The choice of anesthetics and the effect on the Hamilton depression rating scale in therapy resistant depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S327-S328
Author(s):  
F. van Mensvoort ◽  
R. Teijeiro Permuy ◽  
C. Rijnders
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
Shock Duration ◽  
Hamilton Depression Rating Scale ◽  
Anesthetic Drugs ◽  
Significant Difference ◽  
Before And After ◽  
Resistant Depression ◽  
Competing Interest ◽  
Therapy Resistant Depression

IntroductionThe Dutch guideline ECT does not favor any anesthetic drug during electroconvulsive therapy. Although there are differences in seizure duration which may influence the effect of ECT, ethomidate, methohexital and propofol are “equal”. The influence of switching anesthetics during ECT is unknown. The reason for switching anesthetics is insufficient improvement in depressive symptomatology which is based on clinical picture. The Hamilton is a multiple item questionnaire which can give an indication of depression and which can evaluate recovery.ObjectivesDoes the choice of anesthetics or switching anesthetics influence the effect of ECT on the Hamilton depression rating scale?AimsTo determine whether the choice of anesthetic drugs in the case of switching influences the effect on the Hamilton depression rating scale.MethodsWe collected data of patients who received ECT for therapy resistant depression over the past five years. Choice of anesthetics, eventually switch and the score on the HDRS before and after ECT were included. The data was statistical analyzed.Results50 patients received ECT during past 5 years. ECT gives an improvement on the HDRS in all cases, whether there was a switch or not. Switching from methohexital to ethomidate when shock duration is less than 21 seconds gives a significant difference in improvement on the HDRS (BI 1.288 to 13.538) compared to patients who did not switch.ConclusionsThere are no significant differences on HDRS effect between the different anesthetics. Switching from methohexital to ethomidate gives a significant improvement on HDRS compared with no switch.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Otoskills training during covid-19 pandemic: a before-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxime Fieux ◽  
Antoine Gavoille ◽  
Fabien Subtil ◽  
Sophie Bartier ◽  
Stéphane Tringali
Keyword(s):  
Surgical Training ◽  
Rating Scale ◽  
Surgical Simulation ◽  
Global Rating Scale ◽  
Middle Ear Surgery ◽  
Global Rating ◽  
Training Requirements ◽  
Significant Difference ◽  
Before And After ◽  
Total Performance

Abstract Background The ongoing COVID-19 pandemic has disrupted the surgical training of residents. There is a real concern that trainees will not be able to meet their training requirements. Low-fidelity surgical simulation appears to be an alternative for surgical training. The educational benefits of repeating ossiculoplasty simulations under a microscope have never been evaluated. With this study we aimed to evaluate the differences in performance scores and on a global rating scale before and after training on an ossiculoplasty simulator. Methods In this quasi-experimental, prospective, single-centre, before-after study with blinded rater evaluation, residents performed five microscopic ossiculoplasty tasks with a difficulty gradient (sliding beads onto rods, the insertion of a partial prosthesis, the insertion of a total prosthesis, and the insertion of a stapedotomy piston under microscopic or endoscopic surgery) before and after training on the same simulator. Performance scores were defined for each task, and total performance scores (score/min) were calculated. All data were collected prospectively. Results Six out of seven intermediate residents and 8/9 novices strongly agreed that the simulator was an effective training device and should be included in the ENT residency program. The mean effect of training was a significant increase in the total performance score (+ 0.52 points/min, [95 % CI, 0.40–0.64], p < 0.001), without a significant difference between novice and intermediate residents. Conclusions This preliminary study shows that techniques for middle-ear surgery can be acquired using a simulator, avoiding any risk for patients, even under lockdown measures.

scholarly journals Electroconvulsive Therapy and Age: Effectiveness, Safety and Tolerability in the Treatment of Major Depression among Patients under and over 65 Years of Age

