The management and treatment of major depressive disorder are major public health challenges, the lifetime prevalence of this illness being 4.4%–20% in the general population. Major depressive ...disorder and treatment resistant depression appear to be, in part, related to a dysfunction of the immune response. Among the treatments for depression ECT occupies an important place. The underlying cerebral mechanisms of ECT remain unclear.
The aim of this review is to survey the potential actions of ECT on the immuno-inflammatory cascade activated during depression.
A systematic search of the literature was carried out, using the bibliographic search engines PubMed and Embase. The search covered articles published up until october 2017.
The following MESH terms were used: Electroconvulsive therapy AND (inflammation OR immune OR immunology).
Our review shows that there is an acute immuno-inflammatory response immediately following an ECT session. There is an acute stress reaction. Studies show an increase in the plasma levels of cortisol and of interleukins 1 and 6. However, at the end of the course of treatment, ECT produces, in the long term, a fall in the plasma level of cortisol, a reduction in the levels of TNF alpha and interleukin 6.
One of the limitations of this review is that a large number of studies are relatively old, with small sample sizes and methodological bias.
Advances in knowledge of the immuno-inflammatory component of depression seem to be paving the way towards models to explain the mechanism of action of ECT.
•ECT seems to modify the immuno-inflammatory response secondary to a de depression.•There is an acute immuno-inflammatory response immediately following an ECT session.•In the long term, ECT appears to result in a correction of the immuno-inflammatory imbalances found in depression.
Over the last two centuries, rivers have been strongly regulated, inducing notable sediment starvation and flow reduction. This regulation has altered aquatic habitats, biocenosis and ecosystem ...services. Gravel augmentation (GA) is increasingly promoted to restore bedload transport, rejuvenate bed sediments and diversify aquatic and riverine habitats. However, practical questions remain in terms of efficiency and sustainability. The objective of this study is to provide unprecedented feedback from three GA experiments conducted along the Rhine River downstream of the Kembs dam (France/Germany). The restored sites were monitored over periods of 1 to 7 years and the stockpile deposits (SDs) and channel responses were compared to highlight the strengths and limitations of such experiments. The monitoring was based on topo-bathymetry, bedload tracking and grain size surveys. Two-dimensional hydraulic modelling was also performed to link the SD erosion patterns to the critical flow conditions. We show that (i) SD erosion is dependent on the grain size of the introduced sediments and the local flow velocities, (ii) sediment dispersion occurred mostly along the thalweg and increased over time, with a progressive decrease in the virtual velocities, (iii) bathymetric simplification and bed grain size fining were observed when downstream sediment diffusion began, (iv) in the mid-term (~5 years), local channel diversification occurred due to the fragmentation of sediment waves, with deposition occurring preferentially on riffles, and (v) new sediment starvation conditions appeared when the sediment waves travelled downstream in the absence of an upstream sediment supply. These results allow us to propose operational recommendations and management scenarios to improve both the efficiency and the sustainability of GAs conducted in large regulated rivers.
•The erosion of stockpile deposits (SDs) is highly dependent on local hydraulic conditions and sediment grain size.•The effects of GAs are transitory due to the downstream transfer of the sediment wave in the absence of an upstream sediment supply.•High channel morphological diversity downstream of gravel augmentations (GAs) increases their positive effects in terms of habitat improvement, especially for grain size fining.•Feedback from the 3 experiments allows us to formulate operational guidelines and management scenarios that foster the efficiency and sustainability of GA operations.
This longitudinal study aimed at comparing heart rate variability (HRV) in elite athletes identified either in 'fatigue' or in 'no-fatigue' state in 'real life' conditions.
57 elite Nordic-skiers ...were surveyed over 4 years. R-R intervals were recorded supine (SU) and standing (ST). A fatigue state was quoted with a validated questionnaire. A multilevel linear regression model was used to analyze relationships between heart rate (HR) and HRV descriptors total spectral power (TP), power in low (LF) and high frequency (HF) ranges expressed in ms(2) and normalized units (nu) and the status without and with fatigue. The variables not distributed normally were transformed by taking their common logarithm (log10).
172 trials were identified as in a 'fatigue' and 891 as in 'no-fatigue' state. All supine HR and HRV parameters (Beta±SE) were significantly different (P<0.0001) between 'fatigue' and 'no-fatigue': HRSU (+6.27±0.61 bpm), logTPSU (-0.36±0.04), logLFSU (-0.27±0.04), logHFSU (-0.46±0.05), logLF/HFSU (+0.19±0.03), HFSU(nu) (-9.55±1.33). Differences were also significant (P<0.0001) in standing: HRST (+8.83±0.89), logTPST (-0.28±0.03), logLFST (-0.29±0.03), logHFST (-0.32±0.04). Also, intra-individual variance of HRV parameters was larger (P<0.05) in the 'fatigue' state (logTPSU: 0.26 vs. 0.07, logLFSU: 0.28 vs. 0.11, logHFSU: 0.32 vs. 0.08, logTPST: 0.13 vs. 0.07, logLFST: 0.16 vs. 0.07, logHFST: 0.25 vs. 0.14).
