Relationship between Edinburg Postnatal Depression Scale (EPDS) Scores in the Early Postpartum Period and Related Stress Coping Characteristics.

Despite postpartum depression being a common mental health problem, there is no screening method for it. The only risk assessment used is the Edinburgh Postnatal Depression Scale (EPDS). We investigated the relationship between Brief Scale for Coping Profile (BSCP) subscales performed during pregnancy and EPDS scores. We recruited 353 women with normal pregnancies (160 primiparas, and 193 multiparas) and performed BSCP at 26 weeks of gestation. The EPDS was first performed within one week after delivery (T1), and then after one month (T2). Spearman's correlation coefficients were calculated for the BSCP and EPDS for the whole and primi/multipara groups. Multiple regression analysis was performed with the EPDS T2 scores as the dependent variable. The EPDS scores were higher in the primipara group compared to the multipara (p < 0.001), and the EPDS T1 scores were higher than the overall T2 score (p < 0.001). In the multiple regression analysis, EPDS T1 and the "seeking help for solution" subscale were selected as significant explanatory variables when analyzed in the whole group; EPDS T1 and "active solution" for the primiparas; and EPDS T1, "changing mood", and "seeking help for solution" for the multiparas. The BSCP can be used as a screening tool for postpartum depression during pregnancy.

Hepatic Effects of Estrogen on Plasma Distribution of Small Dense Low-Density Lipoprotein and Free Radical Production in Postmenopausal Women.

AIM: Hepatic effects of estrogen therapy on low-density lipoprotein (LDL) subfraction or oxidative stress have not been previously evaluated. The purpose of the present study was to investigate whether the differential hepatic effects of estrogen affect plasma distribution of small dense LDL and free radical production in postmenopausal women. METHODS: In all, 45 postmenopausal women were given 0.625 mg/day of oral conjugated equine estrogen (CEE) (n=15), 1.0 mg/day of oral 17ß estradiol (E2) (n=15), or 50 µg/day of transdermal 17ßE2 (n=15) for 3 months. Subjects received either estrogen alone or with dydrogesterone at 5 mg/day. Plasma concentrations of sex hormone-binding globulin (SHBG), lipids, metallic ions, and derivatives of reactive oxygen metabolites (d-ROMs) were measured. RESULTS: CEE, but not oral 17ßE2, increased the plasma concentrations of triglyceride, copper (Cu), and d-ROMs and the ratio of small dense LDL/total LDL cholesterol, a marker for plasma distribution of small dense LDL. Transdermal 17ßE2 decreased d-ROMs concentrations but did not significantly change other parameters. Plasma concentrations of SHBG increased in the 3 groups. Estrogen-induced changes in triglyceride correlated positively either with changes in SHBG (R=0.52, P=0.0002) or the ratio of small dense LDL/total LDL cholesterol (R=0.65, P＜0.0001). Changes in Cu also correlated positively either with changes in SHBG (R=0.85, P＜0.0001) or d-ROMs (R=0.86, P＜0.0001). CONCLUSION: The hepatic effects of different routes or types of estrogen therapy may be associated with plasma distribution of small dense LDL and free radical production in postmenopausal women.

[A case of Ifosfamide-induced dysuria which could be avoided by changing the regimen of mesna].

A 39-year-old woman with advanced and recurrent cervical carcinoma received chemotherapy with IFM+CDDP(IFM 5, 000mg/m2 by intravenous infusion for 24 hours and CDDP 50 mg/m2 by intravenous infusion for one hour)in September of 2011. Mesna(3, 200mg/body)was administered intravenously for 30min three times a day to prevent IFM-induced hemorrhagic cystitis. She complained of residual urine from the evening of day 2 and felt pain during urination from day 3 (urinary tract pain: Grade 1 CTCAE v4.0 ). Both symptoms continued until day 6. When the infusion rate of mesna was changed to 24 hours of continuous administration, as with IFM on the second course, no symptoms which occurred during the first course were observed. The chemotherapy could be continued without compromising her QOL. The present finding suggests that IFM-induced dysuria could be avoided by changing the regimen to mesna, due to the increase in its binding potency and the metabolite of IFM, acrolein.