870 resultados para Major depression


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The results of the application of the geophysical electromagnetic prospection methods in the resolution of the problems of the spatial location of the travertine quaternary formations of the Banyoles depression are presented

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Previous studies revealed personality changes in elderly patients with early-onset depression (EOD) that persist in euthymic stages. However, depression in older patients is a complex disorder that may affect not only personality, but also cognition and brain structure. To address this issue, a cross-sectional comparison and 2-year follow-up of 28 EOD elderly patients and 48 healthy controls included detailed neurocognitive assessment, estimates of brain volumes in limbic areas and white matter hyperintensities, as well as evaluation of the Five Factor Model of personality, in a remitted mood state. Results revealed that cognitive performances as well as brain volumes were preserved in EOD patients both at baseline and at follow-up. The increased Neuroticism factor and Anxiety facet scores as well as the decreased Warmth and Positive Emotions facet scores found at baseline reached the level of healthy controls after 2years. Only the Depression facet scores remained significantly higher in EOD patients compared to controls upon follow-up. Results were independent of depressive relapse since baseline (25% of patients). These findings suggest that both cognitive performances and brain volumes show long-term preservation in older EOD patients. In contrast, the depression-related personality facet might be a trait like marker that persists in the long-term evolution of this disorder.

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The murine model of infection with Leishmania major has allowed the demonstration of a causal relationship between, on the one hand, genetically determined resistance to infection and the development of a Th1 CD4+ cell response, and on the other hand, genetically determined susceptibility and Th2 cell maturation. Using this murine model of infection, the role of cytokines in directing the functional differentiation pathway of CD4+ T cell precursors, has been demonstrated in vivo. Thus, IL-12 and IFN-gamma have been shown to favour Th1 cell development and IL-4 is crucial for the differentiation of Th2 responses. Maturation of a Th2 response in susceptible BALB/c mice following infection with L. major is triggered by the IL-4 produced during the first two days after parasite inoculation. This IL-4 rapidly renders parasite specific CD4+ T cells precursors unresponsive to IL-12. A restricted population of CD4+ T cells expressing the V beta 4V alpha 8 TCR heterodimer and recognizing a single epitope on the LACK (Leishmania Activated C-Kinase) antigen of L. major is responsible for this rapid production of IL-4, instructing subsequent differentiation towards the Th2 phenotype of CD4+ T cells specific for several parasite antigens.

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Thymic positive and negative selection of developing T lymphocytes confronts us with a paradox: How can a T-cell antigen receptor (TCR)-major histocompatibility complex (MHC)/peptide interaction in the former process lead to transduction of signals allowing for cell survival and in the latter induce programmed cell death or a hyporesponsive state known as anergy? One of the hypotheses put forward states that the outcome of a TCR-MHC/peptide interaction depends on the cell type presenting the selecting ligand to the developing thymocyte. Here we describe the development and lack of self-tolerance of CD8(+) T lymphocytes in transgenic mice expressing MHC class I molecules in the thymus exclusively on cortical epithelial cells. Despite the absence of MHC class I expression on professional antigen-presenting cells, normal numbers of CD8(+) cells were observed in the periphery. Upon specific activation, transgenic CD8(+) T cells efficiently lysed syngeneic MHC class I(+) targets in vitro and in vivo, indicating that thymic cortical epithelium (in contrast to medullary epithelium and antigen-presenting cells of hematopoietic origin) is incapable of tolerance induction. Thus, compartmentalization of the antigen-presenting cells involved in thymic positive selection and tolerance induction can (at least in part) explain the positive/negative selection paradox.

