15 research outputs found

    A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression

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    Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD). Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients. Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction. Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine.publishedVersio

    Climate determines transmission hotspots of Polycystic Echinococcosis, a life-threatening zoonotic disease, across Pan-Amazonia

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    Polycystic Echinococcosis (PE), a neglected life-threatening zoonotic disease caused by the cestode is endemic in the Amazon. Despite being treatable, PE reaches a case fatality rate of around 29% due to late or missed diagnosis. PE is sustained in Pan-Amazonia by a complex sylvatic cycle. The hunting of its infected intermediate hosts (especially the lowland paca ) enables the disease to further transmit to humans, when their viscera are improperly handled. In this study, we compiled a unique dataset of host occurrences (~86000 records) and disease infections (~400 cases) covering the entire Pan-Amazonia and employed different modeling and statistical tools to unveil the spatial distribution of PE's key animal hosts. Subsequently, we derived a set of ecological, environmental, climatic, and hunting covariates that potentially act as transmission risk factors and used them as predictors of two independent Maximum Entropy models, one for animal infections and one for human infections. Our findings indicate that temperature stability promotes the sylvatic circulation of the disease. Additionally, we show how El Niño-Southern Oscillation (ENSO) extreme events disrupt hunting patterns throughout Pan-Amazonia, ultimately affecting the probability of spillover. In a scenario where climate extremes are projected to intensify, climate change at regional level appears to be indirectly driving the spillover of . These results hold substantial implications for a wide range of zoonoses acquired at the wildlife-human interface for which transmission is related to the manipulation and consumption of wild meat, underscoring the pressing need for enhanced awareness and intervention strategies

    A Clinical Rationale for Assessing the Impact of Childhood Sexual Abuse on Adjunctive Subcutaneous Esketamine for Treatment-Resistant Depression

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    Background: A history of child sexual abuse (CSA) is related to higher suicide rates and poor treatment outcomes in depressed adult patients. Twenty years after the first study investigating the effects of ketamine/esketamine on depression and suicide, there is a lack of data on the CSA effects on this emerging treatment. Here, we assess the impact of CSA on adjunctive subcutaneous (SC) esketamine for treatment-resistant depression (TRD). Methods: A directed acyclic graphic (DAG) was designed to identify clinical confounders between CSA and esketamine predictors of response. The confounders were applied in a statistical model to predict depression symptom trajectory in a sample of 67 TRD outpatients. Results: The patient sample had a relatively high prevalence rate of CSA (35.82%). Positive family history of first-degree relatives with alcohol use disorder and sex were clinical mediators of the effects of esketamine in a CSA adult population. Overall, the presence of at least one CSA event was unrelated to esketamine symptom reduction. Conclusions: Unlike responses to conventional antidepressants and psychotherapy, CSA does not appear to predict poor response to esketamine

    Estudo comparativo dos mecanorreceptores dos discos intervertebrais normais e degenerados da coluna lombar de humanos pela radiografia, ressonância magnética e estudo anatomopatológico Comparative study of normal and degenerated intervertebral discs' mechanoreceptors of human lumar spine X-ray, magnetic resonance and anatomopathologic study

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    Os autores fizeram um estudo da coluna lombar de humanos, objetivando avaliar e determinar os diferentes tipos de fibras nervosas no disco intervertebral normal e no degenerado. Foram usadas dez colunas lombares de cadáveres com aproximadamente 48 a 72 horas de óbito. As peças foram submetidas a exames de radiografia simples e ressonância magnética. Após os exames, os discos foram classificados em normais e degenerados. Em seguida, foram dissecados, divididos em regiões anterior e posterior, incluídos em parafina e realizado estudo de imuno-histoquímica com a proteína S100. Com o auxílio de um programa de computador Image-Pro Plus (media cybernetics®), as fibras nervosas tiveram seu diâmetro medidos em micrômetros e classificadas em quatro tipos de fibras. Foram encontrados quatro tipos de fibras nervosas nas diferentes regiões discais. O número e o tipo de fibras variaram de acordo com a região e grau de degeneração do disco intervertebral. Concluíram que as fibras do tipo III são mais freqüentes na região anterior; as fibras dos tipos II e IV são mais freqüentes na região posterior, e as fibras do tipo I não apresentaram diferenças entre a região anterior e a posterior; além disso, o disco degenerado tem mais fibras nervosas que o disco normal.<br>The authors conducted a study on human lumbar spine, aiming to assess and determine the different kinds of nervous fibers in normal and degenerated intervertebral discs. Ten cadaver’s lumbar spines with approximately 48 - 72 of death have been used. The pieces were submitted to simple X-ray and magnetic resonance tests. Subsequently to the tests, discs were divided into normal and degenerated. Then, they were dissected, divided into anterior and posterior according to the region, included in paraffin and an immunohistochemical study with S100 protein was performed. With the aid of Image-Pro Plus computer software (media cybernetics) ®, nervous fibers’ diameters were measured as micrometers and classified into four kinds of fibers. Four types of nervous fibers were found on different disc regions. The number and kind of fibers varied according to the region and degree of intervertebral disc degeneration. It was concluded that type-III fibers are more common at the anterior region; type-II and type-IV fibers are more common at the posterior region, and type-I fibers do not show any differences regarding anterior and posterior regions; in addition, a degenerated disc has a higher number of nervous fibers than a normal one

