Influence of serum levels of thyroid-stimulating hormone and anti-thyroid peroxidase antibodies, age and gender on depression as measured by the Zung Self-Rating Depression Scale.

UNLABELLED: The AIM of the present study was to explore the level of depression in the respondents using the Zung self-rating depression scale (SDS) and find a correlation with the levels of the thyroid-stimulating hormone (TSH) and the anti-thyroid peroxidase antibodies (anti-TPO), the age and gender of the participants. PATIENTS AND METHODS: 2401 subjects aged 20-84 yrs were included, 1344 of them female aged 48.7 +/- 14.4 yrs and 1057 male, aged 46.5 +/- 14.5 yrs (p < 0.001). All participants completed the Zung SDS questionnaire and a depressive score was calculated and interpreted as follows: less than 49 points--no depression, between 50 and 59 points--mild depression, between 60 and 69 points--moderate depression and more than 69 points-- severe depression. Body height and weight were measured and serum TSH and Anti-TPO were determined. RESULTS: SDS was higher in the females (47.6 +/- 9.7 vs. 41.7 +/- 8.6, p < 0.001) and correlated with the subjects' age (Spearman's rho(female) = 0.447, p < 0.001, P(male) = 0.402, p < 0.001). Depression was more prevalent in the females (all p < 0.001) with hypothyroidism than in the euthyroid subjects (odds ratio 1.8, 95% CI 1.15-2.80, p < 0.011). The odds ratio for depression was 3.47 (2.64-4.57) for the female gender and the risk of depression increased by 6% (5 - 7) with each added year of age. The anti-TPO, BMI and waist circumference did not influence the regression models. CONCLUSION: The depressive score was higher in the females and increased with age. Hypothyroidism determined a higher risk of depression in the females.

Chronic hepatitis C virus infection: prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients.

AIM: To assess the prevalence of extrahepatic manifestations in Bulgarian patients with chronic hepatitis C virus (HCV) infection and identify the clinical and biological manifestations associated with cryoglobulinemia. METHODS: The medical records of 136 chronically infected HCV patients were reviewed to assess the prevalence of extrahepatic manifestations. Association between cryoglobulin-positivity and other manifestations were identified using chi2 and Fisher's exact test. Risk factors for the presence of extrahepatic manifestations were assessed by logistic regression analysis. RESULTS: Seventy six percent (104/136) of the patients had at least one extrahepatic manifestation. Clinical manifestations included fatigue (59.6%), kidney impairment (25.0%), type 2 diabetes (22.8%), paresthesia (19.9%), arthralgia (18.4%), palpable purpura (17.6%), lymphadenopathy (16.2%), pulmonary fibrosis (15.4%), thyroid dysfunction (14.7%), Raynaud's phenomenon (11.8%), B-cell lymphoma (8.8%), sicca syndrome (6.6%), and lichen planus (5.9%). The biological manifestations included cryoglobulin production (37.5%), thrombocytopenia (31.6%), and autoantibodies: anti-nuclear (18.4%), anti-smooth muscle (16.9%), anti-neutrophil cytoplasm (13.2%) and anti-cardiolipin (8.8%). All extrahepatic manifestations showed an association with cryoglobulin-positivity, with the exception of thyroid dysfunction, sicca syndrome, and lichen planus. Risks factors for the presence of extrahepatic manifestations (univariate analysis) were: age > or = 60 years, female gender, virus transmission by blood transfusions, longstanding infection (> or = 20 years), and extensive liver fibrosis. The most significant risks factors (multivariate analysis) were longstanding infection and extensive liver fibrosis. CONCLUSION: We observed a high prevalence of extrahepatic manifestations in patients with chronic HCV infection. Most of these manifestations were associated with impaired lymphoproliferation and cryoglobulin production. Longstanding infection and extensive liver fibrosis were significant risk factors for the presence of extrahepatic manifestations in HCV patients.

Nonrheumatic atrial fibrillation and left ventricular hypertrophy in the prognosis of reversible ischaemic neurological deficit.

Nonrheumatic atrial fibrillation (NRAF) and left ventricular hypertrophy (LVH) have long been recognised as risk factors for cerebral ischaemia and as predictors of recurrent vascular events. In the present study we aimed at determining the value of NRAF and LVH as predictors of recurrent vascular events in a cohort of patients with a first-ever episode of reversible ischemic neurological deficit (RIND). The study included 54 patients (37 men and 17 women, aged 62 +/- 9.6 yrs) who had suffered RIND; they were followed up for 30 days after the stroke in clinical conditions and for 12 months as outpatients. The patients were studied during the hospital stay by means of routine tests (electrocardiography, standard laboratory tests) and specialised studies (computer tomography, echocardiography). By the end of the one-year outpatient follow up there were 8 (14.8%) recurrent cerebrovascular events. By combining the statistically significant cerebrovascular risk factors (male sex, sudden onset of the event and moderately high systolic and diastolic blood pressure) with factors not reaching statistical significance (LVH, NRAF) we developed a statistically significant prediction model for patients with RIND.