Evaluation of anxiety and depression in patients prior to myocardial perfusion scintigraphy

PubMedID: 22136214Objective. In myocardial perfusion scintigraphy (MPS) negative results indicate coronary artery diseases which might cause prominent anxiety and other psychological reactions. The aim of this study was to determine anxiety and depression levels of patients prior to MPS procedures. Methods. The Hospital Anxiety Depression Scale(HADS) and the State and Trait Anxiety Inventory I and II were used to evaluate the anxiety and depression levels of the patients. Descriptive analyses and independent sample t-test were used for statistical assessment. Results. The mean score of HADS-anxiety score prior to MPS was 8.1 ± 4.2, whereas the mean HADS depression score was 6.1 ± 3.7. The mean state anxiety score prior to MPS was 39.7 ± 10.6 and the mean trait anxiety score was 45.02 ± 9.1. HAD and state and trait anxiety scores were found to be significantly higher in female patients than male patients and non-smoker patients than smoker patients. Other risk factors such as having bypass operation, myocardial infarction, hypercholesterolemia, diabetes and hypertension were not related to depression and anxiety scores. Conclusion. The results in this study suggest a role for MPS as a risk factor for higher state anxiety. The MPS procedures might lead to an increase in anxiety levels of patients which is possibly associated with anticipation anxiety felt during waiting period and expectation life-threatening. © 2012 Informa Healthcare

Urine endothelin-1 levels as a predictor of renal scarring in children with urinary tract infections

Aims: Endothelin-1 (ET-1) contributes to renal fibrogenesis in several manners such as increasing collagen synthesis in mesangium, decreasing extracellular matrix (ECM) degradation by mesangial cells and stimulating mesangial contraction. The aim of our study was to investigate whether urine level of ET-1 (uET-1) could represent a useful biomarker of renal scarring and if so, to determine the optimal cut-off level for uET-1 to predict a renal scar. Methods: 44 children with renal scarring and 32 children without renal scarring were enrolled in the study. Urine ET-1 was measured by enzyme-linked immunosorbent assay. Results: Mean uET-1 level was significantly higher in the scar group than in controls (2.75 +/- 1.35 fmol/ ml vs. 0.68 +/- 0.41 fmol/ml, p = 0.001). The optimal cut-off level was 1.064 fmol/ml for uET-1 to predict renal scarring. Using this cut-off point, sensitivity and specificity were 97.73% and 93.91%, respectively. AUC was found 0.975 (95% CI 0.917 - 0.996) for uET-1. Mean urine Endothelin-1/Creatinine ratio (uET-1/Cr) was also significantly higher in the scar group than in the control group (4.04 +/- 2.29 fmol/mg Cr vs. 1.09 +/- 0.67 fmol/mg Cr, p = 0.0001). Using 1.67 fmol/mgCr as optimal cut-off level, sensitivity and specificity were 95.45% and 84.09%, respectively. AUC was 0.945 (95% CI 0.875 - 0.982) for uET-1/Cr. Conclusion: Our study suggests that both uET-1 and tiET-1/Cr can be used for prediction of renal scarring in children with normal renal function. Measuring urine level of ET-I can help us to avoid unnecessary DMSA studies if the patient's uET-1 level is found to be under the determined cut-off point

Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review

The most common sites of metastatic differentiated thyroid cancer are the neck lymph nodes, while distant metastases typically involve the lungs, the bones, and less frequently the brain. Uncommon metastatic sites include the liver, adrenal gland, kidney, pancreas, and skin. The epidemiological aspects of thyroid metastases in rare sites are largely unknown and their identification could have a significant impact on patients management. A mini-series of unusual metastatic sites of thyroid carcinoma is proposed as a contribution to current knowledge on anatomopathological characteristics and clinical outcome. Of the six cases that were assessed, the metastases were the following: skin metastases (2), skin and pancreas metastases (1), renal metastasis (1), adrenal metastasis (1), and liver metastasis (1). In our experience, metastases in rare sites do not always represent a negative prognostic factor for disease outcome. In fact they can occur as single distant lesion and if surgically resectable, their treatment can also lead to local disease remission