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PubMed1995

Ultrasound evaluation of normal penile (corporeal) length in children.

Previous studies have established normal penile length for patient age and stage of sexual development. To our knowledge penile length has only been determined to date by measuring the stretched distance from the symphysis to the glans tip. Pilot studies at our institution showed that ultrasound corpora cavernosa length determinations were possible using a 7.5 MHz. linear transducer probe. To determine whether ultrasound is a more accurate modality in assessing penile length, male subjects 0 to 24 months old with normal penile anatomy and palpably descended testicles were enrolled in a prospective analysis. Longitudinal ultrasound images of the flaccid penis were obtained from the dorsal surface. The whole corporeal bodies were easily imaged and measured. In a blinded fashion a separate investigator performed a conventional stretched penile length determination. A total of 27 male subjects 1 week to 22 months old was evaluated and 2 were excluded. Corpora cavernosa measurements using ultrasound revealed a mean length of 32.3 +/- 4.7 mm. (range 22.4 to 44.9). Stretched penile lengths of the same subjects revealed a mean length of 46.8 +/- 8.2 mm. (range 31 to 63). Circumcision status (p = 0.036) and age (p < 0.001) significantly correlated with stretched length determinations. Ultrasound measurements did not significantly vary with patient circumcision status or age. Penile length and race were not correlated when using stretched or ultrasound measurements. Ultrasound determination of corporeal body length is possible in young subjects. From infancy to age 22 months ultrasound measurements are not significantly affected by age or the presence of foreskin. Our experience suggests that corporeal body evaluation by ultrasound may offer a more accurate assessment of functional penile length.

Child, Preschool↗
PubMed2003

Long-term hearing outcome in patients receiving intratympanic gentamicin for Ménière's disease.

OBJECTIVE: To determine the long-term hearing outcome in patients with intractable vertigo caused by unilateral Ménière's disease who were treated with intratympanic injection of gentamicin. STUDY DESIGN: The study was a longitudinal analysis of hearing and control of vertigo in patients with unilateral Ménière's disease who received intratympanic gentamicin. METHODS: Pure-tone thresholds and speech discrimination scores on audiometry were analyzed, along with the control of vertigo. Criteria described in 1995 by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) were used. Patients treated with intratympanic gentamicin had "definite" Ménière's disease and had intractable vertigo despite optimal medical therapy, no symptoms suggestive of Ménière's disease in the contralateral ear, and serviceable hearing in the contralateral ear. The study analyzed the outcomes of 34 patients for whom follow-up data were available for periods greater than 24 months after intratympanic gentamicin. RESULTS: Complete control of vertigo (AAOHNS Class A) was obtained in 90% of the patients. Profound sensorineural hearing loss occurred as a result of gentamicin injection in 1 of the 34 patients (3%). When data from all patients were grouped together, hearing was improved in 5 (15%), unchanged in 23 (68%), and worse in 6 (17%) patients. This distribution of hearing outcome is similar to that in patients whose symptoms of Ménière's disease were managed with medical measures. Recurrent vertigo developed in 10 patients (29%) at an interval of 4 to 15 months after initially complete control. Treatment with additional intratympanic injection(s) of gentamicin did not result in a change in hearing. CONCLUSION: The risk of hearing loss in patients treated with infrequent intratympanic injection(s) of gentamicin is low.

Adult↗
PubMed2001

Th2 cytokine profile in infants predisposes to improved graft acceptance after liver transplantation.

