Neural correlates of emotion processing comparing antidepressants and exogenous oxytocin in postpartum depressed women: An exploratory study

Despite common use of antidepressants to treat postpartum depression, little is known about the impact of antidepressant use on postpartum brain activity. Additionally, although oxytocin has been investigated as a potential treatment for postpartum depression, the interaction between antidepressants and exogenous oxytocin on brain activity is unknown. We explored postpartum depressed women’s neural activation in areas identified as important to emotion and reward processing and potentially, antidepressant response: the amygdala, nucleus accumbens and ventral tegmental area. We conducted a secondary analysis of a functional imaging study of response to sexual, crying infant and smiling infant images in 23 postpartum depressed women with infants under six months (11 women taking antidepressants, 12 unmedicated). Participants were randomized to receive a single dose of oxytocin or placebo nasal spray. There was significantly higher amygdala activation to sexual stimuli than either neutral or infant-related stimuli among women taking antidepressants or receiving oxytocin nasal spray. Among unmedicated women receiving placebo, amygdala activation was similar across stimuli types. There were no significant effects of antidepressants nor oxytocin nasal spray on reward area processing (i.e., in the nucleus accumbens or ventral tegmental area). Among postpartum women who remain depressed, there may be significant interactions between the effects of antidepressant use and exogenous oxytocin on neural activity associated with processing emotional information. Observed effect sizes were moderate to large, strongly suggesting the need for further replication with a larger sample

Bone substitute effect on vascularization and bone remodeling after application of phVEGF165 transfected BMSC

VEGF (vascular endothelial growth factor) promotes vascularization and remodeling of bone substitutes. The aim of this study was to examine the effect of distinct resorbable ceramic carriers on bone forming capacities of VEGF transfected bone marrow stromal cells (BMSC). A critical size defect of the radius in rabbits was filled either by a low surface scaffold called beta-TCP (tricalciumphsphate) or the high surface scaffold CDHA (calcium deficient hydroxy-apatite) loaded with autologous BMSC, which were either transfected with a control plasmid or a plasmid coding for phVEGF165. They were compared to unloaded scaffolds. Thus, six treatment groups (n = 6 in each group) were followed by X-ray over 16 weeks. After probe retrieval, the volume of new bone was measured by micro-CT scans and vascularization was assessed in histology. While only minor bone formation was found in both carriers when implanted alone, BMSC led to increased osteogenesis in both carriers. VEGF promoted vascularization of the scaffolds significantly in contrast to BMSC alone. Bone formation was increased in the beta-TCP group, whereas it was inhibited in the CDHA group that showed faster scaffold degradation. The results indicate that the interaction of VEGF transfected BMSC with resorbable ceramic carrier influences the ability to promote bone healing

Pseudoaneurysm Repair With a Septal Occluder

Introduction: New treatment options, like endovascular aortic repair, reduced the mortality rate of patients suffering from complications after an acute type A aortic dissection repair. Nevertheless, initial successful treatment of an aortic dissection does not fully eliminate the risk of later adverse aortic events like anastomotic pseudoaneurysm. Pseudoaneurysm of the anastomosis between the ascending and the arch graft could initiate complications like peripheral embolization, dysphagia or compression of mediastinum organs. Re-operation via re-sternotomy bears enormous morbidity and mortality for these patients. There is a high unmet need for percutaneous therapeutic options to treat pseudoaneurysms. Case Presentation: A 59-year-old-man treated 15 years ago for type A aortic dissection, was hospitalized due to intermittent abdominal pain. A detailed examination revealed 2 pseudoaneurysms: 1 symptomatic at the level of the reimplanted celiac trunk and 1 asymptomatic at the anastomosis between the brachiocephalic trunk and the aortic arch graft. Due to multiple co-morbidities and previous operations, the risk for surgery was considered too high. Both pseudoaneurysm were treated percutaneously, the symptomatic 1 with covered stent and the asymptomatic with Amplatzer septal-occluder. Discussion: We present an alternative percutaneous therapy approach for treatment of pseudoaneurysm using a septaloccluder. A follow-up computed tomography 3 months later showed successfully excluded pseudoaneurysm

Several submaximal exercise tests reliable, valid and acceptable in patients with chronic pain, fibromyalgia or chronic fatigue: a systematic review.

