TUESDAY, March 11 (HealthDay News) -- Researchers say they've discovered a biomarker for depression that could lead to a quick lab test to determine whether a particular antidepressant is making headway against the disease.

"This may be a very simple biochemical indicator for depression," said study co-author Mark Rasenick, director of the Interdisciplinary Neuroscience Program at the University of Illinois at Chicago. The test "wouldn't tell you which [medication] to start, but it would tell you if the one you're taking is working."

It may even be possible to use the test to determine whether rounds of psychotherapy are reaping any benefit, he said.

For now, however, such a test is a hypothetical, pending further exploration of the finding reported in the March edition of The Journal of Neuroscience.

At issue is whether the brain itself shows physical or chemical signs of depression.

The researchers looked at the interaction of neurotransmitters and a protein called Gs alpha. In brain cells, the protein acts like a kind of butler, passing messages from neurotransmitters on the outside and amplifying their messages, Rasenick explained.

When the protein is working properly, it's like a butler whose "hands are just flying, cooking and cleaning at the same time," he said. But when the brain is depressed, "it just sits there in the corner."

In this post-mortem study, the researchers looked at the protein in the brains of 18 depressed people who committed suicide and compared them to the brains of non-depressed people. They found the protein would have worked less effectively in the brain cells of the suicide victims.

The findings raise the prospect of a blood test that would measure within days whether antidepressants are effectively treating depression, Rasenick said.

Now, it can take several weeks for patients and psychiatrists to figure out if an antidepressant is working properly. According to Rasenick, only about 30 percent of depression patients will respond to a specific drug.

"Unfortunately, we have a very poor ability to predict which antidepressant might be more effective for any individual," said Dr. Gregory Simon, a psychiatrist and mental health researcher with Group Health Cooperative in Seattle. "There's a long history of research using patterns of symptoms or biological measures -- chemicals measured in blood or spinal fluid -- to predict response to a particular antidepressant. None of those hoped-for predictors have significant value."

Genetic tests may provide some clues, he said, and the new study suggests there might be another approach. "It would not eliminate trial-and-error, but it would reduce the waiting time with each trial. But it's a long way from a study like this one to a test that's useful to patients and doctors."

Rasenick is hopeful, however, and he said the proposed test could do more than gauge whether drugs are working. It could conceivably measure the effectiveness of talking to a therapist, study co-author Rasenick said, since psychiatrists think psychotherapy has a physical effect on the brain.

Rasenick said more research and money are needed. The study was funded by the U.S. Public Health Service and the American Foundation for Suicide Prevention.

"The next step is to partner with people who are doing large-scale studies on individuals with depression and begin to look at this," he said. "We can begin to get hundreds of people and see if we can confirm that we're right."

More information

Learn more about depression from the National Institute of Mental Health.

WEDNESDAY, March 12 (HealthDay News) -- A much-touted technology designed to detect when patients are regaining consciousness while under anesthesia during surgery doesn't appear to work any better than standard methods.

Bispectral index (BIS) monitoring did not lower the incidence of "anesthesia awareness" in a large sample of patients, concluded a study from Washington University researchers that is published in the March 13 issue of the New England Journal of Medicine.

"We're left with the way we've done it in the past, that is using clinical signs of movement, high blood pressure, tachycardia, that kind of thing," said Dr. Gary H. Morton, an associate professor of anesthesiology at Texas A&M Health Science Center College of Medicine and vice chairman of anesthesiology at Scott & White in Temple. "The problem with any of these techniques is they're not 100 percent."

"This study is not showing any improvement in doing a better job of maintaining a lack of consciousness than the standard methods," added Gerald Frye, the Joseph H. Shelton professor of neuropharmacology and neurotoxicology in the department of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine.

But this doesn't necessarily close the door to using the system in the future.

"I don't think that this particular study says the BIS monitors are no good," Morton said. "It basically says they're not consistently better than what we have. Even an ASA [American Society of Anesthesiologists] practice advisory says that the BIS monitor may still be helpful in high-risk patients. We need to individualize the way we use them."

"No single study provides a definitive answer," said study author Dr. Michael Avidan, division chief of cardiothoracic anesthesia and cardiothoracic intensive care at Washington University School of Medicine in St. Louis. "Our study adds some interesting information and raises some interesting questions, including why is technology adopted so enthusiastically before there is compelling scientific evidence. . . Our study certainly drives the need for larger studies."

According to an accompanying editorial, more than 21 million patients in North America receive general anesthesia each year, and as many as one or two in every 1,000 may experience some awareness during a procedure. Awareness is more common in patients who have received neuromuscular-blocking drugs, making it impossible for them to communicate their distress.

One patient, undergoing surgery to remove her right eye, heard the surgeon speak to the resident. When she realized she was awake, she tried frantically to blink her eyes and move her head, to no avail. "I was screaming at the top of my lungs, but no noise was coming out," she recalled.

The phenomenon can lead to long-term psychological consequences, even post-traumatic stress disorder.

The FDA-approved bispectral index system leads a growing market in devices promising to reduce anesthesia awareness. It is used in about 60 percent of all operating rooms in the United States yet, according to the study authors, evidence on its utility is scant.

"It works by recording information from an EEG on electrical activity in our brain," explained Avidan. "The type of electrical activity that our brain has is different when it's awake or asleep. This monitors electrical activity from the frontal area of the brain and analyzes the wave form."

For this study, 2,000 patients undergoing general (inhaled) anesthesia were randomly assigned to BIS-guided anesthesia or to conventional anesthesia. They were then assessed for anesthesia awareness at 0 to 24 hours after the procedure, 24 to 72 hours after, and 30 days after.

