to a much larger extent in young calyces compared to older calyces. Depression of exocytosis using pairs of 10-ms depolarizations was reduced by 0.2 mM EGTA compared to 0.05 mM BAPTA to a similar extent in both age groups. These results indicate a developmentally regulated heterogeneity in the sensitivity of different vesicle pools to Ca2+ buffer capacity. We propose that, during development, a population of vesicles that are tightly coupled to Ca2+ channels expands at the expense of vesicles more distant from Ca2+ channels.

Anxiety and depression in parents of a Brazilian non-clinical sample of attention-deficit/ hyperactivity disorder (ADHD) students

Higher prevalence rates of anxiety and depression have been reported in parents of children with attention-deficit/hyperactivity disorder (ADHD). The interaction between the burden of ADHD in offspring, a higher prevalence rate of this highly inherited disorder in parents, and comorbidities may explain this finding. Our objective was to investigate levels of ADHD, anxious and depressive symptomatology, and their relationship in parents of ADHD children from a non-clinical sample using a dimensional approach. The sample included 396 students enrolled in all eight grades of a public school who were screened for ADHD using the SNAP IV rating scale. Positive cases were confirmed through a semi-structured interview. Parents of all 26 ADHD students and 31 paired controls were enrolled. A sample of 36 parents of ADHD children (21 mothers, 15 fathers) and 30 parents of control children (18 mothers, 12 fathers) completed the Adult Self Report Scale, State-Trait Anxiety Inventory, and Beck Depression Inventory in order to investigate anxious and depressive symptomatology. Probands' mothers presented a higher level of ADHD symptomatology (with only inattention being a significant cluster). Again, mothers of ADHD children presented higher depressive and anxiety levels; however, these did not correlate with their own ADHD symptomatology. Only trait-anxiety levels were higher in ADHD mothers. Our findings suggest that: 1) anxious and depressive symptoms might be more prevalent in mothers of ADHD students; 2) anxious and depressive symptomatology might be independent of impairment associated with ADHD symptoms; 3) anxious and depressive symptoms are independent of the presence of ADHD.

Moderate intensity physical training accelerates healing of full-thickness wounds in mice

Physical training influences the cells and mediators involved in skin wound healing. The objective of this study was to determine the changes induced by different intensities of physical training in mouse skin wound healing. Ninety male C57BL6 mice (8 weeks old, 20-25 g) were randomized into three physical training groups: moderate (70% VO2max), high (80% VO2max), and strenuous intensity (90% VO2max). Animals trained on a motorized treadmill for 8 weeks (Elesion: physical training until the day of excisional lesion, N = 10) or 10 weeks (Eeuthan: physical training for 2 additional weeks after excisional lesion until euthanasia, N = 10), five times/week, for 45 min. Control groups (CG) trained on the treadmill three times/week only for 5 min (N = 10). In the 8th week, mice were anesthetized, submitted to a dorsal full-thickness excisional wound of 1 cm², and sacrificed 14 days after wounding. Wound areas were measured 4, 7, and 14 days after wounding to evaluate contraction (d4, d7 and d14) and re-epithelialization (d14). Fragments of lesion and adjacent skin were processed and submitted to routine histological staining. Immunohistochemistry against alpha-smooth muscle actin (α-SMA) was performed. Moderate-intensity training (M) until lesion (M/Elesion) led to better wound closure 7 days after wounding compared to controls and M/Eeuthan (P < 0.05), and both moderate-intensity groups showed better re-epithelialization rates than controls (M/Elesion = 85.9%, M/Eeuthan = 96.4% and M/CG = 79.9%; P < 0.05). Sections of M/Elesion and M/Eeuthan groups stained with hematoxylin-eosin, Picrosirius red and α-SMA showed the most mature granulation tissues among all trained groups and controls. Thus, moderate-intensity physical training improves skin wound healing.

Memory mood congruency phenomenon in bipolar I disorder and major depression disorder patients

The objective of the present study was to evaluate memory performance in tasks with and without affective content (to confirm the mood congruency phenomenon) in acutely admitted patients with bipolar I disorder (BD) and major depression disorder (MDD) and in healthy participants. Seventy-eight participants (24 BD, 29 MDD, and 25 healthy controls) were evaluated. Three word lists were used as the memory task with affective content (positive, negative and indifferent). Psychiatric symptoms were also evaluated with rating scales (Young Mania Rating Scale for mania and Hamilton Depression Rating Scale for depression). Patients were selected during the first week of hospitalization. BD patients showed higher scores in the word span with positive tone than MDD patients and healthy controls (P = 0.002). No other difference was observed for tests with affective tone. MDD patients presented significantly lower scores in the Mini-Mental State Exam, logical memory test, visual recognition span, and digit span, while BD patients presented lower scores in the visual recognition test and digit span. Mood congruency effect was found for word span with positive tone among BD patients but no similar effect was observed among MDD patients for negative items. MDD patients presented more memory impairment than BD patients, but BD patients also showed memory impairment

Inhibition of PKC-dependent extracellular Ca2+ entry contributes to the depression of contractile activity in long-term pressure-overloaded endothelium-denuded rat aortas

