The highest prevalence of depressive disorders was found in the first trimester, the lowest in mid-pregnancy. Several determinants (unwanted and unplanned pregnancy, high neuroticism) were independent predictors of antenatal depressive disorders throughout whole pregnancy, while other determinants (low education, previous history of depression, the occurrence of psychosocial stressors at the end of pregnancy) were trimester specific.

Symptoms of anxiety and depression are prevalent in medical students and in humanities students. Severity of symptoms of anxiety and symptoms of depression in medical students is negatively related to emotional stability and positively related to stress vulnerability.

BackgroundDeterioration of health related quality of life (HRQoL) is common in brain tumor patients. This study evaluated validity and reliability of the Medical Outcomes Study 36-Item Short Form (SF-36) in patients with brain tumors.MethodsTwo hundred and seventy-seven patients admitted for brain tumor surgery were evaluated for HRQoL (SF-36 questionnaire); depressive symptoms (Beck Depression Inventory-II or BDI-II); and functional status (Barthel index or BI). Final histological diagnosis was obtained from pathology reports.ResultsTwo-hundred and twenty-seven (completion rate of 82%) patients (69% women; mean age 55.8 ± 14.4 years) completed the SF-36 questionnaire. The most common brain tumor diagnosis was meningioma (40%), followed high-grade glioma (19%). Missing data rates were ≤4%. Internal consistency was adequate for all (Cronbach α ≥ .728) but Social Functioning (Cronbach α = .527) and General Health (Cronbach α = .693) subscales. Ceiling (≥36%) and floor (≥22%) effect rates were the greatest for the Role Limitations subscales. The SF-36 subscales pertaining physical health correlated the strongest with the BI score, while the SF-36 subscales pertaining emotional health correlated the strongest with the BDI-II score. Patients with mild-moderate depressive symptoms (BDI-II score ≥20) scored lower across all SF-36 subscales, and handicap patients (BI score <90) scored the lower across all, but Mental Health, subscales.ConclusionsThe SF-36 is a valid and reliable instrument in brain tumor patients and therefore can be reliably applied for evaluation of HRQoL in neuro-oncology setting. Further studies exploring other psychometric properties of the SF-36 in brain tumor patients across disease progression stages are warranted.

BACKGROUND A key challenge in the medical treatment of brain tumors is the limited penetration of most chemotherapeutic agents across the blood–brain barrier (BBB) into the tumor and the infiltrative margin around the tumor. Magnetic resonance-guided focused ultrasound (MRgFUS) is a promising tool to enhance the delivery of chemotherapeutic agents into brain tumors. OBJECTIVE To review the mechanism of FUS, preclinical evidence, and clinical studies that used low-frequency FUS for a BBB opening in gliomas. METHODS Literature review. RESULTS The potential of externally delivered low-intensity ultrasound for a temporally and spatially precise and predictable disruption of the BBB has been investigated for over a decade, yielding extensive preclinical literature demonstrating that FUS can disrupt the BBB in a spatially targeted and temporally reversible manner. Studies in animal models documented that FUS enhanced the delivery of numerous chemotherapeutic and investigational agents across the BBB and into brain tumors, including temozolomide, bevacizumab, 1,3-bis (2-chloroethyl)-1-nitrosourea, doxorubicin, viral vectors, and cells. Chemotherapeutic interventions combined with FUS slowed tumor progression and improved animal survival. Recent advances of MRgFUS systems allow precise, temporally and spatially controllable, and safe transcranial delivery of ultrasound energy. Initial clinical evidence in glioma patients has shown the efficacy of MRgFUS in disrupting the BBB, as demonstrated by an enhanced gadolinium penetration. CONCLUSION Thus far, a temporary disruption of the BBB followed by the administration of chemotherapy has been both feasible and safe. Further studies are needed to determine the actual drug delivery, including the drug distribution at a tissue-level scale, as well as effects on tumor growth and patient prognosis.

This study aimed to evaluate how precise the Edinburgh Depression Scale (EDS) is in screening for major depressive disorder (MDD) during different periods of pregnancy. A random sample of 230 pregnant women was interviewed in the first, second, and third trimesters of pregnancy using the EDS and not-patient version of the Structured Clinical Interview for DSM-III-R (SCID-NP). We evaluated test-retest reliability of the EDS; area under the ROC curve (AUC), sensitivity, specificity, and positive predictive value (PPV) of the EDS against the SCID-NP diagnoses in the first, second, and third trimesters of pregnancy. Test-retest reliability of the EDS was 0.81 (p < 0.001). An optimal cutoff score of the EDS for screening current SCID-NP diagnosis of MDD was 12 and higher in the first trimester of pregnancy (AUC 0.94, sensitivity 92%, specificity 95%, and PPV 52%) and 11 and higher in the second and third trimesters of pregnancy (AUC 0.96 and 0.90, respectively; sensitivity 100% and 88%, respectively; specificity 92% and 92%, respectively; PPV 25% and 29%, respectively). The EPDS is a reliable instrument for repeated evaluations of depressive symptoms during pregnancy. It has a good sensitivity and specificity for detecting antenatal MDD with optimal cutoff of 11/12 or higher.

Graphical abstract

No abstract

HighlightsMR elastography allows non-invasive quantification of the shear modulus of tissue.MRE correlates with intra-operative consistency of meningiomas, pituitary adenomas.Reported shear modulus values are widely distributed and overlap.Meningiomas were the stiffest tumor-type relative to normal appearing white matter.Studies are needed to determine clinical applications of MRE in neuro-oncology.