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Bien que de nombreuses études suggèrent des liens entre les troubles psychiatriques et les maladies cardiovasculaires (MCV), peu ont utilisé des investigations somatique, biologique et psychiatrique adéquates. Pour déterminer les potentiels mécanismes impliqués dans ces associations, plusieurs études ont investigué le lien entre les troubles psychiatriques et les facteurs de risque des maladies cardiovasculaires (FRCV) (surpoids, diabète, dyslipidémie, hypertension artérielle, inactivité, consommation de cigarettes). De plus, des biomarqueurs (régulateurs du métabolisme, marqueurs hépatiques et inflammatoires) pouvant être associés à la fois aux troubles psychiatriques et aux FRCV ont été étudiés mais avec des résultats contradictoires. Basée sur un large échantillon de la population générale de la Ville de Lausanne et des investigations somatique et psychiatrique adéquates, cette thèse comporte deux articles: le premier étudie l'association entre les troubles psychiatriques majeurs et les FRCV; le second établit les liens entre certains biomarqueurs et le développement du diabète de type 2. Appliquant une méthodologie rigoureuse sur un échantillon de 3716 sujets de la population lausannoise âgés de 35 à 66 ans, les résultats du premier article ont montré que 1) le sous-type atypique de la dépression était associé à une augmentation du risque de souffrir de plusieurs FRCV (surpoids, diabète et syndrome métabolique), contrairement à d'autres sous-types de dépression, 2) les problèmes d'alcool étaient associés à un risque accru de souffrir de diabète et de dyslipidémie, 3) presque tous les troubles psychiatriques étaient associés à une consommation régulière de cigarettes. Quant au deuxième article, parmi les différents biomarqueurs testés, seul un niveau bas d'adiponectine (une hormone produite par le tissu adipeux qui affecte la sensibilité à l'insuline) était associé à un risque accru de souffrir de diabète par la suite. Ces résultats soulignent la nécessité pour les spécialistes de distinguer les sous-types de dépression pour le risque cardiovasculaire et de donner une attention particulière au sous-type atypique. Un problème d'alcool comorbide pourrait accroître le risque cardiovasculaire. De plus, des efforts pour diminuer la cigarette chez les sujets souffrant de troubles psychiatriques seraient une mesure préventive importante contre le développement des MCV. Le rôle de l'adiponectine dans l'association entre les troubles psychiatriques et les FRCV restant incertain, une prochaine analyse devrait déterminer le lien entre ce biomarqueur et la dépression atypique. - Despite the fact that several studies have highlighted associations between psychiatric disorders and cardiovascular diseases (CVD), few have used adequate somatic, biological and psychiatric measures. To determine potential mechanisms implicated in these associations, several studies have assessed the relationship between psychiatric disorders and cardiovascular risk factors (CVRFs), such as overweight, diabetes, dyslipidemia, hypertension, physical inactivity and smoking. Moreover, biomarkers such as metabolic regulators, hepatic and inflammatory markers, which could be associated with both psychiatric disorders and CVRFs, have been studied yielding contradictory results. Based on a population-based sample from the city of Lausanne and using adequate somatic and psychiatric investigations, this dissertation encompasses two articles: the first studies the associations between major psychiatric disorders established for lifetime and CVRFs; the second studies the associations between certain biomarkers and the development of type 2 diabetes. Using standardized contemporary methodology in a sample composed of 3716 individuals aged from 35 to 66 years, the first article revealed associations between 1) the atypical depression subtype and an increased risk of several CVRFs (overweight, diabetes and the metabolic syndrome) in contrast to other depression subtypes; 2) alcohol disorders and an increased risk of diabetes and dyslipidemia; 3) almost all psychiatric disorders and a lifetime history of regular cigarette smoking. The second article showed, among the various biomarkers tested, that only lower levels of adiponectin (a hormone produced by adiposity which affects sensitivity to insulin) were associated with an increased risk of subsequent type 2 diabetes. Our results highlight the need for specialists to subtype depression when studying the cardiovascular risk and to pay particular attention to the atypical subtype. A comorbid alcohol misuse may further increase the cardiovascular risk. Moreover, efforts to diminish smoking in subjects suffering from psychiatric disorders could be an important tool for preventing subsequent CVD. The role of adiponectin in the association between psychiatric disorders and CVRFs should still be elucidated, and future analyses should focus in particular on the relationship between this biomarker and atypical depression.

