KORELATI I PREVALENCIJA DEPRESIJE KOD OSOBA SMJEŠTENIH U KINESKIM DOMOVIMA ZA STARIJE OSOBE: IMPLIKACIJE ZA USLUGE I INTERVENCIJE

Due to paucity of research on prevalence of depression in Chinese elderly people residing in nursing homes, the present study investigated a set of predictors at personal, physical, social and psychosocial levels among 187 elderly residents in Hong Kong. The results show that 17.6% of the participants reported a manifest level of depression (GDS≥ 8). Financial strain and physical functioning impairment significantly augmented the likelihood of depression; however, strong support networks at residential settings as well as high self-esteem reduce the likelihood of this mental morbidity. Implications for services and intervention policies as well as further research are briefly discussed.Zbog nedostatka istraživanja o raširenosti depresije kod starijih osoba smještenih u kineskim domovima za starije osobe, ova studija istražuje niz prediktora depresije na osobnoj, fizičkoj. socijalnoj i psihosocijalnoj razini među 187 starijih korisnika u Hong Kongu. Rezultati pokazuju da je 17,6% sudionika iskazalo manifestnu razinu depresije (GDS≥ 8). Financijski pritisci i smanjena fizička pokretljivost značajno povećavaju mogućnost depresije. Snažna mreža podrške u rezidencijalnom smještaju kao i visoko samopoštovanje umanjuju mogućnost ovog mentalnog poremećaja. Implikacije za usluge i intervencije kao i za daljnja istraživanja su ukratko prikazani

KORELATI I PREVALENCIJA DEPRESIJE KOD OSOBA SMJEŠTENIH U KINESKIM DOMOVIMA ZA STARIJE OSOBE: IMPLIKACIJE ZA USLUGE I INTERVENCIJE

Due to paucity of research on prevalence of depression in Chinese elderly people residing in nursing homes, the present study investigated a set of predictors at personal, physical, social and psychosocial levels among 187 elderly residents in Hong Kong. The results show that 17.6% of the participants reported a manifest level of depression (GDS≥ 8). Financial strain and physical functioning impairment significantly augmented the likelihood of depression; however, strong support networks at residential settings as well as high self-esteem reduce the likelihood of this mental morbidity. Implications for services and intervention policies as well as further research are briefly discussed.Zbog nedostatka istraživanja o raširenosti depresije kod starijih osoba smještenih u kineskim domovima za starije osobe, ova studija istražuje niz prediktora depresije na osobnoj, fizičkoj. socijalnoj i psihosocijalnoj razini među 187 starijih korisnika u Hong Kongu. Rezultati pokazuju da je 17,6% sudionika iskazalo manifestnu razinu depresije (GDS≥ 8). Financijski pritisci i smanjena fizička pokretljivost značajno povećavaju mogućnost depresije. Snažna mreža podrške u rezidencijalnom smještaju kao i visoko samopoštovanje umanjuju mogućnost ovog mentalnog poremećaja. Implikacije za usluge i intervencije kao i za daljnja istraživanja su ukratko prikazani

An update on irreversible electroporation of liver tumours

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Qualidade de vida no trabalho nivel de estresse dos profissionais das UBS do Distrito Leste do Município de Foz do Iguaçu-PR

