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Messaoud A, Mensi R, Mrad A, Mhalla A, Azizi I, Amemou B, Trabelsi I, Grissa MH, Salem NH, Chadly A, Douki W, Najjar MF, Gaha L. Is low total cholesterol levels associated with suicide attempt in depressive patients? Ann Gen Psychiatry 2017; 16:20. [PMID: 28428806 PMCID: PMC5392998 DOI: 10.1186/s12991-017-0144-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/05/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Patients with major depressive disorder (MDD) have a high risk of suicide. Many pathophysiological factors involved in MDD and suicide such us a low cholesterol levels have been associated with MDD and increased vulnerability to suicide. In this study, we investigate the relation between lipid parameters and suicide risk in patients with MDD. METHODS Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were determined in 160 patients meeting the DSM-IV-TR criteria for MDD (110 patients without suicidal behavior and 52 suicidal attempters) and 151 healthy controls. RESULTS A significant decrease in plasma cholesterol levels was observed in the group of suicidal depressive patients compared to those without suicidal behavior (p < 0.001). For the other lipid levels (triglycerides, HDL cholesterol, and LDL cholesterol), there were no significant differences between suicidal and non-suicidal patients. CONCLUSIONS Our study showed a significant decrease in plasma cholesterol levels in suicidal patients. This result support the hypothesis of the association of low plasma cholesterol level and suicidal behavior in patients with major depressive disorder.
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Affiliation(s)
- A Messaoud
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - R Mensi
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia.,Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - A Mrad
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - A Mhalla
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - I Azizi
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia.,Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - B Amemou
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - I Trabelsi
- Department of Emergency, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - M H Grissa
- Department of Emergency, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - N Haj Salem
- Department of Forensic Medicine, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - A Chadly
- Department of Forensic Medicine, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - W Douki
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia.,Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - M F Najjar
- Laboratory of Biochemistry-Toxicology, Monastir University Hospital, University of Monastir, Monastir, Tunisia
| | - L Gaha
- Research Laboratory 'Vulnerability to psychotic disorders LR 05 ES 10', Department of Psychiatry, Monastir University Hospital, University of Monastir, Monastir, Tunisia
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Mechri A, El Gharbi I, Mrad A, Gassab L, Gaha L. Relationship Between Symptomatic Remission and Social Functioning in Tunisian Patients with Schizophrenia: a Cross-sectional Study. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Mechri A, Ben Haouala S, Mrad A, Gassab L. 2748 – Affective temperaments among patients with familial bipolar I disorder and their unaffected first-degree relatives. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)77347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Mrad A, Mechri A, Rouissi K, Khiari G, Gaha L. Caractéristiques cliniques des patients bipolaires type I en fonction de leurs antécédents familiaux thymiques. Encephale 2007; 33:762-7. [DOI: 10.1016/j.encep.2006.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mechri A, Mrad A, Ajmi F, Zaafrane F, Khiari G, Nouira S, Gaha L. [Repeat suicide attempts: characteristics of repeaters versus first-time attempters admitted in the emergency of a Tunisian general hospital]. Encephale 2005; 31:65-71. [PMID: 15971641 DOI: 10.1016/s0013-7006(05)82373-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED Repeat suicide attempts constitute a special problem in suicidology. It seems that the excess mortality by suicide is even higher among the suicide repeaters. The objectives of this study were to estimate repeat suicide attempts frequency among a sample of suicide attempters admitted in the University Hospital Emergency of Monastir (Tunisia), to compare their features to those