2021 ◽  
Vol 14 (6) ◽  
pp. 582
Author(s):  
Monika Dominiak ◽  
Anna Z. Antosik-Wójcińska ◽  
Marcin Wojnar ◽  
Paweł Mierzejewski
Keyword(s):  
Major Depression ◽  
Autobiographical Memory ◽  
Electroconvulsive Therapy ◽  
Cognitive Functions ◽  
Rating Scale ◽  
Short Form ◽  
Serious Adverse Events ◽  
Before And After ◽  
Trail Making ◽  
Resistant Depression

Electroconvulsive therapy (ECT) remains the most effective therapy in treatment-resistant depression. However, the safety of ECT has been consistently questioned, particularly among elderly patients. We assessed the efficacy and safety of ECT in patients before and after 65 years old. The study was conducted between 2015 and 2018 and included 91 patients (61 under and 29 over 65 years old) with major depression undergoing ECT. The Hamilton Depression Rating Scale was used to evaluate efficacy. Cognitive functions were assessed using: MMSE, RAVLT, Trail Making Test, Stroop Test and Autobiographical Memory Interview-Short Form. ECT was more effective in older patients as compared to younger (p < 0.001). No serious adverse events were observed in either group. Increased blood pressure and arrhythmias were more common in the older compared to the younger group (p = 0.044 and p = 0.047, respectively), while disturbances of consciousness did not differ between groups (p = 0.820). Most of the cognitive functions remained unchanged compared to baseline, whereas the outcomes of MMSE, RAVLT and Stroop tests showed greater improvements in the older compared to the younger group (all p < 0.05). The decline in the retrieval consistency of autobiographical memory was more pronounced in the younger group (p = 0.024). ECT is a highly effective, safe and well-tolerated method of treating depression regardless of age.

scholarly journals Association of Serum Serotonin and Pain in Patients with Chronic Low Back Pain before and after Spinal Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Afshin Farhanchi ◽  
Behrouz Karkhanei ◽  
Negar Amani ◽  
Mashhood Aghajanloo ◽  
Elham Khanlarzadeh ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Low Back ◽  
Significant Difference ◽  
Before And After ◽  
Postoperative Serum ◽  
Serum Serotonin

Introduction. In this study we are aiming to evaluate the changes of serum serotonin and its association with pain in patients suffering from chronic low back pain before and after lumbar discectomy surgery. Patients and Methods. A prospective study was performed on the patients referring to the outpatient clinic in Besat hospital, Hamadan University of Medical Sciences, Hamadan, Iran, during 2016. A 2 mL fasting blood sample was collected from each patient at preoperative day 1 and postoperative day 14 and they were measured for level of serum serotonin. Besides, all patients were asked for severity of their low back pain in preoperative day 1 and postoperative day 14 and scored their pain from zero to ten using a Numerical Rating Scale. Results. Forty patients with the mean age of 47 ± 13 yrs/old (range 25–77) including 15 (37.5%) males were enrolled into the study. The overall mean score of preoperative pain was significantly decreased from 7.4 ± 2.18 (range 4–10) to the postoperative pain score 3.87 ± 2.92 (range 0–10) (P < .001). The overall levels of pre- and postoperative serum serotonin were 3.37 ± 1.27 (range 1.1–6.4) and 3.58 ± 1.32 (range .94–7.1) ng/mL, respectively, with no significant difference (P = .09). The levels of pre- and postoperative serum serotonin were significantly higher in males and patients older than 50 yrs/old compared to the females and patients younger than 50 yrs/old, respectively (P = .03 and .005, respectively). A significant inverse correlation between the postoperative levels of pain and serum serotonin was observed (r = -.36 and P = .02). Conclusion. A negative medium strength linear relationship may exist between the postoperative serum serotonin and low back pain.

