Psychological factors, immune function and recovery from major surgery

2009 ◽  
Vol 21 (4) ◽  
pp. 169-178 ◽  
Author(s):  
Ute Vollmer-Conna ◽  
Kevin D. Bird ◽  
Bryan W Yeo ◽  
Philip G. Truskett ◽  
Reginald F. Westbrook ◽  
...  
Keyword(s):  
Immune Function ◽  
Psychological Factors ◽  
Immune Status ◽  
Major Surgery ◽  
Passive Coping ◽  
Before And After ◽  
Negative Effect ◽  
And Coping ◽  
Induced Changes

Objective:This study used a prospective design and the technique of structural modelling to examine the complex interrelations between psychological factors, immune status and complications after major surgery.Methods:Twenty-nine women scheduled for elective cholecystectomy were studied prospectively. Information regarding medical history, health practices, life stressors, and coping strategies was obtained two weeks prior to admission. At this initial meeting, as well as three days after surgery, and at one month follow-up immunological tests were performed and the level of psychological distress was assessed. The study additionally included measures of post-operative complications, and infections and negative effect during follow-up.Results:Pre-operative immune status emerged as a key variable exerting strong effects on subsequent immune function and, thereby producing significant, indirect effects on every recovery variable. Pre-operative distress was directly linked to increased mood disturbance at follow-up. Moreover, distress significantly influenced immune function both before and after surgery, which mediated a significant impact on most recovery variables. Active coping behaviour directly increased the risk of a complicated recovery.Conclusions:The study demonstrated that distress-induced changes in immune functioning have clinical relevance. Overall, the present findings suggest that recovery from surgery is facilitated in patients with a well-functioning immune system, a low-level of pre-operative distress and a passive coping disposition.

Autoimplantation technique in the treatment of anogenital warts: a clinico-immunological study

1996 ◽  
Vol 7 (1) ◽  
pp. 55-56 ◽  
Author(s):  
N Usman ◽  
K Udayashankar ◽  
S Subramanian ◽  
S P Thyagarajan
Keyword(s):  
Immune Responses ◽  
Clinical Cure ◽  
Immune Status ◽  
Control Group ◽  
Immunological Study ◽  
Anogenital Warts ◽  
Matched Group ◽  
Before And After ◽  
Significant Change

An autoimplantation technique was adopted in the treatment of 50 cases of anogenital warts and was compared with the conventionally used podophyllin regimen in a matched group of 50 patients. They were assessed with 15 untreated subjects in a control group for the rate of clinical cure after 6 weeks, recurrence after 1 year follow up and for humoral and cell mediated immune responses before and after treatment. In the podophyllin group, 70% of patients were cured after 6 weeks while in autoimplantation, only 44% of patients were cured, and none in the control group had natural remission of warts without any treatment. After 1 year all the cured cases (100%) that completed follow up had recurrence of warts with podophyllin treatment, while none had recurrence of lesions in the autoimplantation group. Results of the humoral and cell mediated immune (CMI) response studies revealed that autoimplantation technique significantly augmented both humoral and CMI responses while there was no significant change in the immune status after podophyllin treatment (P>0.001).

scholarly journals Psychological Effects of Hands-On Training Using Public Transportation among Inpatients with Physical Disabilities: Analysis of the Self-Efficacy and Perception of Occupational Enablement Using a Multimethod Design

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Masahiro Ogawa ◽  
Yoriko Hayashi ◽  
Tatsunori Sawada ◽  
Mizuki Kobashi ◽  
Hitoshi Tanimukai
Keyword(s):  
Public Transportation ◽  
Self Efficacy ◽  
Psychological Factors ◽  
Intervention Study ◽  
Physical Disabilities ◽  
Rehabilitation Hospital ◽  
Hands On ◽  
Before And After ◽  
Vas Scores

Introduction. This study is aimed at understanding how practicing the use of public transportation can affect the self-efficacy and perceptions of occupational enablement among patients with physical disabilities in a recovery rehabilitation hospital. Method. We recruited 21 inpatients with physical disabilities caused by stroke or orthopedic diseases from a recovery rehabilitation hospital in Japan and used a multimethod design including an intervention study and a follow-up survey. The intervention study utilized a before-after trial and provided hands-on training in the use of public transportation as the intervention. How self-efficacy and perceptions of occupational enablement changed before and after the intervention was measured using the visual analog scale (VAS). The follow-up survey was conducted to investigate whether patients used public transportation postdischarge. Results. Only differences in the VAS scores regarding self-efficacy were significant between before and after the hands-on training in the use of public transportation, whereas differences regarding the perceptions of occupation enablement were not. Self-efficacy after the intervention was higher than that before the intervention. In the follow-up survey, both VAS scores of the psychological factors were significantly higher in the group that used public transportation postdischarge than in the group that did not. Conclusion. Providing hands-on training in the use of public transportation for inpatients with physical disabilities increased their self-efficacy, indicating that psychological factors should be evaluated to predict their occupational skill improvement and to verify the outcomes of an occupational therapeutic intervention.

