RESUMO
Increases in depression are common in some elderly women. Elderly women often show moderate depressive symptoms, while others display minimal depressive symptoms. These discrepancies have produced contradictory and inconclusive outcomes, which have not been explained entirely by deficits in neurotransmitter precursors. Deficiency in some amino acids have been implicated in major depression, but its role in non-clinical elderly women is not well known. An analysis of essential amino acids, depression and the use of discriminant analysis can help to clarify the variation in depressive symptoms exhibited by some elderly women. The aim was to investigate the relationship of essential amino acids with affective, cognitive and comorbidity measures in elderly women without major depression nor severe mood disorders or psychosis, specifically thirty-six with moderate depressive symptoms and seventy-one with minimal depressive symptoms. The plasma concentrations of nineteen amino acids, Beck Depression Inventory (BDI) scores, Geriatric Depression Scale (GDS) scores, global cognitive scores and comorbidities were submitted to stepwise discriminant analysis to identify predictor variables. Seven predictors arose as important for belong to the group based on amino acid concentrations, with the moderate depressive symptoms group characterized by higher BDI, GDS and cognitive scores; fewer comorbidities; and lower levels of l-histidine, l-isoleucine and l-leucine. These findings suggest that elderly women classified as having moderate depressive symptoms displayed a deficiency in essential amino acids involved in metabolism, protein synthesis, inflammation and neurotransmission.
Assuntos
Aminoácidos Essenciais/sangue , Depressão/sangue , Histidina/sangue , Isoleucina/sangue , Leucina/sangue , Idoso , Aminoácidos Essenciais/deficiência , Estudos Transversais , Depressão/diagnóstico , Análise Discriminante , Feminino , Avaliação Geriátrica , Histidina/deficiência , Humanos , Isoleucina/deficiência , Leucina/deficiência , Valor Preditivo dos Testes , Escalas de Graduação PsiquiátricaRESUMO
Anemia is the most common hematologic disturbance of patients with chronic renal failure. It is usually normocytic, normochromic and the bone marrow does not show erythroblastic compensatory changes. The anemia is the resultant of different factors; inadequate erythropoiesis, hemolysis and bleeding, being the former the most important mechanism. The important role of the erythropoietin and its mechanism of production are discussed. Patients in intermittent peritoneal dialysis program show higher hemoglobin concentration than patients in chronic hemodialysis. The authors mention the therapeutic approach used to minimize the anemia emphasizing the need of reducing the number of blood transfusions (unless absolutely necessary), since they inhibit erythropoiesis.