HRV was significantly lower in 'fatigue' vs. 'no-fatigue' but accompanied with larger intra-individual variance of HRV parameters in 'fatigue'. The broader intra-individual variance of HRV parameters might encompass different changes from no-fatigue state, possibly reflecting different fatigue-induced alterations of HRV pattern.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Strict lockdown rules were imposed to the French population from 17 March to 11 May 2020, which may result in limited possibilities of physical activity, modified psychological and health states. ...This report is focused on HRV parameters kinetics before, during and after this lockdown period.
95 participants were included in this study (27 women, 68 men, 37 ± 11 years, 176 ± 8 cm, 71 ± 12 kg), who underwent regular orthostatic tests (a 5-minute supine followed by a 5-minute standing recording of heart rate (HR)) on a regular basis before (BSL), during (CFN) and after (RCV) the lockdown. HR, power in low- and high-frequency bands (LF, HF, respectively) and root mean square of the successive differences (RMSSD) were computed for each orthostatic test, and for each position. Subjective well-being was assessed on a 0-10 visual analogic scale (VAS). The participants were split in two groups, those who reported an improved well-being (WB+, increase >2 in VAS score) and those who did not (WB-) during CFN.
Out of the 95 participants, 19 were classified WB+ and 76 WB-. There was an increase in HR and a decrease in RMSSD when measured supine in CFN and RCV, compared to BSL in WB-, whilst opposite results were found in WB+ (i.e. decrease in HR and increase in RMSSD in CFN and RCV; increase in LF and HF in RCV). When pooling data of the three phases, there were significant correlations between VAS and HR, RMSSD, HF, respectively, in the supine position; the higher the VAS score (i.e., subjective well-being), the higher the RMSSD and HF and the lower the HR. In standing position, HRV parameters were not modified during CFN but RMSSD was correlated to VAS.
Our results suggest that the strict COVID-19 lockdown likely had opposite effects on French population as 20% of participants improved parasympathetic activation (RMSSD, HF) and rated positively this period, whilst 80% showed altered responses and deteriorated well-being. The changes in HRV parameters during and after the lockdown period were in line with subjective well-being responses. The observed recordings may reflect a large variety of responses (anxiety, anticipatory stress, change on physical activity…) beyond the scope of the present study. However, these results confirmed the usefulness of HRV as a non-invasive means for monitoring well-being and health in this population.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Occipito-mastoid structure normalization (OMSN) is an osteopathic manipulative treatment aimed at reducing tension around the jugular foramen, where cranial nerves IX, X, and XI exit the skull. The ...purpose of this study was to observe how heart rate variability (HRV), a marker of autonomic cardiac regulation, was modulated after an OMSN vs. a sham technique (SHAM). Pre- and post-intervention HRV was analyzed in two randomly chosen groups of 15 participants (OMSN vs. SHAM group). HRV was collected in the supine position 5 min before and 5 min after a 10-min application of either OMSN or SHAM. The time and group effect was analyzed using a two-way ANOVA. Independently from group intervention, a significant time effect induced increased HRV. No group effect differences were observed. Multiple comparisons for time and group interaction showed that the root mean square of successive differences (RMSSD), a vagally mediated HRV variable, increased to a greater extent for the OMSN group (
p
= 0.03) than for the SHAM group. However, both OMSN and SHAM techniques had a significant effect on HRV. Compared to a SHAM technique, OMSN had a significant effect on HRV vagally related metric RMSSD in the short term. We conclude that 10 min of OMSN may be used to induce a short-term influence on parasympathetic autonomic nervous system modulations.
Heart rate variability (HRV) is non-invasive and commonly used for monitoring responses to training loads, fitness, or overreaching in athletes. Yet, the recording duration for a series of ...RR-intervals varies from 1 to 15 min in the literature. The aim of the present work was to assess the minimum record duration to obtain reliable HRV results. RR-intervals from 159 orthostatic tests (7 min supine, SU, followed by 6 min standing, ST) were analyzed. Reference windows were 4 min in SU (min 3-7) and 4 min in ST (min 9-13). Those windows were subsequently divided and the analyses were repeated on eight different fractioned windows: the first min (0-1), the second min (1-2), the third min (2-3), the fourth min (3-4), the first 2 min (0-2), the last 2 min (2-4), the first 3 min (0-3), and the last 3 min (1-4). Correlation and Bland & Altman statistical analyses were systematically performed. The analysis window could be shortened to 0-2 instead of 0-4 for RMSSD only, whereas the 4-min window was necessary for LF and total power. Since there is a need for 1 min of baseline to obtain a steady signal prior the analysis window, we conclude that studies relying on RMSSD may shorten the windows to 3 min (= 1+2) in SU or seated position only and to 6 min (= 1+2 min SU plus 1+2 min ST) if there is an orthostatic test. Studies relying on time- and frequency-domain parameters need a minimum of 5 min (= 1+4) min SU or seated position only but require 10 min (= 1+4 min SU plus 1+4 min ST) for the orthostatic test.
