Interaction of Ibuprofen with Partially Unfolded Bovine Serum Albumin in the Presence of Ionic Micelles and Oligosaccharides at Different λex and pH: A Spectroscopic Analysis

The interaction between the plasma protein bovine serum albumin (BSA) and the drug ibuprofen (IBU) has been investigated at three different pH values (7.4, 6.5, and 8.0) in the presence of oligosaccharides and surfactants. The interaction analysis of BSA with oligosaccharides and surfactants has also been studied in the absence of the drug ibuprofen. The results obtained give convenient and efficient access to understand the mechanism of binding of ibuprofen to BSA, and the major forces involved are found to be hydrophobic forces, hydrogen bonding and ionic interactions. In addition to that, the formation of inclusion complexes of ibuprofen with oligosaccharides (β-CD and 2-HP-β-CD) has been observed, which has depicted that due to the hydrophobic nature of ibuprofen, it becomes more soluble in the presence of oligosaccharides, but due to the larger size of the inclusion complexes, these could not be able to access the hydrophobic pocket of BSA where tryptophan-212 (Trp-212) resides. The binding interaction between BSA and ibuprofen is observed in the presence of surfactants (SDS and CTAB), which partially unfold the protein. Non-radiative fluorescence resonance energy transfer (FRET) from Trp and Tyr residues of BSA in the presence of an anionic surfactant SDS to ibuprofen has depicted that there is a possibility of drug binding even in the partially unfolded state of BSA protein. Furthermore, the distance between the protein and the drug has been calculated from the FRET efficiency, which gives a comprehensive overview of ibuprofen binding to BSA even in its partially denatured state. The hydrophobic drug binding to the partially unfolded serum albumin protein (BSA) supports the "necklace and bead structures" model and opens up a new direction of drug loading and delivery system, which will have critical therapeutic applications in the efficient delivery of pharmacologically prominent drugs.

Anxiety and functional status in older primary care patients

OBJECTIVE

The aim of this study was to test the hypothesis that anxiety in older primary care patients is associated with functional impairment after controlling for depression and medical comorbidity.

METHOD

Primary care patients (n = 303), aged sixty or older were interviewed with a series of instruments designed to measure psychiatric symptoms including anxiety, depression, medical illness burden, and both examiner-rated and self-reported functional status. Anxiety was measured by the anxiety item of the Hamilton Rating Scale for Depression and the anxiety items of the Medical Outcomes Study Short Form SF-36. Multiple regression techniques were used to examine the association of anxiety with functional status after controlling for age, gender, education, medical burden, and depression.

RESULTS

When controlled for depression and medical morbidity, increased anxiety predicted poorer social function. Anxiety was not independently associated with more basic activities of daily living.

CONCLUSIONS

Further studies with more comprehensive measures of anxiety are warranted to clarify the relationships between anxiety and functional status.

Attempted suicide in older depressed patients: effect of cognitive functioning

The authors explored cognitive functioning and suicidal behavior in older depressed patients. Inpatients age 50 years or older (N=103) with major depression, 45 of whom had attempted suicide, were evaluated within 1 week of their hospital admission. Measures of suicidal behavior included suicide attempter status, the Suicide Intent Scale (SIS), ratings of method used (violent/nonviolent), and seriousness of injuries sustained (lethality). The Mini-Mental State Exam (MMSE) score measured cognitive impairment; covariates were age, gender, and living arrangement. The MMSE score was not associated with suicide attempter status, but for attempters, MMSE score showed a positive association with SIS score, but not method or lethality. Findings suggest that although cognitive disturbance may be associated with less-deliberate acts among older depressed suicide attempters, it does not appear to influence the potential lethality of their behavior.

Detection of depression in primary care: comparison of two self-administered scales

Two self-rated questionnaires, SELFCARE (D) and Hospital Anxiety Depression (HAD) Scale, were compared in relation to their efficacy in detecting depression in 72 elderly patients attending general practitioners at a health centre in Liverpool, England. The sensitivity, specificity and overall misclassification rates of both the scales were assessed against a diagnosis arrived at by using a standardized interview schedule, Geriatric Mental State (community version), and a computerized diagnostic scheme, AGECAT. In this preliminary study, SELFCARE (D) was found to be superior to HAD as a screening instrument for depression in the elderly population in primary care.

The 'small spleen' in malaria

A cardinal feature of malaria, splenomegaly, is usually absent in adult patients who have already suffered from falciparum malaria or who are natives of an endemic falciparum zone. This is an attribute of the past episode of clinical or sub-clinical malaria which usually results in regression of the splenic size to below-normal. An ultrasonographic evaluation of spleens was done in 90 healthy adult males, who had suffered from vivax (n = 28) or falciparum (n = 25) malaria in the past, except the controls (n = 22) and natives from an endemic falciparum area (n = 15) who never suffered from malaria. Their ultrasonographic details of spleens, including the size, were compared. Besides other conspicuous differences in the ultrasonographic picture, spleen size was found significantly decreased (p < 0.01) in the group who had been affected by P. falciparum malaria; the smallest measured 7.8 cms. In P. vivax group the decrease was not significant (p < 0.1), but was highly significant in inhabitants of endemic falciparum region (p < 0.001). The present study establishes the 'Small Spleen' and looks at echotexture pattern variations thereof for the first time.

Blunted growth hormone and prolactin responses to L-tryptophan in depression; a state-dependent abnormality

We have investigated whether attenuated growth hormone (GH) and prolactin (PRL) responses to L-tryptophan in depression return to normal with clinical recovery. Ten patients who had received intravenous infusions of L-tryptophan (100 mg/kg) when depressed were retested at least 3 months after full recovery and cessation of treatment. In recovered depressives growth hormone responses showed considerable recovery, in all but three cases to within a few units of their healthy age- and sex-matched controls. Prolactin responses increased with clinical recovery in all six male subjects. Results in females were inconclusive because of the effect of weight loss on prolactin responses. The results suggest that GH and PRL responses to tryptophan are state-dependent abnormalities rather than indicators of predisposition to depression. This allows the possibility that impaired functioning in systems with a 5HT1A or 5HT1D receptor link may be part of the causal chain in depression.

Hormonal response to L-tryptophan infusion: effect of propranolol

There is circumstantial evidence that increases in prolactin secretion evoked by L-tryptophan infusion involve 5-HT1 receptors, whereas growth hormone responses do not. Propranolol is a beta-adrenoceptor antagonist that also possesses antagonist properties at 5-HT1 receptors. Propranolol (80 mg, PO) failed to attenuate the prolactin response to L-tryptophan infusion (100 mg/kg, IV) in seven volunteers; the role of 5-HT1 receptors in this response remains uncertain. The growth hormone response to tryptophan was enhanced by propranolol, consistent with previous reports of an inhibitory beta-adrenoceptor influence on GH secretion. Excessive beta-adrenoceptor function might explain the blunted growth hormone response to tryptophan in depression.

Psychiatric presentation of third ventricular colloid cyst. A case report

A case of colloid cyst of the third ventricle in a patient presenting with delusional depressive syndrome, in clear consciousness and with minimal cognitive impairment, is reported. The possible pathogenesis of the syndrome is discussed in the light of the reported association between aqueduct stenosis, diencephalic dysfunction, hydrocephalus, and psychotic symptoms.