A Prospective Study of Maintenance Electroconvulsive Therapy in an Elderly Depressed Population

Objective: This study was conducted to discern the efficacy of maintenance electroconvulsive therapy (M-ECT) in a population of depressed elderly individuals with treatment-resistant depression. Methodology: Twenty-nine (N = 29) individuals over the age of 65 years of age and older were assigned to a control or treatment group on the basis of their decision to receive M-ECT (treatment group) or to refrain from receiving the treatment (control group). A battery of psychometric tests designed to measure severity of depression, quality of life, and cognition were administered at baseline as well as at 6-month and 1-year intervals. Results: Statistical analysis of the data indicated no significant differences in the efficacy of M-ECT between the control and treatment groups in any of the tests administered during the participation of the study. Conclusion: The results of the study suggest that there is no added benefit for patients administered M-ECT. However, study sample size and availability of alternative treatment regimens for the control group limit generalizability of these findings and warrant further investigation.

Likelihood of hospitalization for a chronic respiratory condition following pediatric infection with enterovirus and rhinovirus strains

Background:Rhino-enteroviruses,particularly enterovirus strain D68(EV-D68),have been associated with severe respiratory distress in children.The goal of this study was to compare the long-term outcomes of children with EV-D68 infection to that of children with other enterovirus/rhinovirus.Methods:Nasopharyngeal swabs from 174 children presenting with respiratory distress were tested by PCR for respiratory viruses.The primary outcome was diagnosis of a chronic respiratory condition within the followup period.Admission to intensive care,and length of stay were recorded.Odds ratios were determined using multinomial logistic regression.Results:During 5 years of follow-up,the crude odds of diagnosis with a chronic respiratory condition were significantly more likely in EV-D68 cases(OR:1.95,95%CI:1.02,3.82),but failed to remain significant after adjusting for a past history of asthma.Upon admission for a primary concern of asthma,length of stay both in hospital and intensive care were significantly longer in EV-D68 cases(OR:2.10[95%CI:1.56,2.82,p<0.001])and(OR:5.18[95%CI:1.90,6.28,p<0.001]),respectively.After adjustment for a history of asthma,EV-D68 cases had significantly longer length of stay in hospital,admitted for 1.94 days for each day that controls were admitted(95%CI:1.40,2.68).In admissions to intensive care,EV-D68 cases spent 2.74 days for each day of admission in controls(95%CI:1.62,4.97,p<0.001).Conclusions:Ours is first study to assess prognostic respiratory outcomes of patients infected with EV-D68 in childhood.Our study finds that EV-D68 cases were significantly more likely be hospitalized for longer than other enterovirus/rhinovirus controls in subsequent admissions for respiratory distress.Need for intensive care was significantly longer in EV-D68 infections.Our next steps will be validation in a larger sample size.

Catch-as-catch-can:mRNA vaccination boosts immune responses to SARS-CoV-2 variants

In a recent article published in Science,Stamatatos et al.1 show that vaccination with mRNA vaccines containing the ancestral form of the SARS-CoV-2 virus boosts cross-variant neutralizing antibodies elicited by infection with that form and to a lesser extent induces such cross-variant antibodies.

Adjuvant-attenuated symptom severity of influenza infections in vaccinated children

Background:Young children are at high risk for developing complications of influenza,as well as severe clinical presentation of disease.Vaccination provides direct protection and reduces symptom severity in breakthrough in-fections.We assessed whether adjuvanted trivalent seasonal influenza vaccine is associated with symptom severity in children who developed laboratory-confirmed influenza,as compared to children who received quadrivalent inactivated influenza.Methods:A cluster randomized controlled trial of influenza vaccines in Canadian Hutterite colonies was conducted from the 2016-2017 to the 2018-2019 influenza season.Children were vaccinated with either quadrivalent inactivated influenza vaccine(QIV),or the MF59 adjuvanted trivalent influenza vaccine(aTIV).We assessed children who developed PCR-confirmed influenza infection for symptom severity outcomes using multivariable generalized negative binomial regression.Results:Among vaccinated children,49 infections were observed across 1779 person-days.Vaccine formulation(aTIV vs QIV)was not significantly associated with composite symptom outcomes,including total number of symptoms or total duration of symptom presentation(p>0.05 for all outcomes).Receipt of aTIV vaccination was significantly associated with attenuation of fever,with an estimated 74%reduction in fever severity.In influenza A type infections,adjuvanted vaccination was significantly associated with reduced systemic symptoms(incidence rate ratios:0.16,95%confidence intervals:0.03,0.64,p=0.01).No associations were observed between vaccine formulation and symptom severity in influenza B infections.Conclusions:In vaccinated children who develop an influenza infection,vaccine formulation was associated with attenuated fever severity,leading to reduced systemic symptoms.In influenza A infections,adjuvanted vaccination was significantly associated with reduced systemic symptoms.