    Reabilitação precoce de atletas utilizando hidroterapia após o tratamento cirúrgico de hérnia discal lombar: relato preliminar de 3 casos Early rehabilitation of athletes using hydrotherapy after surgical treatment of lumbar disc herniation: preliminary report of three cases

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    Os autores avaliaram três atletas do sexo masculino, submetidos a tratamento cirúrgico de hérnia discal lombar, com o objetivo de avaliar os resultados, após serem submetidos a um protocolo de reabilitação com base em hidroterapia. Este método permitiu a reabilitação precoce dos atletas, iniciando-se na primeira semana após a cirurgia. Os atletas foram avaliados em 5 ocasiões: pré-operatório e nos 4 meses seguintes. Houve melhora completa da dor em dois atletas. O terceiro caso apresentou no 4º mês 1,3% da intensidade máxima. As atividades de vida diária no período pré-operatório em média apresentaram-se com 21,6% da freqüência máxima, chegando a 99,3% no 4º mês. A freqüência de prática esportiva teve em média 10% da intensidade no pré-operatório, no 4º mês os atletas já praticavam a atividade esportiva com uma freqüência de 84,6% do normal. O nível de atividade esportiva foi relatado em média como 10% daquele estabelecido pelos atletas antes do início dos sintomas, atingindo 88,3% no 4º mês. Concluímos que os atletas apresentaram melhora evolutiva em todos os parâmetros analisados, especialmente em relação a dor. Portanto, a hidroterapia mostrou-se um método eficaz e bem tolerado na reabilitação precoce da cirurgia de hérnia discal em atletas.<br>Three male athletes submitted to surgical treatment of lumbar disc herniation were assessed aiming to evaluate the results of a rehabilitation protocol based on aquatic therapy. This method allowed early rehabilitation of the athletes, within a week after surgery. The athletes were evaluated in 5 occasions: pre-operatively and in the 4 following months. Complete improvement of pain was observed in two athletes. The third case had 1.3% of the maximum intensity in the 4th month. The daily life activities during the pre-operative period presented 21.6% of the maximum frequency on average, reaching 99.3% in the 4th month. The frequency of practicing sports was on average 10% the pre-operative intensity; in the 4th month the athletes already played sports with a frequency 84.6% of the normal. The level of sporting activities was reported as 10% on average of the one established by the athletes before the symptoms had started, reaching 88.3% in the 4th month. We conclude that the athletes had an evolutionary improvement in all the analyzed parameters, especially as regards pain. Thus, hydrotherapy was an effective and well tolerated method in the early rehabilitation of athletes after disc herniation surgery

    The CARMENES search for exoplanets around M dwarfs: First visual-channel radial-velocity measurements and orbital parameter updates of seven M-dwarf planetary systems

