Influence of adjuvant clonidine on mania, sleep disturbances and cognitive performance – Results from a double-blind and placebo-controlled randomized study in individuals with bipolar I disorder during their manic phase

Background: While the favorable effect of adjuvant clonidine in the treatment of acute mania has been observed already about 40 years ago, this line of treatment has not been further investigated. Here, we resumed this topic, and we tested the effect of adjuvant clonidine, an antihypertensive stimulating the alpha-2 central adrenergic receptor, on symptoms of mania, cognitive performance, and subjective sleep. To this end, we performed a randomized, double-blind and placebo-controlled clinical trial among inpatients with bipolar disorder I during their acute phase of mania. Methods: A total of 70 inpatients (mean age: 37.40 years; 15.7% females) with diagnosed bipolar disorder I and during their acute manic phase were randomly assigned either to the adjuvant clonidine (0.2 mg/d to a maximum of 0.6 mg/d) or to the placebo condition. Standard medication was lithium at therapeutic dosages. At baseline, participants completed a series of self-rating questionnaires covering sociodemographic information and subjective sleep. Subjective sleep was re-assessed 24 days later at the end of the study. Experts rated participants' acute state of mania with the Young Mania Rating Scale at baseline and at day 12 and day 24. Participants' cognitive performance was assessed at baseline and at day 24 at the end of the study. Results: Over time, mania scores significantly decreased (large effect size), but more so in the clonidine condition, compared to the placebo condition (medium effect size). Likewise, over time, subjective sleep improved (large effect size), but more so in the clonidine, compared to the placebo condition (medium effect size). Over time, cognitive performance improved (medium effect size), irrespective from the study condition. Conclusions: Compared to placebo, adjuvant clonidine to lithium improved symptoms of mania, as rated by experts', and subjective sleep quality. Adjuvant clonidine had no further favorable (or detrimental) impact on cognitive performance. Keywords: Bipolar disorder; Clonidine; Cognitive performance; Mania; Subjective sleep quality; alpha(2) central adrenergic receptors

Optical Reading of Nanoscale Magnetic Bits in an Integrated Photonic Platform

In this paper, we propose a compact integrated hybrid plasmonic-photonic device for optical reading of nanoscale magnetic bits with perpendicular magnetic anisotropy in a magnetic racetrack on top of a photonic waveguide on the indium phosphide membrane on silicon platform. The hybrid device is constructed by coupling a doublet of V-shaped gold plasmonic nanoantennas on top of the indium phosphide waveguide. By taking advantage of the localized surface plasmons, our hybrid device can enable detection of the magnetization state in magnetic bits beyond the diffraction limit of light and enhance the polar magneto-optical Kerr effect (PMOKE). We further illustrate how combining the hybrid device with a plasmonic polarization rotator provides magneto-optical read-out by transforming the PMOKE-induced polarization change into an intensity variation of the waveguide mode. According to the simulation results based on a three-dimensional finite-difference time-domain method, the hybrid device can detect the magnetization states in targeted bits in a magnetic racetrack medium down to ~ 100x100 nm2, regardless of the magnetization state of the rest of the racetrack with a relative intensity contrast of greater than 0.5% for a ~ 200x100 nm2 magnetic bit. We believe our hybrid device can be an enabling technology that can connect integrated photonics with nanoscale spintronics, paving the way toward ultrafast and energy efficient advanced on-chip applications

Influence of adjuvant clonidine on mania, sleep disturbances and cognitive performance - Results from a double-blind and placebo-controlled randomized study in individuals with bipolar I disorder during their manic phase

