Prevalence of Anxiety and Depression among Outpatients with Type 2 Diabetes in the Mexican Population

Depression and anxiety are common in diabetic patients; however, in recent years the frequency of these symptoms has markedly increased worldwide. Therefore, it is necessary to establish the frequency and factors associated with depression and anxiety, since they can be responsible for premature morbidity, mortality, risk of developing comorbidities, complications, suffering of patients, as well as escalation of costs. We studied the frequency of depression and anxiety in Mexican outpatients with type 2 diabetes and identified the risk factors for depression and anxiety.We performed a study in 820 patients with type 2 diabetes. The prevalence of depression and anxiety was estimated using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale, respectively. We calculated the proportions for depression and anxiety and, after adjusting for confounding variables, we performed multivariate analysis using multiple logistic regressions to evaluate the combined effect of the various factors associated with anxiety and depression among persons with type 2 diabetes. The rates for depression and anxiety were 48.27% (95% CI: 44.48–52.06) and 55.10% (95% CI: 51.44–58.93), respectively. Occupation and complications in diabetes were the factors associated with anxiety, whereas glucose level and complications in diabetes were associated with depression. Complications in diabetes was a factor common to depression and anxiety (p<0.0001; OR 1.79, 95% CI 1.29–2.4).Our findings demonstrate that a large proportion of diabetic patients present depression and/or anxiety. We also identified a significant association between complications in diabetes with depression and anxiety. Interventions are necessary to hinder the appearance of complications in diabetes and in consequence prevent depression and anxiety

Type 2 diabetes and depression in Guadalajara, Mexico, 2005 [Diabetes tipo 2 y depresi�n en Guadalajara, M�xico. 2005]

Objective: Determining the prevalence of depression and comparing sociodemographic, metabolic and clinical indicators in depressed and nondepressed people suffering from type 2 diabetes. Methods: A comparative cross-sectional study was carried out on a sample of 450 people aged over 30 suffering from type 2 diabetes; they had been diagnosed more than one year before and psychopathology had not been determined for them. A modified Zung's scale was applied and a sociodemographic survey carried out. Glucosylated haemoglobin, body mass index (BMI), blood pressure and glycemia in fasting were all evaluated. Diagnostic history and clinical state regarding diabetes were recorded. Results: There was 63 % depression prevalence in a 3 to 1 ratio, this being greater in women than in men (2,08-4,82 95 %CI, p=0.00). Differences between depressed and non-depressed people were found in schooling, civil state and occupation (p0.05); however, diagnostic history and clinical state were associated with gender, the former being associated just with men and the latter with both sexes. Conclusions: The prevalence of depression was high in people suffering from diabetes and women were at greater risk. No association was revealed between age and people suffering from diabetes who were depressed, unlike schooling, civil state and occupation; depression was presented more amongst people having a longer diagnostic history of diabetes and greater BMI

Melatonin protects against delta-aminolevulinic acid-induced oxidative damage in male Syrian hamster Harderian glands

Effects of the prooxidant delta-aminolevulinic acid (ALA) and the antioxidant melatonin (NIEL) were investigated in the male Syrian hamster Harderian gland (HG). Rodent Harderian glands are highly porphyrogenic organs, which may he used as model systems for studying damage by delta-aminolevulinic acid and its metabolites, us Occurring in porphyrias. Chronic administration of delta-aminolevulinic acid (2 weeks) markedly decreased activities of the porphyrogenic enzymes delta-aminolevulinate synthase (ALA-S) and delta-aminolevulinate dehydratase (ALA-D) and of the antioxidant enzymes superoxide dismutase (SOD). glutathione reductase (GR) and catalase (CAT), whereas Porphobilinogen deaminase (PBG-D) remained unaffected. This treatment led to increased lipid peroxidation (LPO) and oxidatively modified protein (protein carbonyl) as well as to morphologically apparent tissue damage. Melatonin also caused decreases in delta-aminolevulinate synthase, delta-aminolevulinate dehydratase superoxide dismutase, glutathione reductase and catalase. Despite lower activities antioxidant enzymes, lipid peroxidation and protein carbonyl were markedly diminished. The combination of delta-aminolevulinic acid and melatonin led to approximately normal levels of delta-aminolevulinate dehydratase, glutathione reductase, catalase and protein carbonyl, and to rises in superoxide dismutase and porphobilinogen deaminase activities: lipid peroxidation remained even lower than in controls and the appearance of the tissue revealed a protective influence of melatonin. These results suggest that melatonin may have profound effects on the oxidant status of the Harderian,land. (C) 2002 Elsevier Science Ltd. All rights reserved

