ABSTRACT
PURPOSE: Hypercortisolism is associated with a high prevalence of depression and impaired health-related quality of life (QoL). According to the available literature, studies examining the depression risk in patients with adrenal incidentalomas (AI), nonfunctioning and the ones with (possible) autonomous cortisol secretion ((P)ACS) are scarce. The aim of this observational, case-control study was to screen patients with nonfunctioning adrenal incidentalomas (NAI) and the ones with (P)ACS for depression and to assess their QoL. METHODS: The total studied group consisted of 92 subjects-26 with NAI, 34 with (P)ACS and 32 age-matched healthy controls (HC). To screen for depression, we used the Beck Depression Inventory-II (BDI-II) and to assess the QoL, we used the Short-Form 36 Health Survey (SF-36). RESULTS: Patients with (P)ACS had significantly higher BDI-II scores and substantially lower QoL than patients with NAI or HC. Midnight cortisol level was the most significant predictor of BDI-II and SF-36 score. The receiver operating characteristic curve analysis demonstrated that a midnight cortisol value of 86.95 nmol/l had a high sensitivity (82.8%) and high specificity (80%) for detection of mild depression in patients with (P)ACS. CONCLUSION: Screening for depression and QoL assessment should become an integral part of clinical evaluation in patients with (P)ACS.
Subject(s)
Adrenal Cortex Neoplasms/complications , Adrenal Gland Neoplasms/complications , Depression/complications , Depression/etiology , Hydrocortisone/metabolism , Adrenal Cortex Neoplasms/metabolism , Adrenal Gland Neoplasms/psychology , Adult , Aged , Case-Control Studies , Female , Health Status , Humans , Incidental Findings , Male , Mass Screening , Middle Aged , Prevalence , Psychiatric Status Rating Scales , Quality of Life , ROC Curve , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
The aim of this study was to investigate the dynamics of lipid peroxidation and the possible correlation between lipid peroxidation in different brain regions and behavioral manifestations in lindane-induced seizures in rats. Male Wistar rats were divided into the following groups: 1. control, saline-treated group; 2. dimethylsulfoxide (DMSO)-treated group; 3. lindane-treated group (8 mg/kg), intraperitoneally. Animals were sacrificed 0.5 or 4 h after treatment and the malondialdehyde level and superoxide dismutase (SOD) activity were determined in various brain regions spectrophotometrically. Behavioral changes were classified according to the descriptive scale (0--no response, 1--head nodding, lower jaw twitching; 2--myoclonic body jerks, bilateral forelimb clonus with full rearing; 3--progression to generalized clonic convulsions followed by tonic extension of fore- and hind limbs and tail; 4--status epilepticus). A significant rise in the malondialdehyde level was detected in the cerebral cortex, hippocampus, and thalamus of lindane-treated animals 0.5 and 4 h after administration (P < 0.05). SOD activity (total and mitochondrial) was significantly decreased in the hippocampus and the cortex of lindane-treated animals at both time points (P < 0.05). An initial fall in SOD activity was detected in the thalamus 4 h after lindane administration (P < 0.05). A positive correlation between seizure severity and the malondialdehyde level was found in the hippocampus at both time points (P < 0.01). These results suggest that lipid peroxidation may contribute to the neurotoxic effects of lindane in early acute lindane intoxication and that behavioral manifestations correlate with lipid peroxidation in the hippocampus of lindane-treated rats.
Subject(s)
Brain/metabolism , Lipid Peroxidation , Seizures/metabolism , Animals , Behavior, Animal , Cerebral Cortex , Hexachlorocyclohexane/pharmacology , Hippocampus/physiopathology , Malondialdehyde/analysis , Motor Activity , Rats , Seizures/chemically induced , Seizures/diagnosis , Severity of Illness IndexABSTRACT
In this study the authors have stressed the multidisciplinary approach regarding the etiology of psychiatric disorders. This approach provides not only the quantitative but also the qualitative increase within the essence of psychic life and psychiatric disorders pointing out the integrity of biological, psychological and social in a human being. Many somatic diseases are followed by the psychiatric and neurological symptoms. One of these diseases is the acute intermittent porphyria (AIP) that is manifested with a wide spectrum of clinical manifestations and it is called "the great imitator". The AIP attacks are characterized by abdominal pains, neurologic and psychiatric disorders. The most important is to diagnose the disease at the onset. If not, many severe complications may occur, even the lethal outcome is possible. This case report has shown the significance of the above mentioned statements.