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Through a rational design approach, we generated a panel of HLA-A*0201/NY-ESO-1(157-165)-specific T cell receptors (TCR) with increasing affinities of up to 150-fold from the wild-type TCR. Using these TCR variants which extend just beyond the natural affinity range, along with an extreme supraphysiologic one having 1400-fold enhanced affinity, and a low-binding one, we sought to determine the effect of TCR binding properties along with cognate peptide concentration on CD8(+) T cell responsiveness. Major histocompatibility complexes (MHC) expressed on the surface of various antigen presenting cells were peptide-pulsed and used to stimulate human CD8(+) T cells expressing the different TCR via lentiviral transduction. At intermediate peptide concentration we measured maximum cytokine/chemokine secretion, cytotoxicity, and Ca(2+) flux for CD8(+) T cells expressing TCR within a dissociation constant (K(D)) range of ∼1-5 μM. Under these same conditions there was a gradual attenuation in activity for supraphysiologic affinity TCR with K(D) < ∼1 μM, irrespective of CD8 co-engagement and of half-life (t(1/2) = ln 2/k(off)) values. With increased peptide concentration, however, the activity levels of CD8(+) T cells expressing supraphysiologic affinity TCR were gradually restored. Together our data support the productive hit rate model of T cell activation arguing that it is not the absolute number of TCR/pMHC complexes formed at equilibrium, but rather their productive turnover, that controls levels of biological activity. Our findings have important implications for various immunotherapies under development such as adoptive cell transfer of TCR-engineered CD8(+) T cells, as well as for peptide vaccination strategies.

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Na região da Depressão Periférica Paulista, estudaram-se os solos em uma encosta representativa das baixas colinas com relevo suave ondulado e lançantes longos do baixo vale do rio Piracicaba. Após intensas observações de campo, foram amostrados cinco pedons, assentados em rochas psamíticas da formação Itararé (Carbonífero-Permiano). Quatro apresentaram características latossólicas e textura argilosa e um, interposto na porção superior da meia encosta, textura média e B textural. Com observações de campo, estratigráficas, macro e micromorfológicas e da mineralogia da argila, concluiu-se que grande parte do material de origem dos pedons Latossólicos argilosos proveio do retrabalhamento de um sedimento neocenozóico argiloso, previamente bastante intemperizado, com remanescentes semelhantes, hoje ocupando preferencialmente as superfícies cimeiras locais, e sem aparente filiação com as rochas psamíticas subjacentes. Deduziu-se que as características latossólicas dos solos da meia encosta e do sopé foram herdadas de idêntico material. No terço inferior da encosta, ocorreu um Bt, relativamente pouco espesso, interpretado como produto de transformação do transportado Bw, principalmente por mecanismos de argiluviação que coalescem os antigos microagregados tipicamente Latossólicos. O mais provável material de origem do Podzólico Vermelho-Amarelo Latossólico textura média/argilosa no terço superior da meia encosta, foi considerado como derivado, em grande parte, de sedimento correlativo a um antigo e elevado depósito aluvial correspondente a um nível de terraço do rio Piracicaba, hoje quase totalmente reafeiçoado.