Trabalho de conclusão de Residência apresentado ao Programa Multiprofissional em Saúde da Família da Universidade Federal da Integração Latino-Americana, como requisito para obtenção do título de Especialista em Saúde da Família na modalidade de Residência. Orientador: Prof. Dr Thiago Luis de Andrade Barbosa Co-orientador: Prof. Ms. Gilberto Garcia da RochaObjetivo: Avaliar a qualidade de vida no trabalho (QVT) e nível de estresse dos trabalhadores da Atenção Primária à Saúde (APS) do distrito leste de Foz do Iguaçu-PR. Metodologia: Trata-se de estudo transversal no qual participaram 120 profissionais da APS pertencentes a 06 UBS do referido distrito. Os profissionais responderam questionários sociodemográfico, de QVT abreviado (QWLQ-Bref) e Escala do Estresse Percebido (PSS 13). Verificou-se associação da QVT e dos níveis de estresse com variáveis sociodemográficas com uso do teste t de Student, ANOVA, Mann-Whitney e Kruskal-Wallis. Nível de significância adotado foi de 5%. Resultados: A avaliação da QVT dos profissionais foi 62,8±10,0 e associou-se com sexo (p=0,016), idade (p=0,042), presença de dor (p=0,029) e satisfação com trabalho (p=0,002). Em relação aos domínios avaliados da QVT, houve associação com presença de dor e satisfação laboral. O escore total médio de estresse percebido dos participantes foi 24,5±6,0. Notou-se relação com as variáveis percepção quanto à alimentação saudável (p=0,013), presença de dor (p=0,002), dor relacionada ao trabalho (p=0,004) e satisfação com trabalho (p=0,001). Conclusão: Constatou-se satisfatória QVT e níveis médios de estresse dos profissionais o que demanda ações preventivas que melhorem esse panorama na APS do municípioObjective: To evaluate the quality of working life (QWL) and stress level of workers at Primary Health Care (PHC) in the east district of Foz do Iguaçu-PR. Methodology: Cross- sectional study with 120 PHC professionals from 06 basic health units of this district. Professionals answered sociodemographic questionnaire, abbreviated QLW (QWLQ-Bref) and Perceived Stress Scale (PSS 13). We verified the association of QWL and stress levels with sociodemographic variables using Student's t-test, ANOVA, Mann-Whitney and Kruskal-Wallis. Level of significance was 5%. Results: The professional QWL assessment was 62.8 ± 10.0 and was associated with gender (p=0.016), age (p=0.042), presence of pain (p = 0.029) and work satisfaction (p=0.002). In relation to the evaluated domains of QWL, there was an association with presence of pain and job satisfaction. The mean total perceived stress score of the participants was 24.5 ± 6.0. There was a relationship with the variables of perception regarding healthy eating (p=0.013), presence of pain (p=0.002), pain related to work (p=0.004) and satisfaction with work (p=0.001). Conclusion: We observed satisfactory QWL and mean levels of stress of PHC workers that demand improvement of this situationObjetivo: Evaluar la calidad de vida en el trabajo (QVT) y nivel de estrés de los trabajadores de la Atención Primaria a la Salud (APS) del distrito este de Foz do Iguaçu-PR. Metodología: Se trata de un estudio transversal en el que participaron 120 profesionales de la APS pertenecientes a 06 UBS de dicho distrito. Los profesionales respondieron cuestionarios sociodemográficos, de QVT abreviado (QWLQ-Bref) y Escala del estrés percibido (PSS 13). Se verificó asociación de QVT y de los niveles de estrés con variables sociodemográficas con el uso del test t de Student, ANOVA, Mann-Whitney y Kruskal-Wallis. El nivel de significancia adoptado fue del 5%. Resultados: La evaluación de la QVT de los profesionales fue de 62,8 ± 10,0 y se asoció con sexo (p=0,016), edad (p=0,042), presencia de dolor (p=0,029) y satisfacción con el trabajo (p=0,029) 0,002). En relación a los ámbitos evaluados de la QVT, hubo asociación con presencia de dolor y satisfacción laboral. La puntuación total promedio de estrés percibido de los participantes fue de 24,5 ± 6,0. Se observó relación con las variables percepción en cuanto a la alimentación sana (p=0,013), presencia de dolor (p=0,002), dolor relacionado al trabajo (p=0,004) y satisfacción con el trabajo (p=0,001). Conclusión: Se constató satisfactoria QVT y niveles medios de estrés de los profesionales lo que demanda acciones preventivas que mejoren ese panorama en la APS del municipi

Anxiety and depression with neurogenesis defects in exchange protein directly activated by cAMP 2-deficient mice are ameliorated by a selective serotonin reuptake inhibitor, Prozac

Intracellular cAMP and serotonin are important modulators of anxiety and depression. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI) also known as Prozac, is widely used against depression, potentially by activating cAMP response element-binding protein (CREB) and increasing brain-derived neurotrophic factor (BDNF) through protein kinase A (PKA). However, the role of Epac1 and Epac2 (Rap guanine nucleotide exchange factors, RAPGEF3 and RAPGEF4, respectively) as potential downstream targets of SSRI/cAMP in mood regulations is not yet clear. Here, we investigated the phenotypes of Epac1 (Epac1− / −) or Epac2 (Epac2− / −) knockout mice by comparing them with their wild-type counterparts. Surprisingly, Epac2− / − mice exhibited a wide range of mood disorders, including anxiety and depression with learning and memory deficits in contextual and cued fear-conditioning tests without affecting Epac1 expression or PKA activity. Interestingly, rs17746510, one of the three single-nucleotide polymorphisms (SNPs) in RAPGEF4 associated with cognitive decline in Chinese Alzheimer’s disease (AD) patients, was significantly correlated with apathy and mood disturbance, whereas no significant association was observed between RAPGEF3 SNPs and the risk of AD or neuropsychiatric inventory scores. To further determine the detailed role of Epac2 in SSRI/serotonin/cAMP-involved mood disorders, we treated Epac2− / − mice with a SSRI, Prozac. The alteration in open field behavior and impaired hippocampal cell proliferation in Epac2− / − mice were alleviated by Prozac. Taken together, Epac2 gene polymorphism is a putative risk factor for mood disorders in AD patients in part by affecting the hippocampal neurogenesis.published_or_final_versio

