GENDER SPECIFIC DIFFERENCES IN REPORTING DEPRESSIVE SYMPTOMS AMONG PATIENTS HOSPITALIZED WITH ACUTE CORONARY SYNDROME.

In patients with acute coronary syndrome (ACS) low level of depressive symptoms is associated with coronary event recurrence and morbidity. Large epidemiological trials revealed that there is a disparity between males and females in their reports of different somatic depressive symptoms. The aim of our study was to identify gender differences in reporting depressive symptoms in patients with acute coronary events. Depreesion screening using BDI questionnaire was performed in patients with ACS in Emergency Cardiology center, Tbilisi, Georgia. The total number of participants was 84. Patients' data were collected from hospital records. Descriptive statistical tests were used for the calculation of frequencies, means and standard deviations. Chi-square test was applied for categorical variables in order to establish difference between groups. The Independent t-test was used to compare means for numerical variables. The mean age for both genders was 59.2 (10.2) years. Classic coronary risk factors were more prevalent in men than in women. However, women, compared to men have a greater number of cognitive as well as somatic depressive symptoms. Women hospitalized with an acute coronary syndrome reported greater number of depressive symptoms compared to men. Early detection of depressive symptoms will help healthcare providers reduce risks and improve outcome of ACS.

FACTORS ASSOCIATED WITH DEPRESSIVE EPISODE IN PATIENTS HOSPITALIZED WITH ACUTE CORONARY EVENTS.

Severe infarction or its consequences are considered as triggering factors of incidental depression. The aim of our study was to reveal factors associated with depressive episode in patients hospitalized with acute coronary syndrome (acute myocardial infarction, unstable angina). The Beck Depression inventory (BDI) was used for assessment of depressive symptoms in patients with coronary disease in Emergency Cardiology Clinic Tbilisi, Georgia. The study sample included 84 patients. The clinical Information was collected from hospital recordings. The chi-square test was used for assessment the difference between groups. Independent t-test was used to compare means for numerical variable "age". A binary logistic regression was applied in order to assess a relationship between disease severity factors (ejection fraction and revascularization) and depressive episode. Study sample included 79% of men and 21% of women with a mean age 59 years. Coronary obstruction as well as cardiac risk factors was revealed in majority of participants. The mean depression score was 13.0, while BDI score > 16 was revealed in 28.6% of patients. In the binary regression model ejection fraction was inversely associated with depressive episode even after adjustment to the age, gender and coronary risk factors. When disease severity markers (ejection fraction, revascularization) together with classic risk factors were included into the model, they explained only 42% of depressive episodes. It may be concluded that disease severity markers together with classic cardiac risk factors explain only partially depressive episode in patients, hospitalized for acute coronary events. A multidisciplinary approach is needed in order to provide optimal care and improve prognosis of patients with acute coronary syndrome (ACS).

ASSOCIATION OF DEPRESSION WITH HOSPITAL LENGTH OF STAY IN PATIENTS WITH ACUTE CORONARY SYNDROME.

Psychosocial risk factors are known to have a negative impact on coronary disease morbidity and mortality. The aim of our study was to establish contribution of depression on hospital length of stay in patients with acute coronary events. Depression screening was performed in the Chapidze Center, Tbilisi Georgia. Main inclusion criteria in the study were acute coronary events - non-ST elevation myocardial infarction or unstable angina. The total nomber of participants was 84. A binary logistic regression was used in order to assess contribution of depression on prolonged hospital stay. The mean age for both genders was 59.2 (10.2) years. Most patients had coronary risk factors. Higher BDI score was found in elderly patients, females, and in those with systolic dysfunction as well as in whom revascularization was not performed. In binary logistic regression model myocardial infarction and depression were found to be significant contributors of prolonged hospital stay. Depressive symptoms contribute independently to prolongation of hospital stay in patients with non-STEMI.

Prognostic value of gross motor function measure to evaluate the severity of cerebral palsy.

Early adequate evaluation of motor development and prognosis of degree of long-term motor disability is very important not only for parents, but also for correct management of goal oriented rehabilitation treatment and for planning of preventive measures. To estimate the value of Gross Motor Function Measure in evaluation of severity of cerebral palsy, for prognostic counseling with parents and for planning of clinical management. Total of 397 children aged 1 to 12 years at study onset with cerebral palsy were observed for up to 3,5 years during the period from 2002 to 2005. Children were assessed by GMFM-88 (Gross Motor Function Measure), by GMFCS (Gross Motor Function Classification System). Over the course of the study 397 children had a total of 6875 GMFM assessments, or an average of 17,3 observations per child. The study revealed significant differences between developmental limit of each level of gross motor function. Children with lower motor development potential reach their limit more quickly, than children with higher potentials. Children with cerebral palsy reach about 90% of their gross motor function by around age 5 years or younger, depending on their GMFCS level. After this age intervention programs have to address increasing independent activity and to promote participation of children with disabilities.

[Early predictors of neurodevelopmental outcome of neonatal bacterial meningitis].

154 patients, who were hospitalized in M. Iashvili Children's central hospital in 1998-2005 were investigated. In 70 cases the diagnosis was neonatal bacterial meningitis, in 62 cases -- bacterial sepsis and neonatal meningitis and 22 cases patients were in control group with the diagnosis of neonatal bacterial sepsis. From base investigation group -132 patients were divided in two group, in which patients were united by the starting point of disease from the birth: first group included newborns with signs of disease on earlier stage (sings of the disease showed up during 24-72 hours from the birth); second group included newborns with later signs of disease (after 72 hours from the birth). Our conclusion is- outcome of bacterial meningitis depends on the starting point of disease. Meningitis which began earlier than 72 hours of life, characterized by severe prognosis. Mother's chronic infection diseases and brain injury of newborn are predictors of severe complications of neonatal bacterial meningitis. Such complications of bacterial meningitis as are: brain abscess, ventriculitis, neonatal seizures, coma and neutropenia, become predictors of severe latest outcome.