Prevalence and predictors of depression in Iranian patients with multiple sclerosis: a population-based study

Depression is a frequent symptom in multiple sclerosis (MS) which has a negative impact on quality of life and cognitive status. The purpose of this study was to determine the prevalence and associated factors of depression, and status of antidepressant use in Iranian MS patients. One-hundred and sixty patients with definite MS were included. Demographic and clinical characteristics were recorded. Fatigue and depression were evaluated using the fatigue severity scale and Beck depression inventory-II. Cognitive performance and disability were examined by mini-mental status examination and expanded disability status scale. Multiple logistic regressions were used to determine the associated factors of depression and antidepressant use. The prevalence of depression and severe depression was 59.4 and 18.1 %, respectively. However, only 21.1 % of patients were on antidepressant treatment, while the prevalence of unrecognized/untreated depression was found to be as high as 44.1 %. Multivariable analysis showed that fatigue (P < 0.0001, OR = 5.98, 95 % CI = 2.9–12.3) and older age (P = 0.027, OR = 2.24, 95 % CI = 1.09–4.6) were associated with depression in MS patient. A significant association was found between fatigue and antidepressant use (P = 0.001, OR = 6.81, 95 % CI = 2.26–20.48). Our findings demonstrate that depression is significantly associated with fatigue and older age, regardless of other factors. Moreover, despite the high prevalence of depression in MS, most patients do not receive adequate treatment.     

Contribution of electromyography to the diagnosis, treatment and prognosis of cervical disc disease: a study of 114 patients.

The aim of this study is to verify whether EMG has the same diagnostic and prognostic capacity in cervical root syndrome as it does in lumbo-sacral syndromes. Our population includes 114 patients affected by a cervico-brachialgia with EMG denervation provoked by cervical disc disease. 26 patients were submitted to a myelography confirming the discal origin of the syndrome: there were 3 cases of disc protrusion and 23 cases of cervical spondylosis. The agreement between EMG and myelographical data was significant in 20 cases (76.9%). There were no significant differences of evolution between operated and non-operated cases. EMG failed to provide prognostic criteria as it does in lumbo-sacral syndromes: it must hence be concluded that all patients presenting cervico-brachialgia and EMG signs of denervation should in any case be admitted to the hospital for exploratory examination. In this context, the particular role of EMG is to establish the degree of the muscular impairment, the number of roots involved, the duration of the syndrome and--recently--the identification of the intervertebral space to be explored by spinal CT.     

Lifetime prediction of veneered versus monolithic lithium disilicate crowns loaded on marginal ridges

Objective

To evaluate the probability of survival of monolithic and porcelain veneered lithium disilicate crowns comprised by a conventional or modified core when loaded on marginal ridges.