The Glucocorticoid Antagonist RU-486 Suppresses HIV Infectivity and Replication.

The Glucocorticoid Antagonist RU-486 Suppresses HIV Infectivity and Replication.

J Neuropsychiatry Clin Neurosci. 2013 Mar 1; 25(1): 51-7
Benton TD, Lynch KG, Dubé B, Gettes DR, Tustin NB, Metzger DS, Blume J, Douglas SD, Evans DL

The effects of RU-486, a glucocorticoid antagonist, on HIV infection and replication in depressed and nondepressed women were studied using ex vivo models of HIV infection. RU-486 treatment of cells decreased HIV reverse transcriptase activity of monocyte-derived macrophages in a model of acute infectivity. RU-486 also decreased HIV viral replication in the chronically-infected T-cell line ACH-2, but not in the promonocyte cell line U1. No differences were associated with depression status. Thus, glucocorticoid antagonism may suppress HIV infectivity and replication ex vivo. Studies to determine the role of glucocorticoid antagonists in the host defense against HIV should be performed. HubMed – depression

Decision-making in diabetes mellitus type 1.

J Neuropsychiatry Clin Neurosci. 2013 Mar 1; 25(1): 40-50
Rustad JK, Musselman DL, Skyler JS, Matheson D, Delamater A, Kenyon NS, Cáceda R, Nemeroff CB

Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include “hypoglycemia unawareness” and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease. HubMed – depression

Validation of the Korean translation of obesity-related problems scale assessing the quality of life in obese Korean.

J Korean Surg Soc. 2013 Mar; 84(3): 140-53
Lee YJ, Moon KH, Choi JH, Cho MJ, Shin SH, Heo Y

The objective of this study was to translate the obesity-related problems (OP) scale for Koreans and to validate it for use in Korean populations.Translation and back-translation of the OP scale was performed and a pilot test was conducted. Following this, patients who had received treatment at the Obesity Center of Inha University Hospital were selected for participation in the field test. Cronbach’s alpha (?) was used for assessment of the internal consistency of the OP scale. Spearman’s correlation coefficients were used to assess the concurrent validity between the OP scale, the EuroQoL-5D (EQ-5D), and the Beck depression inventory (BDI) scale. One-way analysis of variance and t-test were used to assess the factors associated with the OP scale.A total of 67 individuals participated in the field study. The standardized Cronbach’s ? of the OP was 0.913. A significant negative correlation was observed between the OP scale and the EQ-5D and a positive correlation was observed between the OP scale and the BDI (the correlation coefficient with EQ-5D = -0.316, and the BDI = 0.305, P < 0.05).The results of this study prove that the Korean version of the OP has been translated and adapted correctly in order to meet the standard of its use. HubMed – depression

Depression and use of health care services in patients with advanced cancer.

Can Fam Physician. 2013 Mar; 59(3): e168-74
Lo C, Calzavara A, Kurdyak P, Barbera L, Shepherd F, Zimmermann C, Moore MJ, Rodin G

To examine whether depression in patients with advanced cancer is associated with increased rates of physician visits, especially to primary care.Retrospective, observational study linking depression survey data to provincial health administration data.Toronto, Ont.A total of 737 patients with advanced cancer attending Princess Margaret Hospital, who participated in the Will to Live Study from 2002 to 2008.Frequency of visits to primary care, oncology, surgery, and psychiatry services, before and after the depression assessment.Before the assessment, depression was associated with an almost 25% increase in the rate of primary care visits for reasons not related to mental health (rate ratio [RR] = 1.23, 95% CI 1.00 to 1.50), adjusting for medical morbidity and other factors. After assessment, depression was associated with a 2-fold increase in the rate of primary care visits for mental health-related reasons (RR = 2.35, 95% CI 1.18 to 4.66). However, depression was also associated during this time with an almost 25% reduction in the rate of oncology visits (RR = 0.78, 95% CI 0.65 to 0.94).Depression affects health care service use in patients with advanced cancer. Individuals with depression were more likely to see primary care physicians but less likely to see oncologists, compared with individuals without depression. However, the frequent association of disease-related factors with depression in patients with advanced cancer highlights the need for communication between oncologists and primary care physicians about the medical and psychosocial care of these patients. HubMed – depression

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