BACKGROUND: The T helper cell type 1 (Th1) cytokines interleukin (IL)-2 and interferon (IFN)-gamma are mediators of acute graft rejection after liver transplantation and Th2 cytokines, such as IL-4 and IL-10, may have a protective role and correlate with graft acceptance. To test the hypothesis that infants aged <1 year have an immunological advantage with regard to graft acceptance because of a partially immature immune system with a physiological balance toward a Th2 cytokine profile, we conducted the present study. METHODS: We compared the T helper serum cytokine profiles in 105 infants and children after liver transplantation with or without acute graft rejection and analyzed the normal age-distributed concentrations of T helper cytokines in 51 healthy controls. RESULTS: The incidence of acute graft rejection was as follows: 0 to 12 months, 26.8%; 1 to 3 years, 40.0%; and >3 years, 71.8%. There was a significantly lower incidence of acute rejection in infants 0 to 12 months of age compared with children >1 year (11/41 vs. 38/64; P=0.001). In healthy infants, significant increasing Th1 cytokine concentrations and decreasing Th2 cytokine concentrations were found with increasing age. Patients with acute rejection had significantly higher values of Th1 cytokines compared with nonrejecting subjects, who had significantly higher concentrations of Th2 cytokines. A longitudinal analysis of serum cytokines from patients showed that changes of the cytokine patterns in the follow-up did not differ significantly from preoperative values, except in the 4 weeks posttransplant. CONCLUSIONS: We conclude from the data that the physiological balance toward a Th2 cytokine profile of infants in the first months of life predisposes to improved graft acceptance. Transplantation of children with biliary atresia as early as possible, avoiding Th1 stimulation by recurrent infections and vaccinations, may have a positive impact on overall tolerance.

Acute Disease↗
PubMedDate not supplied

Hopelessness and depression in the early recovery period after hospitalization for acute coronary syndrome.

PURPOSE: Psychosocial factors, such as depression, have been identified as important predictors of morbidity and mortality in individuals with coronary heart disease; however, little research has been done examining hopelessness in this population. This investigation examined the frequency and severity of hopelessness and depression in the early recovery period after hospitalization for acute coronary syndrome (ACS), the relationship between hopelessness and depression, and patient characteristics leading to these 2 variables. METHODS: A total of 525 post-ACS patients at 5 hospitals in Michigan were interviewed. Measures included the cognitive expectations factor of the Beck Hopelessness Scale and the Center for Epidemiologic Studies-Depression Scale. RESULTS: Hopelessness symptoms were frequent and moderate to severe in 27% of the sample, whereas depression was frequent and moderate to severe in 36% of subjects. Hopelessness was moderately correlated with depression, yet a number of different patient characteristics were predictive of each. Lower educational level predicted hopelessness, but not depression. Patients who had coronary artery bypass surgery or coronary angioplasty were more hopeless, but not more depressed. Female gender predicted depression, but not hopelessness. Hopelessness and depression had a shared variance of 33%. CONCLUSIONS: Hopelessness and depression were frequent and moderate to severe in a portion of patients in the early ACS recovery period. An association between hopelessness and depression exists, while different patient characteristics were more strongly associated with each. Longitudinal analysis is needed to examine hopelessness and depression in later phases of the ACS recovery period.

Acute Disease↗
PubMed2001

Differences in fatigue and psychological distress across occupations: results from the Maastricht Cohort Study of Fatigue at Work.

Differences in fatigue and psychological distress across occupations were examined among 8521 employees participating in the Maastricht Cohort Study of "Fatigue at Work." Additional information on the perceived psychosocial work environment was incorporated. A total of 131 occupations, classified according to the Netherlands Standard Classification of Occupations 1992, were studied. Results showed that occupation as a proxy index of the "objective" work environment adds little explanatory information beyond perceived measures of the work environment. Although "occupation" seems to be an easy entree for intervention, focusing on occupation exclusively to prevent, or at least reduce, fatigue and psychological distress may be inadequate. Supplementary information about the perceived work environment of the job occupant is needed to develop preventive measures on the individual level. Further research, including a longitudinal analysis, is required to elucidate the complex relation between occupation, psychosocial risk factors, and fatigue and psychological distress.

Adult↗
PubMed2003

Quantitation of blood lymphocyte mitochondrial DNA for the monitoring of antiretroviral drug-induced mitochondrial DNA depletion.

