Objectives:Evidence suggests that childhood maltreatment may negatively affect not only the lifetime risk of depression but also clinically relevant measures of depression, such as course of illness and treatment outcome. The authors conducted the first meta-analysis to examine the relationship between childhood maltreatment and these clinically relevant measures of depression. Method:The authors conducted searches in MEDLINE, PsycINFO, and Embase for articles examining the association of childhood maltreatment with course of illness (i.e., recurrence or persistence) and with treatment outcome in depression that appeared in the literature before December 31, 2010. Recurrence was defined in terms of number of depressive episodes. Persistence was defined in terms of duration of current depressive episode. Treatment outcome was defined in terms of either a response (a 50% reduction in depression severity rating from baseline) or remission (a decrease in depression severity below a predefined clinical signifi...

Childhood Maltreatment Predicts Unfavorable Course of Illness and Treatment Outcome in Depression: A Meta-Analysis

OBJECTIVE To systematically assess the evidence for an association between sexual abuse and a lifetime diagnosis of psychiatric disorders. PATIENTS AND METHODS We performed a comprehensive search (from January 1980-December 2008, all age groups, any language, any population) of 9 databases: MEDLINE, EMBASE, CINAHL, Current Contents, PsycINFO, ACP Journal Club, CCTR, CDSR, and DARE. Controlled vocabulary supplemented with keywords was used to define the concept areas of sexual abuse and psychiatric disorders and was limited to epidemiological studies. Six independent reviewers extracted descriptive, quality, and outcome data from eligible longitudinal studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I 2 statistic was used to assess heterogeneity. RESULTS The search yielded 37 eligible studies, 17 case-control and 20 cohort, with 3,162,318 participants. There was a statistically significant association between sexual abuse and a lifetime diagnosis of anxiety disorder (OR, 3.09; 95% CI, 2.43-3.94), depression (OR, 2.66; 95% CI, 2.14-3.30), eating disorders (OR, 2.72; 95% CI, 2.04-3.63), posttraumatic stress disorder (OR, 2.34; 95% CI, 1.59-3.43), sleep disorders (OR, 16.17; 95% CI, 2.06-126.76), and suicide attempts (OR, 4.14; 95% CI, 2.98-5.76). Associations persisted regardless of the victim's sex or the age at which abuse occurred. There was no statistically significant association between sexual abuse and a diagnosis of schizophrenia or somatoform disorders. No longitudinal studies that assessed bipolar disorder or obsessive-compulsive disorder were found. Associations between sexual abuse and depression, eating disorders, and posttraumatic stress disorder were strengthened by a history of rape. CONCLUSION A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders.

Sexual Abuse and Lifetime Diagnosis of Psychiatric Disorders: Systematic Review and Meta-analysis

https://www.cell.com/neuron/pdf/S0896-6273(16)00020-9.pdf

Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect

Background
A fragmented research field exists on the prevalence of anxiety disorders Here, we present the results of a systematic review of reviews on this topic We included the highest quality studies to inform practice and policy on this issue

Method
Using PRISMA methodology, extensive electronic and manual citation searches were performed to identify relevant reviews Screening, data extraction, and quality assessment were undertaken by two reviewers Inclusion criteria consisted of systematic reviews or meta-analyses on the prevalence of anxiety disorders that fulfilled at least half of the AMSTAR quality criteria

Results
We identified a total of 48 reviews and described the prevalence of anxiety across population subgroups and settings, as reported by these studies Despite the high heterogeneity of prevalence estimates across primary studies, there was emerging and compelling evidence of substantial prevalence of anxiety disorders generally (38–25%), and particularly in women (52–87%); young adults (25–91%); people with chronic diseases (14–70%); and individuals from Euro/Anglo cultures (38–104%) versus individuals from Indo/Asian (28%), African (44%), Central/Eastern European (32%), North African/Middle Eastern (49%), and Ibero/Latin cultures (62%)

Conclusions
The prevalence of anxiety disorders is high in population subgroups across the globe Recent research has expanded its focus to Asian countries, an increasingly greater number of physical and psychiatric conditions, and traumatic events associated with anxiety Further research on illness trajectories and anxiety levels pre- and post-treatment is needed Few studies have been conducted in developing and under-developed parts of the world and have little representation in the global literature

https://onlinelibrary.wiley.com/doi/pdf/10.1002/brb3.497

A systematic review of reviews on the prevalence of anxiety disorders in adult populations

The immune response may be related to cancer chemotherapy in several ways. First, the patient with advanced cancer may have depressed immunological responsiveness prior to commencement of chemotherapy. Secondly, chemotherapy itself may markedly influence the immune response. Finally, chemotherapy and immunotherapy may be used together in the treatment of specific neoplasms. Before discussing these in detail, it is pertinent to review the immune response and the techniques by which it can be assessed.