Background: While the favorable effect of adjuvant clonidine in the treatment of acute mania has been observed already about 40 years ago, this line of treatment has not been further investigated. Here, we resumed this topic, and we tested the effect of adjuvant clonidine, an antihypertensive stimulating the alpha-2 central adrenergic receptor, on symptoms of mania, cognitive performance, and subjective sleep. To this end, we performed a randomized, double-blind and placebo-controlled clinical trial among inpatients with bipolar disorder I during their acute phase of mania. Methods: A total of 70 inpatients (mean age: 37.40 years; 15.7% females) with diagnosed bipolar disorder I and during their acute manic phase were randomly assigned either to the adjuvant clonidine (0.2 mg/d to a maximum of 0.6 mg/d) or to the placebo condition. Standard medication was lithium at therapeutic dosages. At baseline, participants completed a series of self-rating questionnaires covering sociodemographic information and subjective sleep. Subjective sleep was re-assessed 24 days later at the end of the study. Experts rated participants' acute state of mania with the Young Mania Rating Scale at baseline and at day 12 and day 24. Participants' cognitive performance was assessed at baseline and at day 24 at the end of the study. Results: Over time, mania scores significantly decreased (large effect size), but more so in the clonidine condition, compared to the placebo condition (medium effect size). Likewise, over time, subjective sleep improved (large effect size), but more so in the clonidine, compared to the placebo condition (medium effect size). Over time, cognitive performance improved (medium effect size), irrespective from the study condition. Conclusions: Compared to placebo, adjuvant clonidine to lithium improved symptoms of mania, as rated by experts', and subjective sleep quality. Adjuvant clonidine had no further favorable (or detrimental) impact on cognitive performance. Keywords: Bipolar disorder; Clonidine; Cognitive performance; Mania; Subjective sleep quality; alpha(2) central adrenergic receptors

Enhanced chondrogenic differentiation of bone marrow mesenchymal stem cells on gelatin/glycosaminoglycan electrospun nanofibers with different amount of glycosaminoglycan

Tissue engineering is a new technique to help damaged cartilage treatment using cells and scaffolds. In this study we tried to evaluate electrospun scaffolds composed of gelatin/glycosaminoglycan (G/GAG) blend nanofibers in chondrogenesis of bone marrow-derived mesenchymal stem cells (BMMSCs). Scaffolds were fabricated by electrospinning technique with different concentration of glycosaminoglycan (0, 5, 10, and 15) in gelatin matrix. BMMSCs were cultured on the scaffolds for chondrogenesis process. MTT assay was done for scaffold's biocompatibility and cells viability evaluation. Alcian blue staining was carried out to determine the release of GAG and reverse transcription polymerase chain reaction (RT-PCR) was done for expression of COL2A1 and also immunocytochemistry assay were used to confirm expression of type II collagen. Scaffold with 15 GAG showed better result for biocompatibility (p =0.02). Scanning electron microscopy (SEM) micrographs showed that MSCs have good attachment to the scaffolds. Alcian blue staining result confirmed that cells produce GAG during differentiation time different from GAG in the scaffolds. Also the results for RT-PCR showed the expression of COL2A1 marker. Immunocytochemistry assay for type II collagen confirm that this protein expressed. Scaffold comprising 15 GAG is better results for chondrogenesis and it can be a good applicant for cartilage tissue engineering. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 38�48, 2019. © 2018 Wiley Periodicals, Inc

Posttransplant malignancies and their relationship with human leukocyte antigens in kidney allograft recipients.

INTRODUCTION: Kidney transplant recipients are at increased risk of cancers, most frequently skin cancers, and in some regions, Kaposi sarcoma and non-Hodgkin lymphoma. We sought to investigate the associate of the most frequent malignancies among our patients with human leukocyte antigens (HLAs). MATERIALS AND METHODS: We performed a retrospective study on 44 kidney allograft recipients who had posttransplant malignancy and 44 kidney allograft recipients without malignant lesions (control group). All of the patients had been treated by immunosuppressive regimens including cyclosporine plus prednisolone or cyclosporine, prednisolone, and mycophenolate mofetil. Data on HLA typing were achieved from their transplant records. RESULTS: There were 15 patients (34.1) with Kaposi sarcoma; 13 (29.6) with non-Hodgkin lymphoma, 6 (13.6) with skin cancer, 2 (4.5) with ovary cyst adenocarcinoma, and 8 (18.2) with other tumors. The mean interval from transplantation to diagnosis of malignancy was 15.3 month. Twelve patients died of cancer during the follow-up (mean, 12.3 years). No significant difference was noted in the age, sex, and time of transplantation between these patients and those in the control group. Kaposi sarcoma was associated with HLA-CW4 (P = .03) with an odds ratio of 4.96 (95 confidence interval, 2.90 to 8.12). CONCLUSIONS: We found HLA-CW4 as a risk factor of Kaposi sarcoma in kidney allograft recipients. Screening for malignancies after kidney transplantation sounds very important with special attention to the specific environmental and genetic factors in each population