Question: Are submaximal and maximal exercise tests reliable, valid and acceptable in people with chronic pain, fibromyalgia and fatigue disorders? Design: Systematic review of studies of the psychometric properties of exercise tests. Participants: People older than 18 years with chronic pain, fibromyalgia and chronic fatigue disorders. Intervention: Studies of the measurement properties of tests of physical capacity in people with chronic pain, fibromyalgia or chronic fatigue disorders were included. Outcome measures: Studies were required to report: reliability coefficients (intraclass correlation coefficient, alpha reliability coefficient, limits of agreements and Bland-Altman plots); validity coefficients (intraclass correlation coefficient, Spearman's correlation, Kendal T coefficient, Pearson's correlation); or dropout rates. Results: Fourteen studies were eligible: none had low risk of bias, 10 had unclear risk of bias and four had high risk of bias. The included studies evaluated: Åstrand test; modified Åstrand test; Lean body mass-based Åstrand test; submaximal bicycle ergometer test following another protocol other than Åstrand test; 2-km walk test; 5-minute, 6-minute and 10-minute walk tests; shuttle walk test; and modified symptom-limited Bruce treadmill test. None of the studies assessed maximal exercise tests. Where they had been tested, reliability and validity were generally high. Dropout rates were generally acceptable. The 2-km walk test was not recommended in fibromyalgia. Conclusion: Moderate evidence was found for reliability, validity and acceptability of submaximal exercise tests in patients with chronic pain, fibromyalgia or chronic fatigue. There is no evidence about maximal exercise tests in patients with chronic pain, fibromyalgia and chronic fatigue

Klonierung und heterologe Expression zur Analyse der Metalloproteasen TbMSP-B und TbMSP-C aus Trypanosoma brucei brucei

Die Humane Afrikanische Trypanosomiasis (HAT), die auch als Schlafkrankheit bekannt ist, wird durch Infektion mit Protozoen der Artengruppe Trypanosoma brucei hervorgerufen. Diese einzelligen Parasiten werden durch Tse-Tse-Fliegen übertragen. Die HAT betrifft Menschen in den tropischen Regionen Afrikas und dort insbesondere die ländlichen und wirtschaftlich armen Gebiete. Trotz erheblicher Fortschritte in der Medizin ist die medikamentöse Therapie der HAT nicht zufriedenstellend. Für die langwierigen und invasiven Therapien fehlt es an Infrastruktur und medizinischem Personal. Zudem erfüllen die vorhandenen Medikamente nicht die gängigen Sicherheitsstandards und sind mit ernsthaften Nebenwirkungen verbunden. Die Entwicklung neuer Wirkstoffe ist für Pharmaunternehmen unrentabel. Dennoch werden neue, suffiziente und problemlos zu verabreichende Medikamente dringend benötigt. Um diese Entwicklung voranzutreiben und um neue Zielstrukturen zu finden, ist die Untersuchung der molekularen Mechanismen der Trypanosomen unerlässlich. Die trypanosomale Major surface protease B (TbMSP-B) spielt eine wichtige Rolle beim Wechsel der Oberflächenproteine während der Differenzierung und ist möglicherweise auch beim Verlassen der Blutgefäße und der Ausbreitung der Trypanosomen in andere Kompartimente des Wirts von Bedeutung. Um diesen Sachverhalt weiterführend untersuchen zu können, wurde in der vorliegenden Arbeit ein Konstrukt konzipiert und kloniert, welches durch die Anwendung eines Luciferase-Assays Rückschlüsse auf die Expressionsverhältnisse der TbMSPs zulässt. Der Luciferase-Assay ist äußerst sensitiv und die Ergebnisse sind von der Aktivität der TbMSPs unabhängig. Das Konzept wurde an rekombinanten Trypanosomen der monomorphen Art MiTat1.2 in vitro erfolgreich getestet und beinhaltet die notwendigen Voraussetzungen für eine Anwendung in pleomorphen Trypanosomen und Tiermodellen. Das befähigt zum Erlangen neuer Erkenntnisse und eröffnet möglicherweise Perspektiven für fortschrittliche HAT-Therapie

Comparison of platelet-rich plasma and VEGF-transfected mesenchymal stem cells on vascularization and bone formation in a critical-size bone defect

Both platelet-rich plasma (PRP) and vascular endothelial growth factor (VEGF) can promote regeneration. The aim of this study was to compare the effects of these two elements on bone formation and vascularization in combination with bone marrow stromal cells (BMSC) in a critical-size bone defect in rabbits. The critical-size defects of the radius were filled with: (1) a calcium-deficient hydroxyapatite (CDHA) scaffold + phVEGF(165)-transfected BMSC (VEGF group), (2) CDHA and PRP, or (3) CDHA, autogenous BMSC, and PRP. As controls served: (4) the CDHA scaffold alone and (5) the CDHA scaffold and autogenous BMSC. The volume of new bone was measured by means of micro-CT scans, and vascularization was assessed in histology after 16 weeks. Bone formation was higher in the PRP + CDHA, BMSC + CDHA, and PRP + BMSC + CDHA groups than in the VEGF group (p < 0.05). VEGF transfection significantly promoted vascularization of the scaffolds in contrast to BMSC and PRP (p < 0.05), but was similar to the result of the CDHA + PRP + BMSC group. The results show that VEGF-transfected BMSC as well as the combination of PRP and BMSC improve vascularization, but bone healing was better with the combination of BMSC and PRP than with VEGF-transfected BMSC. Expression of VEGF in BMSC as a single growth factor does not seem to be as effective for bone formation as expanded BMSC alone or PRP which contains a mixture of growth factors. Copyright (C) 2012 S. Karger AG, Base