Depression and anxiety in multisomatoform disorder: Prevalence and clinical predictors in primary care

Objective. Multisomatoform disorder (MSD) is characterised by ≥3 medically inexplicable, troublesome physical symptoms, together with a ≥2-year history of somatisation. The aim of this study was to evaluate the prevalence of depressive and anxiety disorders in a South African sample MSD, and to compare demographic and clinical outcomes in those patients with and without co-morbidity. Methods. Fifty-one adult outpatients with MSD were recruited from primary care clinics in the Cape Town metropole. Participants were assessed for the presence of co-morbid depressive and anxiety disorders using the Mini Neuropsychiatric Interview-Plus (MINI-Plus). Outcomes included somatic symptom severity, disability, reported sick days and health care visits, pain experience, patient satisfaction with health services, and clinician-experienced difficulty. Results. A current co-morbid depressive disorder was present in 29.4% (N=15) of patients, and a current co-morbid anxiety disorder in 52.9% (N=27). MSD patients with a co-morbid depressive disorder (current or lifetime) had significantly higher physical symptom counts, greater functional impairment, higher unemployment rates, more clinicianreported difficulties, and more dissatisfaction with health care services than those without the disorder. A larger number of co-morbid disorders was associated with greater overall disability. Conclusion. High rates of co-morbid depressive and anxiety disorders were present in a South African sample of primary care patients with MSD. Not all patients had co-morbidity, which is consistent with the view that MSD should be viewed as an independent disorder. However, co-morbid depressive disorders were associated with increased symptom severity and functional impairment, consistent with previous reports from developing countries, emphasising the importance of comorbidity in MSD.South African Medical Journal Vol. 98 (6) 2008 pp. 473-47

Оптимизация нормированной переходной функции линейной цепи, описываемой характеристическим уравнением 4-го порядка

Определение параметров усилительной схемы, обеспечивающих наилучшую форму переходной характеристики, является одной из наиболее сложных задач усилительной техники. При наличии нескольких варьируемых параметров, т. е. при характеристических уравнениях выше второй степени, задача значительно усложняется и случайным варьированием или машинным перебором сочетаний параметров решить ее чрезвычайно трудно. С целью значительного сокращения усилий и времени, затрачиваемых на решение подобных задач, разработаны алгоритм и методика определения с помощью цифровых ЭВМ оптимальных значений коэффициентов коррекции переходных функций линейных целей, описываемых характеристическими уравнениями 2-й и 4-й степеней, при заданных значениях первого и второго выбросов. Приведены графики, иллюстрирующие ре­зультаты вычислений

Модифицирование матриксов из поли-L-молочной кислоты импульсным сильноточным электронным пучком

We describe the synthesis, characterisation and surface-modification of magnetic narroparticles and a poly(N-isopropylacrylamide) microgel, followed by the assembly and characterisation of magnetic nanoparticles on the microgel. To facilitate this deposition, the surface of the microgel is first modified via the layer-by-layer assembly of polyelectrolytes. One advantage of this concept is that it allows an independent optimization and fine tuning of the magnetic and thermoresponsive properties of individual components (nanoparticles and microgels) before assembling them so that the hybrid core-shell structure retains all the individual properties. The,decisive parameter when exploiting the thermoresponsive and magnetic properties in such hybrid core-shell structures is the amount of heat transfer from the magnetic core onto the thermosensitive (loaded) microgel (for the subsequent heat-triggered release of drugs). Inductive heat study reveals that the heat generated by the magnetic narroparticles is sufficient to cause the collapse of the microgel above its volume phase transition temperature. Successful confinement of positively and negatively charged magnetic nanoparticles between polyelectrolyte layers is achieved using the layer-by-layer deposition onto the microgel. Dynamic light scattering measurements show (i) the presence of each layer successfully deposited, (ii) the preservation of thermoresponsivity in the coated microgel, and (iii) that the magnetic nanoparticles do not get detached during the phase transition of the microgel. Electrophoresis measurements confirm charge reversal at every stage of layering of polycations, polyanions and magnetic nanoparticles. This unique combination of thermoresponsivity and magnetism opens up novel perspectives towards remotely controlled drug carriers. (c) 200

Inhibition of Trophoblast-Induced Spiral Artery Remodeling Reduces Placental Perfusion in Rat Pregnancy.