OBJECTIVE: To investigate the impact of antiretroviral treatment on the mitochondrial DNA (mtDNA) content of peripheral blood mononuclear cells (PBMCs) from HIV-1-infected patients. DESIGN: As absolute mtDNA copy numbers widely differ between individuals, we performed a longitudinal analysis where the patient's first historical specimen was obtained as a baseline reference for relative comparison with subsequent samples from that patient. METHODS: mtDNA and nuclear DNA quantitation per cell (beta-globin gene copies) were both measured by real-time polymerase chain reaction analysis of whole DNA extracts of 361 serial live-cryopreserved PBMCs collected in former trials and clinical follow-ups from 60 individuals with established or recently acquired HIV-1 infections before and during administration of various antiviral combination therapies. RESULTS: mtDNA amounts were stable or increasing over years of natural HIV-1 infection in untreated patients (n = 7), consistent with our finding of a lack of differences in mtDNA copy numbers in patients with either a long established or recent lentivirus infection. Our quantitation system revealed significant changes in mtDNA copy number depending on the designated triple, quadruple, or quintuple anti-HIV drug combinations. Zidovudine + zalcitabine + ritonavir and zidovudine + lamivudine + didanosine regularly lead to mtDNA depletion in each of the treated patients, whereas none of 7 patients (and 35 cell specimens) receiving a stavudine + lamivudine + indinavir combination had any significant mtDNA content variations. In 7 patients, mtDNA copy numbers returned to pretreatment levels and/or higher levels without any interruption of the previously mtDNA-depleting antiretroviral drug combination. CONCLUSION: Our assay system allowed the detection of significant changes in the mtDNA content of PBMCs from HIV-1-infected patients taking antiretroviral drugs, as has been reported in the literature with other detection systems. Yet, mtDNA copy numbers regularly diminished during administration of some but not all nucleoside analog-containing combinations. This, plus the occasional finding that depleted mtDNA contents spontaneously increased to baseline levels and/or higher levels during uninterrupted treatment, should raise a note of caution about resorting to the PBMC mtDNA marker for monitoring of antiretroviral drug-related mitochondrial toxicities.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Phagocytic efficiency of monocytes and macrophages obtained from Sydney blood bank cohort members infected with an attenuated strain of HIV-1.

Defective function of monocyte-derived macrophages contributes to HIV-1 pathogenesis. We found that phagocytosis of the opportunistic pathogens Mycobacterium avium complex and Toxoplasma gondii was impaired in monocytes obtained from individuals infected with wild-type strains of HIV-1 but generally not in monocytes collected over a 6-year period from Sydney Blood Bank Cohort (SBBC) members infected with nef/long terminal repeats (LTR) region-defective strains of HIV-1. However, longitudinal analysis of phagocytosis in 1 SBBC member, C54, showed the development of defective engulfment of opportunistic pathogens at the most recent time points, coincident with the development of further molecular deletions in the nef/LTR region. Another SBBC member, C98, underwent bronchoscopy, which provided material to examine phagocytic signaling in alveolar macrophages. In contrast to normal phagocytic efficiency of C98's monocytes (over a 6-year period), defective signaling events during FcgammaR-mediated phagocytosis by C98's alveolar macrophages were observed. High basal phosphorylation within HIV-infected macrophages correlated with colocalization of tyrosine-phosphorylated proteins with HIV-1 p24 antigen rather than around the phagocytic targets as observed in uninfected cells. Thus, although phagocytic efficiency appears to be generally unimpaired in monocytes from SBBC members, evidence of impairment in recent samples from 1 SBBC member, coincident with further genetic changes within the virus, and abnormal phagocytic signaling in alveolar macrophages from another SBBC member may herald loss of attenuation of those strains.

Anticoagulants↗
PubMed2005

Dose-dependent influence of didanosine on immune recovery in HIV-infected patients treated with tenofovir.

