The relationship between cognition and depressive symptoms,and factors modifying this association,in Alzheimer’s disease: A multivariate multilevel model

ObjectivesTo examine whether there was a bidirectional association between cognition and depressive symptoms in Alzheimer’s disease (AD), and to explore the role of socio-demographic factors and daily performance in this association.MethodsWe conducted a longitudinal study of 104 community-dwelling patients with confirmed AD from Taiyuan, China. We assessed cognition and depressive symptoms (dependent variables) with the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale-30 (GDS-30), respectively. Socio-demographic information and daily performance were treated as explanatory variables. A multivariate multilevel model was built to investigate the interrelationship between patients’ cognition and depression, as well as the effect of related factors on both outcomes.ResultsMoCA scores were negatively correlated with GDS-30 both at the subject level (correlation coefficient r₃ = −0.68, χ² = 19.26, P < 0.001) and time point level (r₂ = −0.35, χ² = 35.68, P < 0.001) in patients with AD. Multivariate analysis showed several significant factors for cognitive function, including educational level, personality, hobbies, exercise, reading, aluminum utensil use, dietary restriction and hypertension (regression coefficients: 0.60, 0.52, 0.51, 0.48, 0.45, −0.48, 0.67, and −0.74, respectively). Significant factors for depressive symptoms included family status, employment before retirement, homemaking, reading, aluminum utensil use, dietary restriction, and hypertension (regression coefficients: 3.09, −1.33, −1.62, −1.31, 0.96, −1.15, and 1.14, respectively).ConclusionThese findings indicated that cognition was negatively associated with depression in patients with AD, and both were influenced by reading, aluminum utensil use, dietary restriction, and hypertension. Considering patient factors may help to slow the progression of dementia.     

Fabrication and design of transdermal fluconazole spray

The objective of the present study was to formulate fluconazole transdermal spray for obtaining modified drug transport using eutectic mixture, ethyl cellulose, polyethylene oxide and alcohol. The formulated products were characterized. The selection of the optimized batch was done considering the results of drug transport in the first hour, the time required for 90% drug transport, viscosity and spray angle of the formulations. The inclusion of eutectic mixture, consisting of equal parts of camphor and menthol, showed improved drug transport through rat skin. The optimized batch exhibited larger mean zone of inhibition (antifungal activity), efficient in vivo activity and short term stability.     

Compellingness: assessing the practical relevance of clinical research results

While the critical appraisal of clinical research has generally focused on aspects of study design and statistical analysis, other features of clinical studies appear to be more important to clinicians for assessing the value of a particular study in the care of particular patients. These features relate to the quality of the knowledge derived from the research, the value of the results to the care of individual patients, and the responsibility of clinicians to be stewards of limited resources. Twelve features of clinical research studies that affect how compelling individual clinicians find the results are proposed and examined here. By better understanding what makes clinical research compelling enough to alter or reinforce clinical practice, clinical researchers can design future studies to better serve the needs of clinicians and patients.     

老年2型糖尿病患者用药特点分析

目的了解北京朝阳医院西院老年2型糖尿病患者用药现状。方法调取2019年第二季度我院门诊全部处方,对老年2型糖尿病患者的降糖方案、合并症及多重用药情况进行分类统计,分析老年糖尿病患者的用药特点。结果在降糖方案方面,840例患者中,单药、二联、三联及以上治疗的患者占比分别为43.45%,31.55%和25.00%;在合并症及多重用药方面,合并有≥3种以上慢性疾病的患者占比为65.50%,同时服用≥5种药的患者占比为58.81%。结论我院老年2型糖尿病患者的降糖方案与指南相符,慢性疾病合并症方面也符合老年糖尿病患者的流行病学特征,药物治疗过程中潜在的低血糖风险及对骨折风险的评估是药师需要关注的,同时,制定标准化的多重用药评估流程及干预方案,是开展慢性疾病药学管理门诊的重要方向。     

Experiences of returning to work after acquired brain injury

The purpose of this qualitative study was to explore experiences of returning to work after rehabilitation, from the viewpoint of people with acquired brain injury. A purposive sampling of eight informants was made, and data were collected through personal interviews with open questions. The data were then analysed through qualitative content analyses in five steps, resulting in four main categories of experiences: “A new person”, “Stimulants and fellowship”, “Understanding and support”, and “To reach insight” with appurtenant sub-categories. The overarching theme was “Returning to work after acquired brain injury is a long process”. The conclusion of this study is that returning to work after acquired brain injury requires motivated individuals, flexible work, accommodating labour management, and prolonged environmental support. This study also shows that the informants need support for a long period of time to reach a balance and to obtain a functional working role. In order to achieve this, client-centred rehabilitation, professional teamwork, and longer follow-up periods than those of today are required.