Effects of fluoxetine and melatonin on mood, sleep quality and body mass index in postmenopausal women.

Frequent mood and sleep disorders and increased appetite leading to obesity are observed in postmenopausal women. Due to the limitations of hormone replacement therapy the researchers look for other treatment regimes. The aim of the study was to evaluate the efficacy of fluoxetine and melatonin in the treatment of these disorders. The study included 64 overweight postmenopausal women, aged 54 - 65 years, with increased appetite. They were randomly assigned in 2 groups. In group I (n = 30) fluoxetine (20 mg in the morning) and placebo (in the evening) were administered for 24 weeks. Group II (n = 34) received fluoxetine (20 mg in the morning) and melatonin (5 mg in the evening) in the same period of time. Hamilton anxiety rating scale (HARS), Beck depression scale (BDI), the insomnia severity index (ISI) and body mass index (BMI) were used to assess the health status and the treatment efficacy. After 24 weeks, comparable and statistically significant reduction in the level of anxiety and depression was obtained in both groups. In group I, the ISI decreased from 14.9 ± 2.5 points to 10.9 ± 1.9 points (P < 0.05) and in group II from 15.8 ± 2.4 points to 7.7 ± 1.5 points (P < 0.001). In group I no reduction in BMI was achieved whereas in group II this index decreased from 30.9 ± 3.1 to 26.3 ± 3.2 (P < 0.05). We conclude that combined administration of fluoxetine and melatonin was useful option to treat mood, sleep and appetite disorders in postmenopausal women.

Vulneración de derechos y alternativas de exigibilidad en salud comunitaria / Right´s infirgment and alternatives to exigibility in communitarian health

Desde la Epidemiología Crítica, el proceso de salud-enfermedad-atención-cuidado es considerado como un proceso singular y colectivo que acontece en un territorio. La Psicología Crítica aporta tanto la elucidación de dimensiones participativas y dialogales, como el compromiso con la transformación de contextos socioeconómicos, ecológicos, simbólicos y subjetivos. Ambas perspectivas aportan al abordaje de la salud como un campo de confluencia e intersección de sentidos, prácticas y saberes de diferentes actores sociales en territorios particulares. Con un enfoque cualitativo y la modalidad de estudio de casos múltiple, este trabajo se propone elucidar obstáculos y facilitadores en la exigibilidad de la salud como derecho en las comunas 3 y 4 de la Ciudad de Buenos Aires. Entre los resultados se visibilizaron como principales obstáculos: aspectos socioeconómicos, institucionales, epistémicos y tecnocráticos. Mientras que la existencia de actores con implicación crítica y el sostén de redes sociales-comunitarias aparecieron como principales facilitadores en el acceso al derecho a la salud.

Vulneración de derechos y alternativas de exigibilidad en salud comunitaria / Right´s infirgment and alternatives to exigibility in communitarian health

Desde la Epidemiología Crítica, el proceso de salud-enfermedad-atención-cuidado es considerado como un proceso singular y colectivo que acontece en un territorio. La Psicología Crítica aporta tanto la elucidación de dimensiones participativas y dialogales, como el compromiso con la transformación de contextos socioeconómicos, ecológicos, simbólicos y subjetivos. Ambas perspectivas aportan al abordaje de la salud como un campo de confluencia e intersección de sentidos, prácticas y saberes de diferentes actores sociales en territorios particulares. Con un enfoque cualitativo y la modalidad de estudio de casos múltiple, este trabajo se propone elucidar obstáculos y facilitadores en la exigibilidad de la salud como derecho en las comunas 3 y 4 de la Ciudad de Buenos Aires. Entre los resultados se visibilizaron como principales obstáculos: aspectos socioeconómicos, institucionales, epistémicos y tecnocráticos. Mientras que la existencia de actores con implicación crítica y el sostén de redes sociales-comunitarias aparecieron como principales facilitadores en el acceso al derecho a la salud.(AU)

Influence of tianeptine on melatonin homeostasis and psychosomatic symptoms in patients with irritable bowel syndrome.

