What are the effects of preventative interventions on major depressive disorder (MDD) in young adults? A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Depression is a prevalent disorder with a peak rate of onset in young adulthood from 18 to 25 years. To date, no review has systematically assessed the effectiveness of programs that aim to reduce depressive symptoms or diagnosis of depression in young adults. METHOD: A systematic search was performed in Cochrane, PubMed, PsycINFO and EMBASE. We performed a random-effects meta-analysis of the randomized controlled studies that compared an intervention for young adults (aged 18-25) without a diagnosis or history of depression and a control condition. Comparisons between intervention and control group outcomes were carried out at the post-intervention time point. We also compared intervention and control group outcomes at later follow-up time points where data were available. RESULTS: Twenty-six randomized controlled trials among 2865 young adults were included in the analysis. The pooled effect size of the interventions versus control at post-intervention was g = 0.37 (95% CI: 0.28-0.47, NNT = 9) and heterogeneity was moderate I2 = 36 (95% CI: 11-64). There were no significant effects in terms of the type of delivery, focus of study, type of control, or type of support within the interventions. LIMITATIONS: The authors were unable to assess the effects of interventions on the onset of depression as none of the included studies measured incidence. The risk of bias was high in most studies (81%). Only one study included a follow-up of more than a year. Demographic factors were inconsistently reported in the included articles. CONCLUSION: While it was not possible to investigate the effects of interventions on depression incidence, some evidence was found for the effectiveness of preventative interventions in reducing depressive symptoms in young adults. Future research should address limitations of the current evidence base to allow stronger conclusions to be drawn.

Risk factors for influenza-related complications in children during the 2009/10 pandemic: a UK primary care cohort study using linked routinely collected data.

Primary care clinicians have a central role in managing influenza/influenza-like illness (ILI) during influenza pandemics. This study identifies risk factors for influenza-related complications in children presenting with influenza/ILI in primary care. We conducted a cohort study using routinely collected linked data from the Clinical Practice Research Datalink on children aged 17 years and younger who presented with influenza/ILI during the 2009/10 pandemic. We calculated odds ratios (ORs) for potential risk factors in relation to influenza-related complications, complications requiring intervention, pneumonia, all-cause hospitalisation and hospitalisation due to influenza-related complications within 30 days of presentation. Analyses were adjusted for potential confounders including age, vaccination and socio-economic deprivation. Asthma was a risk factor for influenza-related complications (adjusted OR 1.48, 95% confidence interval (CI) 1.21-1.80, P < 0.001), complications requiring intervention (adjusted OR 1.44, 95% CI 1.11-1.88; P = 0.007), pneumonia (adjusted OR 1.64, 95% CI 1.07-2.51, P = 0.024) and hospitalisation due to influenza-related complications (adjusted OR 2.46, 95% CI 1.09-5.56, P = 0.031). Neurological conditions were risk factors for all-cause hospitalisation (adjusted OR 4.25, 95% CI 1.50-12.07, P = 0.007) but not influenza-related complications (adjusted OR 1.46, 95% CI 0.83-2.56, P = 0.189). Community-based early interventions to prevent influenza-related clinical deterioration should therefore be primarily targeted at children with asthma and neurological conditions.

Legal, cultural and ethical considerations on the informing of the cancer patient: a perspective from Greece.

PURPOSE: To discuss the current official legal position of the Greek Council and the official international statement on the subject, as well as the emerging cultural and moral aspects on the issue of informing the cancer patient. METHODS: Perusal of national and international legal and ethics sources, under a multidisciplinary perspective. RESULTS: According to the Council of State of Greece the violation of informing the patient by the physician constitutes urban liability and disciplinary offence. The Greek Code of Medical Ethics declares that the physician is obliged to inform his patient about his health and respect the desire of the patient who decides not to be informed. The UNESCO declaration does not seem to clarify the subject. In Greece, physicians have the tendency to tell the truth more often today than in the past, reflecting the global tendency, although the majority still discloses the truth to the next of kin. The difference in the tactics of informing in several nations reflects huge cultural, social, economic and religious differences in each society. CONCLUSION: Well informed and knowledgeable health-care and legal professionals, alongside with patients and ethical directors, should sit at the same table in order to productively discuss the most sensitive matters of the contemporary medical practice.

The hygienist and sociologist Louis-René Villermé (1782-1863): a pioneer of occupational medicine.

BACKGROUND: Louis-René Villermé's work and research have ranked him among the most important figures in the history of occupational medicine. OBJECTIVES: The aims of this article were to objectively record the influence and the impact of Villermé's life and work on the establishment of occupational medicine. METHODS: A thorough analysis of scientific and historical literature on the subject was conducted. The authors paid special attention to primary French sources. RESULTS: Louis-René Villermé was born in Paris in 10 March 1782. Taking advantage of his good fortune and financial prosperity, due to the recognition of his initial work, he progressed efficiently and with decision towards a new way of thinking. He stressed the importance of observation of the social environment, the role of investigations on lack of hygiene, the significance of statistical recording and the study of demographic statistics, and devoted himself to the labour force's health problems. He died in his homestead on 16 November 1863. CONCLUSIONS: Villermé lived an intense life full of activity, social work and travel. His support of the working classes' rights, his opposition to child labour and gender inequality, and his fight for humane conditions in prisons remain diachronic ideals. He provided a reference model for socio-medical research and contributed to the establishment of the new scientific discipline, Occupational Medicine.

Hippocratic views on Paediatric Dentistry and Ancient Greek origins of Orthodontics.

Hippocrates, the father of medicine, expressed some very interesting ideas on dentistry. His remarks on paediatric dentistry and orthodontics are quite impressive and influenced its practice in ancient Greece. Here we examine his writings in order to find the most important dental references.

Joseph-Claude-Anthelme Récamier (1774-1852): forerunner in surgical oncology.

Professor J.C.A. Récamier (1774-1852), the undisputed founder of modern gynecologic surgery, had also excelled in the field of oncology. In particular, he performed the first successful vaginal hysterectomy for cancer; he conducted extensive research on cancer metastatic process and he was the proponent of a cancer treatment method by compression.

Prenatal presentation of congenital chloride diarrhea: clinical report and review of the literature.

A case of congenital chloride diarrhea was diagnosed after delivery in a patient whose antenatal course was notable for massively dilated small and large bowel and persistent, severe hydramnios refractory to therapy. The pathophysiologic mechanism is a dysfunctional chloride-bicarbonate exchange in the brush border of the ileum. Antenatal presentation, prenatal diagnosis, and a review of the current literature are discussed.