Interaction between anthelmintic treatment and vaccine responses in ponies naturally infected with cyathostomins.

Anthelmintics and vaccines are commonly given concurrently in routine equine management, but it is unknown to what extent an interaction between the two exists. Cyathostomins can modulate the local immune response by stimulating a type 2 helper T cell (Th2) response. In addition, anti-inflammatory effects of ivermectin have been found in rodent models. It is unknown whether these anti-inflammatory effects affect the acute phase response elicited by commonly used vaccines. This study evaluated how the acute phase inflammatory response, leukocyte expression of pro-inflammatory cytokines, and vaccine-specific titers induced by simultaneous injection of three vaccines (West Nile Virus, Equine Herpes Rhinopneumonitis, and Keyhole Limpet Hemocyanin) were modulated by concurrent administration of ivermectin or pyrantel pamoate in ponies naturally infected with cyathostomins. Mixed-breed yearling ponies were blocked by gender and fecal strongyle egg count, then randomly assigned to three treatment groups: ivermectin (n=8), pyrantel pamoate (n=8), and control (n=7). All ponies received vaccinations intramuscularly on days 0 and 29, and anthelmintics were administered on the same days. Whole blood, serum and plasma samples were collected one, three and 14 days after each vaccination. Samples were analyzed for concentrations of acute phase reactants (haptoglobin, serum amyloid A, fibrinogen and iron), mRNA expression levels of cytokines (interleukin (IL)-1ß, IL-4, IL-10, tumor necrosis factor (TNF)-α and interferon (IFN)-γ) in leukocytes, and vaccine-specific antibody titers. A marked acute-phase response was noted following both vaccinations. In contrast, the pattern of change in cytokine expression was less pronounced and more variable. Statistical differences were observed between groups for haptoglobin, fibrinogen, IL-1ß, IL-4, and IL-10, but differences were generally small and none of the vaccine titers were different between the groups. Taken together, the study found some signs of modulation of immunologic or inflammatory responses to the administered vaccines, when anthelmintics were administered concurrently, but these are unlikely to have practical implications for vaccination routines.

Serological detection of grapevine virus a using antiserum to a nonstructural protein, the putative movement protein.

ABSTRACT Grapevine virus A (GVA) is implicated in the etiology of the rugose wood disease. The coat protein (CP) and the putative movement protein (MP) genes of GVA were cloned and expressed in Escherichia coli and used to produce antisera. Both the CP and the MP were detected with their corresponding antisera in GVA-infected Nicotiana benthamiana. The MP was first detected at an early stage of the infection, 6 to 12 h after inoculation, and the CP was detected 2 to 3 days after inoculation. The CP and MP were detected by immunoblot analysis in rugose wood-affected grapevines. The MP could be detected in GVA-infected grapevines that tested negative for CP, both with CP antiserum and with a commercially available enzyme-linked immunosorbent assay kit. The study shows that detection of the nonstructural MP may be an effective means for serological detection of GVA infection in grapevines.

Biological and clinical validation of atypical depression.

Depressed patients with (a) mood reactivity alone (MR group), (b) mood reactivity plus one or more associated features (atypical depression, AD group), and (c) patients with neither mood reactivity nor atypical depression (non-MR/AD group) were compared on their cortisol response to 75 mg of desipramine (DMI), a relatively selective norepinephrine reuptake inhibitor. AD patients exhibited a significantly higher cortisol response to DMI compared with MR and non-MR/AD patients, suggesting that atypical depression may be associated with a less impaired norepinephrine system. MR and non-MR/AD patients did not differ, suggesting that mood reactivity alone is not associated with the biological profile observed in atypical depression. Results indicate that while mood reactivity may be necessary for the diagnosis of atypical depression, the additional presence of at least one associated symptom is required for a distinct biological profile. Our findings provide further biological validation of the concept of atypical depression.

Desipramine treatment in panic disorder.