UNLABELLED: Selective serotonin reuptake inhibitors (SSRIs) exert beneficial effect on gastrointestinal tract (GIT), but its mechanism has not been recognized. One of the hypothesis assumes, that fluoxetine increases indirectly melatonin production. For this reason it can be hypothesized, that administration of drugs of opposite effect, for example tianepine (selective serotonin reuptake enhancer (SSRE), can reduce melatonin production resulting in harmful effects as regards GIT. The aim of the study was to confirm or reject this hypothesis. The study included 100 patients, aged 21-58 years, with irritable bowel syndrome (IBS). Basing on the Rome III Criteria patients with constipation-predominant (IBS-C, n=50) and with diarrhoea-predominant (IBS-D, n=50) and 25 health volunteers (control group C) were distinguished. Visual Analog Scale (VAS) and Hamilton Depression Rating Scale (HDRS) were used to determine the severity of somatic and psychic symptoms. The concentration of 6-sultatoxymelatonin (6-HMS) in the urine was measured by ELISA method. In both groups the patients were administrated tianeptine 12.5 mg three times daily or placebo for 8 weeks. After 8 weeks of tianeptine therapy no significant changes were found in urinary 6-HMS excretion both in IBS-C group (9.9±3.2 versus 11.5±3.5 µg/24 h) and in IBS-D group (11.8±3.3 versus 12.2±3.5 µg/24 h). Eight-week tianeptine therapy resulted in significant decrease of somatic and psychic symptoms in both investigated groups. The improvement in the quality of life indices was obtained in 76.5% of IBS-C and in 63.3% of IBS-D patients. CONCLUSIONS: tianeptine does not impair melatonin homeostasis in patients with IB, diminishes IBS symptoms and improves the patients' quality of life.

Serum and ascitic fluid serotonin levels and 5-hydroxyindoleacetic acid urine excretion in the liver of cirrhotic patients with encephalopathy.

PURPOSE: The excess and deficit of serotonin can be the cause of somatic and mental disorders. The aim of this study was to evaluate serotonin levels in blood and ascitic fluid as well as excretion of 5-hydroxyindoleacetic acid (5-HIAA) in urine in patients with hepatic encephalopathy (HE). MATERIAL AND METHODS: The study included 75 alcoholic cirrhotic patients divided into 3 groups (HE1, HE2, HE3), 25 patients each, with grade 1, 2 and 3 of hepatic encephalopathy according to West-Haven classification. The control group (C) included 25 clinically healthy volunteers. Venous blood and ascitic fluid were collected in fasting. On the same day a 24-hour urine collection was performed. Immunoenzymatic method was used to determine the serotonin level in serum and ascitic fluid, and 5-HIAA in urine (IBL-RE-59121, RE-59131). RESULTS: In the control group, mean serum serotonin level (ng/ml) was 155.5 ± 38.1 and in the 3 study groups: HE1 - 175.2 ± 32.4 (NS), HE2 - 137.2 ± 28.6 (NS), HE3 - 108.3 ± 46.3 (p<0.001). Serotonin concentration in ascitic fluid was on the average about 25% of its level in serum. The excretion of 5-HIAA in urine (mg/24h) in all groups, was: C - 5.9 ± 2.1, HE1 - 5.8 ± 1.8 (NS), HE2 - 4.8 ± 1.2(NS), HE3 - 4.3 ± 1.3 (p<0.05). CONCLUSION: The results of our study indicate that serum and ascitic fluid level of serotonin and urine excretion of 5-HIAA depends on the grade of hepatic encephalopathy. In patients with severe hepatic encephalopathy serotonin concentration in blood is decreased which can affect some clinical manifestation of this disease.

Condicionamientos sociales y de género en adolescentes escolarizados desde la perspectiva de la Psicología Crítica / Social conditionings and of gender in school teenagers since a Critical Psychology perspectiva

Desde la perspectiva de la Psicología Crítica interpreta- mos las significaciones que adolescentes escolarizados de enseñanza media tienen sobre problemas identificados como prioritarios y las implicancias institucionales, territoriales y de género. La revisión de saberes disciplinares sobre la adolescencia, sin la perspectiva de género e inscripción social, universaliza territorios sin advertir los condicionamientos materiales y simbólicos implicados en los procesos de subjetivación y socialización. Con un enfoque de Investigación-Acción como ejercicio prefigurativo práctico, se abordan datos cuali y cuantitativos generados a partir de la aplicación de un cuestionario a una muestra intencional de adolescentes que asisten a escuelas públicas. Las dimensiones del cuerpo, la sexualidad y el futuro aparecen con diferenciales atravesamientos de género y territorialidad. Estos temas propician intervenciones preventivas y promocionales y un enfoque de reflexividad crítica sobre las prácticas disciplinares y la crisis de las instituciones tradicionales.(AU)

