Depression occures in 28-60% of patients with PD. There is little evidence of the efficacy and safety of antidepressant therapies in Parkinson´s disease. This interventive, paralel, RTC, safety/efficiency study included 339 patients aged 36-90, with ICD10/DSMIV criteria for PD and depression. Purpose of the study was to estimate depression, quality of life, and severity od PD symtoms after 3 months of antidepressant therapy. Methods: We have randomly divide patients into control group(N=45) without antidepressants, and experimental groups in accordance with applied antidepressants: clomipramine(N=48), fluoxetine (N=49), sertraline (N=51), escitalopram (N=49), mirtazepine (N=45), and tianeptine (N=52). We have used HAMD for estimation of depression, QOL scale for quality of life, and UPDRS subscales I(behaviour and mood) and II(daily activities) for PD symptoms at pretrial, and after 3 months scores in all groups. Data were processed with SPSS for Windows. Results: There is no statistical significance in pretrial scores between groups. After 3 months there is: significant increase in control and significant discrease(p=0.000) of HAMD scores in all experimental groups, in favour of antidepressant with higher mediana(escitalopram 9; sertralin 8; tianeptin 6;clompramin 3; mirtazapin 3;fluoxetine 1; control-2); significant increase of QOL scores in favour of antidepressant with higher mediana(escitalopram 1.24; sertraline 1.12; tianeptine 0.65; clomipramine 0.40; mirtazapine 0.27; fluoxetine 0.27), and significant difference in UPDRS II pretrial and after 3 months subscores(p=0.016), in favour of escitalopram. Conclusion: All tested antidepressant are efficient in reducing HAMD score, but only escitalopram,sertraline,and tianeptine improved HAMD, QOL, UPDRS I, and II scores without side effects.
The principle objective of this investigation was to establish the frequency and form of the arterial hypertension in children between 7 and 16 years in urban and rural population. Specific goals were to determine by screening method, i.e., by elimination, the arterial hypertension prevalence in relation to permanent residence (town-village), age and sex of children; to determine, by the same method, the prevalence of the essential and borderline arterial hypertension; to test the risk factors in patients with essential and borderline arterial hypertension: obesity, hereditary predisposition (relatives of the first and second line), lipids, and ten-year follow-up of children with essential arterial hypertension. The examination included 3000 children (age 7-16 years) during regular school days. Essential arterial hypertension in this study was defined as blood pressure continuously higher than 95th percentile for age and sex in at least three different measurements; secondary causes of hypertension were excluded by available clinical, laboratory and functional investigations. Borderline hypertension was defined as blood pressure continually higher than 90th percentile, and from time to time higher than 95th percentile for age and sex in at least three measurements, when the secondary causes of hypertension were excluded. The obtained results were the basis for the following conclusions: Prevalence of arterial hypertension for all children was 0.93% and was the lowest in children aged 7-8 years (0.83%), and the highest in chil dren aged 15-16 years (2.96%). Prevalence of the essential arterial hypertension was 0.37% and of borderline arterial hypertension 0.56%. Prevalence of the arterial hypertension was higher in urban than in rural population of children (1.09:0.55%), but without statistically significant difference (p>0.05). Hypertension was verified in 60.7% of family members of children with increased blood pressure. 21.4% of hypertensive children were overweight. Hyperlipidemia was noted in 4 children with essential hypertension. All children with arterial hypertension underwent 24-hours Holter monitoring. Patients with essential arterial hypertension had sinus tachycardia in 95% and patients with borderline hypertension in 60% (in stress and pressure).
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