Effects of delta-aminolevulinic acid and melatonin in the Harderian gland of female Syrian hamsters

Effects of delta-aminolevulinic acid (ALA) and melatonin were investigated in the female Syrian hamster Harderian gland. This is an organ physiologically exposed to strong oxidative stress due to the highest porphyrinogenic rates known in nature. Enzyme activities of porphyrin biosynthesis and of antioxidative protection, oxidative protein modification, and histological integrity were studied. In the porphyrin biosynthetic pathway, ALA and melatonin acted synergistically by downregulating ALA synthase (ALA-S) and stimulating product formation from ALA the combination of ALA and melatonin suppressed ALA-S activity, down to about 1% of that in controls. While ALA effects on porphyrinogenesis can be interpreted in terms of homeostasis, melatonin's actions may be seen in relation to seasonality and/or reduction of oxidative stress. Among antioxidant enzymes, superoxide dismutase (SOD) and glutathione reductase (GR) activities were diminished by ALA, presumably due to the vulnerability of their active centers to free radicals, whereas melatonin moderately increased SOD. Both ALA and melatonin strongly stimulated catalase (CAT), thereby counteracting the oxidative stress induced by ALA and its metabolites. Nevertheless, exogenous ALA caused a strong net rise in protein carbonyl and considerable damage of tissue. When given together with ALA, melatonin antagonized these effects and largely protected the integrity of glandular structures. (C) 2002 Elsevier Science Inc

AB0871-HPR WOMEN IN RHEUMATOLOGY: BARRIERS, LIMITATIONS, AND GENDER INEQUALITY

Background:In the last decades there has been a great progress towards gender equality in medicine, and this can be reflected in the proportion of women in Rheumatology, which has been on the rise recently. However, there continues to be a need for women to be able to succeed on equal opportunities with men (1).Objectives:The aim of this study was to recognize the professional limitations and barriers that Mexican female rheumatologists must face.Methods:Female rheumatologists were invited to participate. An online survey was applied anonymously, consisting of questions regarding demographic characteristics, professional, academic and research activities, as well as perceptions of gender discrimination and limitations of their profession.Results:A total of 127 female rheumatologists voluntarily answered the electronic survey. Most of them were aged between 30 and 35 years (40.9%) and had 1-5 years of professional practice (40.2%) (Table 1); 52% have children and 42.4% of them consider that motherhood has had a negative impact on their professional life; 75.6% of female rheumatologists do not work on research activities and only 20.5% have participated in international congresses in the last 5 years; 80.5% report not participating in medical colleges (as leaders or board members). The three main reasons female rheumatologists refer as limitations on their profession are: having other priorities (34.6%), lack of time (32.3%) and lack of support from their peers/bosses (23.6%). Almost half women (45.7%) consider not being discriminated because of their gender in their profession, while the rest of them consider that they are or may be.Table 1.Demographic characteristics.Age, n (%)Younger than 35 years52 (40.9%)From 35 to 40 years29 (22.8%)From 40 to 45 years16 (12.6%)From 45 to 50 years12 (9.4%)Older than 50 years18 (14.2%)Marital status, n (%)Married66 (52%)Single38 (29.9%)Free union13 (10.2%)Divorced8 (6.3%)Widowed2 (1.6%)Years of professional practice, n (%)From 1 to 5 years51 (40.2%)From 5 to 10 years31 (24.4%)From 10 to 15 years16 (12.6%)From 15 to 20 years10 (7.9%)More than 20 years19 (15%)Conclusion:We found that most female rheumatologists are young and with a few years of professional practice, which coincides with the recent increase in the proportion of women in Rheumatology; and perhaps this is the reason why there is low participation in research activities and medical colleges. It is relevant that almost half of them perceive their gender as a reason of discrimination in their professional life. We consider that initiating the conversation of gender equality in Rheumatology, in national and international forums, and to actively search for a strategy to support and encourage our colleagues, are priorities at this moment.References:[1]Andreoli L, Ovseiko PV, Hassan N, et al. Gender equity in clinical practice, research and training: Where do we stand in rheumatology? Joint Bone Spine 2019;86(6):669-72. doi: 10.1016/j.jbspin.2019.05.005.[2]Colunga-Pedraza IJ, Arvizu-Rivera RI, Serna-Pena G, et al. Women’s journey in Mexican rheumatology. Comment on ‘Gender gap in rheumatology: speaker representation at annual conferences’ by Monga et al. Ann Rheum Dis 2020 doi: 10.1136/annrheumdis-2020-218541.Acknowledgements:We have no acknowledgements to declare.Disclosure of Interests:None declared</jats:sec

