Treatment-resistant depression increases health costs and resource utilization

Objective: Major Depressive Disorder (MDD) is a debilitating condition with a marked social impact. The impact of MDD and Treatment-Resistant Depression (TRD+) within the Brazilian health system is largely unknown. The goal of this study was to compare resource utilization and costs of care for treatment-resistant MDD relative to non-treatment-resistant depression (TRD-). Methods: We retrospectively analyzed the records of 212 patients who had been diagnosed with MDD according to the ICD-10 criteria. Specific criteria were used to identify patients with TRD+. Resource utilization was estimated, and the consumption of medication was annualized. We obtained information on medical visits, procedures, hospitalizations, emergency department visits and medication use related or not to MDD. Results: The sample consisted of 90 TRD+ and 122 TRD-patients. TRD+ patients used significantly more resources from the psychiatric service, but not from non-psychiatric clinics, compared to TRD-patients. Furthermore, TRD+ patients were significantly more likely to require hospitalizations. Overall, TRD+ patients imposed significantly higher (81.5%) annual costs compared to TRD-patients (R$5,520.85; US$ 3,075.34 vs. R$3,042.14; US$ 1,694.60). These findings demonstrate the burden of MDD, and especially of TRD+ patients, to the tertiary public health system. Our study should raise awareness of the impact of TRD+ and should be considered by policy makers when implementing public mental health initiatives

New investigations on the 32S(3He,d)33Cl reaction at 9.6 MeV bombarding energy

The 32S(3He,d)33Cl one-proton transfer reaction is a powerful tool to investigate the spectroscopy of low-lying states in the proton-rich 33Cl nucleus. However, the extraction of firm differential cross-section data at various angles to benchmark and constrain theoretical models is made challenging by the presence of competitive reactions on target contaminants. In this paper we report on arecent measurement using a new generation hodoscope of silicon detectors, capable to detect and identify emitted deuterons down to energies of the order of 2 MeV. The high angular segmentation of our hodoscope combined with a suitable target to control possible contaminants, allowed to unambiguously disentangle the contribution of various states in 33Cl, in particular the 2.352 MeV state lying just few tens of keV above the proton separation energy

Study of reactions induced by 6He on 9Be

We present the results of experiments using a 6He beam on a 9Be target at\ud energies 7 − 9 times the Coulomb barrier. Angular distributions of the elastic, inelastic\ud scattering (target breakup) and the -particle production in the 6He+9Be collision have\ud been analysed. Total reaction cross sections were obtained from the elastic scattering\ud analyses and a considerable enhancement has been observed by comparing to stable systems.FAPESPFundação Araucári

Mass Measurements near N=Z

Abstract After an outline of the physics motivations, that illustrate why we think it is important to measure masses in the region N≈Z, we report on on experiments performed at Ganil. An experiment aimed at measuring the masses of proton-rich nuclei in the mass region A ≈ 60–80 has been performed, using a direct time-of-flight technique in conjunction with SISSI and the SPEG spectrometer at GANIL. The nuclei were produced via the fragmentation of a 78 Kr beam (73 meV/nucleon). A novel technique for the purification of the secondary beams, based on the stripping of the ions and using the α and the SPEG spectrometers, was succesfully checked. It allows for good selectivity without altering the beam quality. Secondary ions of 100 Ag, 100 Cd, 100 In and 100 Sn were produced via the fusion-evaporation reaction 50 Cr + 58 Ni at an energy of 5.1 MeV/nucleon, and were accelerated simultaneously in the second cyclotron of GANIL (CSS2). About 10 counts were observed from the production and acceleration of 100 Sn 22+ . The masses of 100 Cd, 100 In and 100 Sn were measured with respect to 100 Ag using the CSS2 cyclotron, with precisions of 2 × 10 −6 , 3 × 10 −6 and 10 −5 respectively

Study of the 32S(3He,d)33Cl one-proton transfer reaction with a new generation hodoscope

Abstract The 32S(3He,d)33Cl one-proton transfer reaction is a powerful tool to investigate the spectroscopy of low-lying states in the proton-rich 33Cl nucleus. However, the extraction of firm differential cross-section data at various angles, against which benchmarking theoretical models to correctly constrain the spectroscopy of 33Cl, is made challenging by the presence of competitive reaction products contaminating the detected energy spectra. We have recently measured the 32S(3He,d)33Cl reaction at 9.8 MeV incident energy by using a new generation hodoscope of silicon detectors, capable to detect and identify emitted deuterons down to energies of the order of 2 MeV. The high angular segmentation of our hodoscope allowed to unambiguously disentangle the contribution of one-proton transfer reactions in the ground state of 33Cl and in its 0.810 MeV, 2.352 MeV, 2.685 MeV, 2.846 MeV excited states from contaminant deuteron-emitting reactions. These data will be crucial to help to constrain Jπ and spectroscopic factor C 2 Sp values of low-lying 33Cl states, still ambiguous in the literature. The present status of the analysis is discussed in the paper

The Li-8(p, alpha)He-5 reaction at low energies, and Be-9 spectroscopy around the proton threshold

