A clinical predictive score for mood disorder riskin low-income primary care settings

Artículo de publicación ISIBackground: Despite availability of validated screening tests for mood disorders, busy general practitioners (GPs) often lack the time to use them routinely.This study aimed to develop asimplified clinical predictive score to help screen for presence of current mood disorder in low-income primary care settings. Methods: In across-sectionalstudy, 197 patients seen at 10 primary care centers in Santiago, Chile completed self-administered screening tolos for mood disorders: the Patient Health question naire (PHQ-9) and the Mood Disorder Questionnaire (MDQ).To determine participants’ current-point mood disorder status,trained clinicians applied agold-standard diagnostic interview (SCID-I).Asimplified clinical predictive model (CM) was developed based on clinical feature sand selected questions from the screening tools.Using CM, a clinical predictive score (PS) was developed. Full PHQ – 9 and GP assessment were compared with PS. Results: Using multivariate logistic regression, clinical and demographic variables predictive of current mood disorder were identified for asimplified 8-point predictive score (PS). PS had better discrimination than GP assessment (auROC-statistic¼0.80 [95%CI0.72,0.85] vs. 0.58 [95%CI0.52,0.62] p-value o0.0001), but not as good as the full PHQ-9 (0.89 [95%CI0.85,0.93], p-value ¼ 0.03). Compared with GP assessment, PS increased sensitivity by 50% ata fixed specificity of 90%. Administered in a typical primary care clinical population, itcorrectly predicted almost 80% of cases. Limitations: Further research must verify external validity of the PS. Conclusion: An easily administered clinical predictive score determined, with reasonable accuracy, the current risk of mood disorders in low-income primary care settings

Psychopathology of Mixed States

Mixed states are frequent clinical pictures in psychiatric practice but are not well described in nosologic systems. Debate exists as to defining mixed states. We review factor and cluster analytical studies and prominent clinical/conceptual models of mixed states. While mania involves standard manic symptoms and depression involves standard depressive symptoms, core additional features of the mixed state are, primarily, psychomotor activation and, secondarily, dysphoria. Those features are more pronounced in mixed mania than in mixed depression but are present in both

Cannabidiol: Assessing preclinical safety in ovarian and endometrial carcinoma cell lines.

e24130 Background: Cancer patients use cannabidiol (CBD) for chemotherapy and cancer symptoms, though research of CBD safety and efficacy for these conditions are ongoing and mixed. We sought to determine endometrial (ECC1) and epithelial ovarian cancer (Kuramochi) cell proliferation when exposed to different concentrations of CBD, for the broader goal to establish if CBD can safely be utilized to treat the symptoms of cancer, including those caused by chemotherapy. Methods: ECC1 and Kuramochi cells were kept in media (RPMI with 10% bovine serum and 1% penicillin/streptomycin). We passaged cells when &gt; 90% confluent by adding tryspin-EDTA, incubating at 37C for 3 minutes, then spinning down with media to harvest the cell pellet. Cells were re-suspended in media, counted and apportioned to 96 well plates. Plates were incubated at 37C x 24 hours. CBD (from Cayman Chemical) was suspended in DMSO per manufacturer instruction then used to treat cells x72 hours at different concentrations (2.5-50uM). MTT was added to cells, cells incubated at 37C x 3 hours, media and MTT were removed and DMSO was added. Optical depth (OD) was calculated for plates using SoftMaxPro version 6.2.2. ODs were used to calculate inhibitory concentration for 50% cell death (IC50). Results: Kuramochi and ECC1 demonstrated decreased cell proliferation when exposed to CBD for 72hours. ECC1 IC50 fell between 2.5-5uM. Kuramochi IC50 fell between 15-20uM. Nearly all ECC1 growth was inhibited at concentrations 10uM or greater. Kuramochi proliferation was 15% that of controls at concentrations of 40 and 50uM CBD. Conclusions: ECC1 and Kuramochi cells demonstrated decreased proliferation in the presence of CBD. This bodes well for future studies of concurrent exposure to CBD and cytotoxic chemotherapy. Further preclinical research needed on CBD effects in endometrial and ovarian cancer, as patients turn to CBD for symptomatic relief from cancer and chemotherapy side effects. [Table: see text] </jats:p

Oxidative Phosphorylation: A Target for Novel Therapeutic Strategies Against Ovarian Cancer

Aerobic glycolysis is an important metabolic adaptation of cancer cells. There is growing evidence that oxidative phosphorylation is also an active metabolic pathway in many tumors, including in high grade serous ovarian cancer. Metastasized ovarian tumors use fatty acids for their energy needs. There is also evidence of ovarian cancer stem cells privileging oxidative phosphorylation (OXPHOS) for their metabolic needs. Metformin and thiazolidinediones such as rosiglitazone restrict tumor growth by inhibiting specific steps in the mitochondrial electron transport chain. These observations suggest that strategies to interfere with oxidative phosphorylation should be considered for the treatment of ovarian tumors. Here, we review the literature that supports this hypothesis and describe potential agents and critical control points in the oxidative phosphorylation pathway that can be targeted using small molecule agents. In this review, we also discuss potential barriers that can reduce the efficacy of the inhibitors of oxidative phosphorylation