of first-time attempters and to determine factors associated with repeat suicide. METHOD A transversal survey involves a review of all patients committing suicide attempt and who are admitted in the emergency service during the second semester of 1999. Study variables included: demographic parameters, family and personal psychiatric history, axis I psychiatric disorder and circumstances of the present suicide attempt. Also, subjects were evaluated with the following scales: Montgomery and Asberg Depression Rating Scale (MADRS) and The Social Readjustment Rating Scale of Holms and Rahe. RESULT Among the 90 suicide attempters, 42.2% (n = 38) had made at least one previous suicide attempt. More repeaters than first-time attempters were divorced or separated: 21.1% versus 5.8% (p = 0.05). Belonging to a numerous family (n > or = 4) was more frequent in the repeaters group: 73.7% versus 46.2% (p = 0.01). The two groups did not differ as to level of education but were significantly different with regard to their professional activity: 60.5% of repeaters were unemployed versus 34.6% of first-time attempters (p = 0.01). Repeaters had more loaded family psychiatric disorders: 26.3% versus 7.7% (p = 0.03). However there were practically no differences between repeaters and first-time attempters in regard of suicide in their families. Personal previous history of repeaters was characterized by frequency of psychiatric hospitalization: 50% versus 11.5% (p = 0.00005). Sexual abuse was more frequent in repeaters group but this difference was not significant. Alcohol and drug abuse were not frequent in the two groups. Concerning the actual suicide attempt, the most frequently diagnosed disorder was adjustment disorders. However depressive and psychotic disorders were significantly more frequent in the repeaters group: 34.2% versus 13.4% (p = 0.05). Repeaters had more frequently elevated scores (> 14) in MADRS: 71.1% versus 48.1% (p = 0.01), and raised intensity of stress factors lived during the six months preceding actual suicide attempt: 68.4% versus 42.3% (p = 0.04). Nevertheless we hadn't noticed any differences between the two groups regarding the methods used or the motives. CONCLUSION Differences in the characteristics of repeaters and first-time attempters are therefore of interest when discussing future suicidal risk and should clear on preventive actions in order to face the increase of suicidal recidivism. A broad based, multidisciplinary intervention approach is recommended.
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Affiliation(s)
- A Mechri
- Service de Psychiatrie, Unité de Recherche en Santé Mentale 01/UR/08 08, Centre Hospitalo-Universitaire de Monastir, 5000 Monastir, Tunisie
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Ben Hamda K, Betbout F, Maatouk F, Gamra H, Hendiri T, Azidi M, Maoui S, Boughanmi H, Mrad A, Ben Farhat M. [Unstable angina: study of in-hospital and short-term prognosis]. Tunis Med 2001; 79:600-8. [PMID: 11892428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
UNLABELLED The aim of our study was to identify predictor factors of coronary ischemic events to stratify the risk. 367 patients, mean age 59 years (22-90), 288 men (88%), Coronary risk factors: Smoking (62%), diabetes (38%), hypertension (37%), hypercholesterolemia (18%). BRAUNWALD class III was predominant (60%). Electrocardiographic changes were present in 113 patients. Coronary angiography identified: 148 single-vessel disease, 92 double-vessel and 68 triple-vessel. In the hospital phase, 296 patients (80.5%) were stabilised. 65 had recurrent ischemia (17.5%), 6 myocardial infarction (1.5%) and 6 deaths (1.5%). After multivariate logistic regression the predictors factors of ischemic events were. Age > or = 65 years (p = 0.03), coronary artery bypass grafting (p = 0.05), left ventricular failure (p = 0.024), modified baseline electrocardiogram (p = 0.04), ST-segment depression (p = 0.05), without aspirin (p = 0.043) and heparin (p = 0.047). At 6 months, 181 patients were asymptomatic (59.1%), 101 had recurrent ischemia (33%), 14 myocardial infarction (4.6%) and 10 deaths (3.3%). After multivariate analysis, the predictor factors were: Age > or = 65 years (p = 0.026), previous unstable angina (p = 0.023), left main stenosis (p = 0.008) and without aspirin (p = 0.003). CONCLUSION Our study identified a subgroup of high risk patients who would benefit most from either low-molecular-weight heparins and Glycoprotein IIb/IIIa receptor blockers with an early revascularisation strategy.
