[Screening for depression in an elderly population living at home. Interest of the Mini-Geriatric Depression Scale]. / Dépistage de la dépression chez une population âgée vivant à domicile. Intérêt de la « Mini-Geriatric Depression Scale ¼

BACKGROUND: Depression is the most usual mental disorder in the elderly, but underdiagnosed and undertreated. Its prevalence is variable. Symptoms of depression present in the elderly can be masked and difficult to recognize. The purpose of this study was to examine prevalence and risk factors for depression in elderly living in their home. METHODS: A cross-sectional study of randomly selected homes in randomly selected geographical islets was carried out Monastir City (Tunisia). Questionnaire-based interviews were conducted among the elderly aged more than 65 years living in their home. Depression symptoms were assessed using a Mini-Geriatric Depression Scale. The relationship between the risk of depression and sociodemographic and health-related variables was studied using logistic regression. RESULTS: Out of 598 (female 66 %, mean (SD) age 72.3 (7.4) years) elderly persons interviewed, 136 (22.7 %) were screened to have a Mini-Geriatric Depression Scale more than or equal to 1. Multiple logistic regression analysis revealed that the following were significant (P<0.01) independent predictors of risk of depression: female sex (OR=2.36 [95 % CI=1.43-3.94]), having a low level of education (OR=4.02 [95 % CI=1.38-11.65]), disability (OR=3.50 [95 % CI=1.94-6.46]), a history of stroke (OR=2.90 [95 % CI=1.20-7.72]) and the use of hypnotic medications (OR=2.47 [95 % CI=1.38-4.42]). CONCLUSION: This study suggests that the risk of depression is a common psychiatric disorder in elderly living in their home, and underlines the usefulness of the Mini-Geriatric Depression Scale to detect the risk of depression in the elderly. This clinical approach should be encouraged in all medical practices to improve the prognosis of depression in the elderly.

Hyperhomocysteinemia and elevated ox-LDL in Tunisian type 2 diabetic patients: role of genetic and dietary factors.

INTRODUCTION: Total plasma homocysteine (tHcy) is an emerging risk factor for the development of atherosclerosis. However, its relationship with diabetes is still unclear. OBJECTIVES: We evaluated the association between tHcy levels and methylenetetrahydrofolate reductase (MTHFR) 677C-->T genotype in a type 2 diabetes mellitus (DM) population and their relationship with oxidized LDL (ox-LDL) according to dietary habits and vascular complications. DESIGN AND METHODS: Eighty-six DM patients were compared to 120 healthy volunteers. RESULTS: Associated higher tHcy levels and significantly higher ox-LDL levels (p<0.001) were found in DM patients compared to healthy subjects. Homozygosity for the T allele of MTHFR was more frequent in diabetics than in healthy subjects (12.8% vs. 7.2%) and it was associated with higher tHcy levels. Moreover, this elevated level was associated with significantly higher ox-LDL levels in DM patients with hypertension (p<0.05). Improving folate and vitamin C intakes could have beneficial effects on lowering the tHcy and ox-LDL levels. CONCLUSIONS: The interplay of genetic and dietary factors modulates the effect of homocysteine on cardiovascular risk factors.

Association between dietary fat and antioxidant status of Tunisian type 2 diabetic patients.

BACKGROUND: The antioxidant enzymes: superoxide dismutase (Cu/Zn SOD) and glutathione peroxidase (GSH-Px) provide a defense against the damage of cells by reactive oxygen species, which increased in diabetic state. It was demonstrated that dietary treatment could improve the antioxidant status in patients with type 2 diabetes mellitus. This study was undertaken to determine if erythrocyte Cu/Zn SOD and GSH-Px activities correlate with dietary nutrients in 35 selected type 2 diabetic patients (21 women and 14 men) without diabetic complications. RESULTS: We found that erythrocyte Cu/Zn SOD was diminished in patients with poor controlled diabetes and GSH-Px activity was significantly decreased in obese compared with non-obese type 2 diabetic patients (1.07+/-0.87 and 2.36+/-1.99 U/ml, respectively; P=0.024). Both erythrocyte Cu/Zn SOD and GSH-Px activities were positively correlated to erythrocyte omega3-polyunsaturated fatty acids (PUFA). In non-obese diabetic patients, only GSH-Px activity was correlated negatively to the fraction of linoleic acid (18:2omega6) and arachidonic acid (20:4omega6) in erythrocytes phospholipids. CONCLUSIONS: The data of this study reveal that activities of erythrocyte antioxidant enzymes were altered in type 2 diabetic patients. Further studies are needed to determine if diet supplemented with omega3-PUFA is required to improve antioxidant defense system in diabetic state.

In vitro activities of five new quinolones against 88 genital and neonatal Haemophilus isolates.

In vitro activities of five new quinolones against 88 strains of Haemophilus influenzae and H. parainfluenzae isolated from genitourinary or neonatal infections were studied. All strains were susceptible, and MICs were similar to those for respiratory tract isolates. However, H. influenzae biotype IV appeared to be more susceptible to norfloxacin, enoxacin, and ciprofloxacin than the other biotypes were.