BACKGROUND: Antiretroviral therapy (ART) containing tenofovir disoproxil fumarate (TDF) and didanosine (ddI) has been associated with poor immune recovery despite virologic success. This effect might be related to ddI toxicity since ddI exposure is substantially increased by TDF. OBJECTIVE: To analyze whether immune recovery during ART with TDF and ddI is ddI-dose dependent. DESIGN AND METHODS: A retrospective longitudinal analysis of immune recovery measured by the CD4 T-cell slope in 614 patients treated with ART containing TDF with or without ddI. Patients were stratified according to the tertiles of their weight-adjusted ddI dose: low dose (< 3.3 mg/kg), intermediate dose (3.3-4.1 mg/kg) and high dose (> 4.1 mg/kg). Cofactors modifying the degree of immune recovery after starting TDF-containing ART were identified by univariable and multivariable linear regression analyses. RESULTS: CD4 T-cell slopes were comparable between patients treated with TDF and a weight-adjusted ddI-dose of < 4.1 mg/kg per day (n = 143) versus TDF-without-ddI (n = 393). In the multivariable model the slopes differed by -13 CD4 T cells/mul per year [95% confidence interval (CI), -42 to 17; P = 0.40]. In contrast, patients treated with TDF and a higher ddI dose (> 4.1 mg/kg per day, n = 78) experienced a significantly impaired immune recovery (-47 CD4 T cells/microl per year; 95% CI, -82 to -12; P = 0.009). The virologic response was comparable between the different treatment groups. CONCLUSIONS: Immune recovery is impaired, when high doses of ddI (> 4.1 mg/kg) are given in combination with TDF. If the dose of ddI is adjusted to less than 4.1 mg/kg per day, immune recovery is similar to other TDF-containing ART regimen.

Adenine↗
PubMed2006

Bacterial overgrowth as a cause of irritable bowel syndrome.

PURPOSE OF REVIEW: To review recently published studies investigating any association between gut flora and symptoms of irritable bowel syndrome. RECENT FINDINGS: Experimental studies demonstrate associations between gut flora, gut motility, mucosal inflammation and visceral hypersensitivity. Scientific bases for possible benefits of selected probiotics on irritable bowel symptoms have been identified. Disturbances in viable counts of fecal flora have been demonstrated in patients with irritable bowel syndrome. Results of studies based on breath tests are conflicting as to whether the prevalence of small intestinal bacterial overgrowth is increased in this group. Nonetheless, a longitudinal analysis based on bacteriological assessments of serial small intestinal aspirates suggests that this entity should be considered in patients with irritable bowel symptoms, especially in the setting of predisposition to bacterial overgrowth. Clinical trials of probiotic treatment for irritable bowel syndrome have yielded conflicting results. SUMMARY: Recent studies provide increasing support for the concept that disturbances in gut flora occur in patients with irritable bowel syndrome and that such abnormalities may contribute to irritable bowel syndrome-type symptoms. The relative importance of disturbed gut flora to symptom pathogenesis, along with the therapeutic potential of modulation of the gut flora for amelioration of irritable bowel syndrome symptoms, however, remains to be fully defined.

Animals↗
PubMed2003

Genetic and plastic responses of a northern mammal to climate change.

Climate change is predicted to be most severe in northern regions and there has been much interest in to what extent organisms can cope with these changes through phenotypic plasticity or microevolutionary processes. A red squirrel population in the southwest Yukon, Canada, faced with increasing spring temperatures and food supply has advanced the timing of breeding by 18 days over the last 10 years (6 days per generation). Longitudinal analysis of females breeding in multiple years suggests that much of this change in parturition date can be explained by a plastic response to increased food abundance (3.7 days per generation). Significant changes in breeding values (0.8 days per generation), were in concordance with predictions from the breeder's equation (0.6 days per generation), and indicated that an evolutionary response to strong selection favouring earlier breeders also contributed to the observed advancement of this heritable trait. The timing of breeding in this population of squirrels, therefore, has advanced as a result of both phenotypic changes within generations, and genetic changes among generations in response to a rapidly changing environment.

Acclimatization↗
PubMed2005

Absence of CD26 expression on skin-homing CLA+ CD4+ T lymphocytes in peripheral blood is a highly sensitive marker for early diagnosis and therapeutic monitoring of patients with Sézary syndrome.

