Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics

Background  

For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9). The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument for depression in diabetes patients in outpatient clinics.     

高效液相色谱法同时测定五加中剌五加苷B、苷E的含量

目的测定甘肃产五加中剌五加苷B、苷E的含量。方法高效液相色谱法,ODSKromasal柱。水乙晴(955)为流动相,检测波长222nm,柱温度25℃。结果本文可同时测定剌五加苷B、苷E的含量。剌五加苷B、苷E分别在0.064～0.320μg/ml;0.074～0.370μg/ml范围内峰面积与浓度呈线性关系,平均回收率分别为102.5%,RSD=4.2%,95.5%,RSD=4.6%。结论剌五加苷B、苷E在红毛五加中含量最高;茎皮中含量最高;剌五加苷E的含量高于苷B。     

单克隆抗体—表阿霉素免疫偶合物的制备和体外活性

用双功能试剂己二酰肼制备腙键连接的聚谷氨酸—表阿霉素,通过控制交联条件,所得产物克服了大分子自身交联的缺点,交联率较高。聚谷氨酸的载药量与分子量呈正比,平均每8～11个谷氨酸单体连接1分子表阿霉素。分子量为14300的聚谷氨酸做载体其载药量为1:11,与单抗交联所得的偶合物McAb:PGA:PAR为1:2:22。偶合物较好地保留了抗体活性,体外细胞毒性较游离药物略有下降,但表现出单抗介导的靶细胞选择性杀伤作用。本研究用腙键交联法成功地制备了药/抗比高且体外有效的免疫偶合物,为进一步制备细胞靶向的肿瘤化疗制剂奠定了基础。     

固相萃取GC-FID和GC-MS分析血浆中碱性药物

报道了用X-5固相萃取分离、毛细管GC-FID和GC-MS定性定量分析人血浆中34种碱性药物的方法。在优化的提取条件下,大部分药物的最低检测浓度在0.5～2.0μg·ml^-1之间,线性范围、定量精密度等满足临床中毒分析的要求。     

The Impact of Migraine on Health Status

Problems.-What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than of migraine itself? Methods.-A group of 846 migraineurs, selected from the general population following IHS criteria, and a control group were surveyed with the Medical Outcomes Study 36-item Short-Form Health Survey, Nottingham Health Profile, EuroQol instrument, end the COOP/WONCA charts. Questions on demographic characteristics and comorbidity were included. Results.-The health status of migraineurs appeared to be significantly impaired in comparison to the control group. Because statistical significance is distinct from relevance, effect size estimators were employed. Although the direction of the differences indicated consistently a worse health status of the migraineurs, regardless of the instrument used, the sizes of the differences were small to medium. Self-reported comorbidity, especially depression, was more prevalent in the migraine group. However, this offered only a partial explanation for the impaired health status of the migraine group. Conclusions.-Migraine has an independent moderately deteriorating effect on the daily functioning of individuals.     

Osler's maneuver, pseudohypertension, and true hypertension in the elderly

Up to half of the geriatric population has been reported to have arterial hypertension and, therefore, an augmented risk of heart attack, stroke, congestive heart failure, and sudden death. Recent studies indicate that mechanisms serving to elevate arterial pressure in the elderly diametrically differ from those in younger patients with similar elevation of arterial pressure. Elderly hypertensive patients have a low cardiac output, elevated vascular resistance, impaired tissue flow, and increased arterial stiffness. Arterial stiffness, if marked, can give rise to pseudohypertension--an entity often responsible for inappropriate diagnosis and inappropriate therapy in the geriatric population. Pseudohypertension can be suspected from a simple bedside maneuver that was hinted at by Sir William Osler almost a century ago. Arterial hypertension seems to accelerate the physiologic process of aging in the cardiovascular system and threatens, therefore, to set the biologic clock at a faster pace. Hopefully, antihypertensive agents more closely tailored to underlying mechanisms of pressure elevation will reverse hypertensive damage to target organs and thereby reset the aging process of the cardiovascular system at a slower pace.     

Intraocular inflammations. Anamnesis and clinical study

Extensive laboratory work-ups are often called for to establish the diagnosis in uveitis cases. In order to interpret the results, however, the degree of validity of the tests must be known. As the number of laboratory tests increases there is a considerable increase in the probability of false-positive results. Demographic peculiarities help in interpreting the results and findings. The information value of laboratory results can be increased by establishing a clear differential diagnosis and compiling a list of precise questions, on the basis of a meticulous clinical examination and a detailed history. The clinical examination remains the key to uveitis diagnosis. If the clinical diagnosis is obvious, contradictory laboratory results should be disregarded.     

Environmental factors as a risk for future hypertension

A review of the literature indicates that several factors have been purported to increase the risk for the development of arterial hypertension: family history, age, sex, race, nutritional factors, salt intake, obesity, various chemical agents, traffic noise, occupational stress, socioeconomic status and social stress. However, it is not known whether these are really independent risk factors for hypertension. We point out that these factors are related to each other and that they differ with regard to their impact on the pathogenesis of essential hypertension. In particular, a hyper-responsiveness of blood pressure to different stimuli, reflecting an overreactivity of the sympathetic nervous system, appears to play a central role in the pathogenesis of hypertension. Thus, the haemodynamic response to provocative stress tests may enable us to identify individuals at high risk for future hypertension.