Usefulness of two instruments in assessing depression among elderly Mexicans in population studies and for primary care.

Introduction Medication errors (MEs) are the main type of preventable adverse events in medical care, as well as safety indicators in the medication processes. Advances in the quality of care in pediatric acute lymphoblastic leukemia (ALL) have enabled to improve clinical outcomes. However, ME epidemiology in pediatric oncology is still incipient in developing countries. In view of this, the objectives of this study were to estimate the incidence of MEs, determine their types and consequences, as well as their preventability in the induction treatment of children with ALL at Hospital Infantil de Mexico Federico Gómez. Methods We reviewed the remission‐induction chemotherapy records of children with ALL between January 2015 and December 2017. A two‐phase review was carried out for ME identification and verification. The consequences of errors were determined by agreement between reviewers. Results We reviewed 1762 chemotherapy orders involving 181 children. MEs were observed in 16.9% of orders and in 57.5% of patients. Prescription errors were the most common (93.3%), with wrong dose errors (90.2%) being predominant. Only 3.7% of wrong dose errors were intercepted, while 12.2% of the children experienced adverse drug events (ADEs) preceded by some wrong dose error. Conclusions MEs were common, since they occurred in 57.5% of children with ALL on induction treatment and involved 16.5% of chemotherapy orders. Only 3.7% of MEs were intercepted, while 12.2% of children had ADEs related to overdose. Measures are required to prevent calculation error in prescriptions, as well as training of the nursing staff to intercept MEs.

Background. Depression is associated with an increased use of medical resources and reduced quality of life, cognitive functions, functionality and general health. The treatment of depression is limited by the scarcity of mental health professionals, as reflected in the mental health atlas of the World Health Organization. Method. A randomised controlled trial that was not blinded was conducted. Family doctors referred patients older than 60 years who were suspected to have depression to the screening module. The PHQ-9 questionnaire, the Six-Item Screener, and previous diagnosis for psychiatric disorders were collected. Major depression was excluded. Those with a score from two to six on the PHQ-9 and with no comorbidities were referred to the Baseline Phase. A simple random process without blocking was applied. Groups of 7-10 participants engaged in weekly sessions over the course of three months. The control group was referred to their family physician. Reduction in depression score of the PHQ-9 was the main outcome. Results and discussion. There were 40 patients in the control group (CG) and 41 in the intervention group (IG). 84% were women, 41% married and 41% reported at least primary education. The mean age for the GC was 69.7 years vs. 71.3 in the GI. The baseline mean MMSE score was 23.7 in the GC and 24.1 in the IG. No significant baseline differences between groups were reported. In the IG, 56% of the participants (n=23) displayed a decrease that was greater than or equal to 5 points on the PHQ-9 compared with 30% (n=12) in the control group. The CT group evidenced a marginal improvement.

The main objective was to show the decrement of serotoninergic brain activity in depressed women, through the analyses of the slope amplitude of N1/P2 components of the auditory-evoked potentials (AEP), and the measurement of the L-tryptophan free fraction in plasma (FFT). This cross-sectional study was carried out in 60 women, 30 depressed and 30 normal controls. Both groups were measured FFT, glucose, and neutral amino acids (NAA) levels; besides performing AEP to analyses the N1/P2 slope amplitude. It was found a lengthening in the slope amplitude of N1/P2 components of AEP in the group of depressed women, and despite that the level of FFT was low, there were no changes between bound fraction and the total L-Trp. The former suggests a decrease in serotonergic brain activity in the group of depressed women. Otherwise, since the auditory cortex response to sound is regulated by serotonergic innervation, it was expected a change in the behavior of AEP in the group of depressed patients. Thus, the slope amplitude of N1/P2 components of the AEP and the measurement of FFT have proved to be a good clinical indicators of the serotonergic neurotransmission state in the brain of depressed patients, and in another clinical conditions where brain serotonin is involved.

No abstract