Depressive symptoms and risk factors among perimenopausal women

BACKGROUND: Several studies indicate that approximately 4.6of the Puerto Rican Population has been affected by depression at some time in their life. Perimenopausal women have been one of the most frequently mentioned population in scientific literature prone to develop depression. Sociodemographic factors along with medical history have been hypothesized to be associated with the development of depression. This study has the purpose to know the prevalence of depressive symptoms in a sample of women age 40 to 55 years attending a gynecological outpatient clinic in the Medical Sciences Campus of the University of Puerto Rico. We also want to identify sociodemographic risk factors that can predispose these women to develop depressive symptoms. METHOD: A cross sectional study was done during the months of June 2000 thru December 2000. Female subjects age 40 to 55 selected by availability. The Zung Self-Rating Depression Scale (1995 Spanish Version) and a questionnaire were administered to each subject. Results. The overall prevalence of depressive symptoms in this sample of 64 women was 39.1. Among the variables considered as possible associated risk factors for the development of depressive symptoms, educational level, prior visit to a mental health professional or a spiritual guide, and prior diagnosis of depression and antidepressant use were of statistical significance. DISCUSSION: A high prevalence of depressive symptoms was found in this sample. As reported in other studies, higher educational level is a protective factor against depression. Contrary of other studies, no association is found between depression and other sociodemographic and medial factors.

Time course and cellular localization of inducible nitric oxide synthases expression during cardiac allograft rejection.

BACKGROUND: We have demonstrated that inhibition of inducible nitric oxide synthase (NOS) ameliorated acute cardiac allograft rejection. This study determined the time course and cellular localization of inducible NOS expression during the histologic progression of unmodified acute rat cardiac allograft rejection. METHODS: Tissue from syngeneic (ACI to ACI) and allogeneic (Lewis to ACI) transplants were harvested on postoperative days 3 through 10 and analyzed for inducible NOS mRNA expression (ribonuclease protection assay), inducible NOS enzyme activity (conversion of L-[3H]arginine to nitric oxide and L-[3H]citrulline), and nitric oxide production (serum nitrite/nitrate levels). Inducible NOS mRNA and protein expression were localized using in situ hybridization and immunohistochemistry. RESULTS: Inducible NOS mRNA and enzyme activity were expressed in allografts during mild, moderate, and severe acute rejection (postoperative days 4 through 10), but were not detected in normals, isografts, or allografts before histologic changes of mild acute rejection (postoperative day 3). Inducible NOS expression resulted in increased serum nitrite/nitrate levels during mild and moderate rejection (postoperative days 4 through 6). Inducible NOS mRNA and protein expression localized to infiltrating mononuclear inflammatory cells in allograft tissue sections during all stages of rejection but were not detected in allograft parenchymal cells or in normals or isografts. CONCLUSIONS: Inducible NOS expression and increased nitric oxide production occurred during the early stages of acute rejection, persisted throughout the unmodified rejection process, and localized to infiltrating inflammatory cells but not allograft parenchymal cells during all stages of acute rejection.

Inhibition of inducible nitric oxide synthase prevents myocardial and systemic vascular barrier dysfunction during early cardiac allograft rejection.

NO is produced during cardiac allograft rejection by expression of inducible NO synthase (iNOS) in the rejecting heart. Recent evidence indicates that NO modulates vascular permeability under both physiological and pathophysiological conditions. The present study explored the effects of early acute cardiac allograft rejection, and specifically the effects of NO, on myocardial and systemic vascular barrier function using a quantitative double-tracer permeation method in a rat cardiac transplant model. Early allograft rejection increased albumin permeation twofold to fivefold in the allograft heart and systemic vasculature (brain, lung, sciatic nerve, diaphragm, retina, muscle, kidney, and uvea) compared with isografts and controls. There were no detectable differences in regional blood flow or hemodynamics, suggesting that increased albumin permeation resulted from increased vascular permeability. iNOS mRNA was expressed in the allograft heart and native lung and was associated with increased serum nitrite/nitrate levels. iNOS inhibition with aminoguanidine prevented or attenuated allograft heart and systemic vascular barrier dysfunction and reduced allograft serum nitrite/nitrate levels to isograft values. Aminoguanidine did not affect the mild histological changes of rejection present in allografts. These data demonstrate the novel observations that (1) endothelial barrier function is compromised in the systemic vasculature, particularly in the brain, remote from the site of allograft rejection; (2) allograft vascular barrier dysfunction is associated with increased NO production and iNOS mRNA expression in the affected tissues (eg, native lung and grafted heart); and (3) inhibition of NO production by iNOS prevents vascular barrier dysfunction in the allograft heart and systemic vasculature.