Exploring the relationship between generalised anxiety/depression scales and asthma-specific quality of life/control questionnaires in a specialist asthma clinic.

INTRODUCTION: Psychological issues are common in patients with chronic disabling diseases such as asthma. National guidance recommends that specialist asthma clinic attendees should complete questionnaires screening for psychological comorbidities. However, completing these in addition to asthma specific questionnaires can be burdensome. In order to investigate whether anxiety and depression questionnaires can be used in a targeted manner, this study investigates the correlation between the respective scores. We hypothesize that there is correlation between asthma-specific and anxiety/depression questionnaire scores. METHODS: Three-hundred individuals with poorly controlled asthma attending a specialist clinic were asked to complete Asthma Control Questionnaire (ACQ), mini-Asthma Quality of Life Questionnaire (mini-AQLQ), Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaires (PHQ-9). A Pearson correlation coefficient was generated and area under ROC and confusion matrices were used to assess correlation. RESULTS: 49% and 47% of patients completing the GAD-7 or PHQ-9 questionnaires, respectively had scores above the screening level for co-morbid anxiety and depression. Additional questionnaires were often incomplete (GAD-7 = 150 and PHQ-9 = 140). GAD-7 and PHQ-9 correlated with ACQ and mini-AQLQ (all p = <0.001, r values 0.53-0.65). Asthma-specific questionnaire scores were predictive of GAD-7 and PHQ-9 scores (AUCs of 0.78 to 0.84). 75% of patients with a mini-AQLQ score of <3 met the threshold GAD-7 and PHQ-9 score of 10. CONCLUSIONS: ACQ and mini-AQLQ correlate with GAD-7 and PHQ-9 amongst specialist asthma clinic attendees. A mini-AQLQ >3 suggests patients are unlikely to have anxiety or depression. These findings could be used to identify patients requiring formal screening for psychological co-morbidity.

ADAM 33 gene V4 C/G rs2787094 polymorphism in psoriasis.

AIMS: Psoriasis is a common chronic inflammatory disease. A disintegrin and metalloproteinase 33 (ADAM33) gene is the first novel susceptibility gene for asthma. The aim of this study was to investigate the relationship of ADAM 33 gene V4 C/G rs2787094 polymorphism with the risk of psoriasis in the Turkish population. METHODS: ADAM33 gene polymorphism (V4 C/G rs2787094) was analyzed in 97 psoriasis patients and 50 healthy control subjects. This study was performed by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) analysis. RESULTS: There was no significant difference in ADAM33 genotype and allele distributions between psoriasis and control groups (p > 0.05). CONCLUSIONS: ADAM33 V4 C/G rs2787094 polymorphism was not associated with psoriasis risk in the Turkish population. Larger studies with different ethnicities are needed to determine the impact of ADAM33 polymorphism on the risk of developing psoriasis (Tab. 3, Fig. 1, Ref. 16).

Effects of trimetazidine in acute pancreatitis induced by L-arginine.

BACKGROUND: In acute pancreatitis, oxygen free radicals (OFRs) and cytokines have been shown to play a role in the failure of pancreatic microcirculation and the development of local tissue damage. We studied the effects of trimetazidine (TMZ), a potent antioxidant and anti-ischemic agent, on acute pancreatitis. METHODS: Rats were randomized into 3 groups: a control group (n = 15), a study group (n = 15) in which acute pancreatitis was induced with with L-arginine, and a treatment group (n = 15) in which pancreatitis was induced and treated with TMZ intraperitoneally. The rats were followed for 24 hours. At the 24th hour we determined serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase, lactate dehydrogenase (LDH), interleukin 1-β (IL-1β), interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α), and the pancreatic tissues were analyzed histopathologically. RESULTS: The AST (p < 0.001), ALT (p < 0.01), amylase (p < 0.001), LDH (p < 0.01), TNF-α (p < 0.01), IL-1ß (p < 0.001) and IL-6 (p < 0.001) levels, and pancreatic tissue edema (p < 0.01), hemorrhage (p < 0.05), acinar cell necrosis (p < 0.001) and level of perivascular inflammation (p < 0.01), were significantly lower in the treatment group than the study group. CONCLUSION: Trimetazidine markedly decreases biochemical and histopathologic changes during the early stages of acute pancreatitis, thus preserving the pancreas histologically.

CONTEXTE: Dans la pancréatite aiguë, les radicaux libres de l'oxygène et les cytokines contribuent à l'insuffisance de la microcirculation pancréatique et à l'endommagement des tissus localement. Nous avons étudié les effets de la trimétazidine (TMZ), un puissant agent antioxydant et anti-ischémique, sur la pancréatite aiguë. MÉTHODES: Des rats ont été assignés aléatoirement à 1 de 3 groupes : un groupe témoin (n = 15), un groupe (n = 15) dans lequel la pancréatite aiguë a été induite au moyen de L-arginine et un groupe (n = 15) dans lequel la pancréatite a été induite, puis traitée par TMZ par voie intrapéritonéale. Les rats ont été suivis pendant 24 heures. À la 24e heure, nous avons mesuré les taux sériques d'aspartate aminotransférase (AST), d'alanine aminotransférase (ALT), d'amylase, de lacticodéshydrogénase (LDH), d'interleukine 1-ß (IL-1ß), d'interleukine 6 (IL-6) et de facteur de nécrose tumorale α (TNF-α), et les tissus pancréatiques ont été soumis à un examen histopathologique. RÉSULTANTS: Les taux d'AST (p < 0,001), d'ALT (p < 0,01), d'amylase (p < 0,001), de LDH (p < 0,01), de TNF-α (p < 0,01), d'IL-1ß (p < 0,001) et d'IL-6 (p < 0,001), de même que l'oedème tissulaire (p < 0,01), les saignements (p < 0,05), la nécrose des cellules acineuses (p < 0,001) et le degré d'inflammation périvasculaire (p < 0,01) pancréatiques,étaient significativement moindres dans le groupe traité que dans le groupe non traité. CONCLUSIONS: La trimétazidine atténue nettement les modifications biochimiques et histopathologiques qui accompagnent les premiers stades d'une pancréatite aiguë, ce qui permet de préserver le pancréas au plan histologique.

Valsalva manoeuvre effect on distribution of lung damage in heroin inhalation.

This article reports the case of a patient demonstrating acute bilateral pneumonitis almost completely confined to the upper lobes as a result of inhaling heroin. We attribute this distribution to the patient performing the Valsalva manoeuvre immediately after inhaling heroin. This pattern has not been reported before and we believe it may be seen more frequently owing to a switch amongst drug users from intravenous to inhaled heroin.