Patients with Sézary syndrome (SS) show clonal expansion in the peripheral blood of skin-homing CD4+ T-helper cells expressing cutaneous lymphocyte antigen (CLA). However, an increase of CLA+ CD4+ T cells can also be observed in various inflammatory dermatoses. To facilitate early diagnosis and therapeutic monitoring of SS using flow cytometry, we evaluated the expression of CD7 and CD26 on the CLA+ CD4+ lymphocyte subset. Peripheral lymphocytes from 7 patients with SS, 16 patients with mycosis fungoides (MF) and 11 healthy controls were analysed by flow cytometry for the expression of CD4, CD7, CD26, CLA and CCR4. In addition, a longitudinal study was performed over 16 months in two patients with SS. Absence of CD7 and CD26 on CLA+ CD4+ T cells was highly specific for SS. Importantly, the absence of CD26 on CLA+ CD4+ T cells was very sensitive for SS, at 100% in our patient cohort. The number of CD26- CLA+ CD4+ T cells closely correlated with therapeutic interventions in the longitudinal analysis of two patients over more than 1 year. We conclude that the absence of CD26 expression on skin-homing CLA+ CD4+ T-helper cells is a very sensitive and highly specific parameter for early diagnosis and therapeutic monitoring of patients with SS.

Antigens, CD7↗
PubMed2006

Left ventricular hypertrophy in pediatric kidney transplant recipients: long-term follow-up study.

Cross-sectional studies indicate that LVH, known cardiovascular risk factor, is frequent in pediatric patients post-kidney transplant. We performed a retrospective longitudinal analysis of echocardiographic data collected in children and adolescents who received kidney transplant from 1998 to 2003. The first echo was performed at a median time post-transplant of 14 months in 47 children; a second echo (echo 2) was carried out at a median time of 33 months in 31 and a third echo (echo 3) was performed at a median time of 49 months in 14 children. LVH was defined as LV mass index >/=95th percentile for children. LVH was present in echo 1 in 25 (54%) subjects. Systolic blood pressure (p = 0.02) and BMI (p = 0.02) independently predicted the LVH seen in echo1 in multivariate logistic regression. In 14 subjects with three consecutive echocardiograms LVM index significantly decreased from echo 1 to echo 2 and from echo 1 to echo3 (p < 0.05), but no significant changes were observed between echo 2 and echo 3. The overall prevalence of LVH remained unchanged but its severity significantly decreased during the follow-up. The results of the study suggest that despite regression of LVM index overtime-pediatric patients post-kidney transplant are at continuous risk for developing cardiovascular disease.

Adolescent↗
PubMed1982

Effect of aging on the cardiothoracic ratio of men.

The potential usefulness of chest radiographs in the assessment of physical dimensions was examined in 243 men (age range 20-95 years) who had been followed up for an average of 12.3 years. From 1,124 of these films, measurements of cardiac diameter (CD) and thoracic diameter (TD) were made, and the cardiothoracic ratio (CTR) was calculated. Cross-sectional age differences were associated with a tendency toward increases in the CD and CTR throughout the lifespans of the 243 men, regardless of the presence or absence of heart disease. The thoracic diameter (TD) was greater in middle-aged than in young subjects, but less in the oldest than in the middle-aged subjects. Cumulative percentage curves for the CTR showed a shift to higher fiftieth to ninetieth percentile values with age. However, among the subjects free of heart disease, only one (age 95) had a CTR exceeding 50 per cent. Longitudinal analysis data agreed with the cross-sectional data. Forty-nine deceased subjects were matched with living subjects of the same heart disease classifications. Increases in the CD and CTR were predictive of death in the group with heart disease but not in the group without identifiable heart disease. An increase in CD was not correlated with an increase in systolic blood pressure. The decline in TD appeared to reflect a decline in rib-cage mobility with aging.

Adult↗
PubMed2006

Influence of sarcopenia on the development of physical disability: the Cardiovascular Health Study.

