40 research outputs found
Chemokines in depression in health and in inflammatory illness: a systematic review and meta-analysis
Inflammatory illness is associated with depression. Preclinical work has shown that chemokines are linked with peripheral–central crosstalk and may be important in mediating depressive behaviours. We sought to establish what evidence exists that differences in blood or cerebrospinal fluid chemokine concentration discriminate between individuals with depression and those without. Following PRISMA guidelines, we systematically searched Embase, PsycINFO and Medline databases. We included participants with physical illness for subgroup analysis, and excluded participants with comorbid psychiatric diagnoses. Seventy-three studies met the inclusion criteria for the meta-analysis. Individuals with depression had higher levels of blood CXCL4 and CXCL7 and lower levels of blood CCL4. Sensitivity analysis of studies with only physically healthy participants identified higher blood levels of CCL2, CCL3, CCL11, CXCL7 and CXCL8 and lower blood levels of CCL4. All other chemokines examined did not reveal significant differences (blood CCL5, CCL7, CXCL9, CXCL10 and cerebrospinal fluid CXCL8 and CXCL10). Analysis of the clinical utility of the effect size of plasma CXCL8 in healthy individuals found a negative predictive value 93.5%, given the population prevalence of depression of 10%. Overall, our meta-analysis finds evidence linking abnormalities of blood chemokines with depression in humans. Furthermore, we have demonstrated the possibility of classifying individuals with depression based on their inflammatory biomarker profile. Future research should explore putative mechanisms underlying this association, attempt to replicate existing findings in larger populations and aim to develop new diagnostic and therapeutic strategies
Percutaneous coronary intervention in the elderly: changes in case-mix and periprocedural outcomes in 31758 patients treated between 2000 and 2007
<p>Background: The elderly account for an increasing proportion of the population and have a high prevalence of coronary heart disease. Percutaneous coronary intervention (PCI) is the most common method of revascularization in the elderly. We examined whether the risk of periprocedural complications after PCI was higher among elderly (age ≥75 years) patients and whether it has changed over time.</p>
<p>Methods and Results: The Scottish Coronary Revascularization Register was used to undertake a retrospective cohort study on all 31 758 patients undergoing nonemergency PCI in Scotland between April 2000 and March 2007, inclusive. There was an increase in the number and percentage of PCIs undertaken in elderly patients, from 196 (8.7%) in 2000 to 752 (13.9%) in 2007. Compared with younger patients, the elderly were more likely to have multivessel disease, multiple comorbidity, and a history of myocardial infarction or coronary artery bypass grafting (χ2 tests, all P<0.001). The elderly had a higher risk of major adverse cardiovascular events within 30 days of PCI (4.5% versus 2.7%, χ2 test P<0.001). Over the 7 years, there was a significant increase in the proportion of elderly patients who had multiple comorbidity (χ2 test for trend, P<0.001). Despite this, the underlying risk of complications did not change significantly over time either among the elderly (χ2 test for trend, P=0.142) or overall (χ2 test for trend, P=0.083).</p>
<p>Conclusions: Elderly patients have a higher risk of periprocedural complications and account for an increasing proportion of PCIs. Despite this, the risk of complications after PCI has not increased over time.</p>
Recent outbreaks of infectious syphilis, United Kingdom, January 2012 to April 2014
Six outbreaks of infectious syphilis in the United Kingdom, ongoing since 2012, have been investigated among men who have sex with men (MSM) and heterosexual men and women aged under 25 years. Interventions included case finding and raising awareness among healthcare professionals and the public. Targeting at-risk populations was complicated as many sexual encounters involved anonymous partners. Outbreaks among MSM were influenced by the use of geospatial real-time networking applications that allow users to locate other MSM within close proximity
Radial access during percutaneous interventions in patients with acute coronary syndromes: should we routinely monitor radial artery patency by ultrasonography promptly after the procedure and in long-term observation?
De-industrialization: a case study of Dundee, 1951–2001, and its broad implications
Using a case study of one Scottish city, Dundee, this article addresses some of the tensions involved in the use of the concept of ‘de-industrialization’. Widely used to try to understand economic and social change in the post-war years, this term is complex and controversial. This article unravels some of this complexity, arguing that the term is potentially very helpful, but needs careful definition, nuanced application and recognition of its limits. The focus here is on the impact of changing industrial structures on the labour market. After analysing the processes of firm births and deaths, the study looks at the decline of the ‘old staple’ industry, jute manufacturing in Dundee. The next sections assess the role of multinational enterprises in re-shaping the employment structure of the city, before looking at the contraction of some of the city’s other industries. Attention then turns to the impact of all these changes on the economic welfare of the city. The final section draws conclusions about our general understanding of de-industrialization from the Dundee case