Comparison of efficacy between risperidone and aripiprazole in combination with sodium valproate in patients with acute manic or mixed episodes

2017 ◽  
Vol 41 (S1) ◽  
pp. S749-S749
Author(s):  
N. Amanat ◽  
A. Nazeri Astane ◽  
B. Dieji ◽  
O. Rezaie ◽  
A. Biglarian
Keyword(s):  
Weight Gain ◽  
Sodium Valproate ◽  
Rating Scale ◽  
Analysis Of Covariance ◽  
Young Mania ◽  
Double Blind ◽  
Measurement Evaluation ◽  
Significant Difference ◽  
Competing Interest ◽  
Bipolar Patients

Today, despite of the improvement in the psychological therapeutic approach, mania still remains as a challenging problem for health system. The aim of this study is comparison efficacy of risperidone and aripiprazole in combination with sodium valproate in bipolar patients with acute manic or mixed episodes who hospitalized in Razi psychiatric hospital in Tehran. This study was conducted as a double blind randomized clinical trial in two groups of bipolar disorder patients with manic or mixed episodes (18–65 age). Patients randomly set in two groups who received valproate with aripiprazole or risperidone. Clinical response was assessed with young mania rating scale (YMRS) and weight gain at 3 and 6 weeks. Data was analyzed with Chi2 test, paired t-test and analysis of covariance and repeated measurement. Evaluation of treatment response after 3 and 6 weeks (50% reduction in Young's scale) in both groups did not show any significant difference between the two therapeutic combinations. The combination of sodium valproate and risperidone showed higher weight gain in comparison with the combination of valproate and aripiprazole at the end of week 6 (P < 0.001). The mentioned combination in bipolar I disorder with manic or mixed episode has similar therapeutic effect, so that both of them are effective and usable. There was no difference in their efficacy, and both treatments can be used. Due to the less weight gain, the combination of valproate and aripiprazole in patients who prone to weight gain, this approach is recommended as more safe and effective therapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Agomelatine vs fluoxetine: Efficacy and improvement of cognitive functions in patients with MDD

2016 ◽  
Vol 33 (S1) ◽  
pp. S405-S405
Author(s):  
E. Aydın ◽  
M. Güleç ◽  
E. Oral ◽  
A.G. Daloğlu
Keyword(s):  
Cognitive Functions ◽  
Rating Scale ◽  
Word Association ◽  
Digit Span ◽  
Verbal Learning ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Neurocognitive Functions ◽  
Significant Difference ◽  
Competing Interest

IntroductionIn major depressive disorder (MDD) neurocognitive functions are impaired. In addition to melatonergic properties of agomelatine, via 5-HT2C antagonism it increases extracellular noradrenaline and dopamine in frontal cortex and may improve the neurocognitive functions of patients with MDD.Aims and objectivesTo investigate the extent of neurocognitive improvement and efficacy of agomelatine and fluoxetine in patients with MDD.Material and methodAgomelatine 25 mg/day (n: 24) and fluoxetine 20 mg/day (n: 24) were administered to drug-naive unipolar, non-psychotic, non-suicidal MDD patients according to DSM-IV. Evaluations were performed just before the treatment and at the sixth week of treatment via administering Hamilton Depression Rating Scale, Rey Auditory Verbal Learning Test, Controlled Oral Word Association Test (COWAT), Digit Span Test (DST), Trail Making Test (TMT-A/B), Stroop Test and Wisconsin Card Sorting Test.ResultsBoth agomelatine and fluoxetine was found to be efficacious for the treatment of MDD (P < 0.05 for both). Further there was no difference between the antidepressant efficacy of two drugs. Both of the drugs improved measured neurocognitive functions (P < 0.05), except scores of DST (P > 0.05) and only fluoxetine improved significantly scores of COWAT (P < 0.05). Only in terms of TMT-B there was significant difference between groups and agomelatine was superior to fluoxetine (P < 0.05).ConclusionAgomelatine and fluoxetine were efficacious in treatment of MDD. Furthermore both of the drugs improved cognitive functions in patients with MDD. Superiority of agomelatine in improvement of executive functioning (TMT-B) is important and therefore it could be an appropriate choice for MDD patients who have pronounced executive disturbances.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depression in Schizophrenia: A Descriptive Study

1996 ◽  
Vol 30 (3) ◽  
pp. 354-357 ◽  
Author(s):  
Petros Markou
Keyword(s):  
Rating Scale ◽  
Depressive Symptomatology ◽  
Structured Interview ◽  
Depression Score ◽  
Outcome Variable ◽  
Outpatient Group ◽  
Significant Difference ◽  
Significant Depression ◽  
Inpatient Group ◽  
Clinically Significant

