RESUMO
We present the unusual case of a 35 year-old woman with stage IV melanoma and widespread metastases, who was undergoing treatment with interferon alpha-2b and who presented with interferon-associated retinopathy. The patient, who had been taking interferon treatment for three months, complained of a sudden loss of visual acuity in the left eye. An ocular examination revealed multiple cotton wool spots along the retina and macular involvement. Interferon treatment was suspended. Although rare, retinopathy represents a potentially serious adverse effect of interferon treatment. Although normally patients are asymptomatic, complications derived of its use may arise, which can lead to significant visual impairment. We therefore suggest that before initiating treatment with this drug, patients should be informed of its potential ocular risks, and that regular eye examinations are conducted along with the treatment.
RESUMO
We present the unusual case of a 35 year-old woman with stage IV melanoma and widespread metastases, who was undergoing treatment with interferon alpha-2b and who presented with interferon-associated retinopathy. The patient, who had been taking interferon treatment for three months, complained of a sudden loss of visual acuity in the left eye. An ocular examination revealed multiple cotton wool spots along the retina and macular involvement. Interferon treatment was suspended. Although rare, retinopathy represents a potentially serious adverse effect of interferon treatment. Although normally patients are asymptomatic, complications derived of its use may arise, which can lead to significant visual impairment. We therefore suggest that before initiating treatment with this drug, patients should be informed of its potential ocular risks, and that regular eye examinations are conducted along with the treatment.
Apresentamos o caso de uma mulher de 35 anos com melanoma em estágio IV e metástases generalizadas tratados com interferon alpha-2b, que proporcionou uma retinopatia associada ao interferon. Mulher de 35 anos de idade tratados com interferon durante os últimos três meses apresentou uma perda súbita da acuidade visual no olho esquerdo. Exame ocular revelou vários pontos de algodão ao longo da retina e mácula. Tratamento com interferon foi parado. Retinopatia associada ao uso de interferon está entre os possíveis efeitos colaterais, embora rara, não deve ser subestimada. Embora geralmente assintomática, complicações decorrentes de seu uso podem levar à perda visual significativa. Consideramos, portanto, que antes de iniciar o tratamento com este medicamento, os pacientes devem ser informados sobre os riscos potenciais e os exames oftalmológicos são recomendados durante cada tratamento.
Assuntos
Humanos , Doenças Retinianas/induzido quimicamente , Interferon-alfa/efeitos adversos , Interferon-alfa/uso terapêutico , Melanoma/secundárioRESUMO
BACKGROUND: Suicidal behavior is a leading cause of injury and death worldwide. Several studies have provided a possible relationship between genetic factors and suicidal behavior. Also, these studies have shown evidence for altered serotonergic neural transmission in the pathogenesis of suicidal behavior. In addition, genes pertaining to the serotonergic system have been proposed as candidates to establish biological correlates between suicidal behavior and the serotonergic system. The most studied genes are SCL6A4, HTR2A, HTR2C, HTR1A, HTR1B, TPH-1, and TPH-2. To get a comprehensive understanding of the association with suicidal behavior we will conduct genotype assays studies in a Mexican population. METHODS/DESIGN: We will conduct a case-control study. The population sample will comprise adolescent and adult patients admitted for attempted of suicide and diagnosed by a psychiatrist. A peripheral blood sample will be taken from all the subjects (cases and controls). Genomic DNA from the leukocytes blood sample will be extracted. The genotypes of interest are distributed in the following genes: SCL6A4, HTR2A, HTR1A, HTR1B, HTR2C, TPH-2 and TPH-1. All the samples will be analyzed using a polymerase chain reaction (PCR) end-point method. We will evaluate the Hardy-Weinberg Equilibrium. The chi-squared test or Fisher's exact test will be used to compare genotype and allele frequencies between control and case groups. The Quanto 1.2 software will measure the sample size of the association. For all the association analyses the level of significance will be set at p = 0.05 and the confidence interval at 95%. DISCUSSION: Suicidal behavior has been increase in Mexico, principally in young population. Our study will demonstrate the association between serotoninergic genes and suicide behavior in Mexican population.
Assuntos
Predisposição Genética para Doença , Neurônios Serotoninérgicos/fisiologia , Ideação Suicida , Transmissão Sináptica/genética , Adolescente , Adulto , Alelos , Estudos de Casos e Controles , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , México , Pessoa de Meia-Idade , Receptores de Serotonina/genética , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Triptofano Hidroxilase/genética , Adulto JovemRESUMO
AIMS: The aim of this study was to assess the prevalence of anxiety and depression in groups of obese and normal-weight individuals with type 2 diabetes. Also, to analyze the severity of depression in type 2 diabetics by taking into account the body mass index in people with this condition. METHODS: This study included 702 patients with type 2 diabetes, 236 with normal weight, and 231 with obesity. All participants completed a demographic questionnaire, the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale. RESULTS: In patients with obesity, 48.48% (95% CI: 41.82-55.14) were positive for anxiety and 49.78% (95% CI: 43.11-56.44) for depression. A significant correlation existed between the Hamilton Depression Rating Scale and body mass index with a correlation coefficient of 0.11 (p = 0.003). Also, a significant correlation coefficient equal to 0.107 (p = 0.005) between the Hamilton Anxiety Rating Scale and body mass index was found. In addition, when we analyzed depression scores, significant differences were encountered for gender between normal-weight and obesity groups in the range of severe (p = 0.01) and very severe (p = 0.04) cases. CONCLUSION: In view of the existing relationships observed among obesity, depression, anxiety, and gender in type 2 diabetics, we consider that a psychological intervention is necessary for an integral management of these patients.