OBJECTIVES: To examine the temporal relationship between sarcopenia and disability in elderly men and women. DESIGN: Cardiovascular Health Study, a longitudinal study of cardiovascular disease and its risk factors in older people. SETTING: Four U.S. communities. PARTICIPANTS: Five thousand thirty-six men and women aged 65 and older. MEASUREMENTS: Whole-body skeletal muscle mass was measured at baseline, and subjects were classified as having normal muscle mass, moderate sarcopenia, or severe sarcopenia based on previously established thresholds. Disability was measured via questionnaire at baseline in up to eight annual follow-up examinations. The cross-sectional relationship between sarcopenia and prevalent disability at baseline was examined using logistic regression models. The longitudinal relation between sarcopenia and incident disability over 8 years of follow-up was examined using Cox proportional hazards models. RESULTS: At baseline, the likelihood of disability was 79% greater in those with severe sarcopenia (P<.001) but was not significantly greater in those with moderate sarcopenia (P=.38) than in those with normal muscle mass. During the 8-year follow-up, the risk of developing disability was 27% greater in those with severe sarcopenia (P=.006) but was not statistically greater in those with moderate sarcopenia (P=.23) than in those with normal muscle mass. CONCLUSION: Severe sarcopenia was a modest independent risk factor for the development of physical disability. The effect of sarcopenia on disability was considerably smaller in the longitudinal analysis than in the cross-sectional analysis.

Activities of Daily Living↗
PubMed2005

Subclinical brain magnetic resonance imaging abnormalities predict physical functional decline in high-functioning older adults.

OBJECTIVES: To determine whether severity of subclinical brain magnetic resonance imaging (MRI) abnormalities predicts incident self-reported physical impairment or rate of decline in motor performance. DESIGN: Longitudinal analysis, average follow-up time: 4.0 years. SETTING: Cardiovascular Health Study (CHS). PARTICIPANTS: CHS participants with modified Mini-Mental State Examination (3MS) score of 80 or greater, no self-reported disability, no history of stroke, and at least one assessment of mobility (n=2,450, mean age=74.4). MEASUREMENTS: Brain MRI abnormalities (ventricular enlargement, white matter hyperintensities, subcortical and basal ganglia small brain infarcts), self-reported physical impairment (difficulty walking half a mile or with one or more activities of daily living), and motor performance (gait speed, timed chair stand). RESULTS: After adjusting for demographics, cardiovascular risk factors, and diseases, risk of incident self-reported physical impairment was 35% greater for those with severe ventricular enlargement than for those with minimal ventricular enlargement, 22% greater for those with moderate white matter hyperintensities than for those with minimal white matter hyperintensities, and 26% greater for participants with at least one brain infarct than for those with no infarcts. Those with moderate to severe brain abnormalities experienced faster gait speed decline (0.02 m/s per year) than those with no MRI abnormalities (0.01 m/s per year). Further adjustment for incident stroke, incident dementia, and 3MS score did not substantially attenuate hazard ratios for incident self-reported physical impairment or coefficients for decline in gait speed. CONCLUSION: Subclinical structural brain abnormalities in high-functioning older adults can increase the risk of developing physical disabilities and declining in motor performance.

Activities of Daily Living↗
PubMed2006

Alcohol use, comorbidity, and mortality.