Rats harboring the human angiotensinogen and human renin genes develop preeclamptic features in pregnancy. The preeclamptic rats exhibit a deeper trophoblast invasion associated with a reduced resistance index by uterine Doppler. Doxycycline inhibits matrix metalloproteinase activity. We tested the hypothesis that matrix metalloproteinase inhibition reduces trophoblast invasion with subsequent changes in placental perfusion. Preeclamptic and pregnant control Sprague-Dawley rats were treated with doxycycline (30 mg/kg of body weight orally) from gestational day 12 until day 18. Placental perfusion was assessed using a micromarker contrast agent. The animals were euthanized on day 18 of pregnancy; biometric data were acquired, and trophoblast invasion was analyzed. Doxycycline resulted in intrauterine growth retardation and lighter placentas in both groups. Maternal body weight was not affected. As shown earlier, preeclamptic rats exhibited a deeper endovascular trophoblast invasion. However, doxycycline treatment reduced trophoblast invasion in the preeclamptic rats. The physiological spiral artery remodeling, as assessed by the deposition of fibrinoid and α-actin in the spiral artery contour, was significantly reduced by doxycycline. The vascularity index, as assessed by perfusion measurement of the placenta, was reduced after doxycycline treatment in preeclamptic rats. Thus, matrix metalloproteinase inhibition with doxycycline leads to reduced trophoblast invasion and associated reduced placental perfusion. These studies are the first to show that reducing trophoblast-induced vascular remodeling decreases subsequent placental perfusion. Our model allows the study of dysregulated trophoblast invasion and vascular remodeling in vivo to gain important insights into preeclampsia-related mechanisms

Effects of Circulating and Local Uteroplacental Angiotensin II in Rat Pregnancy.

The renin-angiotensin (Ang) system is important during placental development. Dysregulation of the renin-Ang system is important in preeclampsia (PE). Female rats transgenic for the human angiotensinogen gene crossed with males transgenic for the human renin gene develop the PE syndrome, whereas those of the opposite cross do not. We used this model to study the role of Ang II in trophoblast invasion, which is shallow in human PE but deeper in this model. We investigated the following groups: PE rats, opposite-cross rats, Ang II–infused rats (1000 ng/kg per day), and control rats. Ang II infusion increased only circulating Ang II levels (267.82 pg/mL), opposite cross influenced only uteroplacental Ang II (13.52 fmol/mg of protein), and PE increased both circulating (251.09 pg/mL) and uteroplacental (19.24 fmol/mg of protein) Ang II. Blood pressure and albuminuria occurred in the models with high circulating Ang II but not in the other models. Trophoblast invasion increased in PE and opposite-cross rats but not in Ang II–infused rats. Correspondingly, uterine artery resistance index increased in Ang II–infused rats but decreased in PE rats. We then studied human trophoblasts and villous explants from first-trimester pregnancies with time-lapse microscopy. Local Ang II dose-dependently increased migration by 75%, invasion by 58%, and motility by 282%. The data suggest that local tissue Ang II stimulates trophoblast invasion in vivo in the rat and in vitro in human cells, a hitherto fore unrecognized function. Conceivably, upregulation of tissue Ang II in the maternal part of the placenta represents an important growth factor for trophoblast invasion and migration

Why Some Interfaces Cannot be Sharp

A central goal of modern materials physics and nanoscience is control of materials and their interfaces to atomic dimensions. For interfaces between polar and non-polar layers, this goal is thwarted by a polar catastrophe that forces an interfacial reconstruction. In traditional semiconductors this reconstruction is achieved by an atomic disordering and stoichiometry change at the interface, but in multivalent oxides a new option is available: if the electrons can move, the atoms don`t have to. Using atomic-scale electron energy loss spectroscopy we find that there is a fundamental asymmetry between ionically and electronically compensated interfaces, both in interfacial sharpness and carrier density. This suggests a general strategy to design sharp interfaces, remove interfacial screening charges, control the band offset, and hence dramatically improving the performance of oxide devices.Comment: 12 pages of text, 6 figure

Is the association between blood pressure and cognition in the oldest-old modified by physical, vascular or brain pathology markers? The EMIF-AD 90 + Study