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OBJECTIVES: To investigate whether associations of smoking with depression and anxiety are likely to be causal, using a Mendelian randomisation approach. DESIGN: Mendelian randomisation meta-analyses using a genetic variant (rs16969968/rs1051730) as a proxy for smoking heaviness, and observational meta-analyses of the associations of smoking status and smoking heaviness with depression, anxiety and psychological distress. PARTICIPANTS: Current, former and never smokers of European ancestry aged ≥16 years from 25 studies in the Consortium for Causal Analysis Research in Tobacco and Alcohol (CARTA). PRIMARY OUTCOME MEASURES: Binary definitions of depression, anxiety and psychological distress assessed by clinical interview, symptom scales or self-reported recall of clinician diagnosis. RESULTS: The analytic sample included up to 58 176 never smokers, 37 428 former smokers and 32 028 current smokers (total N=127 632). In observational analyses, current smokers had 1.85 times greater odds of depression (95% CI 1.65 to 2.07), 1.71 times greater odds of anxiety (95% CI 1.54 to 1.90) and 1.69 times greater odds of psychological distress (95% CI 1.56 to 1.83) than never smokers. Former smokers also had greater odds of depression, anxiety and psychological distress than never smokers. There was evidence for positive associations of smoking heaviness with depression, anxiety and psychological distress (ORs per cigarette per day: 1.03 (95% CI 1.02 to 1.04), 1.03 (95% CI 1.02 to 1.04) and 1.02 (95% CI 1.02 to 1.03) respectively). In Mendelian randomisation analyses, there was no strong evidence that the minor allele of rs16969968/rs1051730 was associated with depression (OR=1.00, 95% CI 0.95 to 1.05), anxiety (OR=1.02, 95% CI 0.97 to 1.07) or psychological distress (OR=1.02, 95% CI 0.98 to 1.06) in current smokers. Results were similar for former smokers. CONCLUSIONS: Findings from Mendelian randomisation analyses do not support a causal role of smoking heaviness in the development of depression and anxiety.

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BACKGROUND: Chronic daily headache (CDH) in children has been documented in general and clinical populations. Comorbid psychological conditions, risk factors and functional outcomes of CDH in children are not well understood. OBJECTIVES: To examine anxiety and depression, associated risk factors and school outcomes in a clinical population of youth with CDH compared with youth with episodic headache (EH). METHODS: Data regarding headache characteristics, anxiety, depression and missed school days were collected from 368 consecutive patients eight to 17 years of age, who presented with primary headache at a specialized pediatric headache centre. RESULTS: A total of 297 patients (81%) were diagnosed with EH and 71 were diagnosed with CDH. Among those with CDH, 78.9% presented with chronic tension-type headache and 21.1% with chronic migraine (CM). Children with CDH had a higher depression score than the standardized reference population. No difference was observed for anxiety or depression scores between children with CDH and those with EH. However, children with CM were more anxious and more depressed than those with chronic tension-type headache. Youth experiencing migraine with aura were three times as likely to have clinically significant anxiety scores. Headache frequency and history were not associated with psychopathological symptoms. Children with CDH missed school more often and for longer periods of time. CONCLUSIONS: These findings document the prevalence of anxiety, depression and school absenteeism in youth with CDH or EH. The present research also extends recent studies examining the impact of aura on psychiatric comorbidity and the debate on CM criteria.

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Citalopram is a chiral antidepressant drug. Its eutomer, S-citalopram (escitalopram), has recently been introduced as an antidepressant. In an open pilot study, four outpatients and two inpatients with a major depressive episode (ICD-10), and who were nonresponders to a 4-week pretreatment with 40-60 mg/day citalopram, were comedicated for another 4-week period with carbamazepine (200-400 mg/day). Some of the patients suffered also from comorbidities: Phobic anxiety disorder with panic attacks (n=2), generalised anxiety disorder, alcohol abuse, dependent personality disorder, hypertension (n=1). After a 4-week augmentation therapy with carbamazepine, a significant (P<0.03) decrease of the plasma concentrations of S-citalopram and R-citalopram, by 27 and 31%, respectively, was observed. Apparently, the probable induction of CYP3A4 by carbamazepine results in a nonstereoselective increase in N-demethylation of citalopram. Moreover, there was a significant (P<0.03) decrease of the ratio S/R-citalopram propionic acid derivative, the formation of it being partly regulated by MAO-A and MAO-B. Already, within 1 week after addition of carbamazepine, there was a slight but significant (P<0.03) decrease of the MADRS depression scores, from 27.0+/-7.7 (mean+/-S.D.) to 23.3+/-6.6, and the final score on day 56 was 18.8+/-10.9. The treatment was generally well tolerated. There was no evidence of occurrence of a serotonin syndrome. After augmentation with carbamazepine, treatment related adverse events were: Nausea in one case, diarrhea in one case, and rash in two cases. In conclusion, the results of this pilot study suggest that carbamazepine augmentation of a citalopram treatment in previous nonresponders to citalopram may be clinically useful, but that in addition carbamazepine can lead to a decrease of the plasma concentrations of the active enantiomer escitalopram.