Effects of the circadian mutation 'tau' on the Harderian glands of Syrian hamsters

The Syrian hamster Harderian gland (HG) is an organ continually exposed to oxidative stress caused by high concentrations of porphyric metabolites. According to previous studies, melatonin, which is rhythmically secreted by the pineal gland and tonically produced by the HG, antagonizes the oxidative damage. HGs exhibit a strong gender-dependent correlation between porphyrins, melatonin, and histological appearance. In HGs of both sexes, we have investigated effects of a single gene defect in the circadian clock system (tau mutation) causing a shortened free-running period and an advanced maximum of circulating melatonin. Comparisons were made with wild-type animals, one group of which received daily pharmacological injections of melatonin in late photophase. Changes were observed in histological characteristics, porphyrin content, antioxidant enzyme activities, and damage of proteins and lipids. HGs of tau hamsters showed morphological changes which can be partially interpreted in terms of increased damage. Additionally, tau females exhibited a many-fold augmentation in the percentage of so-called type II cells, which are otherwise typical for the male glands. In tau hamsters of both sexes, major antioxidative enzyme activities (superoxide dismutase, glutathione reductase, and catalase) were markedly enhanced, a presumably compensatory response to increased oxidative stress. Higher oxidative damage in tau HGs was directly demonstrable by a many-fold increase in protein carbonyl. Rises in antioxidative enzymes were also observed upon injections of melatonin; this was, however, not accompanied by changes in protein carbonyl, so that enzyme inductions by the hormone should be understood as protective actions. Our data are not only in accordance with findings on protective effects by melatonin, but also with our earlier observation made in Drosophila that perturbations in the circadian system lead to increased oxidative stress. J. Cell. Biochem. 83: 426-434, 2001. (C) 2001 Wiley-Liss, Inc

Validation of Health Behavior and Stages of Change Questionnaire

Leivy Patricia Gonzalez-Ramirez,1,2 Jose Maria De la Roca-Chiapas,2 Cecilia Colunga-Rodriguez,3,4 Maria de Lourdes Preciado-Serrano,3 Adrian Daneri-Navarro,5 Francisco Javier Pedroza-Cabrera,6 Reyna Jazmin Martinez-Arriaga1 1Department of Health Sciences, University Centre of Tonala, University of Guadalajara, Guadalajara, 2Department of Psychology, Division of Health Sciences, Campus Leon, University of Guanajuato, Guanajuato, 3Department of Public Health, University Centre for Health Sciences, University of Guadalajara, 4Paediatric Hospital, Western National Medical Centre, Mexican Social Security Institute, 5Departament of Physiology, University Centre for Health Sciences, University of Guadalajara, Guadalajara, 6Department of Psychology, Autonomous University of Aguascalientes, Aguascalientes, Mexico Background: The transtheoretical model (TTM) has been widely used to promote healthy behaviors in different groups. However, a questionnaire has not yet been developed to evaluate the health behaviors that medical practitioners often consider in individuals with cancer or at a high risk of developing cancer.Purpose: The aim of this study was to construct and validate the Health Behavior and Stages of Change Questionnaire (HBSCQ), which is based on the TTM and health recommendations related to risk and factors that protect against cancer. Methods: Content validity was conducted in two phases (qualitative and quantitative). Item difficulty index, item discrimination index, and discrimination coefficient were obtained based on the classical test theory. Finally, Cronbach&rsquo;s alpha was used.Results: Measure of concordance showed scores considered adequate and excellent. The item discrimination index obtained a rating of &ldquo;excellent&rdquo; and suggested the preservation of all items. The discrimination coefficient scores are &gt;0.74. The global internal consistency of the HBSCQ was 0.384. HBSCQ specification between groups of internal consistency for the sample of men was 0.712 and that for the sample of women was 0.378. Conclusion/implications for practice: The HBSCQ represents a proposal for a fast, simple, and innovative screening test, which aims to identify persons who may benefit from interventions to promote health behaviors delimited to the stage of change. Keywords: screening tests, health promotion, lifestyle, transtheoretical mode