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Abstract Objectives Evidence suggests that ketamine's influence on brain-derived neurotrophic factor (BDNF) might be involved in its mechanism of rapid antidepressant action. We aimed to evaluate the differential impact of ketamine and esketamine on serum BDNF levels and its association with response patterns in treatment-resistant depression (TRD). Methods Participants (n = 53) are from a randomized, double-blind clinical trial comparing the efficacy of single-dose ketamine (0.5mg/kg, n = 27) and esketamine (0.25mg/kg, n = 26) in TRD. Depression severity was assessed before and 24 hours, 72 hours, and 7 days after the intervention, using the Montgomery-Åsberg Depression Rating Scale (MADRS). Blood samples were collected before infusion, 24 hours, and 7 days afterwards. Results There were no significant changes in BDNF levels at post-infusion evaluation points, and no difference in BDNF levels comparing ketamine and esketamine. Both drugs exhibited similar therapeutic effect. There was no association between BDNF levels and response to treatment or severity of depressive symptoms. Conclusion There was no significant treatment impact on BDNF serum levels - neither with ketamine nor esketamine - despite therapeutic response. These results suggest that ketamine or esketamine intervention for TRD has no impact on BDNF levels measured at 24 hours and 7 days after the infusion. This clinical trial is registered on the Japan Primary Registries Network: UMIN000032355.
ABSTRACT
Objectives: Past suicide attempt (SA) is one of the most important risk factors for suicide death. An ideation-to-action framework posits that impulsivity, potentially traumatic events, and mental disorders also play a role in increasing suicide risk. This study aimed to assess the association between trait impulsivity, lifetime exposure to trauma, and post-traumatic stress disorder (PTSD) with SA in a sample of Brazilian college students. Methods: A total of 2,137 participants filled self-reported questionnaires consisting of a sociodemographic and clinical questionnaire, Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist - Civilian version, and Barratt Impulsiveness Scale. Results: Our findings suggest that trait impulsivity may be interpreted as exerting a distal effect on SA, even in the presence of other variables - such as trauma history, psychological neglect, and PTSD - which also increase the odds of SA. High and medium levels of impulsivity, history of trauma, and PTSD increased the likelihood of SA. Conclusions: Intervention strategies to prevent SA may target trait impulsivity and exposure to traumatic experiences.
ABSTRACT
ABSTRACT Oral amyloidosis is a disease characterized by extracellular and irreversible deposition of amorphous and fibrillar proteins in the oral cavity, being strongly associated with Multiple Myeloma. The objective of this study is to report a case of a 62-year-old woman diagnosed with Multiple Myeloma who, approximately 2 years after starting treatment for the underlying disease, presented a lesion on the lateral border of the tongue with exophytic growth, pinkish color, vascularized, painless, measuring 3cm in its largest diameter. After histopathological analysis through incisional biopsy, a final diagnosis of amyloidosis was obtained. As a local treatment, we opted for complete excision of the lesion. The patient evolved to death due to Multiple Myeloma influenced by the diagnosis of systemic amyloidosis. Oral amyloidosis is usually associated with the systemic presentation of the disease, making it necessary to conduct a thorough investigation of other organs. Its diagnosis is important since the prognosis is directly related and can negatively influence survival rates and treatment of the underlying disease.
RESUMO A amiloidose oral é uma doença caracterizada pela deposição extracelular e irreversível de proteínas amorfas e fibrilares na cavidade bucal, sendo fortemente associada com Mieloma Múltiplo. O objetivo deste trabalho é relatar o caso de uma mulher com 62 anos de idade diagnosticada com Mieloma Múltiplo que, aproximadamente 2 anos após o início do tratamento para a doença de base, apresentou lesão em borda lateral de língua com crescimento exofítico, de coloração rósea, vascularizada, indolor, medindo 3 cm em seu maior diâmetro. Após análise histopatológica através de biópsia incisional, obteve-se diagnóstico final de amiloidose. Como tratamento local, optou-se pela exérese completa da lesão. A paciente evoluiu para óbito por consequência do Mieloma Múltiplo com complicações associadas à amiloidose sistêmica. A amiloidose oral geralmente está associada com a apresentação sistêmica da doença, tornando necessária uma investigação aprofundada nos demais órgãos. Seu diagnóstico é importante uma vez que pode influenciar diretamente no prognóstico e, consequentemente, negativamente nas taxas de sobrevida e no tratamento da doença de base.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Birth Weight , Breast Feeding/statistics & numerical data , Exercise , Nutrition Surveys , Maternal Nutrition , Reproductive Health/statistics & numerical data , Uruguay , Developmental Disabilities/epidemiology , Health Surveys , Child Nutrition , Failure to Thrive/epidemiologyABSTRACT