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Résumé Objectifs: Cette étude relève la prévalence des principaux facteurs de risque cardiovasculaire dans les coronaropathies précoces (P-CAD) familiales, survenant chez au moins deux frères et/ou soeurs d'une même fratrie. Méthodes: Nous avons recruté 213 survivants atteints de P-CAD, issus de 103 fratries, diagnostiqués avant l'âge de 50 ans chez les hommes et 55 ans chez les femmes. La présence ou non d'hypertension, d'hypercholestérolémie, d'obésité et de tabagisme a été documentée au moment de l'événement chez 163 de ces patients (145 hommes et 18 femmes). Chaque patient a été comparé à deux individus de même âge et sexe, chez qui un diagnostic de P-CAD «sporadique» (non familiale) était posé, et à trois individus choisis au hasard parmi la population générale. Résultats: En comparaison de la population générale, les patients atteints de P-CAD sporadique avaient une prévalence supérieure pour l 'hypertension (29% vs. 14%, p<0.001), le cholestérol (54% vs. 33%, p<0.001), l'obésité (20% vs. 13%, p<0.001) et le tabagisme (76% vs. 39%, p<0.001). Ces facteurs de risque étaient de prévalences similaires, voire supérieures chez les patients atteints de P-CAD familiale (43% [p0.05 vs. P-CAD sporadiques], 58% [p=0.07], 21% et 72% respectivement). Seulement 7 (4%) des 163 patients atteints de P-CAD familiale et 22 (7%) des 326 patients atteints de P-CAD sporadique, ne présentaient aucun facteur de risque cardiovasculaire, comparés à 167 (34%) des 489 patients issus de la population générale. Conclusions: Les facteurs de risque cardiovasculaire classiques et réversibles ont une haute prévalence chez les patients atteints de P-CAD familiale. Ce fait rend improbable une contribution génétique prédominante, agissant en l'absence de facteurs de risque. Summary Objectives: This study was designed to assess the prevalence of major cardiovascular risk factors in familial premature coronary artery disease (P-CAD), affecting two or more siblings within one sibship. Background: Premature CAD has a genetic component. It remains to be established whether familial P-CAD is due to genes acting independently from major cardiovascular risk factors. Methods: We recruited 213 P-CAD survivors from 103 sibships diagnosed before age ?50 (men) or ?55 (women) years old. Hypertension, hypercholesterolemia, obesity, and smoking were documented at the time of the event in 163 patients (145 men and 18 women). Each patient was compared with two individuals of the same age and gender, diagnosed with sporadic (nonfamilial) P-CAD, and three individuals randomly sampled from the general population. Result: Compared with the general population, patients with sporadic P-CAD had a higher prevalence of hypertension (29% vs. 14%, p < 0.001), hypercholesterolemia (54% vs. 33%, p < 0.001), obesity (20% vs. 13%, p < 0.01), and smoking (76% vs. 39%, p < 0.001). These risk factors were equally or even more prevalent in patients with familial P-CAD (43% [p < 0.05 vs. sporadic P-CAD], 58% [p = 0.07], 21% and 72%, respectively). Overall, only 7 (4%) of 163 of patients with familial P-CAD and 22 (7%) of 326 of patients with sporadic P-CAD had none of these conditions, as compared with 167 (34%) of 489 patients in the general population. Conclusions: Classic, remediable risk factors are highly prevalent in patients with familial P-CAD. Accordingly, a major contribution of genes acting in the absence of these risk factors is unlikely.