Review of epidemiology of depression and implications for community nursing practice

Depression is regarded as one of the most common mental disorders, but available data point out that only less than one third of adults with depression obtain appropriate professional treatment. This is attributed (amongst other reasons) to the under-recognition of the problem by the health professionals including the general practice nurses. In order to improve recognition rates it is imperative that nurses and especially those working at community settings appreciate the importance of prompt diagnosis which, on one hand presumes an understanding and knowledge of basic aspects of the problem and on the other hand an understanding of their role. This overview presents basic epidemiological data and the potential consequences on daily functioning and other aspects of life that depression may have as to become aware and sensitive regarding to depressive clients. It also discusses the role of nurses in the community, in order to improve recognition rates.     

Hefen der Gattung Trichosporon Identifizierung,Epidemiologie und Bedeutung der dermatologischen Krankheitsbilder

Zusammenfassung Das Genus Trichosporon wurde kürzlich auf der Basis molekularer Daten reklassifiziert. 6 humanpathogene Species konnten abgegrenzt werden, die eine enge Beziehung zu umschriebenen Krankheitsbildern aufweisen. Mit Hilfe von kommerziellen Testsystemen und einfachen Schlüsselkriterien nach dem Vorschlag von Gueho et al. [15] wurden 44 aus dem Zeitraum 7/92–1/96 zun?chst als Tr. cutaneum identifizierte Isolate reklassifiziert. In die Auswertung der klinischen Daten wurden weitere 66 nicht mehr zug?ngliche Isolate sowie 27 Tr. inkin St?mme einbezogen. Trichosporon-Hefen finden sich in 4,8% aller Hefe-Isolate (3,8% Tr. cutaneum, 1% Tr. inkin). Nahezu jedes zweite Tr. cutaneum Isolat stammt dabei aus Nagelmaterial, w?hrend Tr. inkin vor allem von der Haut des Genitoanalbereichs isoliert werden kann. Die Reklassifikation erbrachte in 38 F?llen die Diagnose Tr. mucoides und je 3 mal Tr. ovoides bzw. Tr. asteroides, w?hrend Tr. asahii als besonders beachtenswerter Erreger von Systemmykosen nicht gefunden wurde. Klinisch zeigt sich eine H?ufung von Tr. mucoides bei Zehnagelmykosen, was in der Onychomykosetherapie berücksichtigt werden k?nnte. Therapeutische überlegungen bei Hautisolaten sollten zudem die steigende Inzidenz systemischer Trichosporon-Mykosen einbeziehen. Eingegangen am 19. Februar 1996 Angenommen am 26. Juni 1996     

Hypoxaemic reperfusion ameliorates the histopathological changes in the pig brain after a severe global cerebral ischaemic insult

BACKGROUND AND PURPOSE: We have recently shown that hypoxaemic reperfusion, after an ischaemic brain insult, improves neurological outcome and decreases lipid peroxidation. In the present study, we investigated the effect of hypoxaemic reperfusion on brain histopathological changes. METHODS: Sixteen pigs subjected to a 10-min global cerebral ischaemia were either hypoxaemically (PaO2 = 35 mmHg, hypoxaemic reperfusion (HR) group, n = 8) or hyperoxaemically (PaO2 > 300 mmHg, control (C) group, n = 8) reperfused. The brains were removed 24 h after reperfusion and six neuropathological abnormalities were evaluated blindly and scored semi-quantitatively (0: normal to 3: severe injury) on eight representative regions of the brain. The overall cumulative score of the abnormalities and their regional prevalence, as well as the neurological outcome, were compared between the two groups. RESULTS: The neuronal degeneration, assessed in terms of cumulative score (P = 0.002) and regional prevalence (P = 0.025 to P = 0.041), was lower in the HR group than in the C group. Spongy degeneration attained statistically significant difference only in cerebellum (P = 0.002) and inflammation only in hippocampus (P = 0.046) but the difference in the cumulative score of these abnormalities was not statistically significant. The difference of the three neurological assessments over time was statistically significant between the two groups, i.e. after resuscitation (P = 0.001), at 8 h (P = 0.006) and at 24 h (P = 0.001) after reperfusion. CONCLUSIONS: Hypoxaemic reperfusion during resuscitation from a severe global ischaemic cerebral insult is associated with statistically significantly fewer histopathological changes of the brain than in controls. This is associated with a superior neurological outcome.     

The Angiopoietin/Tie2 Axis Mediates Malignant Pleural Effusion Formation

Purpose

Angiopoietins and their receptor, Tie2, participate in angiogenesis, regulation of vascular permeability, and inflammation, all central to the pathogenesis of malignant pleural effusions (MPEs). In the present study, we aimed to examine the role of the angiopoietin/Tie2 axis in MPE pathogenesis.

Experimental Design

MPE was induced by intrapleural injection of murine adenocarcinoma cells in C57BL/6 mice. Animals were given twice-weekly intraperitoneal injections of 40 mg/kg MuTekdeltaFc or vehicle. MuTekdeltaFc is a soluble Tie2 (sTie2) receptor that binds murine angiopoietins thereby disrupting their interaction with Tie2 receptors expressed on tissues. Animals were killed on day 14.

Results

Angiopoietin/Tie2 axis blockade significantly reduced pleural fluid volume and pleural tumor foci. The mean ± SEM pleural fluid volumes were 617 ± 48 µl and 316 ± 62 µl for the control and treated groups, respectively (P = .001), whereas the mean ± SEM tumor foci were 7.3 ± 1.0 and 3.0 ± 0.52 for the control and treated groups, respectively (P = .001). In addition, tumor-associated cachexia, tumor angiogenesis, pleural vascular permeability, recruitment of inflammatory cells to the pleural cavity, and local elaboration of vascular endothelial growth factor and interleukin 6 were also downregulated, and tumor cell apoptosis was induced in animals treated with the inhibitor.

Conclusions

Our results indicate that the angiopoietin/Tie2 axis is an important component of MPE pathogenesis. Further studies are required to determine whether therapeutic interventions targeting this pathway could be beneficial for patients with MPE.