OBJECTIVES: To examine the combined influence of alcohol use and comorbidity on 20-year mortality in older adults (average age 66 at the time of the baseline survey). DESIGN: Longitudinal analysis of a national probability sample-based cohort study. SETTING: Data sources were the National Health and Nutrition Examination Survey I (NHANES I), 1971-1974, and the NHANES Epidemiologic Followup Survey, 1992. PARTICIPANTS: Four thousand six hundred ninety-one adults aged 60 and older who provided data on alcohol use. MEASUREMENTS: The prevalence of at-risk drinking in older adults in the United States and the 20-year all-cause mortality risk associated with it. At-risk drinking status was determined from amount of alcohol consumed and comorbidities, using a previously validated method. RESULTS: The prevalence of at-risk drinking in the United States between 1971 and 1974 in older adults was 10% (18% of men, 5% of women). The majority of at-risk drinkers were identified as such because of their use of alcohol in amounts deemed risky in the presence of relevant comorbidities (69%) (e.g., drinking 2-3 drinks per day and having gout or anxiety or taking a medication for pain). In men, at-risk drinking was associated with higher mortality rates than not-at-risk drinking (hazard ratio=1.20, 95% confidence interval=1.01-1.41); abstinence was not associated with greater mortality. In women, neither abstinence nor at-risk drinking was associated with greater mortality rates. CONCLUSION: In this first, large population-based study of older adults examining the mortality risks of alcohol use and comorbidity, at-risk drinking was associated with greater mortality rates in men. These findings suggest that a lower threshold of alcohol use should be recommended for older adults with specific comorbidities to reduce mortality risks.

Aged↗
PubMed2006

Evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large sample of older French people: Results from the personnes agées quid study.

OBJECTIVES: To describe the evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large representative sample of older community-dwelling French people. DESIGN: Prospective cohort designed in 1988/89 to study cerebral and functional aging. SETTING: Urban and rural communities in southwestern France. PARTICIPANTS: Three thousand six hundred thirty-seven adults aged 65 and older living in noninstitutional settings at baseline. MEASUREMENTS: Participants were interviewed 3, 5, 8, and 10 years after the initial data collection. Depressive symptomatology was evaluated using a French version of the Center for Epidemiological Studies Depression Scale. Longitudinal analysis of the prevalence of depressive symptomatology was performed using a logistic mixed model adjusted for antidepressant use, sex, age, education level, living conditions, psychiatric antecedents, drug consumption, and diagnosis of dementia. RESULTS: Over the 10 years of follow-up, the prevalence of depressive symptomatology decreased from 13.8% to 8.3%. This decrease was statistically significant even after adjustment (odds ratio = 0.88 per increased year, 95% confidence interval = 0.85-0.90) and was more pronounced in subjects having reported previous depression at baseline. During the same period, antidepressant use rose from 5.2% to 11.9%, mainly due to increased use of selective serotonin reuptake inhibitors. Furthermore, the proportion of subjects who had depressive symptoms and did not use antidepressants decreased from 11.8% to 6.2%. CONCLUSION: This study suggests better management of late-life depression in the last decade and illustrates the heterogeneity of depression disorder in late life.

Aged↗
PubMed2006

Fcgamma receptor polymorphisms and periodontal status: a prospective follow-up study.

AIMS: The aims of this study were to assess: (i) the distribution of Fcgamma receptor polymorphisms among patients with chronic periodontitis ("cases") and control subjects with no/minimal loss of periodontal tissue support in a Caucasian population; (ii) whether these polymorphisms can serve as severity markers for periodontitis; and (iii) whether they have any bearing on the response to periodontal therapy. METHODS: The study sample consisted of 132 cases and 73 controls of comparable age and gender. Full-mouth periodontal status was assessed. Subgingival plaque (PL) samples and blood samples were obtained and analysed with respect to 19 bacterial species and homologous serum immunoglobulin G titres. Polymorphisms in the Fcgamma receptor IIa (131R/H) and IIIb (NA1/NA2) were assessed by polymerase chain reaction. Patients underwent periodontal therapy and were followed up at 4 and 30 months. RESULTS: Neither polymorphism showed a skewed distribution among cases and controls. At baseline, periodontitis patients with Fcgamma RIIa-H/H131 genotype had more PL and deeper pockets than patients in other genotype groups (p < 0.05). Both bacterial levels and antibody titres were unrelated to genotype. The longitudinal analysis failed to detect an association between genotype and response to periodontal therapy. CONCLUSIONS: The present data failed to demonstrate a clinically relevant relationship between the Fcgamma receptor IIa (131R/H) or IIIb (NA1/NA2) polymorphism and periodontal status.

Adult↗