Immunological Aspects of Cancer Chemotherapy

Context Many patients presenting for general medical care have a history of sexual abuse. The literature suggests an association between a history of sexual abuse and somatic sequelae. Objective To systematically assess the association between sexual abuse and a lifetime diagnosis of somatic disorders. Data Sources and Extraction A systematic literature search of electronic databases from January 1980 to December 2008. Pairs of reviewers extracted descriptive, quality, and outcome data from included studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled across studies by using the random-effects model. The I 2 statistic was used to assess heterogeneity. Study Selection Eligible studies were longitudinal (case-control and cohort) and reported somatic outcomes in persons with and without history of sexual abuse. Results The search identified 23 eligible studies describing 4640 subjects. There was a significant association between a history of sexual abuse and lifetime diagnosis of functional gastrointestinal disorders (OR, 2.43; 95% CI, 1.36-4.31; I 2  = 82%; 5 studies), nonspecific chronic pain (OR, 2.20; 95% CI, 1.54-3.15; 1 study), psychogenic seizures (OR, 2.96; 95% CI, 1.12-4.69, I 2  = 0%; 3 studies), and chronic pelvic pain (OR, 2.73; 95% CI, 1.73-4.30, I 2  = 40%; 10 studies). There was no statistically significant association between sexual abuse and a lifetime diagnosis of fibromyalgia (OR, 1.61; 95% CI, 0.85-3.07, I 2  = 0%; 4 studies), obesity (OR, 1.47; 95% CI, 0.88-2.46; I 2  = 71%; 2 studies), or headache (OR, 1.49; 95% CI, 0.96-2.31; 1 study). We found no studies that assessed syncope. When analysis was restricted to studies in which sexual abuse was defined as rape, significant associations were observed between rape and a lifetime diagnosis of fibromyalgia (OR, 3.35; 95% CI, 1.51-7.46), chronic pelvic pain (OR, 3.27; 95% CI, 1.02-10.53), and functional gastrointestinal disorders (OR, 4.01; 95% CI, 1.88-8.57). Conclusion Evidence suggests a history of sexual abuse is associated with lifetime diagnosis of multiple somatic disorders.

https://jamanetwork.com/journals/JAMA/articlepdf/184347/jrv90004_550_561.pdf

Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis.

Vancomycin-resistant enterococci (VRE) are becoming a major concern in medical practice. Their increased prevalence and their ability to transfer vancomycin resistance to other bacteria (including methicillin-resistant Staphylococcus aureus) have made them a subject of close scrutiny and intense investigation. Colonization is usually acquired by susceptible hosts in an environment with a high rate of patient colonization with VRE (eg, intensive care units, oncology units). Vancomycin-resistant enterococci can survive in the environment for prolonged periods (>1 week), can contaminate almost any surface, and can be passed from one patient to another by health care workers. Whether VRE colonization leads to infection depends on the health status of the patient. Whereas immunocompetent patients colonized with VRE are at low risk for infection, weakened hosts (patients with hematologic disorders, transplant recipients, or severely ill patients) have an increased likelihood of developing infection following colonization. Quinupristin-dalfopristin and linezolid are among the anti-infective agents that have recently become available to treat infection caused by VRE. Other antimicrobials are currently under development. Molecular techniques such as polymerase chain reaction and standard culture studies are being used to detect VRE colonization, infection, and outbreaks.

Vancomycin-Resistant Enterococci: Colonization, Infection, Detection, and Treatment

B lymphocytes contribute to immune surveillance, by tumor-specific Abs and Ag presentation to T lymphocytes, but are insufficiently studied in humans. In this article, we report a flow cytometric i ...

Multiplex B Cell Characterization in Blood, Lymph Nodes, and Tumors from Patients with Malignancies

Recent studies indicate that chemotherapeutic agents may increase the anti-tumoral immune response. Based on the pivotal role of dendritic cells (DCs) in host tumour-specific immune responses, we i ...

https://onlinelibrary.wiley.com/doi/pdf/10.1111/cei.12060

Ali Zirakzadeh

Papers

Sexual Abuse and Lifetime Diagnosis of Psychiatric Disorders: Systematic Review and Meta-analysis

Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis.

Vancomycin-Resistant Enterococci: Colonization, Infection, Detection, and Treatment

Multiplex B Cell Characterization in Blood, Lymph Nodes, and Tumors from Patients with Malignancies

The effects of chemotherapeutic drugs on human monocyte‐derived dendritic cell differentiation and antigen presentation