Heart rate variability (HRV) is a common means of monitoring responses to training, yet in professional cycling, one may question its usefulness, particularly during multi-day competitions such as ...Grand Tours.
This study aims to report and analyze HRV responses in a male professional cyclist over a season, including the Tour de France.
A professional cyclist recorded resting and exercise inter-beat intervals during 5 months, comprising a training period with two altitude sojourns and two competition blocks, including the Tour de France. Resting recordings lasted 5 min in the supine position and were used for computation of mean heart rate (HR), root mean square of the successive differences (RMSSDs), and power in the low- and high-frequency bands (LF and HF, respectively). Training load quantification was based on recorded HR during exercise and expressed as training impulses (TRIMPSs).
LF (3,319 ± 2,819 vs. 1,097 ± 1,657 ms
), HF (3,590 ± 1858 vs. 1,267 ± 1,683 ms
), and RMSSD (96 ± 26 vs. 46 ± 30 ms) were higher and HR (47 ± 4 vs. 54 ± 2 bpm) was lower during the training period when compared to the two competition blocks. The coefficient of variation (CV) was significantly lower during the training period than during the two competition blocks for RMSSD (26 vs. 72%), LF (85 vs. 160%), and HF (58 vs. 141%).
The present study confirms that monitoring daily HRV responses during training periods is valuable in professional cycling, but questions its usefulness during the Tour de France. Moreover, the previous suggestion that CV in RMSSD would help to predict poor performance was not confirmed in a professional cyclist.
Abstract Pharmacodynamic mechanisms of diabetes induced by antipsychotic drugs remain unclear, while numerous receptors have been suspected to be involved in the genesis of this Adverse Drug Reaction ...(ADR). We investigated potential relationships between antipsychotics׳ receptor occupancy (serotonin 5-HT1A, 5-HT2A, 5-HT2C, histamine H1, muscarinic M3, adrenergic α1 , α2 or dopaminergic D2 D3 occupancies) and reports of diabetes using VigiBase® , the World Health Organization (WHO) global Individual Case Safety Report (ICSR) database. All ADR reports from 15 first and second generation antipsychotic drugs recorded in VigiBase® were extracted. Logistic regression models, completed by disproportionality analysis, were used to determine the associations between antipsychotics׳ receptor occupancy and ICSRs of diabetes on VigiBase® . During the study period, 94,460 ICSRs involved at least one of the 15 antipsychotics of interest. Diabetes was reported in 1799 (1.9%) patients. Clozapine was the most frequently suspected drug ( n =953; 53.0%). A significant and positive association was found between histamine H1, muscarinic M3 and serotonin 5-HT2C, 5-HT2A receptor occupancies and reports of diabetes. A multivariable stepwise regression model showed that only serotonin 5-HT2c (AOR=2.13, CI 95% 1.72–2.64) and histamine H1 (AOR=1.91, CI 95% 1.38–2.64) predicted the risk for diabetes mellitus ( p <0.001). Using an original pharmacoepidemiology-pharmacodynamic (PE-PD) approach, our study supports that antipsychotic drugs blocking simultaneously histamine H1 and serotonin 5-HT2C receptors are more frequently associated with diabetes reports in VigiBase® than other antipsychotics. These findings should encourage investigation of histamine H1 and serotonin 5-HT2C properties for predicting the risk of glycemic effects in candidate antipsychotics.
Previous studies have identified factors associated with admission to hospital after suicide spectrum behaviors. In this study, we aim to identify specific factors associated with psychiatric ...hospitalization after self-poisoning. Given earlier findings suggesting that alcohol use disorder is not associated with hospital admission, we also aim to consider its impact, as well as blood alcohol concentrations, on hospitalization decisions after a suicide attempt.
We studied the association between demographic features, suicide intent, psychiatric characteristics and admission to hospital in self-poisoning patients in an emergency department in France.
Suicide intent, a past history of suicide attempts, bipolar disorder and depression were associated with psychiatric hospital admissions. Despite alcohol use disorder being known to be associated with a suicide risk, it was not linked with psychiatric hospitalization. A positive blood alcohol concentration in the emergency department likewise had no association with admission to a psychiatric ward for inpatient care.
Our findings were similar to those reported for other suicide spectrum behaviors. Alcohol use disorder was not associated with admission for inpatient psychiatric care, whereas depression clearly was. The cause of this discrepancy must be determined in future research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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