Objective: To assess the level of depressive symptomatology among a group of patients with schizophrenia, both inpatients and outpatients, and speculate as to the reasons why differences among the groups may be occurring. Method: Fifty inpatients of Baillie Henderson Hospital, a chronic stay psychiatric hospital in Queensland, and 44 outpatients of this hospital were assessed on a number of measures including the Positive and Negative Syndrome Scale for Schizophrenia, Abnormal Involuntary Movements Scale, Hamilton Rating Scale for Depression and Beck Depression Inventory. All patients were assessed in a structured interview for 35–40 minutes by the same clinician. A chart review also occurred. The chief outcome variable was a Hamilton Depression Rating Scale of 17 or greater. Results: Clinically significant depression, as defined by a Hamilton Depression score of 17 or greater, was found in 10% (n = 5) of the inpatient sample. Of the outpatient sample, 4.5% (n = 2) showed a clinically significant depression, which was not significantly different to the inpatient group. The prevalence of mild to moderate depression, as defined by a Hamilton Depression score of between 10 and 17, was 42% in the inpatient group and 47.7% in the outpatient group. There was no significant difference between the two groups on the mean Hamilton Depression scores. Conclusions: The results suggest a high level of depressive symptomatology in patients with schizophrenia. As suicide is common in this group, this finding is important. Self-reporting of this problem by patients with schizophrenia, by means of questionnaire, is feasible and provides comparable results to objective clinician ratings.

scholarly journals Additional intranasal oxytocin to escitalopram improves depressive symptoms in resistant depression: An open trial

2015 ◽  
Vol 30 (1) ◽  
pp. 65-68 ◽  
Author(s):  
G. Scantamburlo ◽  
M. Hansenne ◽  
V. Geenen ◽  
J.J. Legros ◽  
M. Ansseau
Keyword(s):  
Depressive Symptoms ◽  
Rating Scale ◽  
Open Trial ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Hamilton Depression Rating Scale ◽  
Resistant Depression ◽  
Synthetic Oxytocin

AbstractThe aim of this open trial was to assess the antidepressant/anxiolytic effects of oxytocin used as an adjunct to antidepressant in treatment-resistant depression. Fourteen patients, who have not responded to 40 mg of escitalopram, received intranasal synthetic oxytocin during 4 weeks, in association with antidepressant. This is the first open trial study suggesting OT in association with escitalopram significantly reduced scores on Hamilton Depression Rating Scale.

The Effect of Using an Electric Fan on Dyspnea in Chinese Patients With Terminal Cancer

2016 ◽  
Vol 34 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Sio Leng Wong ◽  
Sok Man Leong ◽  
Cheng Man Chan ◽  
Sut Peng Kan ◽  
Hon Wai Benjamin Cheng
Keyword(s):  
Advanced Cancer ◽  
Large Scale ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Relevant Literature ◽  
Chinese Patients ◽  
Control Group ◽  
Significant Difference ◽  
Before And After ◽  
Experimental Group

Background: Fan therapy is often suggested for relieving the symptom of dyspnea in patients with advanced cancer, but relevant literature among Asians is limited. Objective: Phase 2 clinical trial to assess the clinical feasibility and outcome of using an electric fan to alleviate the symptom of dyspnea in Chinese patients with advanced cancer. Methods: Thirty patients with advanced cancer having unresolved breathlessness were recruited from Hospice and Palliative Care Centre of Kiang Wu Hospital in Macau. Participants were randomly and equally allocated to the experimental group and the control group, respectively. Outcome Measures: Verbal numerical rating scale (NRS) of breathlessness, respiratory rate (RR), and saturation of peripheral oxygen (SpO2) was collected before and after the intervention. Results: T test was used to analyze the data collected. There was a significant difference in the NRS scores of the experimental group ( P < .01), indicating a significant reduction in the patients’ sensation of breathlessness after fan therapy, whereas no significant difference was found in the objective statistic results of RR and SpO2. No significant difference ( P > .05) was found in the control group for all the 3 variables before and after routine treatment. Conclusion: The results of the study suggested that fan therapy could be effective in alleviating dyspnea in Chinese patients with advanced cancer. It should be considered as one of the nonpharmacological treatment option. Future large-scale phase 3 clinical trials are warranted.

