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Yekta Dowlati,1,2 Maxim Maheux,3 Jeffrey H Meyer1,2 1CAMH Research Imaging Centre and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada; 2Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; 3TransBioTech, Levis, QC G6v 6Z3, CanadaCorrespondence: Jeffrey H MeyerCentre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, CanadaTel +1 416-535-8501 x34007Fax +1 416-260-4188Email Jeff.meyer@camhpet.caPurpose: Greater oxidative signaling is implicated in major depressive disorder; hence, there is considerable interest in developing oral supplements with anti-oxidant properties to prevent or treat mood disorders, such as postpartum depression. L-cysteine is a precursor for glutathione, an important antioxidant in the brain. So, developing L-cysteine as a dietary supplement may be useful, provided oral supplementation substantially raises its concentration in blood plasma yet does not affect its total concentration in breast milk. This study assessed the effect of oral L-cysteine on its concentration in breast milk and blood plasma of breastfeeding mothers.Participants and Methods: Twenty-four health breastfeeding women were randomly assigned to 0, 1.5, or 3 g of oral L-cysteine. Free and total cysteine in breast milk; and free cysteine in plasma were measured. While breast milk is the gold standard, measurement of infant formulas provides indices of nutritional intake considered safe. Therefore, free cysteine was also measured in six different formulas.Results: Total cysteine in breast milk was not affected by oral L-cysteine (Repeated Measures of ANOVA (rANOVA), intervention effect: p=0.75). Free cysteine levels in breast milk did rise (rANOVA, intervention effect: p=0.017), but were within the range of common infant formulas. There was no significant effect of L-cysteine supplementation on free cysteine levels in plasma (rANOVA, intervention effect: p=0.25), although a post hoc analysis found a trend towards greater plasma cysteine 30 minutes after oral supplementation (t(14)=− 1.69, p=0.11, 3g versus no-dose).Conclusion: The negligible effect of oral cysteine administration on its total concentration in breast milk was favorable, but the minimal effect on its blood plasma concentration more strongly argues against further development of oral L-cysteine in postpartum, as well as other conditions.Keywords: cysteine, breast milk, postpartum depression, antioxidant

Yekta Dowlati,1,2 Danilo R de Jesus,1,2 Peter Selby,1–3 Ian Fan,2,4 Jeffrey H Meyer1,2 1CAMH Research Imaging Centre and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; 2Department of Psychiatry, University of Toronto, Toronto, ON, Canada; 3Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; 4Mood Disorders Association of British Columbia, Vancouver, BC, Canada Background: Cigarette smoking is the leading preventable cause of death; however, quitting is difficult and early relapse is common. Dysphoric mood during early cigarette withdrawal is associated with relapse, and with the exception of bupropion and nortriptyline, few interventions have been developed to prevent this. During early cigarette withdrawal there is an elevation in the levels of monoamine oxidase-A (MAO-A), which removes monoamines excessively and induces oxidative stress and is implicated in creating sad mood. Hence, we conducted a randomized, placebo-controlled, double-blind crossover trial of a dietary supplement designed to counter the effects of elevated MAO-A levels on vulnerability to depressed mood.Methods: Twenty-one otherwise healthy cigarette smokers completed the protocol, receiving either active dietary supplement followed by washout and placebo or the same in reverse order. The dietary supplement was composed of monoamine precursors (2 g tryptophan, 10 g tyrosine) and blueberry antioxidants (blueberry juice with blueberry extract). Vulnerability to depressed mood was measured by the change in scores of depressed mood on the visual analog scale (VAS) following the sad mood induction paradigm (MIP).Results: There was a significant increase in VAS depressed mood scores after the sad MIP during supplement and placebo, but no difference between active and placebo conditions. There was also a significant increase in urge-to-smoke scores after sad MIP during supplement and placebo but no difference between active and placebo conditions. Reliability of the increase in VAS after MIP was very good.Conclusion: The dietary supplement had negligible effect on depressed mood, but sad MIP is a very reliable method that can be applied in future studies to assess other interventions for preventing dysphoric mood during early cigarette withdrawal. Keywords: cigarette withdrawal, dysphoria, dietary supplement, mood induction, monoamines