Two patients experienced definite anesthesia awareness in each group, an overall incidence of 0.21 percent. Five more patients (four in the BIS group and one in the control group) had possible awareness.

The device may be of benefit to patients receiving intravenous anesthesia, which is used in a minority of surgical procedures and which is considered to be a risk factor for anesthesia awareness, the authors stated.

One of the problems is that administering anesthesia is such a finely calibrated, delicate procedure that other important variables need to be taken into account.

"It's sort of like flying an airplane. There are a lot of dials to look at," Frye said. "Maintaining proper air speed is important in flying and, in anesthesia, sometimes you have to lower the depth of the anesthesia to maintain stable vital signs in the patient."

More information

For more information, visit the Anesthesia Awareness Campaign  , founded by a patient who experienced the phenomenon.

TUESDAY, March 11 (HealthDay News) -- Universal screening for a common antibiotic-resistant bacteria is no better than standard infection control at reducing the rate of hospital-acquired infections in surgical patients, new Swiss research shows.

The bacteria, methicillin-resistant Staphylococcus aureus (MRSA), is an increasing public health concern.

But there is still hope, said study author Dr. Stephan Harbarth, attending physician in infectious diseases and associate hospital epidemiologist at University of Geneva Hospitals and Medical School in Geneva, noting that there has been an "unprecedented" decline of MRSA rates in several European countries and a stable, relatively low rate in others.

"Clearly, these recent findings suggest that MRSA spread can be curbed in hospitals, provided that active control programs are implemented," he continued. "For instance, following the introduction of specific programs for limiting cross-transmission, first at regional level and subsequently at national level, MRSA infection rates decreased by almost 50 percent between 1993 and 2006 in hospitals of the Paris region, and by 20 percent since 2001 in more than 50 hospitals across France."

Still, Harbarth cautioned, "this needs strong public health action, something not to be expected under the current federal administration of the U.S."

The findings are in the March 12 issue of the Journal of the American Medical Association.

Hospital-acquired and community-acquired MRSA infections have become a major public health challenge. The bacterium can lead to skin and blood infections and pneumonia.

According to a related editorial in the same issue of the journal, one-quarter of U.S. hospitals reported at least one MRSA outbreak in the prior year. And an estimated 18,000 or more deaths could be attributable to invasive MRSA infections in the United States in 2005. More than 4 million individuals in the United States may be carriers of the pathogen, and as many as 1.2 million U.S. hospital patients may be infected each year with MRSA.

Although medical experts and policymakers have called for universal screening at hospitals, no trial has looked into the matter.

This study, conducted between July 2004 and May 2006, involved 21,754 surgical patients at a Swiss teaching hospital. Researchers compared two control strategies for MRSA: rapid screening upon hospital admission plus standard infection control measures versus standard infection control measures only.

Patients on 12 surgical wards with different specialties were assigned to one group for nine months then switched to the other for another nine months.

The rate of surgical-site infections and hospital-acquired infections did not differ drastically between the two groups. The authors estimated that 30 patients would have to be screened at admission to detect one previously unidentified MRSA carrier.

One future option might be to target screening to surgical patients undergoing elective procedures with a higher risk of MRSA infection, the authors stated.

The study raises another important issue about the distinction between community-acquired and hospital-acquired infection, and whether universal screening might be more effective in the future.

"If you do screening on admission in the future, will it start to make a difference to MRSA transmission in the medical setting if the distinction continues to break down?" asked Philip Alcabes, an associate professor of urban public health at Hunter College School of Health Sciences in New York City. "That remains a question worth asking."

And existing procedures are nothing to scoff at in terms of effectiveness. "Standard infection control procedures do seem to work," said Alcabes. "It's a good idea, and that, in some ways, may be the most fundamental message. Don't forget routine infection control."

More information

The U.S. Centers for Disease Control and Prevention has more on MRSA.

SATURDAY, March 8 (HealthDay News) -- Persistent criticism, belittling comments, bullying and other forms of workplace aggression may inflict more harm on employees than sexual harassment, according to a Canadian study.

"As sexual harassment becomes less acceptable in society, organizations may be more attuned to helping victims, who may therefore find it easier to cope. In contrast, non-violent forms of workplace aggression such as incivility and bullying are not illegal, leaving victims to fend for themselves," lead author M. Sandy Hershcovis, of the University of Manitoba, said in a prepared statement.

In their work, the researchers reviewed 110 studies conducted over 21 years. They found that both workplace aggression and sexual harassment create negative work environments and unhealthy consequences for workers, but aggression has more severe consequences.

Workers faced with bullying, incivility or interpersonal conflict were more likely to quit their jobs, have a lower level of well-being, be less satisfied with their jobs, and have less satisfying relationships with their bosses than workers who were sexually harassed, the researchers concluded.

In addition, bullied employees reported more job stress, less job commitment and higher levels of anger and anxiety.

"Bullying is often more subtle and may include behaviors that do not appear obvious to others," Hershcovis said. "For instance, how does an employee report to their boss that they have been excluded from lunch? Or that they are being ignored by a co-worker? The insidious nature of these behaviors makes them difficult to deal with and sanction."

The study was to be presented Saturday in Washington, D.C., at the International Conference on Work, Stress and Health, co-sponsored by the American Psychological Association, the U.S. National Institute of Occupational Safety and Health, and the Society for Occupational Health Psychology.

More information

Mental Health America has more about workplace issues  .