Are symptoms of depression more common in diabetes? Results from the Heinz Nixdorf Recall study

Aims To estimate the association between depressive symptoms and Type 2 diabetes, as well as previously undetected diabetes, in a large population‐based sample in Germany and to determine associated variables. Methods We used baseline data on 4595 participants (age 45–75 years, 50.2% women) from the German Heinz Nixdorf Recall study, a population‐based, prospective cohort study which started in 2000. Diabetes mellitus was assessed by self report (physician diagnosis or medication), undiagnosed diabetes based on blood glucose levels. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES‐D) scale short form (cut‐off ≥ 15 points). We fitted multiple logistic regression models. Results The prevalence of diagnosed and previously undetected diabetes was 9.3% (95% confidence interval 8.2–11.6) and 7.6% (6.6–8.8) in men and 6.0% (5.1–7.1) and 3.2% (2.5–4.0) in women, respectively. Compared with non‐diabetic women, the prevalence of depressive symptoms was not significantly different in diabetic women (age‐adjusted odds ratio, 95% confidence interval 1.48; 0.98–2.24) and women with undiagnosed diabetes (0.67; 0.33–1.36). In men, the prevalence of depressive symptoms tended to be lower in diabetic than in non‐diabetic subjects (0.62; 0.35–1.09), but the depressive symptoms were significantly less frequent in men with undiagnosed diabetes (0.30; 0.13–0.70). The pattern remained after further adjustment. Significant associations with depressive symptoms were found for co‐morbidities and living without a partner in both women and in men, and for body mass index and activity level in women only. Conclusions After adjustment for relevant covariates, the association between depressive symptoms and Type 2 diabetes was heterogenous in our population‐based study. In subjects with undiagnosed diabetes, however, depressive symptoms were less frequent in men. Co‐morbidities and psychosocial conditions are strongly associated with depressive symptoms.     

Rhinorrhea is increased in Parkinson's disease

We have observed that rhinorrhea is increased in people with Parkinson's disease (PD) but only a single publication supports this. We performed two separate case control studies to assess the prevalence of rhinorrhea in PD in Rhode Island. One was cross‐sectional and the other in consecutive de novo patients. We further questioned subjects as to whether rhinorrhea might be associated with olfactory impairment. We found that rhinorrhea affects about half of PD patients in Rhode Island, is an early feature, being present at the time of presentation, was significantly more common than in controls and was associated with self‐perceived reduced olfaction. These observations confirm that rhinorrhea is a common problem and raise the questions as to whether some olfactory impairment found in PD could be confounded by rhinorrhea and also whether rhinorrea may be a premotor symptom. © 2007 Movement Disorder Society     

Psychosocial factors and gender as predictors of symptoms associated with sick building syndrome

Sick building syndrome (SBS) refers to a cluster of symptoms that typically worsen when employees are at work and diminish when they leave. A higher prevalence of symptoms is frequently observed among female employees. Although its aetiology is debated, evidence suggests that psychosocial factors might be at least as important as features of the working environment in predicting SBS symptoms. Utilizing a sample of 346 office‐based employees (55 per cent female) located in five buildings with no known environmental problems, this study examined job control, job satisfaction, work‐related mood and negative affectivity as predictors of self‐reported symptoms typical of SBS. The role played by gender in symptom‐reporting was also investigated. Findings revealed that employees who experienced more symptoms reported significantly less job control and job satisfaction and more work‐related depression and anxiety. A positive relationship was also observed between symptom‐reporting and negative affectivity. In contrast to previous research, no gender differences were observed in the prevalence of self‐reported symptoms, but men and women differed in the predictors of symptoms and the proportion of variance explained. The findings suggest that demographic and psychosocial factors, as well as features of the objective physical environment, should be considered in future investigations of SBS. Copyright © 2008 John Wiley & Sons, Ltd.     

Self‐worth therapy for depressive symptoms in older nursing home residents

Title. Self‐worth therapy for depressive symptoms in older nursing home residents. Aim. The aim of this study is to report the effects of self‐worth therapy on depressive symptoms of older nursing home residents. Background. Depression in older people has become a serious healthcare issue worldwide. Pharmacological and non‐pharmacological therapies have been shown to have inconsistent effects, and drug treatment can have important side‐effects. Method. A quasi‐experimental design was used. Older people were sampled by convenience from residents of a nursing home in northern Taiwan between 2005 and 2006. To be included in the study participants had to: (i) have no severe cognitive deficits; (ii) test positive for depressive status and (iii) take the same anti‐depressant medication in the previous 3 months and throughout the study. Participants in the experimental group (n = 31) received 30 minutes of one‐to‐one self‐worth therapy on 1 day a week for 4 weeks. Control group participants (n = 32) received no therapy, but were individually visited by the same research assistant, who chatted with them for 30 minutes on 1 day/week for 4 weeks. Depressive status, cognitive status and functional status were measured at baseline, immediately after the intervention and 2 months later. Data were analysed by mean, standard deviations, t‐test, chi‐squared test and univariate anova . Findings. Self‐worth therapy immediately decreased depressive symptoms relative to baseline, but not relative to control treatment. However, 2 months later, depressive symptoms were statistically significantly reduced relative to control. Conclusion. Self‐worth therapy is an easily‐administered, effective, non‐pharmacological treatment with potential for decreasing depressive symptoms in older nursing home residents.     

