RESUMO
Objectives: The aims of the current study were to determine the prevalence and severity of anxiety and depression, and to explore associated factors among hospitalized patients with type 2 diabetes mellitus
Subjects and Methods: All patients with type 2 diabetes [160 patients] who were admitted to the Internal Medicine Wards of the King Abdulaziz Medical City, Riyadh, Saudi Arabia, from January to August 2015 were asked to participate, and 158 patients agreed to do so. A self-administered questionnaire consisting of 2 parts was used. The first part was on sociodemographic information, and the second part was a validated screening tool for assessing depression and anxiety. The severity of anxiety and depression was classified as normal, mild, moderate, and severe. Logistic regression was carried out to identify variables that were independently associated with anxiety and depression
Results: Using the screening tool, 85 [53.8%] and 80 [50.6%] study patients were identified as patients who suffered from depression and anxiety, respectively. The severity of distress was moderate/severe in 36 [42.4%] patients with depression and 41 [51.3%] patients with anxiety. The factors independently associated with the risk for anxiety in hospitalized patients with diabetes were physical inactivity and staying 8 days or longer in the hospital. On the other hand, factors that were independently associated with the risk for depression were older age, low income, and nephropathy
Conclusion: The majority of hospitalized patients with diabetes developed moderate/severe anxiety or depression, or both, during hospitalization. Hence, screening for anxiety and depression in high-risk hospitalized diabetic patients is recommended during hospitalization
RESUMO
Tacrolimus is a macrolide immunosuppressant used for prevention of allograft rejection in organ transplantation and metabolized in the liver and intestine by cytochrome P450 3A4 [CYP3A4] enzyme. A single nucleotide polymorphism [SNP] in the CYP3A4 promoter region has been identified. It has been shown that the presence of CYP3A4[asterisk]1B allele [variant GG] is associated with a reduced catalytic activity of CYP3A4 in vivo. The aim of this study was to determine the role of CYP3A4[asterisk]1B on tacrolimus dosing and clinical outcome in liver transplant recipients. Forty-eight liver transplant recipients were stratified according to the genotype. There were 32 wild-type [AA] patients and 5 homozygous variant [GG] and 11 [AG] heterozygous. Tacrolimus doses and trough concentrations as well as phenotypic data were collected in the first 10 days of the transplant. The tacrolimus concentration was significantly higher in the wild [AA] group as compared to homozygous variant [GG] and heterozygous [AG] patients. Homozygous variant [GG] group had significantly lower dose requirements. However, no significant difference was observed in the concentration/dose ratio between all groups. Based on our results, it may be concluded that CYP3A4[asterisk]1B of recipient is an important factor influencing pharmacokinetic of tacrolimus, as patients with CYP3A4[asterisk]1B polymorphism may require lower tacrolimus doses to maintain therapeutic levels. The dose reduction may not affect clinical outcomes after liver transplant