Comparing the effects of fluoxetine and fluvoxamine in the treatment of children and adolescents with depression

Background: Major depressive disorder (MDD) is a severe disorder that has a significant impact on the psychological and social functioning of children and adolescents. Considering the current limitations in the treatment of this disorder the present study aimed to examine the effect of fluoxetine and fluvoxamine on the treatment of child and adolescent depression. Materials and Methods: In this double-blind clinical trial study, 40 children and adolescents with MDD referred to child psychiatric clinic of Kashan University of Medical Sciences (during 2013-2014) were randomly divided into the fluvoxamine and fluoxetine groups. Data were collected using the children's depression inventory, children's global assessment scale, and drug side effect questionnaire. The participants were evaluated at the beginning and 2, 4, and 8 weeks after the beginning of the treatment. Results: The mean age of children and adolescents was 12.40±2.63 years. The mean scores of CDI in the flouxetine and fluvoxamine groups were significantly decreased from 25.65±10.49 to 11.55±3.23 and from 28.45±7.61 to 8.05±4.87, respectively. Moreover, the mean scores of CDI in the flovaxamine group demonstrated a significant decrease at weeks 4 and 8 compared to the fluoxetine group (P=0.03 and P=0.005, respectively). In the 8th week the response rates to treatment were 85 and 55 in the fluvoxamine and fluoxetine groups, respectively. No serious side effect was observed in the participants and no suicidal attempts were reported during the study. Conclusion: Considering that there is a significant reduction in the depression score in the fluvoxamine group compared to the fluoxetine one, fluvoxamine can be used as an effective and safe drug in the treatment of MDD in children and adolescents

Abandoned petroleum wells as sustainable sources of geothermal energy

A reliable heat transfer model was developed to determine the performance of a double pipe heat exchanger retrofitted to an abandoned petroleum well. The proposed model is compared against an analytical heat transfer model and two numerical models, in order to determine the reliability and accuracy of the proposed model. Rock mass properties and well dimensions are based on realistic averages, with the geothermal gradient and depth of the well based on an abandoned well in the Persian Gulf. The proposed model makes use Fourier's diffusion law coupled with terms to account for the unsteady state of the model and the convective heat transfer. These three properties are coupled with the energy conservation equation and simulated with the finite element modeller FlexPDE. The proposed model was developed with a constant inlet temperature and a constant power configuration. The constant inlet temperature model is used to ascertain the effects of insulation, inlet fluid temperature, mass flow rate, thermal conductivity of the rock mass, geothermal gradient, and vertical groundwater flow. The constant power model is better suited to direct use and heat pump applications due to the requirement of a stable power source.NPRP 09-1043-2-404 from the Qatar National Research Fund (a member of Qatar Foundation).Scopu

Global impact of COVID-19 on stroke care

Background: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide. Aims: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March–31 May 2020) compared with two control three-month periods (immediately preceding and one year prior). Methods: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers. Results: The hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three pandemic months, representing declines of 19.2% (95%CI, −19.7 to −18.7), 11.5% (95%CI, −12.6 to −10.6), and 12.7% (95%CI, −13.6 to −11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/mechanical thrombectomy centers. High-volume COVID-19 centers (−20.5%) had greater declines in mechanical thrombectomy volumes than mid- (−10.1%) and low-volume (−8.7%) centers (p < 0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions. Conclusion: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes. © 2021 World Stroke Organization