Effects of a group-based lifestyle medicine for depression : a pilot randomized controlled trial

Given the growing evidence that a range of lifestyle factors are involved in the etiology of depression, a ‘lifestyle medicine’ approach can be potentially safe and cost-effective to prevent or treat depression. To examine the effects and acceptability of a group-based, integrative lifestyle medicine intervention as a standalone treatment for managing depressive symptoms, a pilot randomized controlled trial (RCT) was conducted in a Chinese adult population in 2018. Participants (n = 31) with PHQ-9 score above the cut-off of ≥ 10, which was indicative of moderate to severe depression, were recruited from the general community in Hong Kong and randomly assigned to lifestyle medicine group (LM group) or care-as-usual group (CAU group) in a ratio of 1:1. Participants in the LM group received 2-hour group sessions once per week for six consecutive weeks, which covered diet, exercise, mindfulness, psychoeducation, and sleep management. Linear mixed-effects model analyses showed that the LM group had a significant reduction in PHQ-9 scores compared to the CAU group at immediate posttreatment and 12-week posttreatment follow-up (d = 0.69 and 0.73, respectively). Moreover, there were significantly greater improvements in anxiety, stress, and insomnia symptoms (measured by DASS-21 and ISI) at all time points in the LM group (d = 0.42–1.16). The results suggests that our 6-week group-based, integrative lifestyle intervention program is effective in lowering depressive, anxiety, stress, and insomnia symptoms in the Chinese population. Further studies in clinical populations with a larger sample size and longer follow-up are warranted

Genetic study of congenital bile-duct dilatation identifies de novo and inherited variants in functionally related genes

Background: Congenital dilatation of the bile-duct (CDD) is a rare, mostly sporadic, disorder that results in bile retention with severe associated complications. CDD affects mainly Asians. To our knowledge, no genetic study has ever been conducted. Methods: We aim to identify genetic risk factors by a “trio-based” exome-sequencing approach, whereby 31 CDD probands and their unaffected parents were exome-sequenced. Seven-hundred controls from the local population were used to detect gene-sets significantly enriched with rare variants in CDD patients. Results: Twenty-one predicted damaging de novo variants (DNVs; 4 protein truncating and 17 missense) were identified in several evolutionarily constrained genes (p < 0.01). Six genes carrying DNVs were associated with human developmental disorders involving epithelial, connective or bone morphologies (PXDN, RTEL1, ANKRD11, MAP2K1, CYLD, ACAN) and four linked with cholangio- and hepatocellular carcinomas (PIK3CA, TLN1 CYLD, MAP2K1). Importantly, CDD patients have an excess of DNVs in cancer-related genes (p < 0.025). Thirteen genes were recurrently mutated at different sites, forming compound heterozygotes or functionally related complexes within patients. Conclusions: Our data supports a strong genetic basis for CDD and show that CDD is not only genetically heterogeneous but also non-monogenic, requiring mutations in more than one genes for the disease to develop. The data is consistent with the rarity and sporadic presentation of CDD

Wnt activation downregulates olfactomedin-1 in Fallopian tubal epithelial cells:a microenvironment predisposed to tubal ectopic pregnancy