Apart from imipramine (IMI), the efficacy of tricyclic antidepressants in panic disorder (PD) has received surprisingly little investigation. The authors report on a 6 week open trial of desipramine (DMI) preceded by a 10 day placebo lead-in, in 15 patients with PD. By week 6, 80% of the patients were globally rated as much or very much improved on a mean dose of 198 mg. Much of the improvement resulted from a reduction in non-panic attack symptomatology (i.e., psychic, somatic and phobic anxiety). Longer duration of illness, male gender and residual psychic anxiety were associated with poorer response in a subgroup of patients. DMI caused minimal intolerable side effects, suggesting possible compliance advantages in comparison to IMI. Beyond supporting the efficacy of DMI in PD, the results of the study point to a significant medication responsive non-panic illness component and caution against over-relying on panic attacks in assessing both illness severity and treatment response.

Plasma dexamethasone and cortisol levels in depressed outpatients.

We investigated the 1-mg dexamethasone suppression test (DST) in 41 outpatients with major depressive disorder assessing the role of dexamethasone blood level, age and basal cortisol on DST results. Non-suppressors (approximately 25% of patients) had lower dexamethasone levels, and post-dexamethasone cortisol was negatively correlated with plasma dexamethasone; these findings were more significant after covarying out age and basal cortisol, factors that were also significantly associated to non-suppressors. A subgroup of patients (n = 19) also had 0.75-mg and 2.0-mg DST to evaluate whether a threshold dexamethasone blood level existed; a dexamethasone blood level greater than 1.5 ng/ml converted all non-suppressors to suppressors. Implications of these findings are discussed.

Knowledge of the diagnostic criteria for major depression. A survey of mental health professionals.

Major depression, a mental disorder responsive to specific treatments, may be misdiagnosed by psychiatrists and other mental health personnel. Many patients referred to a depression clinic with other, generally less severe diagnoses were reevaluated by clinic staff and shown to meet DSM-III criteria for a major depressive episode. Discussions with referring therapists about these diagnostic discrepancies revealed frequent misconceptions about the diagnosis of major depression. In response to these observations, a questionnaire was devised to assess clinicians' knowledge about the DSM-III criteria for major depression. One hundred thirteen questionnaires were distributed to clinicians of varied disciplines and levels of experience, and 54 of these questionnaires were returned. Misconceptions about the DSM-III criteria for a major depressive episode were frequent among responders. The most common errors involved the incorrect assumption that vegetative signs and a distinct quality of mood are required for the diagnosis of major depression and that the diagnosis should not be made if chronic. Other major areas of confusion and potential causes of diagnostic error are discussed. Significantly, there were no differences in kind and number of errors when trainees and nontrainees were compared.

Clinical variables and hypothalamic-pituitary-adrenal function in depression. The importance of mood reactivity.

Forty outpatients with major depressive disorder were studied with the 1 mg DST and the Afternoon Cortisol Test. No relationship was found between hypothalamic-pituitary-adrenal (HPA) axis function and Research Diagnostic Criteria subtypes of depression, with the exception of higher log post-dexamethasone cortisol levels in endogenous depressives. Patients with mood reactivity had lower cortisol values on all assessments. The data suggest that the presence of mood reactivity may be useful as a predictor of normal HPA function in depression.

A study of former mental patients who returned to visit the ward on which they were hospitalized.

We have observed that former psychiatric inpatients often return to visit the ward after they have been discharged. Nothing has been written about this phenomenon, but it seemed to us that since not all discharged patients return to visit, a difference must exist between those who do visit and those who do not. The following report presents the results of our investigation into the distinguishing characteristics of the visiting ex-patients. Reider (1953) and Safirstein (1967, 1970) have described the phenomenon of institutional transference, which deals with patients' attachment to the institution rather than to an individual therapist. However, our data show that the phenomenon of former patients visiting goes beyond that, in some instances reflecting meaningful relationships with staff members and other patients, but in other instances indicating continuing treatment needs of various kinds.