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    The appendix tables are only available at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/609/A117Context. The main goal of the CARMENES survey is to find Earth-mass planets around nearby M-dwarf stars. Seven M dwarfs included in the CARMENES sample had been observed before with HIRES and HARPS and either were reported to have one short period planetary companion (GJ 15 A, GJ 176, GJ 436, GJ 536 and GJ 1148) or are multiple planetary systems (GJ 581 and GJ 876). Aims. We aim to report new precise optical radial velocity measurements for these planet hosts and test the overall capabilities of CARMENES. Methods. We combined our CARMENES precise Doppler measurements with those available from HIRES and HARPS and derived new orbital parameters for the systems. Bona-fide single planet systems were fitted with a Keplerian model. The multiple planet systems were analyzed using a self-consistent dynamical model and their best fit orbits were tested for long-term stability. Results. We confirm or provide supportive arguments for planets around all the investigated stars except for GJ 15 A, for which we find that the post-discovery HIRES data and our CARMENES data do not show a signal at 11.4 days. Although we cannot confirm the super-Earth planet GJ 15 Ab, we show evidence for a possible long-period (P = 7030 d) Saturn-mass (msini = 51.8M) planet around GJ 15 A. In addition, based on our CARMENES and HIRES data we discover a second planet around GJ 1148, for which we estimate a period P = 532.6 days, eccentricity e = 0.342 and minimum mass msini = 68.1M. Conclusions. The CARMENES optical radial velocities have similar precision and overall scatter when compared to the Doppler measurements conducted with HARPS and HIRES. We conclude that CARMENES is an instrument that is up to the challenge of discovering rocky planets around low-mass stars.© ESO, 2018.CARMENES is an instrument for the Centro Astronomico Hispano-Aleman de Calar Alto (CAHA, Almeria, Spain). CARMENES is funded by the German Max-Planck-Gesellschaft (MPG), the Spanish Consejo Superior de Investigaciones Cientificas (CSIC), the European Union through FEDER/ERF FICTS-2011-02 funds, and the members of the CARMENES Consortium (Max-Planck-Institut fur Astronomie, Instituto de Astrofisica de Andalucia, Landessternwarte Konigstuhl, Institut de Ciencies de l'Espai, Insitut fur Astrophysik Gottingen, Universidad Complutense de Madrid, Thuringer Landessternwarte Tautenburg, Instituto de Astrofisica de Canarias, Hamburger Sternwarte, Centro de Astrobiologia and Centro Astronomico Hispano-Aleman), with additional contributions by the Spanish Ministry of Economy, the German Science Foundation (DFG), the Klaus Tschira Stiftung, the states of Baden-Wurttemberg and Niedersachsen, the DFG Research Unit FOR2544 >Blue Planets around Red Stars>, and by the Junta de Andalucia. This work has made use of data from the European Space Agency (ESA) mission Gaia (https://www.cosmos.esa.int/gaia), processed by the Gaia Data Processing and Analysis Consortium (DPAC, https://www.cosmos.esa.int/web/gaia/dpac/consortium). Funding for the DPAC has been provided by national institutions, in particular the institutions participating in the Gaia Multilateral Agreement. This work used the Systemic Console package (Meschiari et al. 2009) for cross-checking our Keplerian and Dynamical fits and the python package astroML (VanderPlas et al. 2012) for the calculation of the GLS periodogram. The IEEC-CSIC team acknowledges support by the Spanish Ministry of Economy and Competitiveness (MINECO) and the Fondo Europeo de Desarrollo Regional (FEDER) through grant ESP2016-80435-C2-1-R, as well as the support of the Generalitat de Catalunya/CERCA programme. The IAA-CSIC team acknowledges support by the Spanish Ministry of Economy and Competitiveness (MINECO) through grants AYA2014-54348-C03-01 and AYA2016-79425-C3-3-P as well as FEDER funds. The UCM team acknowledges support by the Spanish Ministry of Economy and Competitiveness (MINECO) from projects AYA2015-68012-C2-2-P and AYA2016-79425- C3-1,2,3-P and the Spanish Ministerio de Educacion, Cultura y Deporte, programa de Formacion de Profesorado Universitario, under grant FPU15/01476. T. T. and M.K. thank to Jan Rybizki for the very helpful discussion in the early phases of this work. V.J.S.B. is supported by grant AYA2015-69350-C3-2-P from the Spanish Ministry of Economy and Competiveness (MINECO). J.C.S. acknowledges funding support from Spanish public funds for research under project ESP2015-65712-C5-5-R (MINECO/FEDER), and under Research Fellowship program >Ramon y Cajal> with reference RYC2012-09913 (MINECO/FEDER). The contributions of M.A. were supported by DLR (Deutsches Zentrum fur Luft- und Raumfahrt) through the grants 50OW0204 and 50OO1501. J.L.-S. acknowledges the Office of Naval Research Global (award No. N62909-15- 1-2011) for support. C.d.B. acknowledges that this work has been supported by Mexican CONACyT research grant CB-2012-183007 and the Spanish Ministry of Economy and Competitivity through projects AYA2014-54348-C3-2-R. J.I.G.H., and R.R. acknowledge financial support from the Spanish Ministry project MINECO AYA2014-56359-P. J.I.G.H. also acknowledges financial support from the Spanish MINECO under the 2013 Ramon y Cajal program MINECO RYC-2013-14875. V. Wolthoff acknowledges funding from the DFG Research Unit FOR2544 >Blue Planets around Red Stars>, project No. RE 2694/4-1.We thank the anonymous referee for the excellent comments that helped to improve the quality of this paper
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