Mediation of the association between vascular risk factors and depressive symptoms by c-reactive protein: Longitudinal evidence from the UK Biobank

People with vascular risk factors (VRFs) are at higher risk for depressive symptoms. Given recent findings implicating low-grade systemic inflammation in both vascular and mental health, this study examined the extent to which the VRF–depressive symptom association might be mediated by low-grade systemic inflammation. To this end, we analysed longitudinal data of 9,034 participants from the UK Biobank (mean age = 56.54 years), who took part in three consecutive assessments over the course of about 8 years. Cumulative VRF burden at baseline was defined as the presence of 5 VRFs (hypertension, obesity, hypercholesterolemia, diabetes, and smoking). Low-grade systemic inflammation was assessed using serum-derived C-reactive protein (CRP) and depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). We performed mediation models using longitudinal data and a path analytic framework, while controlling for age, gender, racial-ethnic background, socioeconomic status, and baseline mood. VRFs at baseline showed a small association with higher depressive symptoms at follow-up (total effect = 0.014, 95% CI [0.007; 0.021]). CRP mediated this association (indirect effect = 0.003, 95% CI [0.001; 0.005]) and accounted for 20.10% of the total effect of VRF burden on depressive symptoms. Exploratory analyses taking a symptom-based approach revealed that mediating pathways pertained to specific depressive symptoms: tiredness and changes in appetite. These results suggest that the small association between VRF burden and depressive symptoms may be partly explained by the inflammation-promoting effects of VRFs, which might promote a specific symptom-profile of depression

Mediation of the association between vascular risk factors and depressive symptoms by c-reactive protein

BackgroundThis study examined whether C-reactive protein (CRP), a marker of low-grade systemic inflammation, mediates the association between VRF burden and depressive symptoms.MethodsWe drew on the prospective design of the UK Biobank to include participants with longitudinal data on VRF burden, CRP, and depressive symptoms. Total, direct, and indirect effects were estimated using regression-based mediation models, while controlling for confounding by sociodemographic factors, baseline CRP, and baseline depression. Sensitivity analyses probed the robustness of results to unmeasured confounding.ResultsWe analysed data from 10,470 participants from the UK Biobank (mean age = 56.75 years at baseline). Net of covariates, VRFs at baseline were associated with higher depressive symptoms at follow-up (total effect = 0.099, 95% CI [0.002; 0.163]). CRP mediated this association (indirect effect = 0.010, 95% CI [0.004; 0.017]), accounting for 10.0% (95% CI [0.3%; 30.0%]) of the total effect of VRF burden on depressive symptoms. Exploratory analyses suggested that the total and indirect effects pertained to somatic depressive symptoms (tiredness and appetite).ConclusionsThese results suggest that inflammation-promoting effects of VRFs might contribute to depressive symptoms in mid- and later life. However, the mediating pathway via CRP only explains a small part of the association between VRFs and depression after accounting for important covariates and might pertain to specific depressive symptoms. Future studies leveraging similar longitudinal designs are needed to further disentangle the time-varying effects between VRFs, inflammation, and certain depressive symptoms while addressing important confounders

Effect of the molecular structure of the polymer and nucleation on the optical properties of polypropylene homo- and copolymers.

Two soluble nucleating agents were used to modify the optical properties of nine PP homo- and random copolymers. The ethylene content of the polymers changed between 0 and 5.3 wt%. Chain regularity was characterized by the stepwise isothermal segregation technique (SIST), while optical properties by the measurement of the haze of injection molded samples. Crystallization and melting characteristics were determined by differential scanning calorimetry (DSC). The analysis of the results proved that lamella thickness and change in crystallinity influence haze only slightly. A model was introduced which describes quantitatively the dependence of nucleation efficiency and haze on the concentration of the nucleating agent. The model assumes that the same factors influence the peak temperature of crystallization and optical properties. The analysis of the results proved that the assumption is valid under the same crystallization conditions. The parameters of the model depend on the molecular architecture of the polymer. Chain regularity determines supermolecular structure and thus the dependence of optical properties on nucleation

A personalidade do alcoólatra: variáveis sócio-culturais, psicopatológicas e psicodinâmicas

Oitenta e seis alcoólatras crônicos, hospitalizados em três clínicas psiquiátricas, foram examinados mediante um questionário e o teste projetivo de Szondi. A divsão em dois grupos, alcoolistas "sociais e psicóticos, permitiu evidenciar diferenças significativas. Os pacientes psicóticos têm uma idade média inferior aos "sociais", o que indica que neles o processo mórbido se inicia mais cedo. Ademais, o teste projetivo revela que este processo é também qualitativamente diferente, na medida em que o psicótico utiliza mecanismos defensivos de negação e de auto-bloqueio com um alcance auto-destruidor. Isto impede a individualiza-ção e fixa o paciente, sem consistência interna, a um nível de regressão prege-nital, o que se manifesta exteriormente pela sua marginalização

Factors Influencing Renal Distribution of Antibiotics a Key to Therapy of Pyelonephritis

Pyelonephritis is often considered a benign disease, yet in some studies as high as 35 percent of the cases progressed to severe renal disease. Treatment failures occur because of relapse of infection, emergence of secondary infecting organisms, re-infection and the development of antibiotic resistance. In addition, inadequate renal tissue concentrations of antibiotics account for a majority of treatment failures. The factors which influence diffusion of antibiotics into renal tissues are discussed. The importance of renal medullary tissue levels of antibiotics is emphasized, as well as the influence that protein binding, non-ionic diffusion and the state of hydration have on these levels. Distribution kinetics of sulfisoxazole, ampicillin, tetracyclines, cephalosporins, nalidixic acid, nitrofurantoin, gentamicin, carbenicillin indanyl sodium, sulfamethoxazole and trimethoprim as they relate to the treatment of pyelonephritis are also presented. </jats:p