Unlocking the diagnosis of depression in primary care: Which key symptoms are GPs using to determine diagnosis and severity?

Objective: Diagnosing depression in primary care settings is challenging. Patients are more likely to present with somatic symptoms, and typically with mild depression. Use of assessment scales is variable.

Severity alone should no longer determine therapeutic choice in the management of depression in primary care: findings from a survey of general practitioners.

Background: The treatment of depression in primary care remains suboptimal for reasons that are complex and multifactorial. Typically GPs have to make difficult decisions in limited time and therefore, the aim of this study was to examine the management of depression of varying severity and the factors associated with treatment choices.

Method: Nested within a primary care educational initiative we conducted a survey of 1760 GPs.

A role for cyclooxygenase in aging-related changes of beta-adrenoceptor-mediated relaxation in rat aortas.

beta-Adrenoceptor-mediated vasorelaxation decreases with age in various vascular beds. The present study investigated the roles of cyclooxygenase (COX) on beta-adrenoceptor vasorelaxation by isoprenaline in 8- and 54-week-old rat aortas. The vasorelaxation responses by isoprenaline (0.

Endogenous nitric oxide attenuates beta-adrenoceptor-mediated relaxation in rat aorta.

1. Divergent evidence suggests that the intracellular signalling pathways for beta-adrenoceptor-mediated vascular relaxation involves either cAMP/protein kinase (PK) A or endothelial nitric oxide (NO) release and subsequent activation of cGMP/PKG. The present study identifies the relative roles of NO and cAMP, as well as dependence on the endothelium for beta-adrenoceptor-mediated relaxation of rat isolated aortas.

Age-related changes in monocyte and platelet cyclooxygenase expression in healthy male humans and rats.

Cyclooxygenase (COX) catalyses the formation of prostanoids that are crucial in maintaining hemostasis and important in inflammation. Animal studies reveal that COX-1 and COX-2 expression increase in some cell types during aging. This study determined age-related changes in COX expression in platelets and monocytes.

Endogenous imidazoline receptor ligands relax rat aorta by an endothelium-dependent mechanism.

Agmatine and harmane have been proposed as endogenous ligands of imidazoline receptors. Agmatine has been reported to activate nitric oxide synthetase (NOS) in endothelial cells, so we sought to determine if agmatine or harmane and an analogue of harmane, propyl harmane, produced vasodilatation through an endothelium-dependent mechanism. The experiments were performed in endothelium-denuded and intact rat aortic rings preconstricted with phenylephrine (0.

Gender differences in protein kinase G-mediated vasorelaxation of rat aorta.

Although gender and oestrogen treatment influence production of the vasorelaxant, NO, their influence on factors downstream in the NO signal-transduction pathway, specifically protein kinase G (PKG), remains unknown. We aimed to study the influence of sex hormones on PKG, along with the endothelial modulation of these effects, in rat thoracic aortic rings in two separate groups, control male and female rats and ovariectomized female rats after treatment with oestrogen or vehicle. Vessel preparations were preconstricted with phenylephrine (0.

The role of cyclic nucleotides and calcium in the relaxation produced by amrinone in rat aorta.

(1) The vasorelaxation produced by the phosphodiesterase 3 (PDE3) inhibitor, amrinone was investigated in isolated rat aorta denuded of endothelium. In the presence of extracellular Ca(2+), amrinone, milrinone and 3-isobutyl-1-methylxanthine (IBMX), relaxed endothelium-denuded rat aortic rings constricted with phenylephrine. While the actions of milrinone and IBMX were inhibited by the protein kinase G (PKG) inhibitor, Rp-8-Bromo guanosine-3',5' monophosphothioate (Rp-8-Br-cGMPS; 0.

Amrinone reduces ischaemia-reperfusion injury in rat heart.

We investigated the effects of amrinone on ischaemia-induced changes in myocardial function in isolated rat hearts. Isolated hearts from male Sprague-Dawley rats (150-275 g) were perfused with physiological salt solution at a constant flow rate. The effects of amrinone (30 microM) on left ventricular end diastolic pressure, positive and negative dP/dt, heart rate and coronary perfusion pressure were observed following global ischaemia and reperfusion.

Age-related involvement of the endothelium in beta-adrenoceptor-mediated relaxation of rat aorta.

The signalling pathway involved in beta-adrenoceptor relaxation was studied in aortas from rats either 8 or 54 weeks of age. The vasorelaxation produced by isoprenaline was almost completely abolished by endothelium removal in 54-week aortas, whereas in 8-week aortas, the effect was much smaller. The nitric oxide synthase inhibitor N-methyl-1-arginine acetate (L-NMMA) partially attenuated the isoprenaline induced relaxation to a similar extent in both age groups when the endothelium was intact, suggesting that although nitric oxide was involved, it could not explain the age-related difference.

Effect of cGMP inhibitors on the actions of nitrodilators in rat aorta.

1. The involvement of cGMP in vasodilatation produced by a range of nitrodilators was investigated using two different protein kinase G inhibitors, R(p) 8-bromoguanosine-3'5'-cyclic monophosphothioate (RBrcGMPS) and KT 5823. 2.

Evaluation of resistance to Marek's disease in three white Plymouth Rock lines and in two reciprocal crosses.

Two White Plymouth Rock lines (WPR), both developed into lines resistant for Marek's disease (MD), and one commercial WPR line, supposedly susceptible to the disease, were mated in a number of combinations to evaluate resistance to MD in their pure- and crossbred progeny. For this purpose the pedigreed 1-day-old progeny chicks were exposed to 3-week-old spreader chicks which had been inoculated at 1-day-old with virulent MD virus (MDV) and reared with them for the whole experimental period of 15 weeks. Response to the challenge showed that resistance to MD in the cross-breds was intermediate to that of resistant and susceptible parental lines.

The development of two White Plymouth Rock lines resistant to Marek's disease by breeding from survivors.

A programme to develop resistance to Marek's disease (MD) in chickens in two non-inbred White Plymouth Rock (WPR) lines by breeding from survivors was initiated in 1968 and since then nine generations have been produced. In each generation only sires and dams which survived heavy exposure to virulent MD virus (MDV), Dutch strain K, either by inoculation (for the first two generations) or by contact-exposure (for the following seven generations) were used. In this long term trial a high level of resistance to MD was reached within five generations; thereafter no marked further increase in resistance could be obtained.