The Portuguese validation of the International Consultation on Incontinence Questionnaire—Vaginal Symptoms (ICIQ-VS) for Brazilian women with pelvic organ prolapse

The aim of this study is to validate the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) in Portuguese. Two hundred four women (108 symptomatic, 94 asymptomatic, and two with no data) with mean age of 55.4 years received a Portuguese version of the ICIQ-VS. Clinical data and pelvic organ prolapse quantification index (POP-Q) were obtained. Retest was performed 3 weeks later. Responsiveness was assessed after 20 weeks of postsurgical follow-up. Overall, most patients presented POP-Q > 2. ICIQ-VS demonstrated good psychometric properties (validity, reliability and responsiveness). The test-retest reliability was moderate to excellent for all questions. The construct validation distinguished differences in ICIQ-VS scores between symptomatic (ICIQ-VS5a > 0) and asymptomatic (ICIQ-VS5a = 0) women. ICIQ-VS was highly responsive to surgical treatment and discriminated between levels of change in the vaginal symptoms score, sexual matters score, quality-of-life score, and POP-Q. The Portuguese version of ICIQ-VS was successfully validated.     

Auditory Oddball fMRI in Schizophrenia: Association of Negative Symptoms with Regional Hypoactivation to Novel Distractors

Schizophrenia is associated with abnormal processing of salient stimuli, which may contribute to clinical symptoms. We used fMRI and a standard auditory three-stimulus task to examine attention processing. Target stimuli and novel distractors were presented to 17 patients and 21 healthy controls and activation was correlated with negative and positive symptoms. To targets, patients overactivated multiple regions including premotor cortex, anterior cingulate, temporal cortex, insula, and hippocampus, and also showed attenuated deactivation within occipital cortex. To distractors, patients overactivated left ventrolateral prefrontal cortex. This overactivation may reflect hypersensitivity to salient stimuli in schizophrenia. Patients also exhibited an inverse correlation between negative symptom severity and activation to novel distractors in the dorsolateral prefrontal cortex, premotor area, and ventral striatum. Novelty-induced activity within prefrontal cortex and ventral striatum may represent a useful intermediate phenotype for studies of negative symptoms.     

百路达合并维思通与单用维思通治疗精神分裂症的对照研究

目的评价银杏叶提取物（百路达）对精神分裂症的疗效。方法采用随机双盲方法，共40例精神分裂症患者分为对照组和研究组，研究组在维思通治疗下加用百路达240mg／d，对照组仅单服维思通治疗，治疗时间为8周。结果从治疗的第6周起，百路达治疗组的简明精神病量表（BPRS）和阴性症状量表（SANS）评分的降低显著大于对照组（P〈0．05），治疗中两组患者的药物副反应差异无显著性。结论百路达是一个与维思通合并应用治疗精神分裂症的有效药物，在240mg／d的剂量范围内无明显不良药物反应。     

中医辨证分期治疗视网膜静脉阻塞86例

目的:观察应用中医辨证分期治疗视网膜静脉阻塞的临床疗效.方法:对86例视网膜静脉阻塞患者初期应用生蒲黄汤加减、中期应用通窍活血汤加减、后期应用驻景丸加减治疗.结果:显效32例,有效40例,无效14例.结论:中医辨证分期治疗可以有效的治疗视网膜静脉阻塞.     

中医治疗慢性盆腔炎34例疗效分析

目的:探索中医综合治疗慢性盆腔炎的有效方法。方法:对34例慢性盆腔炎患者根据中医辨证分为湿热壅阻、寒湿凝滞、气滞血瘀、气虚血瘀四型论治;配合中药保留灌肠、中药局部外敷,10天为1个疗程,治疗3个疗程后,作疗效分析。结果:痊愈12例(35.29%),显效11例(32.35%),有效7例(20.59%)、无效4例(11.76%),总有效率为88.24%。结论:中医综合治疗慢性盆腔炎能增强血液循环,促进炎症吸收,迅速改善症状,且无毒副作用,在临床有显著疗效。     

Dependence of the Risk of Encephalopathy on the Radiotherapy Volume after Combined Surgery and Radiotherapy of Invasive Pituitary Tumours

Summary  The effectiveness of radiotherapy in reducing tumour recurrence of pituitary adenomas is well documented. On the other hand, the risk of side effects to the surrounding central nervous system normal tissue should not be underestimated. This retrospective study includes 58 patients with subtotally resected pituitary tumours. Photon from a 5,7 MV linear accelerator of a 60 cobalt unit with a source-isocenter distance of 80 cm were used throughout for treatment. The doses per fraction ranged from 45 Gy to 60 Gy. For a direct comparison of the different fractionation schedules, the biological effective total dose with 2 Gy per fraction was calculated for all the different application schemes with doses per fraction longer or smaller than 2 Gy. To do this, a fractionation sensitivity of the normal cerebral tissue by an □/□ value of 2 Gy was assumed. Encephalopathy developed in 17 cases (28 percentage) after follow-up times of more than 5 years. Pathological CT- or MRI-findings were seen in 13 cases.  Two factors were important for the genesis of radiogenic encephalopathy: 1.*Multivariate analysis revealed that the risk of encephalopathy was associated with the radiation volume. 2.*The location of the upper field border line was the strongest prognostic factor associated with the risk of encephalopathy (p<0.05).