We examined the contractile responsiveness of rat thoracic aortas under pressure overload after long-term suprarenal abdominal aortic coarctation (lt-Srac). Endothelium-dependent angiotensin II (ANG II) type 2 receptor (AT2R)-mediated depression of contractions to ANG II has been reported in short-term (1 week) pressure-overloaded rat aortas. Contractility was evaluated in the aortic rings of rats subjected to lt-Srac or sham surgery (Sham) for 8 weeks. ANG I and II levels and AT2R protein expression in the aortas of lt-Srac and Sham rats were also evaluated. lt-Srac attenuated the contractions of ANG II and phenylephrine in the aortas in an endothelium-independent manner. However, lt-Srac did not influence the transient contractions induced in endothelium-denuded aortic rings by ANG II, phenylephrine, or caffeine in Ca2+-free medium or the subsequent tonic constrictions induced by the addition of Ca2+ in the absence of agonists. Thus, the contractions induced by Ca2+ release from intracellular stores and Ca2+ influx through stored-operated channels were not inhibited in the aortas of lt-Srac rats. Potassium-elicited contractions in endothelium-denuded aortic rings of lt-Srac rats remained unaltered compared with control tissues. Consequently, the contractile depression observed in aortic tissues of lt-Srac rats cannot be explained by direct inhibition of voltage-operated Ca2+ channels. Interestingly, 12-O-tetradecanoylphorbol-13-acetate-induced contractions in endothelium-denuded aortic rings of lt-Srac rats were depressed in the presence but not in the absence of extracellular Ca2+. Neither levels of angiotensins nor of AT2R were modified in the aortas after lt-Srac. The results suggest that, in rat thoracic aortas, lt-Srac selectively inhibited protein kinase C-mediated activation of contraction that is dependent on extracellular Ca2+ entry.

Bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis of randomized controlled trials

There has been concern regarding the use of controversial paradigms for repetitive transcranial magnetic stimulation (rTMS) to manage treatment-resistant depression (TRD). This meta-analysis assessed the efficacy of bilateral rTMS compared with unilateral and sham rTMS in patients with TRD. PubMed, Embase, CENTRAL, PsycINFO, Web of Science, EAGLE and NTIS databases were searched to identify relevant studies, and randomized controlled trials (RCTs) on bilateral rTMS for TRD patients were included. The response was defined as the primary outcome, and remission was the secondary outcome. Ten RCTs that included 634 patients met the eligibility criteria. The risk ratio (RRs) of both the primary and secondary outcomes of bilateral rTMS showed non-significant increases compared to unilateral rTMS (RR=1.01, P=0.93; odds ratio [OR]=0.77, P=0.22). Notably, the RR of the primary bilateral rTMS outcome was significantly increased compared to that for sham rTMS (RR=3.43, P=0.0004). The results of our analysis demonstrated that bilateral rTMS was significantly more effective than sham rTMS but not unilateral rTMS in patients with TRD. Thus, bilateral rTMS may not be a useful paradigm for patients with TRD.

Effects of defatted amaranth (Amaranthus caudatus L.) snacks on lipid metabolism of patients with moderate hypercholesterolemia

We evaluated the effects of defatted amaranth (Amaranthus caudatus L.) snacks on plasma lipids in moderate hypercholesterolemic patients. Twenty-two subjects [30-65 years old), 11 males, with total cholesterol (TC) > 240 mg.dL-1, low-density cholesterol (LDL-c) 160-190 mg.dL-1 and plasma triglycerides (TG) < 400 mg.dL-1] were randomized in a double blind clinical trial to receive an amaranth snack (50 g/day) or equivalent corn snack (placebo) for 2 months. There were no differences between amaranth and placebo on TC and LDL-c, and TG respectively: -8.4 and -5.7% (p = 0.17); -12.3 and -9.7% (p = 0.41) and -0.6 and -7.3% (p = 0.47). However, amaranth snacks significantly reduced high-density cholesterol (HDL-c): -15.2 vs. -4% (p = 0.03). In conclusion, the intake of 50 g of extruded amaranth daily during 60 days did not significantly reduce LDL-c in moderate hypercholesterolemic subjects; furthermore there was a significant reduction in HDL-c. Studies with greater number of subjects and greater quantity of this food are necessary to test the effects of amaranth on lipid metabolism in humans.

Investigative links between cognitive function and moderate-to-vigorous physical activity in elementary physical education

Research has noted both physical and psychosocial benefits when children participate in regular physical activity. Recent studies are indicating that there may also be academic benefits and that students may be more efficient learners with participation in physical activity. This study investigated the influence of acute moderate-to-vigorous physical activity on four cognitive functions: planning, attention, simultaneous processing, and successive processing. Three classes (59 students) were each tested twice using a balanced design (intervention, balance, and control groups). It was found that the intervention group had a large increase in planning abiHty (ES = 1.67) when compared to the balance (ES = .80) and control (ES = -.89) groups. On the three remaining cognitive functions, the intervention group showed effect sizes similar to that of the balance and control groups. These results indicate that improved planning after physical activity may playa role in improving student performance.