19 research outputs found

    Sub-threshold depression and antidepressants use in a community sample: searching anxiety and finding bipolar disorder

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    <p>Abstract</p> <p>Background</p> <p>To determine the use of antidepressants (ADs) in people with sub-threshold depression (SD); the lifetime prevalence of mania and hypomania in SD and the link between ADs use, bipolarity and anxiety disorders in SD.</p> <p>Methods</p> <p>Study design: community survey. Study population: samples randomly drawn, after stratification from the adult population of municipal records. Sample size: 4999 people from seven areas within six Italian regions. Tools: Questionnaire on psychotropic drug consumption, prescription; Structured Clinical Interview NP for DSM-IV modified (ANTAS); Hamilton Depression Rating Scale (HAM-D); Mood Disorder Questionnaire (MDQ); Short Form Health Survey (SF-12). SD definition: HAM-D > 10 without lifetime diagnosis of Depressive Episode (DE).</p> <p>Results</p> <p>SD point prevalence is 5.0%. The lifetime prevalence of mania and hypomania episodes in SD is 7.3%. Benzodiazepines (BDZ) consumption in SD is 24.1%, followed by ADs (19.7%). In SD, positive for MDQ and comorbidity with Panic Disorder (PD) or Generalized Anxiety Disorders (GAD) are associated with ADs use, whereas the association between a positive MDQ and ADs use, without a diagnosis of PD or GAD, is not significant. Only in people with DE the well-being (SF-12) is higher among those using first-line antidepressants compared to those not using any medication. In people with SD no significant differences were found in terms of SF-12 score according to drug use.</p> <p>Conclusions</p> <p>This study suggests caution in prescribing ADs to people with SD. In people with concomitant anxiety disorders and SD, it should be mandatory to perform a well-designed assessment and evaluate the presence of previous manic or hypomanic symptoms prior to prescribing ADs.</p

    Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: A cross-sectional survey among midlife Nepalese women

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    <p>Abstract</p> <p>Background</p> <p>Majority of Nepalese women live in remote rural areas, where health services are not easily accessible. We determined the validity of Menopause Rating Scale (MRS) as a screening tool for identification of women with severe menopausal symptoms and cut-off MRS score for referral.</p> <p>Methods</p> <p>A cross-sectional survey was carried out between February and August, 2008. Trained health workers administered MRS and a questionnaire to 729 women (40 to 65 years) attending health screening camps in Kaski district of Western Development Region of Nepal. Information about demographics, menopausal status, and use of hormone replacement therapy (HRT), chronic disease, self-perceived general health and reproductive history was also collected. Menopausal status was classified according to the Staging of Reproductive Ageing Workshop (STRAW). We calculated rates of menopausal symptoms, sensitivity, and specificity and likelihood ratios of MRS scores for referral to a gynaecologist. We also carried out multivariate analyses to identify the predictors for referral to a gynaecologist for severe symptoms.</p> <p>Results</p> <p>A total 729 women were interviewed. Mean age at menopause was 49.9 years (SD 5.6). Most frequently reported symptoms were, sleeping problems (574, 78.7%), physical and mental exhaustion (73.5%), hot flushes (508, 69.7%), joint and muscular discomfort (500, 68.6%) and dryness of vagina (449, 61.6%). Postmenopausal women (247, 33.9%) and perimenopausal (215, 29.5%) women together experienced significantly higher prevalence of all symptoms than the premenopausal (267, 36.6%) women. MRS score of ≄16 had highest ratio for (sensitivity + specificity)/2. Women who reported urogenital symptoms [OR 5.29, 95% CI 2.59, 10.78], and self perceived general health as poor [OR 1.29, 95% CI 1.11, 1.53] were more likely to be referred to a gynaecologist for severe menopausal symptoms. While women reporting somatic [OR 0.72, 95% CI 0.63, 0.82] and psychological [OR 0.86, 95% CI 0.74, 0.99] symptoms were less likely to be referred.</p> <p>Conclusion</p> <p>MRS may be used as a screening tool at a cut-off score of ≄16 with least misclassification rate. However, its utility may be limited by woman's general health status and occurrence of urogenital symptoms.</p

    Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis

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    Bronchiectasis is a disease associated with chronic progressive and irreversible dilatation of the bronchi and is characterised by chronic infection and associated inflammation. The prevalence of bronchiectasis is age-related and there is some geographical variation in incidence, prevalence and clinical features. Most bronchiectasis is reported to be idiopathic however post-infectious aetiologies dominate across Asia especially secondary to tuberculosis. Most focus to date has been on the study of airway bacteria, both as colonisers and causes of exacerbations. Modern molecular technologies including next generation sequencing (NGS) have become invaluable tools to identify microorganisms directly from sputum and which are difficult to culture using traditional agar based methods. These have provided important insight into our understanding of emerging pathogens in the airways of people with bronchiectasis and the geographical differences that occur. The contribution of the lung microbiome, its ethnic variation, and subsequent roles in disease progression and response to therapy across geographic regions warrant further investigation. This review summarises the known geographical differences in the aetiology, epidemiology and microbiology of bronchiectasis. Further, we highlight the opportunities offered by emerging molecular technologies such as -omics to further dissect out important ethnic differences in the prognosis and management of bronchiectasis.NMRC (Natl Medical Research Council, S’pore)MOH (Min. of Health, S’pore)Published versio

    Porous underwater chamber (PUC) for in-situ determination of nutrient and pollutant bioavailability to microorganisms

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    © 2014, by the Association for the Sciences of Limnology and Oceanography. Physical (e.g., temperature and light) and biogeochemical (e.g., cycling) parameters are known to affect bioavailability and toxicity of nutrients and pollutants to microorganisms. A system that would allow exposure of selected microorganisms to in situ conditions could provide relevant and novel evaluations of bioavailability. A simple and low cost 37 mL porous underwater chamber (PUC), in which test microorganisms are exposed to field conditions, is presented. The PUC is a thin, acrylic cylinder with polycarbonate membranes on each side, providing an optimal (75 cm2) exchange with the external solution. Regardless of the membrane pore size (0.4 and 5 Όm), the PUC required 10 h to equilibrate with the external solution, close to the theoretical time determined for the diffusion of a model compound, the Suwannee River fulvic acid. For in situ use, the PUCs can be filled with filtered water to minimize the equilibration time. The system was validated in 20 to 60 L artificial freshwater by evaluating (1) Cd bioaccumulation by the microalga Chlamydomonas reinhardtii and (2) iron bioavailability to a cyanobacterial bioreporter in comparison with conventional bottle assays. The use of the PUC resulted in no significant differences in Cd uptake fluxes or iron bioavailability. Field experiments undertaken on Lake Erie demonstrated that the PUCs could be used to evaluate the contribution of particulate iron to iron bioavailability. Because the PUCs might not correctly reflect bioavailability for substances at low concentrations with high biouptake fluxes, a critical discussion with respect on the rate-limiting steps of the device is presented. Several considerations that might facilitate the appropriate use of the PUCs are given

    Neotectonic deformation stages in the central Ouarsenis culminating zone, Northwestern Algeria

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    International audienceThe Tellian system in the north of Algeria results from the convergence of the African and Eurasian plates which began in the Late Cretaceous. The strong tangentional tectonics at the origin of the emplacement of nappes in its external domain occurred mainly during the Early Miocene. This major tectonic episode was followed by another important compressive deformation-oriented NNE-SSW and NNW-SSE during the Pliocene and the Quaternary, respectively. The Ouarsenis culminating zone is part of the Tellian domain and is characterized by an altogether distinct orographical structure made up of: (i) Jurassic formations which overthrust Cretaceous terrains; (ii) completely upturned series; diversely oriented faults (N40°, N70°, N120°, and N160°) of different kinds (thrust, reverse, normal, and shear faults). Triassic gypsum crops out along some of these faults. Microtectonic data analysis has shown alternation of two main compressive stresses, NW-SE and NE-SW oriented. The more recent stress, probably of Pliocene age, ∌N56° oriented, is responsible for the current face of the culminating zone. It highlights a major ∌N120° sinistral shear fault-generated deformation especially in its central part, affecting ductile material represented by Albo-Aptian turbidites. This fault also generated secondary shears accommodated according to a Riedel deformation model. The central part of this area has a complex tectonic structure squeezed between two massifs composed of hard material, along the sinistral shears. It has been extruded towards the north and has evolved as a positive “flower structure.
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