Background. The association between gallstone disease (gallstones or cholecystectomy) and plasma lipids was evaluated in 2,089 subject who attended a private health care facility in Mexico city from august 1991 to August 1992. Methods. All participants provided data on their sociodemographic status, non-insulin dependent diabetes mellitus diagnoses, alcohol consumption, and smoking habits; women also gave data regarding their obstetric-gynecologic histories. Ultrasounds of the liver and biliary tract were performed. Cholesterol levels, high-density lipoproteins cholesterol, and triglyceride plasma concentration were determined. Results. This study shows a strong inverse association between gallstone disease and plasma cholesterol concentration, with OR = 0.61 (95 percent CI = 0.42-0.89) in the category of 181-239 mg/dL, and OR = 0.49 (95 percent CI 0.32-0.77) in the group of 240 mg/dL or more, when compared to 180 mg/dL or less, after adjusting for the following risk factors; gender, age, and body mass index. Conclusions. These results suggest an increment in the catabolic pool of cholesterol, reflected in lower levels of plasm cholesterol in subjects with gallstone disease
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cholelithiasis/blood , Cholesterol/blood , Cholecystectomy , Retrospective StudiesABSTRACT
Se informa el caso de una mujer con cirrosis biliar primaria asociada a mieloma múltiple e hipotiroidismo. La biopsia hepática mostró daño histológico estadio II-III de la clasificación de Scheuer. El mieloma múltiple era estadio II-A y correspondió al tipo IgG-lambda. Se han informado otros tres casos adicionales en la literatura que presentaron cirrosis biliar primaria asociada a mieloma múltiple. Como grupo, los cuatro casos han cursado con daño hepatico leve moderado, con lesiones óseas extensas; en tres el mieloma múltiple ha sido del tipo IgG-lambda. Aunque esta asociación puede ser sólo incidental, existen evidencias que hacen sospechar una relación patológica entre estas enfermedades: este reporte resume esta información
Subject(s)
Humans , Female , Hypothyroidism , Immunoglobulin G , Liver Cirrhosis, Biliary , Multiple MyelomaABSTRACT
La colangitis supurativa aguda es una entidad que amenaza la vida siendo la descomprensión biliar temprana, esencial para la supervivencia. Se analizó retrolectivamente la evolución de 31 pacientes (21 mujeres y 10 hombres con una edad promedio de 64 años) con colangitis supurativa aguda (CSA) a quienes se les realizó drenaje biliar (DB) endoscópico y/o esfinterotomía. Doce pacientes habían presentado cuadros previos sugestivos de colangitis en el año previo al procedimiento. La estancia hospitalaria fue de 18ñ12 días, ocurriendo cinco muertes durante la hospitalización, ninguna relacionada con la descompresión biliar, 16 pacientes tenían colecistectomía previa, 12 habían presentado colangitis en el año previo, 23 pacientes tuvieron coledocolitiasis y tres pacientes más tuvieron neoplasias pancreatobiliares y litiasis en colédoco. Sólo el 67.7 por ciento presentó la clásica triada de Charcot (fiebre, dolor abdominal e ictericia). Después del DB se observó disminución significativa en la concentración de bilirrubina total, aspartato aminotransferasa, alanino aminotransferasa y en el número total de leucocitos (p<0.05). La única complicación relacionada con el procedimiento endoscópico, fue la perforación retroperitoneal en un paciente. Estos resultados sugieren que la canulación endoscópica es un procedimiento seguro y efectivo para la descompresión biliar de emergencia para el tratamiento de la colangitis supurativa aguda
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Bile Ducts/physiopathology , Cholangiography , Cholangitis/therapy , Drainage, Sanitary , Endoscopy/statistics & numerical data , Sphincterotomy, Endoscopic , Data Interpretation, StatisticalSubject(s)
Humans , Chronic Disease , Liver Diseases/metabolism , Liver Diseases/therapy , Nutritional SciencesABSTRACT
La dieta al poder ser manipulable puede de una u otra forma comprometer la función del hígado o contribuir para mantener la misma a niveles óptimos. El objetivo del presente trabajo fue revisar los recientes avances del efecto de la nutrición sobre los aspectos clínicos en enfermedades hepáticas crónicas y el uso adecuado de medidas dietéticas haciendo énfasis en los estudios que al respecto se han realizado en México. Se incluyeron informes originales en inglés y español a través de información computada (Medline) hasta 1994, además de los informes publicados en revistas nacionales sobre el aspecto nutricio en enfermedades hepáticas
Subject(s)
Humans , Chronic Disease , Energy Metabolism , Liver Diseases/diet therapy , Liver Diseases/metabolism , Minerals/administration & dosage , Nutritional Sciences , Nutritional Requirements , Protein-Energy Malnutrition/etiology , Vitamins/administration & dosageABSTRACT
El síndrome de úlcera rectal solitaria (SURS), es una entidad poco frecuente en nuestro medio. Su origen, historia natural y tratamiento son aún inciertos. Se informa el caso de siete pacientes con las características clínicas, histopatológicas y endoscópicas del síndrome atendidos en el Instituto Nacional de la Nutrición entre 1980 y 1992. Los síntomas más frecuentes fueron: hemorragia rectal, dolor abdominal, pujo, tenesmo recta y moco en heces. Los exámenes de laboratorio fueron inespecíficos. En el 85.7 por ciento se encontró una o más úlceras. La distancia promedio de la lesión desde la margen anal fue de 5.2 cm., y ésta se encontró en la pared rectal anterior. El tratamiento médico quirúrgico fue satisfactorio.