We present a direct measurement of the low-energy Li-8(p, alpha)He-5 cross section, using a radioactive Li-8 beam impinging on a thick target. With four beam energies, we cover the energy range between E-c.m. = 0.2 and 2.1 MeV. An R-matrix analysis of the data is performed and suggests the existence of two broad overlapping resonances (5/2(+) at E-c.m. = 1.69 MeV and 7/2(+) at E-c.m. = 1.76 MeV). At low energies our data are sensitive to the properties of a subthreshold state (E-x = 16.67 MeV) and of two resonances above threshold. These resonances were observed in previous experiments. The R-matrix fit confirms spin assignments, and provides partial widths. We propose a new Li-8(p, alpha)He-5 reaction rate and briefly discuss its influence in nuclear astrophysics. DOI: 10.1103/PhysRevC.86.064321Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2003/10099-2, 2004/07379-6, 2008/09341-7]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Comissao de Aperfeicoamento do Ensino Superior (CAPES)Comissao de Aperfeicoamento do Ensino Superior (CAPES

Perturbed angular correlations in \'ANTPOT.41 K\' going back into \'ANTPOT.40 AR\'

Mediu-se a distribuição angular perturbada da transição de 1293.64 keV, emitida do segundo estado excitado do núcleo 41K(T=10.5 nseg), em função da pressão do alvo gasoso de 4°Ar. A medida da distribuição angular não perturbada utilizando alvo de argônio implantado em tântalo, permitiu extrair valores do fator de atenuação integrado em tempo G2 (oo) em função da pressão.Perturbed angular correlations in \'ANTPOT.41 K\' going back into \'ANTPOT.40 AR\

Resource utilization for major depressive disorder and treatment-resistant depression in a São Paulo tertiary Hospital

Objetivo: O Transtorno Depressivo Maior (TDM) é uma condição debilitante com grande impacto social. Estimativas indicam que 30% dos indivíduos com TDM são resistentes a tratamento (DRT). Os objetivos deste estudo são identificar e comparar a utilização de recursos por pacientes com DRT e com TDM não resistente no Hospital das Clínicas da FM-USP. Método: Foram analisados retrospectivamente prontuários de 212 pacientes do Instituto de Psiquiatria do hospital com diagnóstico de TDM, de acordo com os critérios da CID-10. Utilizaram-se critérios específicos para identificar os pacientes com DRT dentre aqueles diagnosticados com TDM. A utilização de recursos foi estimada contando procedimentos e insumos listados nos prontuários de 1997 a 2002. Resultados: Os pacientes com DRT utilizaram em média significantemente mais exames anualmente (11,23 vs. 8,47) e tiveram maior consumo de medicamentos e mais hospitalizações (3,53 diárias vs. 1,72). Pacientes com depressão resistente a tratamento tiveram um maior custo direto anual, R$6.171,78, do que pacientes com depressão não resistente, R$ 4.351,08 (reais de novembro de 2003). Conclusões: Pacientes com DRT utilizaram mais recursos e tiveram um custo mais elevado do que pacientes não resistentes. Este estudo é o primeiro no Brasil a avaliar o custo de tratamento da depressão e poderá ajudar a estimar o custo social da depressão.Objective: Major Depressive Disorder (MDD) is a debilitating condition with a marked social impact. Estimates indicate that 30% of individuals with MDD have treatment-resistant depression (TRD). The study objectives were to identify and compare the resource utilization by non-resistant MDD and TRD patients in a university psychiatric hospital in São Paulo- Brazil. Methods: We analyzed retrospectively 212 hospital charts of patients from the Hospital\'s Psychiatry Institute, diagnosed with MDD according to CID-10 criteria. Specific criteria were used to identify patients with TRD among those with MDD. Resource utilization was estimated by counting procedures listed on the hospital charts from 1997 to 2002. Results: Patients with TRD had on average significantly more laboratory exams yearly (11.23 vs. 8.47) than non-TRD patients, as well as more medication consumption and hospitalizations (3.53 hospital days vs.1.72). TRD patients had higher yearly treatment costs (R$6,171.78) than MDD patients (R$ 4,351.08 ) did. Conclusions: Patients with TRD used more resources and had higher direct costs than non-TRD patients. This study is the first in Brazil to evaluate depression treatment costs, and might be helpful to evaluate the economic burden of depression to society

Nuclear astrophysics: nucleosynthesis in the Universe

Nuclear astrophysics is a relatively young science; it is about half a century old. It is a multidisciplinary subject, since it combines nuclear physics with astrophysics and observations in astronomy. It also addresses fundamental issues in astrobiology through the formation of elements, in particular those required for a carbon-based life. In this paper, a rapid overview of nucleosynthesis is given, mainly from the point of view of nuclear physics. A short historical introduction is followed by the definition of the relevant nuclear parameters, such as nuclear reaction cross sections, astrophysical S-factors, the energy range defined by the Gamow peak and reaction rates. The different astrophysical scenarios that are the sites of nucleosynthesis, and different processes, cycles and chains that are responsible for the building of complex nuclei from the elementary hydrogen nuclei are then briefly described. Received 28 February 2012, accepted 5 April 2012, first published online 9 May 201