Posttransplant malignancies and their relationship with human leukocyte antigens in kidney allograft recipients.

INTRODUCTION: Kidney transplant recipients are at increased risk of cancers, most frequently skin cancers, and in some regions, Kaposi sarcoma and non-Hodgkin lymphoma. We sought to investigate the associate of the most frequent malignancies among our patients with human leukocyte antigens (HLAs). MATERIALS AND METHODS: We performed a retrospective study on 44 kidney allograft recipients who had posttransplant malignancy and 44 kidney allograft recipients without malignant lesions (control group). All of the patients had been treated by immunosuppressive regimens including cyclosporine plus prednisolone or cyclosporine, prednisolone, and mycophenolate mofetil. Data on HLA typing were achieved from their transplant records. RESULTS: There were 15 patients (34.1) with Kaposi sarcoma; 13 (29.6) with non-Hodgkin lymphoma, 6 (13.6) with skin cancer, 2 (4.5) with ovary cyst adenocarcinoma, and 8 (18.2) with other tumors. The mean interval from transplantation to diagnosis of malignancy was 15.3 month. Twelve patients died of cancer during the follow-up (mean, 12.3 years). No significant difference was noted in the age, sex, and time of transplantation between these patients and those in the control group. Kaposi sarcoma was associated with HLA-CW4 (P = .03) with an odds ratio of 4.96 (95 confidence interval, 2.90 to 8.12). CONCLUSIONS: We found HLA-CW4 as a risk factor of Kaposi sarcoma in kidney allograft recipients. Screening for malignancies after kidney transplantation sounds very important with special attention to the specific environmental and genetic factors in each population

Risk factors for delayed graft function in deceased donor kidney transplantation; A potential preventive role for intraoperative thymoglobulin

Introduction: Delayed graft function (DGF) is associated with significant adverse outcomes in deceased donor kidney transplantation (KT) including lower graft survival. However, risk factors and potential preventive strategies like intraoperative rabbit antithymocyte globulin (rATG; thymoglobulin) have not yet been fully evaluated. Objectives: The aim of this study was to investigate DGF risk factors and determine the association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients. Patients and Methods: We retrospectively examined medical records of 163 first time deceased donor kidney transplant recipients at two major kidney transplant centers from 2014 to 2016. All the donors were standard heart-beating, brain death donors. Risk factors for DGF in recipients were evaluated using multivariate logistic regression analysis. Results: The mean recipients' age was 43±13 years and the majority of participants were male (64). The overall rate of DGF was 27. Intraoperative rATG was significantly associated with a lower rate of DGF (adjusted odds ratio AOR, 0.33, 95% CI, 0.11-0.95). Intraoperative transfusion (AOR, 3.7, 95% CI, 1.4-9.9) and diabetes mellitus (AOR, 3.7, 95% CI, 1.5-8.9) were significantly associated with higher risk of DGF. Conclusion: This study showed that intraoperative blood transfusion and diabetes mellitus were associated with increased risk of DGF. Meanwhile, administration of intraoperative rATG was associated with reduced odds ratio of DGF. Future studies are needed to evaluate the potential role of rATG in DGF-related renal outcomes. © 2019 The Author(s)