RESUMO
BACKGROUND: The aim of our study was to retrospectively analyze FDG PET/CT data in patients with facial nerve palsy (FNP) for the presence of the monocle sign. PATIENTS AND METHODS: A total of 85 patients with unilateral FNP were included into our study, thereof 73 with peripheral FNP and 12 with central FNP. FDG uptake (SUVmax, SUVmean, total lesion glycolysis) was measured in both orbicularis oculi muscles (OOMs). FDG uptake of paretic and nonparetic muscles was compared in patients with FNP (Wilcoxon test and Mann-Whitney U test) and was also compared with FDG uptake in 33 patients without FNP (Mann-Whitney U test). SUVmax ratios of OOM were compared. A receiver operating characteristic curve and Youden Index were used to determine the optimal cutoff SUVmax ratio for the prevalence of contralateral peripheral FNP. RESULTS: The SUVmax ratio of OOM was significantly higher in patients with peripheral FNP compared with patients with central FNP and those without FNP (1.70 ± 0.94 vs 1.16 ± 0.09 vs 1.18 ± 0.21, respectively; P < 0.001). The SUVmax ratio of OOM yielded an area under the curve (AUC) of 0.719 (95% confidence interval, 0.630-0.809), with an optimal cutoff of 1.41, yielding a specificity of 94.4% and a sensitivity of 44.1% for identifying contralateral peripheral FNP. One hundred percent specificity is achieved using a cutoff of 1.91 (sensitivity, 29.4%). CONCLUSIONS: Asymmetrically increased FDG uptake of the OOM (the "monocle sign") indicates contralateral peripheral FNP. A nearly 2-fold higher SUVmax represents a practically useful cutoff.
RESUMO
BACKGROUND: The number of young depressive patients approaching the primary health care centres in Saudi Arabia for supportive care and treatment has enormously increased, but more cases of depression are not being diagnosed properly at the primary health care level. AIM: To assess the prevalence and associated factors of depression among young adult patients attending the primary health centres in Tabuk, Kingdom of Saudi Arabia. METHODS: A cross-sectional study was done in selected primary health care centres in Tabuk city from March 2018 to June 2018. Patient Health Questionnaire- PHQ-2 and PHQ-9 and a modified questionnaire were used to collect the necessary information and data were analysed by using SPSS (Version 25.0, SPSS Inc. Chicago, IL, USA). RESULTS: The study included 384 patients aged between 20 and 40 years. Most of them (76.6%) were females. The prevalence of depression was 74%; mild among 37.8%, moderate among 20.8% whereas moderately severe to severe among 15.4% of them. Multivariate logistic regression analysis revealed that married patients were at lower risk for depression (Adjusted odds ratio "AOR" was 0.36, 95% confidence interval "CI" was 0.20-0.93), p < 0.001. Patients who reported a lack of social support were more likely to be depressed than those with social support (AOR = 2.05, 95% CI = 1.03-4.07), p = 0.041. Patients who reported disturbed marriage were at almost four-folded risk of depression compared to those without disturbed marriage (AOR = 3.50, 95% CI = 1.23-9.98), p = 0.019. Patients with financial problems were at almost double risk for developing depression compared to those without financial problems (AOR = 2.37, 95% CI = 1.16-4.85), p = 0.019. Those with stressful experience were significantly more likely to have depression compared to those without stressful experience (AOR = 4.75, 95% CI = 2.58-8.71), p < 0.001. Opposed to patients without a family history of depression, those with such history were at higher significant risk for depression (AOR = 2.75, 95% CI = 1.23-6.14), p = 0.014. Also, patients who reported sleep disorders were at nearly double folds of having depression compared to those without such disorders (AOR = 2.24, 95% CI = 1.16-4.30), p = 0.016. CONCLUSION: Depression among young adult patients (20-40 years) attending primary healthcare centres in Tabuk is very high. However, it is mostly mild to moderate in its severity. Suicidal thoughts were reported by one-tenth of the participants. Some predictors for depression among them were identified.
