KYNURENINE METABOLITES AND INFLAMMATION MARKERS IN DEPRESSED PATIENTS TREATED WITH FLUOXETINE OR COUNSELLING

• 1 Depression could result from changes in tryptophan availability caused by activation of the kynurenine pathway as a result of inflammation. In the present study, we examined patients newly diagnosed with depression to determine whether kynurenines and related factors change in parallel with improvements in mood.
• 2 Concentrations of 5‐hydroxytryptamine (5‐HT; serotonin), 5‐hydroxyindoleacetic acid (5‐HIAA), oxidized tryptophan metabolites, brain‐derived neurotrophic factor (BDNF) and inflammatory mediators (interleukin (IL)‐2, C‐reactive protein (CRP), neopterin) were measured in peripheral blood during an 18 week period of treatment with fluoxetine, fluoxetine plus tri‐iodothyronine (T₃) or psychiatric counselling.
• 3 The results showed significant improvements in mood, with reduced 5‐HT concentrations in patients given fluoxetine and a rise in plasma tryptophan in patients given counselling or fluoxetine and T₃. The addition of T₃ to the fluoxetine regimen appeared to slow recovery from depression, although the use of T₃ was associated with a fall in thyroxine concentrations. Changes in 5‐HT concentrations did not correlate with psychiatric scores and were seen only in drug‐treated groups, not those given counselling. There were no associated changes in absolute concentrations of kynurenines, BDNF, CRP, neopterin or IL‐2. With fluoxetine treatment, there were correlations between the concentrations of kynurenine metabolites and the psychiatric rating scores, whereas no correlations were found with BDNF or inflammatory markers.
• 4 It is concluded that depression scores are largely independent of inflammatory status, but kynurenine metabolism may be related to the degree of depression after fluoxetine treatment.

     

Transfusion-related acute lung injury (TRALI) in an obstetric patient

Transfusion-related lung injury (TRALI) is the leading cause of mortality following transfusion of blood products. Despite increasing awareness, the condition often remains unrecognised and therefore underreported. A 28-year-old with moderate preeclampsia had a post-partum haemorrhage following emergency caesarean section. Shortly after receiving three units of packed red cells she went into respiratory failure, which progressed to cardiac arrest. She was successfully resuscitated and made a slow but full recovery. Investigation through the National Blood Service confirmed the diagnosis of TRALI. TRALI is an increasingly common life-threatening complication of blood transfusion and should be included in the differential diagnosis of collapse in an obstetric patient who has recently received a blood product transfusion.     

Androgenetic alopecia and current methods of treatment

Androgenetic alopecia (AGA) is a common dermatological condition affecting both men and women. In the case of men, up to 30% over the age of 30 and more than 50% over the age of 50 are affected. AGA also affects women although clinical signs are usually milder and associated with diffuse thinning of the scalp hair. AGA invariably causes serious psychological problems especially in women. By far the most promising approaches to the treatment of baldness in men are drug therapies, such as topical minoxidil and finasteride administered systemically. Mild to moderate AGA in women can be treated with antiandrogens and/or topical minoxidil with good results in many cases.     

Pharmacokinetic and clinical comparison of two 8-methoxypsoralen brands

Summary We compared the Danish 8-MOP brand Meladinine with the Austrian brand Oxsoralen because of our discouraging result with PUVA in treating psoriasis. Nine healthy volunteers participated in the investigation. The plasma level of 8-MOP was measured by a gas chromatographic-mass spectrometric method using isotopic dilution technique. The level obtained with Oxsoralen was on the average 5.8 times higher than that with Meladinine.     

Magnetic resonance imaging visualization of a vaginal septum

Magnetic resonance imaging is considered the gold-standard imaging technique in cases of Müllerian and vaginal anomalies, however, vaginal delineation often proves difficult, owing to the fact that vaginal walls are normally collapsed and in close proximity. Instilling gel through the introitus allows for better depiction of the distal vagina.