Background: There is evidence for an association between major depressive disorder (MDD) and both inflammatory and phosphodiesterase (PDE) pathways. This study aimed to evaluate the adjunct role of the PDE inhibitor pentoxifylline (PTX), a compound with anti-inflammatory properties, in the treatment of adult patients with MDD. Methods: This was a prospective, 12-week, double-blind study of parallel groups. Eighty adult outpatients who met the DSM-IV criteria for MDD participated in the trial. Patients were required to have a baseline Hamilton Rating Scale for Depression (HAM-D) score of at least 18. Patients were allocated randomly: 40 received escitalopram 20 mg/day plus placebo while the other 40 received escitalopram 20 mg/day plus PTX (400 mg b.i.d.). Patients were assessed by a psychiatrist at baseline, and 4, 8, and 12 weeks after the medication had been started. The serum levels of TNF-α, IL-6, IL-10, BDNF, 8-OHdG, and serotonin were measured at baseline and after therapy. Results: After 8 and 12 weeks, the PTX group showed a statistically significantly greater improvement in HAM-D score compared to the control group (least squares mean difference [LSMD] –3.29, p = 0.000 and LSMD –3.49, p = 0.000, respectively). Moreover, the PTX group showed a statistically significantly greater reduction in the serum levels of TNF-α, IL-6, IL-10, and 8-OHdG along with a statistically significant increase in the levels of BDNF and serotonin in comparison with the control group after the treatment. Conclusion: The findings of this study suggest that PTX could be a promising adjunct to antidepressants in the treatment of MDD patients.

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Sorafenib use should be limited to patients with Child A, PS 0-1, and low disease burden.

Purpose: To evaluate the role of N-terminal pro-brain natriuretic peptide, homocysteine and methylenetetrahydrofolate reductase gene polymorphism (TT, CT or CC) in elderly patients with mild cognitive impairment or depression, and to determine the association between TT genotype and both homocysteine and N-terminal pro-brain natriuretic peptide on one-hand and depressive and cognitive scores on other-hand. Material and Methods: This study included 60 elderly patients, subdivided into, patients with depression, patients with mild cognitive impairment, in addition to the control group. N-terminal pro-brain natriuretic peptide, homocysteine, folate and methylenetetrahydrofolate reductase gene polymorphism were determined. Results: Both N-terminal pro-brain natriuretic peptide and homocysteine were significantly increased in the patient groups as compared to the control, and were significantly positively correlated with depression scores, but significantly negatively correlated with cognitive impairment. TT genotypes had an increased risk of developing depression and had significant higher plasma level of both N-terminal pro-brain natriuretic peptide and homocysteine than CT or CC patients. Conclusion: The methylenetetrahydrofolate reductase gene may play a role in the modulation of mood but does not contribute to genetic susceptibility to cognitive performance in later life. It is also associated with N-terminal pro-brain natriuretic peptide and homocysteine levels, which may play a role in linking depression and mild cognitive impairment with increased cerebrovascular and/or cardio-vascular risk.

Background: Obsessive compulsive disorder (OCD) is a common and potentially debilitating disorder. Neuropsychological assessment provides unique complementary information that is critical for evaluating higher cortical abilities. This study aimed to assess the neuropsychological functions in OCD patients which can then point to the brain structures or pathways and to study the correlation between these assessments and different clinical variables. Methods: This cross-sectional case control study had included sixty patients who were divided into two groups, Group I: thirty OCD patients diagnosed by DSM-IV and Group II: thirty healthy controls who were recruited from the community, matched with patients’ age, gender, and education. Results: The age of onset in our study was 19.13 ± 0.35 years, the mean duration was 7.44 ± 3.88 years, 40% of the studied cases had severe OCD symptoms and 33.3% of them were compulsive cleaners. There was a high significant difference between the two groups regarding WCST in favor of the control group. There was a high significant difference between the two groups regarding ROCF where the control group showed better results than the OCD patients. Conclusions: Neuropsychological test performance remains an informative and objective means of investigation, especially when applied to psychiatric disorders. The executive functions in OCD patients were impaired in comparison to the normal study subjects.