A course of bilateral ECT (mean number of applications 8.8+/-3.2) was applied to 22 patients (age 46.3±9.8; males 45.8%;IQ 97.2±11.6) with baseline HAMD 28.5±3.6, DASS 95±15, MMSE 29.1±1,1, who were tested by Sockings of Cambridge (SOC) tests (Cambridge Automated Neuropsychological Test Battery)at baseline (T0), immediately after ECT (T1) and one month later (T2). ECT was delivered with a modern square-wave machine with EEG and ECG monitoring. Modified treatment was performed in all cases.

The intensity of depressive symptoms (HAMD and DASS) was significantly reduced at T1 and T2 in comparison to baseline (p<.001) and MMSE was improved (p<.001). SOC improvement at both T1 and T2 in comparison to baseline was found in mean initial thinking time (p=.002) and mean subsequent thinking time (p=.003). Number of problems solved in minimum moves did not differ before and after ECT (range 7.8-8.2; p=.639).

ECT reduced depression without impairing executive function. As it is less likely that improvement in mean thinking time on SOC is directly associated with ECT, we suggest that improved execution is rather due to the decreased individual sensitivity to negative feedback during performing the task.

The core mechanism of maladaptive stress response includs aberrant phosphorylation of the glucocorticoid receptor (GR) at serine 221 (pGR211) or GR serine 226 (pGR226), which enhance or attenuate GR transcriptional activity, respectively. In the current study we tested a hypothesis that alterations in the nuclear levels and/or ratios of GR, pGR211 and pGR226 in peripheral blood mononuclear cells (PBMC) may reflect individual level of distress and/or psychological vulnerability.

In 36 healthy adults we evaluated the relation of total PMBC nuclear level of GR (tGR), pGR221, pGR226 and activated JNK1 (pJNK1) and its relation to environmental stress exposure, self reported distress (Depression Anxiety Stress Scale) and personality traits (Eysenck Personality Questionnaire). Molecular and psychometric data were cross-correlated by SPSS MannWhitney statistics.

In women, self reported distress (DASS score) correlated more with neuroticism, while in men it correlated with environmental stressor. Also, in women, PBMC nuclear tGR level correlated with pGR211, while in men it correlated with pGR226. Cross-analysis of psychometric and molecular data indicated that in women both neuroticism and self reported distress correlated positively with nuclear pGR226, while in men the only correlation was between environmental stressor and pJNK1.

This findings provide preliminary support that the nuclear level of pGR226 and pGR211/pGR226 ratio in PBMC may serve as a measure of affective vulnerability in healthy women, while nuclear level of pJNK1 may reflect environmentaly imposed distress in healthy men. The relevance of these molecular parameters as biomarkers requires broader verification in healthy and in clinical settings.

The authors have not supplied their declaration of competing interest.

This study aimed to compare two sampling methods for nasal nitric oxide in healthy individuals and allergic rhinitis patients, and to examine the within-subject reliability of nasal nitric oxide measurement.

The study included 23 allergic rhinitis patients without concomitant asthma and 10 healthy individuals. For all participants, nitric oxide levels were measured non-invasively from the lungs through the mouth (i.e. the oral fractional exhaled nitric oxide) and the nose. Nasal nitric oxide was measured by two different methods: (1) nasal aspiration via one nostril during breath holding and (2) single-breath quiet exhalation against resistance through a tight facemask (i.e. the nasal fractional exhaled nitric oxide).

Compared with healthy participants, allergic rhinitis patients had significantly higher average oral and nasal nitric oxide levels. All methods of nitric oxide measurement had excellent reliability.

Nasal nitric oxide measurement is a useful and reliable clinical tool for diagnosing allergic rhinitis in patients without asthma in an out-patient setting.

Current literature provides insufficient information on the degree of cognitive impairment during and after electroconvulsive therapy (ECT), mostly due to the fact that applied tests lacked sensitivity and flexibility. Our goal was to evaluate cognitive functioning in adult depressed patients treated with bi-temporal ECT, using tests sensitive for detection of possible acute and medium-term memory changes.

Thirty adult patients with major depressive disorder, treated with a course of bi-temporal ECT, underwent clinical and cognitive measurements three times: at baseline, immediately after a course of ECT, and 1 month later. For cognition assessment, we used learning and visual, spatial and figural memory tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Bi-temporal ECT has proven to be an effective treatment. The linear mixed model, used to analyze changes in depression severity and patients’ cognitive performances over time and to assess dynamic correlations between aforementioned features, did not show any significant memory impairment as a potential acute or medium-term ECT effect. However, it yielded significant improvement on visual memory and learning at the follow-up, which positively correlated with the improvement of depression.

Good progress is being made in the search for ECT-related acute and medium-term cognitive side-effects by using the tests sensitive to detect memory dysfunction with parallel forms of the tasks (to counter practice effects on repeat testing). Our results on learning and memory in relation to ECT during treatment of depression did not bring forth any prolonged and significant bi-temporal ECT-related memory deficit.

This study aimed to compare the prognostic impact of comorbidity grading by the Adult Comorbidity Evaluation 27 index and the Charlson Comorbidity Index on the five-year overall and disease-specific survival in patients undergoing surgery for laryngeal squamous cell carcinoma.

The impact of comorbidity and other factors on survival was examined retrospectively in a group of 177 patients with previously untreated tumour stage one to four laryngeal squamous cell carcinoma surgically treated at the Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, between 2000 and 2003. The Cox proportional hazard model was used to identify independent prognostic factors.

On univariate analysis, comorbidity had an impact on prognosis regardless of which index was used. On multivariate analysis, the significant predictors of patients' five-year overall and disease-specific survival were tumour–node–metastasis stage and comorbidity as graded by the Adult Comorbidity Evaluation 27 index.

The Adult Comorbidity Evaluation 27 index is a more reliable predictor of survival than the Charlson Comorbidity Index in patients with laryngeal squamous cell carcinoma.