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Affiliation(s)
- K Ben Hamda
- Service de Cardiologie, CHU F. Bourguiba Monastir, 5000 Tunisie
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Baklouti F, Maréchal J, Wilmotte R, Alloisio N, Morlé L, Ducluzeau MT, Denoroy L, Mrad A, Ben Aribia MH, Kastally R. Elliptocytogenic alpha I/36 spectrin Sfax lacks nine amino acids in helix 3 of repeat 4. Evidence for the activation of a cryptic 5'-splice site in exon 8 of spectrin alpha-gene. Blood 1992; 79:2464-70. [PMID: 1571558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Elliptocytogenic alpha I/36 spectrin Sfax is a new variant found in a Tunisian family. The alpha I/36 allele yielded a clinically manifest picture only when occurring in trans to a recently identified, low expression level polymorphism referred to as the alpha V/41 allele. Spectrin dimers were slightly increased in 4 degrees C extracts. On peptide maps, the alpha I domain split into two abnormal fragments of 36 and 33 Kd. The mutated alpha-chain represented 20% and 44% of total alpha-chain in alpha/alpha I/36 and alpha V/41/alpha I/36 heterozygotes, respectively. Peptide sequencing showed that the 36-Kd fragment started at Ala 357 and displayed a deletion extending from amino acids 363 to 371. The corresponding 27-nucleotide deletion was found in alpha-spectrin mRNA. However, exon 8 of spectrin alpha-gene failed to disclose this deletion. Instead, an A to G substitution appeared in position 3 of codon 362, leading to the occurrence of the critical GU dinucleotide within a cryptic 5'-splice site surrounding codon 362. This event would account for the splicing out of codons 363 to 371. The reading frame was preserved and even amino acid 362 (AGG, Arg) remained unaltered. As in most spectrin alpha-chain elliptocytogenic variants, the change involved a helix 3. This is the first elliptocytogenic mutation recorded in repeat alpha 4.
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Affiliation(s)
- F Baklouti
- CNRS URA 1171, Faculté de Médecine Grange-Blanche, Lyon, France
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Rouyer-Fessard P, Leroy-Viard K, Domenget C, Mrad A, Beuzard Y. Mouse beta thalassemia, a model for the membrane defects of erythrocytes in the human disease. J Biol Chem 1990; 265:20247-51. [PMID: 2243088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The present study describes the pathophysiology, at the cellular level, of the mouse beta thalassemia and shows the pertinence of this model for the human disease. The homozygous state of mouse beta thalassemia is characterized by a clinical syndrome similar to the human beta thalassemia intermedia, but it cannot be explained by the small deficiency in beta chain synthesis. The small pool of unpaired and soluble alpha chains present in mouse reticulocytes contrasts with the large amount of insoluble alpha chains in erythrocytes which is induced by the high instability of mouse alpha chains and the absence of significant proteolysis. The amount of insoluble alpha chains associated with red cell ghosts is similar in human and mouse disease of similar severity. The study of membrane protein defects showed a decreased amount of spectrin (alpha and beta chains) and dramatic changes in the distribution of the most reactive thiol groups of membrane proteins. These results were similar to that previously described in the human disease (Rouyer-Fessard, P., Garel, M. C., Domenget, C., Guetarni, D., Bachir, D., Colonna, P., and Beuzard, Y. (1989) J. Biol. Chem. 264, 19092-19098). Abnormal density distribution curves of erythrocytes and oxidant-induced lysis of red blood cells used as functional tests were similar in the human and mouse beta thalessemia. We conclude from the present study that 1) mouse beta thalassemia is an excellent model for the membrane defects occurring in the human disease; 2) disease expression is not the reflection of the globin chain unbalance only nor of the soluble pool of alpha hemoglobin chain but mainly is a reflection of insoluble alpha chains; and 3) the rate of proteolysis and instability of alpha chains are important factors which must be taken into consideration in the pathophysiology and the clinical heterogeneity of the disease.