The immune responses induced against Leishmania antigens in volunteers who were vaccinated in a double-blind, randomized field efficacy trial of a preparation of autoclaved Leishmania major (ALM) mixed with a low dose of Bacille Calmette–Guerin vaccine (BCG) who developed either a cutaneous leishmaniasis (CL) lesion due to exposure to infected sandfly bite(s) or did not develop a lesion during the course of the trial were studied and compared with those of non-vaccinated controls. Blood samples were also assayed from different groups including volunteers with history of CL and volunteers with previous positive or negative leishmanin skin test (LST) without a history of CL. The vaccinated volunteers had received a single dose of either ALM mixed with a low dose of BCG or the same dose of BCG alone. The LST and in vitro proliferative response (stimulation index, SI), interferon gamma (IFN- γ) production and, in a few cases, interleukin (IL)-4 production of peripheral blood mononuclear cells to soluble Leishmania antigens were measured. The results indicated that volunteers who developed CL in the vaccine arm showed a slightly higher SI than cases who received BCG alone. Volunteers with history of CL and volunteers with positive LST demonstrated the strongest proliferation indices and IFN- γ production. The data suggest that a single dose of ALM + BCG induces a weak Th1 response in vaccinated volunteers that is far lower than that in volunteers with prior subclinical infection or volunteers with history of CL, who are presumed to be immune. [ABSTRACT FROM AUTHOR]

BACKGROUND: Toenail onychomycosis is a common disease that can have serious adverse effects on the quality of life (QOL) of patients. AIM: To evaluate the impact of itraconazole pulse therapy on the QOL of patients with toenail onychomycosis. METHODS: A total of 20 patients with disto-lateral subungual toenail onychomycosis were treated with itraconazole 200mg twice daily for 1 week every 4 weeks for 12 weeks. The patients were asked to complete a QOL questionnaire before treatment and on the last follow-up visit (week 48). A score of 0-4 was given according to the five possible responses to each question and these were summed to give the final score of the patient. The mean of the final scores of the patients before and after treatment were compared using the Wilcoxon matched-pairs test. RESULTS: At 48 weeks after commencing treatment, 14 patients (70%) responded to treatment (nine patients were cured with almost totally clear toenails and five patients improved), and 16 patients (80%) were mycologically cured (negative KOH smear and culture). The mean of the QOL scores of the patients before treatment was 18.0±7.8, which reduced to 13.1 ± 11.3 after treatment (two-tailed, p=0.009). CONCLUSION: ltraconazole pulse therapy is an effective treatment and can improve the QOL of patients with toenail onychomycosis. [ABSTRACT FROM AUTHOR]

Background: Allergic contact dermatitis is a common inflammatory skin disease, which may occur as a result of exposure to specific allergens. Genetic and allergen exposure variations are determinants of different frequency of sensitization in different countries. The objective of this study was to determine the frequency of sensitization to contact allergens in the Iranian patients with dermatitis. Materials and Methods: We analyzed our patch-test database in a referral skin clinic in Tehran, Iran, retrospectively. All patients patch-testing with a clinical diagnosis of contact dermatitis and/or atopic dermatitis over a 10-year period (1993 to 2002) were included. The 23-allergen European standard series (ESS) screening has been used for evaluation in all the patients. Results: Data were available from a total of 222 patients. Out of them, 145 patients (65.3%) showed at least one positive reaction and 34 patients (15.3%) had more than two positive reactions. The five most common allergens were: nickel sulfate 50 (22.6%), cobalt chloride chloride 32 (14.5%), fragrance mix 30 (13.6%), potassium dichromate 21 (9.5%) and neomycin sulfate 20 (9.0%). Contact allergy to nickel sulfate was significantly more common in females and in younger patients ( P < 0.05). Fragrance mix was the most common allergen in male patients, but there was no significant difference in its frequency between males and females. Conclusion: The ESS seems to be suitable for patch testing patients in Iran. Nickel sulfate was found to be the most common contact allergen in Iran, mostly affecting women and younger patients probably due to more exposure.