El diagnóstico diferencial entre la Depresión Bipolar y la Depresión Monopolar en la práctica clínica / Bipolar depression and unipolar depression: differential diagnosis in clinical practice

When assessing a patient with depression it is crucial not to miss a diagnosis of bipolar depression. In this review we suggest that it can be achieved, first, by consistently using standardised diagnostic criteria (e.g. DSM-IV-TR or ICD 10) and, second, by ascertaining the presence of some clinical features. The latter include previous episodes of mood elevation, current or past episodes of psychotic depression, onset of recurrent depressive disorder before the age of 25, a strong family history of mood disorder and suicide, lack of response or “wearing off” of response to well conducted antidepressant treatment, and an unusually fast response to antidepressants with features of elation. Although more and better research is required to establish the validity, sensitivity, specificity, and predictive value of each one of these features we suggest that from a practical point of view they would increase clinicians’ awareness of bipolar depression.

El consumo de Lycopersicum esculentum podría aumentar lipoproteínas de alta densidad (HDL) y disminuir el estrés oxidativo a corto plazo / Short-term Lycopersicum esculentum consumption may increase plasma high density lipoproteins and decrease oxidative stress

Background: Tomato has a high antioxidant capacity due to its high content of vitamin C, vitamin E and lycopene that is a powerful free radical scavenger. However, the effects of tomato on plasma lipoproteins is not well known, and there is little evidence about the relationship between tomato consumption and oxidative state changes in humans. Aim: To assess in vivo the effects of dietary supplementation with pure concentrated tomato juice on short term changes in oxidative state and plasma lipoproteins in healthy volunteers. Subjects and methods: Seventeen healthy volunteers were studied. They received a supplement of pure tomato juice during 7 days. At baseline, at the end of the supplementarion period and eight days after the end of the supplementation, a blood sample was drawn to measure total antioxidant capacity (TRAP), enzymatic antioxidants (catalase and superoxide dismutase), non-enzimatic antioxidants (lycopene and a-tocopherol) and plasma lipoproteins. Results: Lycopene level increased early and significantly in comparison with basal levels (48%; p <0.05). TRAP, catalase and superoxide dismutase did not change significantly. HDL cholesterol increased significantly in 5.6±4.3 mg/dL (p <0.002) on the second sampling period, improving the ratio cholesterol/HDL. It returned to baseline in the third period. Conclusions: Dietary supplementation of concentrated tomato juice significantly increases lycopene levels and HDL cholesterol. Non significant changes observed in TRAP, catalase and superoxide dismutase were observed during the supplementation period.