BACKGROUND: Prior studies suggest a changing association between blood pressure (BP) and cognition with aging, however work in the oldest-old has yielded ambiguous results. Potentially, these mixed results can be explained by modifying factors. The aim of this study was to establish whether physical, vascular or brain pathology markers that describe a state of increased vulnerability, affect the association between BP and cognition in the oldest-old. Results may influence clinicians’ decisions regarding the use of antihypertensives in this age group. METHODS: We included 122 individuals (84 without cognitive impairment and 38 with cognitive impairment) from the EMIF-AD 90 + Study (mean age 92.4 years). First, we tested cross-sectional associations of systolic and diastolic BP with a cognitive composite score. Second, we tested whether these associations were modified by physical markers (waist circumference, muscle mass, gait speed and handgrip strength), vascular markers (history of cardiac disease, carotid intima media thickness as a proxy for atherosclerosis and carotid distensibility coefficient as a proxy for arterial stiffness) or brain pathology markers (white matter hyperintensities and cortical thickness). RESULTS: In the total sample, there was no association between BP and cognition, however, waist circumference modified this association (p-value for interaction with systolic BP: 0.03, with diastolic BP: 0.01). In individuals with a high waist circumference, higher systolic and diastolic BP tended to be associated with worse cognition, while in individuals with a low waist circumference, higher systolic BP was associated with better cognition. The others physical, vascular and brain pathology markers did not modify the association between BP and cognition. CONCLUSIONS: When examining various markers for physical, vascular and brain vulnerability, only waist circumference affected the association between BP and cognition. This warrants further research to evaluate whether waist circumference may be a marker in clinical practice influencing the use of antihypertensives in the oldest-old

Multidrug resistant Kluyvera ascorbata septicemia in an adult patient: a case report

<p>Abstract</p> <p>Introduction</p> <p><it>Kluyvera ascorbata </it>has become increasingly significant due to its potential to cause a wide range of infections, as well as its ability to transfer gene encoding for CTX-M- type extended spectrum B-lactamases (ESBLs) to other Enterobacteriaceae.</p> <p>Case presentation</p> <p>We report the case of a 64-year-old African-American male diagnosed with severe sepsis due to a multidrug resistant <it>Kluyvera ascorbata</it>, which was isolated from his blood. He was treated with meropenem and had a favorable outcome.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first case report of a multidrug resistant <it>Kluyvera ascorbata </it>isolated from the blood in an adult patient with sepsis.</p

Система управления персоналом в организации "Ростелеком"

Объект ВКР - система управления персоналом. Цель ВКР – определение особенности сущности концепта "система управления персоналом предприятия", его целей, задач и свойств. В процессе исследования проводились социологические исследования. В результате исследования были разработаны несколько мероприятий по совершенствованию системы управления персоналом. Основные конструктивные, технологические и управленческие характеристики: исследуемое предприятие ПАО "Ростелеком" имеет большую численность персонала, а также подвержено высокой текучести кадров по причине неэффективной системы управления персоналом. Степень внедрения: разработанные мероприятия по совершенствованию системы управления персоналом применены и используются в ПАО "Ростелеком".The object of the study is (are) - PJSC "Rostelecom". The purpose of the work is to define the essence of the concept of the "hr-management system of the enterprise", its goals, tasks and properties. In the process of research were conducted sociological methods of studying. As a result of the research, several measures were developed to improve the hr-management system. The main design, technological and management characteristics: the company PJSC "Rostelecom" has a large number of employees, and has problems with high staff turnover due to inefficient hr-management system. Degree of implementation: the developed measures to improve the personnel management system are applied and used in PJSC "Rostelecom"

Определение кинетических параметров процесса каталитического крекинга

This study describes a facile two-step approach to modify the surface of nanoparticles, thereby imparting a core-shell structure to the system. The core consists of magnetic nanoparticles and the shell is composed of thermo responsive hydroxypropyl cellulose, using a coupling agent to covalently bind the core to the shell. Hydroxypropyl cellulose is known for its biocompatibility and biodegradability, and its thermoresponsive properties make it an excellent candidate for fabricating biocompatible stimuli-responsive magnetic nanoparticles. We report the synthesis of magnetic nanoparticles and the successful binding of the polymer to them. X-ray diffraction studies show that the surface modification of the magnetic nanoparticles does not result in any phase change and the size of the magnetic core thus calculated (7 nm) reveals that such hybrid core-shell system is superparamagnetic in nature, as further confirmed by magnetization measurements. The size obtained by X-ray diffraction is in good agreement with that obtained by transmission electron microscope. Evidence of binding is given by Fourier transform infrared spectroscopy and a quantitative analysis of the polymeric content obtained by thermogravimetry analysis. Dynamic light scattering as a function of temperature reveals the thermoresponsive behavior of the particles with a lower critical solution temperature around 41 degrees C, which is also the temperature at which cellulose undergoes a coil-to-globule transition