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High efficacy of onabotulinumtoxinA treatment in patients with comorbid migraine and depression: a meta-analysis
(BMC, 2021-01-01) Affatato, Oreste; Moulin, Thiago C.; Pisanu, Claudia; Babasieva, Victoria S.; Russo, Marco; Aydinlar, Elif I.; Torelli, Paola; Chubarev, Vladimir N.; Tarasov, Vadim V.; Schioeth, Helgi B.; Mwinyi, Jessica
Background: Migraine and depression are highly prevalent and partly overlapping disorders that cause strong limitations in daily life. Patients tend to respond poorly to the therapies available for these diseases. OnabotulinumtoxinA has been proven to be an effective treatment for both migraine and depression. While many studies have addressed the effect of onabotulinumtoxinA in migraine or depression separately, a growing body of evidence suggests beneficial effects also for patients comorbid with migraine and depression. The current meta-analysis systematically investigates to what extent onabotulinumtoxinA is efficient in migraineurs with depression. Methods: A systematic literature search was performed based on PubMed, Scopus and Web of Science from the earliest date till October 30th, 2020. Mean, standard deviation (SD) and sample size have been used to evaluate improvement in depressive symptoms and migraine using random- effects empirical Bayes model. Results: Our search retrieved 259 studies, eight of which met the inclusion criteria. OnabotulinumtoxinA injections administered to patients with both chronic migraine and major depressive disorder led to mean reduction of - 8.94 points (CI {[} - 10.04,- 7.84], p < 0.01) in the BDI scale, of - 5.90 points (CI {[} - 9.92,- 1.88], p < 0.01) in the BDI-II scale and of - 6.19 points (CI {[} - 9.52,- 2.86], p < 0.01) in the PHQ-9 scale, when evaluating depressive symptoms. In the case of the migraine-related symptoms, we found mean reductions of - 4.10 (CI {[} - 7.31,- 0.89], p = 0.01) points in the HIT6 scale, - 32.05 (CI {[} - 55.96,- 8.14], p = 0.01) in the MIDAS scale, - 1.7 (CI {[} - 3.27,- 0.13], p = 0.03) points in the VAS scale and of - 6.27 (CI {[} - 8.48,- 4.07], p < 0.01) migraine episodes per month. Comorbid patients showed slightly better improvements in BDI, HIT6 scores and migraine frequency compared to monomorbid patients. The latter group manifested better results in MIDAS and VAS scores. Conclusion: Treatment with onabotulinumtoxinA leads to a significant reduction of disease severity of both chronic migraine and major depressive disorder in patients comorbid with both diseases. Comparative analyses suggest an equivalent strong effect in monomorbid and comorbid patients, with beneficial effects specifically seen for certain migraine features.
Factors Affecting Adherence to Antiretroviral Treatment among HIV/AIDS Patients in Turkey
(BILIMSEL TIP YAYINEVI, 2021-01-01) Nur Karakoc, Hanife; Kaya, Selcuk; Aydin, Merve; Koksal, Iftihar
Introduction: Adherence to antiretroviral treatment (ART) is critical for the success of Human Immunodeficiency Virus (HIV) infection treatment. There is no approved consensus that defines adherence. In this study, it was aimed to examine the adherence rate of our patients with high-efficacy ART and to determine the factors affecting treatment adherence. Materials and Methods: Seventy-two patients admitted to the study between January 1, 2018 and July 31, 2018 with the diagnosis of HIV/AIDS who received ART for at least three months and agreed to participate in the study were included in the study. The effect of treatment adherence was investigated by examining the sociodemographic and clink characteristics and laboratory findings, and moods of the patients. Treatment adherence of the patients was evaluated with the Center for Adherence Support Evaluation (CASE) adherence questionnaire and pill counting method. The Hamilton Depression Rating Scale questionnaire was used to investigate the effect of depression severity on treatment adherence in patients. Results: Of the patients, 72.2\% were males and 27.8\% were females. Mean age of the patients was 44.9 +/- 14.8 years. Of the patients, 59.7\% were defined as treatment compatible. Sixty (83.3\%) patients used a single tablet regimen. The most commonly used combination was tenofovir alafenamide-emtricitabine-elvitegravir-cobicistate. Patients' age, disease duration, frequency of follow-up clinic depressive mood, substance use, and HIV positivity in their partners were found effective on treatment adherence. However, sex, marital and educational status, occupation, residential area, transmission route, duration on ART, ART regimen, ART treatment revision, recent CD4+ T lymphocyte count, recent viral load, side effect, additional treatments, antibiotic prophylaxis, smoking habit, alcohol use, comorbidity, co-infection were not statistically associated with treatment adherence. Conclusion: Sufficient awareness should be created by allocating enough time to patients, and patients should be followed up more frequently. Since alcohol and substance use affects treatment adherence, support should be sought from relevant institutions to limit alcohol and substance use in patients. Depressive mood is more common in HIV/AIDS patients compared to the normal population and negatively affects treatment adherence.
Restrained, emotional eating and depression can be a risk factor for metabolic syndrome
(ARAN EDICIONES, S L, 2022-01-01) Akillioglu, Tugce; Bas, Murat; Kose, Gizem
Introduction: metabolic syndrome (MetS) can have a bidirectional effect on emotional and restrained eating. Objectives: our aims are to find interrelations between MetS and emotional eating, restrained eating, additionally with depression.Methods: cross-sectional study. Participants aged between 18 and 63, and mostly were obese (n = 200). Eating Attitudes Test (EAT-26), Beck Depression Inventory (BDI) and Dutch Eating Behavior Questionnaire (DEBQ) were used to find associations between eating patterns and metabolic syndrome.Results: our study ensured evidences for physiological relations between restrained and emotional eating with MetS. Biochemical parameters showed that restrained eaters were less insulin resistant and participants with MetS had higher emotional eating and lower restrained eating. Besides, restrained eaters had lower triglyceride, homeostasis model assessment-insulin resistance (HOMA-IR), fasting insulin, blood glucose, and higher high-density lipoprotein cholesterol (HDL-C) levels

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