THYROID HORMONES AS A THIRD LINE OF AUGMENTATION MEDICATION IN TREATMENT-RESISTANT DEPRESSION.

INTRODUCTION: Clinical or subclinical hypothyroidism dictates the severity of depressive episodes and more frequently overlaps psychotic phenomenology. There are also major depressive episodes resistant to treatment in patients with euthyroidism, in which supplementation of antidepressant medication with thyroid hormones is beneficial. MATERIAL: Systematization of meta-analyses from perspectives: hypothyroidism and depression, autoimmune and depression pathology, gestational and puerperal pathology in association with hormonal and dispositional changes, presentation of therapeutic schemes. RESULTS: Hypothyroidism is more commonly comorbid with major depression in women. It associates the need for hospitalizations, psychotic phenomenology, resistance to treatment, somatic comorbidities. Autoimmune pathology is associated with depression and requires thorough investigation. A possible genetic candidate for thyroid dysfunction is the DIO1 gene. FT4 may be a predictor, but the combination of FT4 + TBG measured during the prenatal period has a higher prognostic power for a future depressive episode. CONCLUSION: The article presents psychiatric medication schemes that combine antidepressants and antipsychotics of various classes with other enhancers, an important role going back to step three, which includes thyroid hormones, mainly T3. The doses used are smaller than the amount of endogenous production of T3 daily, with a small risk of inducing clinical hyperthyroidism.

[The role of Brinzolamide 1% ophtalmic suspension in corneal edema]. / Utilizarea suspensiei de Brinzolamida 1% în edemul corneean--studiu experimental pe animale de laborator.

PURPOSE: The study is aimed at assessing the efficacy and safety of topical carbonic anhydrase inhibitor (IAC--i.e. ophthalmic suspension of brinzolamide 1%--Azopt) in the treatment of corneal edema. METHOD: For this purpose, we carried out an experimental, epidemiological-operational, randomised, placebo-controlled and double blind study, on three groups of laboratory animals (rabbits): group 1 (5 rabbits) included endothelial corneal injuries inflicted by ultrasound exposure by means of a phacoemulsification sound in both eyes group 2 (5 rabbits) included endothelial corneal injuries inflicted by direct trauma in both eyes group 3 (3 rabbits)--no endothelial corneal lesions (control group) In each group we instilled, all the animals, with ophthalmic suspension of brinzolamide 1% (Azopt), 1 drop t.i.d., in one eye for 14 days (starting the following day after infliction of endothelial injuries, when the corneal edema was evidenced by biomicroscopic examination) and placebo (saline solution 0.9% with the same osmolar and pH values as the Azopt) in the other eye. The assessment was performed throughout the following stages: To: preceding the infliction of corneal endothelial injuries, resorting to: biomicroscopic examination ultrasound pahimetry direct specular microscopy T1: the following day after infliction of corneal endothelial injuries, resorting to: biomicroscopic examination (the assessment of corneal edema) ultrasound pahimetry (measurement of corneal thickness and, hence edema) direct specular microscopy (cell density and endothelial ultrastructure evaluation: cellular polimegetism, pleiomorphism) T2: in the wake of 14 days therapy (after eye removal), adding to the previous examinations: indirect specular microscopy (with the same aim as the direct examination, yet examination carried out from the endothelial side) pathologic examination (using hematoxilin-eosin dye and Van-Gieson dye).

Physiopathological considerations on the arterial coronary spasm. Some diagnostic and therapeutical conclusions.

Starting from the cyclicity of the anginal attack in variant angina, the authors point out the role of alkalosis, besides the richness in alfa-adrenoceptors of the great coronary trunks. At the level of the muscular cell there is a competition between H+-ions and Ca++-ions. The diminution of H+-ions as a result of alkalosis brings about the penetration of Ca++ into the cell and the appearance of the coronary spasm. So, we worked out an original method for the provocation of the spasm (the cold and hiperpneea test) and an original therapeutical procedure (by acetozolamid). We present, herein the first results scored in 16 patients.