Ectopic pregnancy (EP) occurs when the embryo fails to transit to the uterus and attach to the luminal epithelium of the Fallopian tube (FT). Tubal EP is a common gynecological emergency and more than 95% of EP occurs in the ampullary region of the FT. In humans, Wnt activation and downregulation of olfactomedin-1 (Olfm-1) occur in the receptive endometrium and coincided with embryo implantation in vivo. Whether similar molecular changes happen in the FT leading to EP remains unclear. We hypothesized that activation of Wnt signaling downregulates Olfm-1 expression predisposes to EP. We investigated the spatiotemporal expression of Olfm-1 in FT from non-pregnant women and women with EP, and used a novel trophoblastic spheroid (embryo surrogate)-FT epithelial cell co-culture model (JAr and OE-E6/E7 cells) to study the role of Olfm-1 on spheroid attachment. Olfm-1 mRNA expression in the ampullary region of non-pregnant FT was higher (P0.05) in the follicular phase than in the luteal phase. Ampullary tubal Olfm-1 expression was lower in FT from women with EP compared to normal controls at the luteal phase (histological scoring (H-SCORE)1.30.2 vs 2.40.5; P0.05). Treatment of OE-E6/E7 with recombinant Olfm-1 (0.2-5 g/ml) suppressed spheroid attachment to OE-E6/E7 cells, while activation of Wnt-signaling pathway by Wnt3a or LiCl reduced endogenous Olfm-1 expression and increased spheroid attachment. Conversely, suppression of Olfm-1 expression by RNAi increased spheroid attachment to OE-E6/E7 cells. Taken together, Wnt activation suppresses Olfm-1 expression, and this may predispose a favorable microenvironment of the retained embryo in the FT, leading to EP in humans. © 2012 USCAP, Inc All rights reserved.link_to_OA_fulltex

Diagnostic value of whole-exome sequencing in Chinese pediatric-onset neuromuscular patients

BACKGROUND: Neuromuscular disorders (NMDs) comprise a group of heterogeneous genetic diseases with a broad spectrum of overlapping the clinical presentations that makes diagnosis challenging. Notably, the recent introduction of whole-exome sequencing (WES) is introducing rapid changes on the genetic diagnosis of NMDs. We aimed to investigate the diagnostic value of WES for pediatric-onset NMDs. METHODS: We applied integrated diagnostic approach and performed WES in 50 Chinese subjects (30 males, 20 females) with undiagnosed pediatric-onset NMDs despite previous specific tests. The patients were categorized in four subgroups according to phenotyping and investigation findings. Variants on NMDs gene list and open exome analysis for those with initial negative findings were identified. RESULTS: WES identified causative variants in ACTA1 (n = 2), POMT1, COL6A1 (n = 2), MTMR2, LMNA, SELENON, DNM2, TGFB1, MPZ, IGHMBP2, and LAMA2 in 13 patients. Two subjects have variants of uncertain significance (VUSs) in TTN and SCN11A, unlikely to be pathogenic due to incompatible phenotypes. The mean interval time from symptom onset to genetic diagnosis was 10.4 years (range from 1 month to 33 years). The overall diagnostic yield of WES in our cohort was 26%. Open exome analysis was necessary to identify the pathogenic variant in TGFB1 that caused skeletal dysplasia with neuromuscular presentation. CONCLUSION: Our study shows a clear role of WES in the pathway of integrated diagnostic approach to shorten the diagnostic odyssey in patients with rare NMDs

A loop of cancer-stroma-cancer interaction promotes peritoneal metastasis of ovarian cancer via TNFα-TGFα-EGFR.

Peritoneum is the most common site for ovarian cancer metastasis. Here we investigate how cancer epigenetics regulates reciprocal tumor-stromal interactions in peritoneal metastasis of ovarian cancer. Firstly, we find that omental stromal fibroblasts enhance colony formation of metastatic ovarian cancer cells, and de novo expression of transforming growth factor-alpha (TGF-α) is induced in stromal fibroblasts co-cultured with ovarian cancer cells. We also observed an over-expression of tumor necrosis factor-alpha (TNF-α) in ovarian cancer cells, which is regulated by promoter DNA hypomethylation as well as chromatin remodeling. Interestingly, this ovarian cancer-derived TNF-α induces TGF-α transcription in stromal fibroblasts through nuclear factor-κB (NF-κB). We further show that TGF-α secreted by stromal fibroblasts in turn promotes peritoneal metastasis of ovarian cancer through epidermal growth factor receptor (EGFR) signaling. Finally, we identify a TNFα-TGFα-EGFR interacting loop between tumor and stromal compartments of human omental metastases. Our results therefore demonstrate cancer epigenetics induces a loop of cancer-stroma-cancer interaction in omental microenvironment that promotes peritoneal metastasis of ovarian cancer cells via TNFα-TGFα-EGFR