From the Critical Psychology we interpret the school teenagers significances about problems who were identified as priority, and the institutional, territorial and gender implications. The review of knowledge about adolescence without a gender perspective and a social inscription, produce a generalization of the territories without warning the material and symbolic conditionings involved in the subjetivation and socialization processes. From a Prefigurative Action Research, qualitative and quantitative information was recollected from a selective sampling of institutions and quotas by a questionnaire. The body, sexuality and future were variables with different dimensions of gender and territoriality. These issues promote preventive and promotional interventions and a reflexive critic approach on disciplinarians practices and the crisis of the traditional institutions.(AU)

Derechos sexuales y reproductivos de las mujeres de la CABA: Obstáculos y resistencias / Sexual and reproductive rights of women of CABA: Obstacles and resistance

El presente trabajo tiene como objetivo explorar las diferentes barreras que obstaculizan el acceso a los derechos sexuales y reproductivos, de las usuarias de dos establecimientos públicos de salud y su relación con el marco legal vigente y las prácticas institucionales. Se indagó sobre el acceso a la solicitud de ligadura de tubaria, la atención de la violencia sexual, la prevención/atención de Enfermedades de Transmisión Sexual y VIH/SIDA, la anticoncepción hormonal de emergencia y la atención del aborto no punible. Por otra parte, se exploraron las representaciones de las entrevistadas acerca de la sexualidad y la salud reproductiva, la despenalización o legalización del aborto y sobre los beneficios y riesgos de los medicamentos, tecnologías y tratamientos médicos. Mediante un diseño exploratorio-descriptivo y cualitativo, se utilizaron observación participante, entrevistas en profundidad y cuestionarios a usuarias en edad reproductiva de un centro de salud y de un hospital público especializado en salud materno infantil, de la zona sur de la Ciudad Autónoma de Buenos Aires. Las congruencias o no con los tratados y los corpus jurídicos fueron interpretados a luz de los hallazgos epidemiológicos, las brechas sanitarias y las narrativas de los actores sociales.

The objective of this work is to explore sexual and reproductive rights representations and practices of women, the different obstacles that are present in public health spaces, and the existence of gaps within the legal frame and institutional answers. It is of specific consideration the access to tubal sterilization, sexual violence care, prevention of Sexual Transmited Diseases (STD) and HIV, emergency hormonal contraceptive and not penalized abortion. We also include aspects such as the possible legalization of abortion and the information provided about sexuality and reproductive health, about the benefits and risks of medicine, technology and medical treatment. Using a an exploratory descriptive design and qualitative methodology, different interviewing techniques were conducted in depth with patients from a health center and from a Public Hospital especializated in maternal and child health, in the south of City of Buenos Aires. Congruences or not treaties and judicial corpus are interpreted in light of epidemiological findings, health gaps and narratives of social actors.

Loss of adipose tissue and plasma phospholipids: relationship to survival in advanced cancer patients.

BACKGROUND & AIMS: Extensive loss of adipose tissue is a key feature of cancer cachexia. Advanced cancer patients also exhibit low plasma phospholipids. It is not known whether these processes coincide across the cancer trajectory nor has their relationship with survival been defined. Changes in adipose tissue mass and plasma phospholipids were characterized within 500days prior to death and prognostic significance assessed. METHODS: Adipose tissue rate of change was determined in a retrospective cohort of patients who died of colorectal and lung cancers (n=108) and who underwent >2 computed tomography scans in the last 500days of life. Plasma phospholipid fatty acids were measured prospectively in a similar cohort of patients with metastatic cancer (n=72). RESULTS: Accelerated loss of adipose tissue begins at 7months from death reaching an average loss of 29% of total AT 2months from death. Plasma phospholipid fatty acids were 35% lower in patients closest to death versus those surviving >8months. Losses of phospholipid fatty acids and adipose tissue occur in tandem and are predictive of survival. CONCLUSIONS: Depletion of plasma phospholipids likely indicates a deficit of essential fatty acids in the periphery which may contribute to loss of adipose tissue.

The DNA probe and PCR assay as useful tools to control an acid fast bacteria-dependent biotechnological process.

Specific DNA probe has been developed for fast-growing, mycobacterial mutants able to selectively biotransform side chain of plant sterols. The PCR assay, using primers complementary to the sequence of the probe, was shown to distinguish biotechnological mutants from other fast-growing mycobacteria. Moreover, the species identification of biotechnological strains was done using PCR-restriction analysis based on amplification and digestion of the inner part of hsp65 gene (PRA-assay) as well as 16S rRNA sequencing.