Effectiveness of long-acting aripiprazole in schizoaffective disorders: A naturalistic longitudinal study

2017 ◽  
Vol 41 (S1) ◽  
pp. S757-S757
Author(s):  
A. Nivoli ◽  
M. Antonioli ◽  
L. Folini ◽  
L. Floris ◽  
G. Meli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Schizoaffective Disorder ◽  
Rating Scale ◽  
Psychiatric Clinic ◽  
Significant Difference ◽  
Sample Test ◽  
Competing Interest ◽  
Long Acting ◽  
Over Time

IntroductionIntramuscular paliperidone palmitate (PP) is a long-acting, atypical anti-psychotic for once monthly intramuscular (IM) administration in the treatment of patients with schizophrenia.ObjectiveTo study the effectiveness (efficacy and quality of life) of ARP in the maintenance treatment of schizoaffective disorder.MethodsA non-randomized, prospective naturalistic study was performed in out-patients with schizoaffective disorder unsuccessfully treated with oral anti-psychotics. Efficacy of ARP over time was evaluated by using brief psychiatric rating scale (BPRS 24-items), quality of life was evaluated by using QL-Index, both at T0 and at most recent visit (T1). Data were analyzed with Student's t-tests and Pearson correlations (α value, two tailed). Paired t-test was applied for BPRS and for Ql-Index total scores (T0–T1).ResultsData were available for 8 outpatients consecutively prescribed ARP and naturalistically treated attending at the psychiatric clinic, university of Sassari. Mean time on ARP treatment was 207.14 days (sd 137.2). BPRS mean total score at T0 was 57 (sd 13.2) and at T1 was 39.7 (sd 10.8). QL-Index mean total score was at T0 5.43 (sd 1.6) and at T1 7.14 (sd 2.7). Paired sample test showed a statistically significant difference in decreasing symptoms at BPRS over time (P = 0.001) and QL-Index total score (P = 0.023). The analyses showed a significant improving at the following BPRS sub-items: anxiety (P = 0.005), mood elevation (P = 0.014) conceptual disorganization (P = 0.048), emotional withdrawal (P = 0.05), tension (P = 0.02) and distractibility (P = 0.03).Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Effect of Human Relations and Communication Lesson on Eloquent Speaking Skill

2021 ◽  
Author(s):  
Meryem Altun Ekiz
Keyword(s):  
Physical Education ◽  
Rating Scale ◽  
Control Group ◽  
Group Model ◽  
Human Relations ◽  
Skill Scores ◽  
Significant Difference ◽  
Before And After ◽  
Speaking Skill ◽  
Speaking Skills

In this study, the effect of human relations and communication lessons on eloquent speaking skills was examined by using the pretest-posttest control group model. 96 students studying at Hatay Mustafa Kemal University School of Physical Education and Sports participated in the research voluntarily in the spring semester of 2020-2021. The data were collected during the oral presentations made in the human relations and communication lesson with the Rating Scale to Assess Speaking Skills for Turkish Native Speakers developed by Bozkurt and Arıca-Akkök (2019). Descriptive statistics were used to determine the level of speaking skills of physical education teacher candidates before and after speaking practices, and their standard deviation and arithmetic mean scores were examined. Wilcoxon Signed-Ranks Test was applied to determine whether there was a significant difference in speaking skill scores before and after the lesson. According to the research findings; while the pretest averages of the experimental group students were lower than the control group, their posttest averages were higher than the control group. It was determined that there was a significant difference between the scores of the students participating in the study before and after the experiment from the speaking skills observation form, and when the mean rank and totals of the difference scores were taken into account, it was seen that this difference was in favor of the positive ranks, that is, the posttest score. It was determined that there was no significant difference between the pre-test and post-test scores obtained from the speaking skills observation form of the students participating in the study in the control group.

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