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Affiliation(s)
- P Rouyer-Fessard
- Institut National de la Santé et de la Recherche Médicale U. 91, Hôpital Henri Mondor, Créteil, France
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Lacombe C, Promé D, Blouquit Y, Bardakdjian J, Arous N, Mrad A, Promé JC, Rosa J. New results of hemoglobin variant structure determinations by fast atom bombardment mass spectrometry. Hemoglobin 1990; 14:529-48. [PMID: 2079433 DOI: 10.3109/03630269009005806] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Fast atom bombardment mass spectrometry has already been used for the identification of mutations in abnormal human hemoglobin chains. This paper presents new results obtained with this technique. The methodology used here is compared with more conventional biochemical techniques and automated microsequencing. In every case, a well-chosen combination of peptide-high performance liquid chromatography, mass spectrometry, amino acid analysis, and sequence analysis led rapidly to the identification of the mutant. The high sensitivity of these techniques holds great promise for the analysis of molecular abnormalities in various genetic disorders presently detectable only by the application of a molecular biological approach.
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Affiliation(s)
- C Lacombe
- I.N.S.E.R.M. U.91, C.N.R.S. UA 607, C.H.U. Henri Mondor, Créteil, France
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Wajcman H, Mrad A, Blouquit Y, Parmentier C, Riou J, Galacteros F. Hemoglobin Villejuif [beta 123(H1) Thr----Ile]: a new variant found in coincidence with polycythemia vera. Am J Hematol 1989; 32:294-7. [PMID: 2816924 DOI: 10.1002/ajh.2830320410] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A new abnormal hemoglobin, Hb Villejuif [beta 123(H1) Thr----Ile] has been discovered during the exploration of a polycythemia in a 87-year-old patient of French origin. The isoelectric focusing of the lysate revealed the presence of a variant hemoglobin with an isoelectric point very close to that of HbA. The oxygen binding properties of the patient's red blood cells being normal, it was clear that the polycythemia was not a consequence of the presence of this hemoglobin. In fact, the red blood cell morphology and the involvement of the other blood cell lines, demonstrating excessive hemopoiesis, led to the diagnosis of polycythemia vera.
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Affiliation(s)
- H Wajcman
- INSERM U299, Hôpital de Bicêtre, France
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Mrad A, Kister J, Feo C, Poyart C, Kastally R, Blibech R, Galacteros F, Wajcman H. Hemoglobin Athens-Georgia [alpha 2 beta 2 40(C6)Arg----Lys] in association with beta 0-thalassemia in Tunisia. Am J Hematol 1989; 32:117-22. [PMID: 2757008 DOI: 10.1002/ajh.2830320208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We describe an Hb Athens-Georgia (Hb A-Ga)/beta 0-thalassemia compound heterozygosity, found in a Tunisian patient. Oxygen binding studies of red cell suspensions of this patient, containing approximately 95% Hb A-Ga, revealed an almost normal oxygen affinity. Nevertheless, dilute solutions of Hb A-Ga showed an increased overall oxygen affinity and decreased heme-heme interaction. This could be explained by a tetrameric hemoglobin with normal oxygen binding properties but with increased dissociation into monomers or dimers, as a consequence of a structural abnormality within the alpha 1 beta 2 interface. Such an interpretation would explain the increased oxygen affinity reported in previous studies performed on heterozygous Hb A/Hb A-Ga patients.
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Affiliation(s)
- A Mrad
- Laboratoire d'Hématologie, Hôpital Habib Thameur, Tunis, Tunisia
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Affiliation(s)
- A Mrad
- Laboratoire de Biochimie, Hôpital Habib Thameur, Tunis, Tunisie
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Mrad A, Blouquit Y, Lacombe C, Blibech R, Arous N, Bardakdjian J, Kastally R, Rosa J, Galacteros F. Hb Tunis [alpha 2 beta 2 124 (H2)Pro----Ser], a new beta chain variant identified by HPLC. Hemoglobin 1988; 12:23-30. [PMID: 3384695 DOI: 10.3109/03630268808996879] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
During a routine hematological investigation of a child from Tunis, a silent hemoglobin variant was discovered by isoelectric-focusing. This variant was not detectable by conventional electrophoretic methods, had normal stability, expression, and oxygen affinity, and did not produce any clinical symptoms. This new variant beta 124(H2)Pro----Ser was named Hb Tunis.
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Affiliation(s)
- A Mrad
- Hôpital Habib Thameur, Tunis, Tunisie
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