Adherence to Antidepressant Therapies in Patients with Depressive Disorders Attending an Outpatient Clinic in a Public Mental Health Hospital,Antioquia, Colombia in 2017

Psychiatric Quarterly - To evaluate the level of adherence to antidepressant therapies and associated factors in patients with depressive disorders. a cross-sectional analytical study was conducted...     

Minimal important differences in the Migraine-Specific Quality of Life Questionnaire (MSQ) version 2.1

To propose minimal important differences (MID) for the Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQ v2.1). To our knowledge (to date), no published MID values exist for the MSQ v2.1 in any population. Analyses were performed on data from two pivotal clinical trials of topiramate for migraine prevention ( n  = 916), as well as from the QualityMetric National Headache Survey ( n  = 1016). Analyses included both distribution- and anchor-based MID techniques as well as group- and individual-level MID values. Group-level anchor-based MID values ranged from 3.2 [Role Restrictive domain (RR)] to 7.5 [Emotional Functioning domain (EF)], setting the minimum level of appropriate MID (which can also aid with power analysis). Individual-level distribution-based MID values resulted in highly similar estimates from two large databases: median MID of 8.5 for RR, 9.2 for Role Preventive (RP) and 12.0 for EF. Finally, individual-level anchor-based MID values ranged from 5.0 (RR and RP domains) to 10.6 (EF). For group-level purposes of calculating power for future studies, an MID of 3.2, 4.6 and 7.5 for RR, RP and EF is recommended. For within-group analyses for analysing clinical trial efficacy of each patient's change with responder analyses, 5 points is necessary for RR. For RP and EF, ranges are recommended: 5.0 to 7.9 for RP and 8.0 to 10.6 for EF. These latter two domains tend to have more error in the MID, and thus a sensitivity analysis with both ends of the range should be used to confirm significant differences in responder analyses.     

Is phenytoin contraindicated in patients receiving cranial irradiation ?

Three recent publications have reported the development of erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens-Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens-Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation.     

Prostaglandin concentrations in amniotic fluid of women with intra-amniotic infection and preterm labor

This study was undertaken to examine the effects of intrauterine infection and preterm labor on the amniotic fluid concentrations of prostaglandins in women with premature rupture of the membranes. Amniotic fluid was obtained from four groups of patients with premature rupture of the membranes: group 1, patients without labor or infection; group 2, patients with labor but without infection; group 3, patients with an intra-amniotic infection but without labor; group 4, patients with both infection and labor. Prostaglandins E2 and F2a were measured by radioimmunoassays. Preterm labor, in the absence of infection, was not associated with significant increases in amniotic fluid concentrations of prostaglandins. Women with preterm labor and intra-amniotic infections had higher amniotic fluid concentrations of prostaglandins than women with preterm labor in the absence of infection or women with intra-amniotic infection in the absence of labor. These observations are compatible with the participation of prostaglandins in the mechanisms of onset of preterm labor associated with intra-amniotic infection.     

Arachidonate lipoxygenase metabolites in amniotic fluid of women with intra-amniotic infection and preterm labor

This study was undertaken to examine the effects of intrauterine infection and preterm labor on the amniotic fluid concentrations of arachidonate lipoxygenase metabolites in women with premature rupture of membranes. Amniotic fluid was obtained from four groups of women with premature rupture of membranes: group 1, women without labor or infection; group 2, women with labor but without infection; group 3, women with intra-amniotic infection but without labor; and group 4, women with both infection and labor. 12-Hydroxyeicosatetraenoic acid, 15-hydroxyeicosatetraenoic acid, and leukotriene B4 were measured by radioimmunoassays. Amniotic fluid concentrations of 12-hydroxyeicosatetraenoic acid were found not to differ significantly among the four groups. Amniotic fluid concentrations of 15-hydroxyeicosatetraenoic acid in group 4 were significantly higher than in women in groups 1 and 3 (p less than 0.05). In addition, amniotic fluid concentrations in leukotriene B4 were significantly higher in group 4 than in any of the other three groups (p less than 0.05). Leukotriene B4 concentrations were higher in groups 2 and 3 than in group 1, suggesting that the presence of both labor and infection increases the concentration of this metabolite in amniotic fluid. Infection and labor had an additive effect in the elevation of amniotic fluid concentrations of leukotriene B4. These results suggest that the amniotic fluid concentrations of arachidonate lipoxygenase metabolites are affected differently by the presence of infection and labor in women with premature rupture of membranes.