Browsing by Subject "anxiety"
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Item Astrocyte HIV-1 Tat Differentially Modulates Behavior and Brain MMP/TIMP Balance During Short and Prolonged Induction in Transgenic Mice(Frontiers Media S.A., 2020-12-15) Joshi, Chaitanya R.; Stacy, Satomi; Sumien, Nathalie; Ghorpade, Anuja; Borgmann, KathleenDespite effective antiretroviral therapy (ART), mild forms of HIV-associated neurocognitive disorders (HAND) continue to afflict approximately half of all people living with HIV (PLWH). As PLWH age, HIV-associated inflammation perturbs the balance between brain matrix metalloproteinases (MMPs) and their tissue inhibitors of metalloproteinases (TIMPs), likely contributing to neuropathogenesis. The MMP/TIMP balance is associated with cognition, learning, and memory, with TIMPs eliciting neuroprotective effects. Dysregulation of the MMP/TIMP balance was evident in the brains of PLWH where levels of TIMP-1, the inducible family member, were significantly lower than non-infected controls, and MMPs were elevated. Here, we evaluated the MMP/TIMP levels in the doxycycline (DOX)-induced glial fibrillary acidic protein promoter-driven HIV-1 transactivator of transcription (Tat) transgenic mouse model. The HIV-1 protein Tat is constitutively expressed by most infected cells, even during ART suppression of viral replication. Many studies have demonstrated indirect and direct mechanisms of short-term Tat-associated neurodegeneration, including gliosis, blood-brain barrier disruption, elevated inflammatory mediators and neurotoxicity. However, the effects of acute vs. prolonged exposure on Tat-induced dysregulation remain to be seen. This is especially relevant for TIMP-1 as expression was previously shown to be differentially regulated in human astrocytes during acute vs. chronic inflammation. In this context, acute Tat expression was induced with DOX intraperitoneal injections over 3 weeks, while DOX-containing diet was used to achieve long-term Tat expression over 6 months. First, a series of behavior tests evaluating arousal, ambulation, anxiety, and cognition was performed to examine impairments analogous to those observed in HAND. Next, gene expression of components of the MMP/TIMP axis and known HAND-relevant inflammatory mediators were assessed. Altered anxiety-like, motor and/or cognitive behaviors were observed in Tat-induced (iTat) mice. Gene expression of MMPs and TIMPs was altered depending on the duration of Tat expression, which was independent of the HIV-associated neuroinflammation typically implicated in MMP/TIMP regulation. Collectively, we infer that HIV-1 Tat-mediated dysregulation of MMP/TIMP axis and behavioral changes are dependent on duration of exposure. Further, prolonged Tat expression demonstrates a phenotype comparable to asymptomatic to mild HAND manifestation in patients.Item Psychological Mechanisms and Physiological Consequences of Panic Attack in Recreational Scuba Diving(1996-12-01) May, Kyle P.; Michael Smith; David BarkerRecreational scuba diving has become increasingly popular in recent years. With the increasing number of participant, the risk associated with the sport needs to be addressed. Some authorities suggest it should be classified as a high-risk sport while others suggest that the dangers of the activity have been down-played due to the commercialization of the diving community. Panic is an important topic in assessing the risk to recreational divers. The National Underwater Accident Center, NUADC, for the period of 1976 to 1988 indicated that 19% of diving fatalities reported involved probable panic. Furthermore, in a sample of 245 male and female divers, 54% experienced panic or near-panic behavior while diving on one or more occasion. The physiological consequences of a panic attack while diving can be deadly. Instructors, physicians and dive students should be made aware of the risk to persons prone to panic attack. Instructors need to be trained in recognizing the manifestations of frank panic during instruction and discourage these students from continuing. More subtle cases of panic disorder must be screened out by a physician while performing a medical clearance physical for a recreational diving student. The physician can make subtle inquiries and through the answers screen out potentially panic prone divers. Such questions as “How many visits to the emergency room have you made?” as opposed to “Have you ever visited the emergency room?” will elicit a more complete history versus a blanket denial of previous illness or injury. The nature of the E.R. visits will often be revealing to the astute physician. Persons with histories of asthma attacks or hyperventilation syndrome may indicate an underlying panic disorder. The students themselves need to be warned of the hazards of diving if panic prone. The idea needs to be stressed in scuba diving books and manuals much more than it is currently. For example, one of the most popular scuba diving books, The Encyclopedia of Recreational Diving, does not cover panic or the problems that can result due to panic. If this concept is made clear to students while in class, those prone to panic episodes may then self-screen themselves and discontinue a scuba class thereby avoiding injury or death. Scuba diving should be considered a high-risk sport and participants screened for such activity. Not only does a panicked diver put himself in jeopardy, he risks the lives of others in a group with the loss of cognitive abilities seen during panic. Individuals with elevated anxiety levels are more likely to experience a panic episode while diving due to the number of stressors involved in the sport. These persons should be selectively screened out and encouraged to find other avenues for recreation.Item The association of COVID-19 vaccine availability with mental health among adults in the United States(Frontiers Media S.A., 2022-08-09) Shen, Chen; Rashiwala, Lucy; Wiener, R. Constance; Findley, Patricia A.; Wang, Hao; Sambamoorthi, UshaObjective: To assess whether COVID-19 vaccine approval and availability was associated with reduction in the prevalence of depression and anxiety among adults in the United States. Methods: We adopted cross sectional and quasi-experimental design with mental health measurements before vaccine availability (June 2020, N = 68,009) and after vaccine availability (March 2021, N = 63,932) using data from Census Pulse Survey. Depression and anxiety were derived from PHQ-2 and GAD-2 questionnaires. We compared rates of depression and anxiety between June 2020 and March 2021. Unadjusted and adjusted analysis with replicate weights were conducted. Results: Depression prevalence was 25.0% in June 2020 and 24.6% in March 2021; anxiety prevalence was 31.7% in June 2020 and 30.0% in March 2021 in the sample. In adjusted analysis, there were no significant differences in likelihood of depression and anxiety between June 2020 and March 2021. Conclusion: Depression and anxiety were not significantly different between June 2020 and March 2021, which suggests that the pandemic effect continues to persist even with widespread availability of vaccines.Item The SPADE symptom cluster and physical disability in chronic low back pain patients(2019-12) Hendrix, Zachary N.; Cross, Deanna S.; Licciardone, John C.; Kearns, Cathleen; Mathew, Stephen O.Introduction: Chronic pain is a major healthcare issue. It is debilitating and often occurs simultaneously with other health issues (Murray et al., 2013; Shmagel et al., 2016). The SPADE symptom cluster (sleep disturbance, pain interference, anxiety, depression, and low energy/fatigue) is common in chronic low back pain (cLBP) patients and may interact with their disability (Alamam et al., 2019; Davis et al., 2016; Tavares et al., 2019). Methods: This cross-sectional study utilized data from the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION). The PROMIS-29 v2.0 was used to assess SPADE symptoms, and the Roland-Morris Disability Questionnaire was used to measure disability. The Spearman-Rho correlation between each SPADE symptom and disability was calculated. The correlations were then tested for significant differences and ranked in order of strongest to weakest correlation. Lastly, groups were assigned based on the number of presenting symptoms and tested for between-groups differences in mean disability. Results: Each of the five SPADE symptoms and the composite SPADE score were all positively and significantly correlated with disability. Pain Interference was most strongly correlated with disability. SPADE comorbidity was related to disability. Conclusion: SPADE symptoms greatly increase disability in chronic low back pain patients.