The role of psychological factors in bipolar disorder: prospective relationships between cognitive style, coping style and symptom expression

2013 ◽  
Vol 26 (2) ◽  
pp. 81-95 ◽  
Author(s):  
Kathryn Fletcher ◽  
Gordon Parker ◽  
Vijaya Manicavasagar
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Style ◽  
Psychological Factors ◽  
Coping Style ◽  
Coping Styles ◽  
Symptom Expression ◽  
Mood Symptoms ◽  
Bipolar Ii ◽  
And Coping

ObjectivePsychological factors contribute to bipolar disorder illness course, representing targets for psychological intervention. Research to date has focused on bipolar I disorder, extrapolating results to bipolar II disorder. The current study addresses this discrepancy by exploring cognitive and coping styles in patients diagnosed with bipolar I or II disorder.MethodsParticipants were recruited from the Sydney-based Black Dog Institute. Diagnoses were derived via the MINI International Neuropsychiatric Interview. Baseline cognitive and coping style measures were completed, and mood symptoms assessed over a 6-month period. Clinician-rated mood status was assessed at follow-up to determine the predictive utility of cognitive and coping styles.ResultsThe follow-up sample comprised 151 participants. Differential relationships between cognitive style, coping styles and mood symptoms emerged across the bipolar sub-types. Some key differences were that a broader set of negative cognitive styles were associated with bipolar II depression symptoms; while few relationships were observed between coping styles and bipolar II symptoms.ConclusionDifferences in cognitive and coping style relationships with symptom expression across bipolar I and II disorder may provide clinicians with fruitful guides for directing treatment interventions when relevant maladaptive styles are observed. Further exploration of differences in cognitive and coping styles in bipolar I and II disorder is warranted.

scholarly journals IMPROV FOR CARE: TEACHING CAREGIVERS IMPROVISATION IMPROVES MOOD AND SENSE OF BURDEN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S852-S852
Author(s):  
Ruth Almen ◽  
Jessica Z Kirkland Caldwell
Keyword(s):  
Depressive Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Care Program ◽  
Course Completion ◽  
Rank Tests ◽  
Post Intervention ◽  
Signed Rank ◽  
Before And After ◽  
And Coping

Abstract There is a growing need for novel intervention for caregivers of family members with dementia. Improv for Care is a six-week program designed to teach improvisation (“improv”) skills to caregivers to practice flexible communication, build social support, and process the demands of caregiving through humor and play. This study aimed to examine changes in caregiver depression (Beck Depression Inventory-II), perception of burden (Zarit Burden Interview), qualitative experiences related to caregiving, and their cared-for person’s neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire). Fifteen caregivers completed questionnaires before and after the Improv for Care program. Wilcoxon signed rank tests for related samples revealed significant declines in both caregivers’ depressive symptoms, Z = -2.64, p = .008, and sense of burden, Z = -2.16, p = .031, after completing the program. Caregivers reported that their loved ones’ neuropsychiatric symptoms increased during the course of the intervention, Z = -2.10, p = .036, though associated distress did not also increase, Z = -1.12, p = .265. Of the 15 caregivers, 12 completed follow up questionnaires three months after course completion, which showed that their post-intervention reduction in depressive symptoms remained stable, Z = -1.02, p = .306. The Improv for Care program shows promise as an intervention for caregivers to improve stress, mood, and coping skills.

Anthropometric Evaluation of Photographic Images Before and After Functional Nasal Surgery in Patients With Deviated Noses

2020 ◽  
pp. 194589242098311
Author(s):  
Joerg Lindemann ◽  
Franziska Stupp ◽  
Marc Scheithauer ◽  
Anna Schmadl ◽  
Eva Goldberg-Bockhorn ◽  
...  
Keyword(s):  
Facial Asymmetry ◽  
Nasal Surgery ◽  
Biometric Analysis ◽  
Photographic Images ◽  
Deviated Nose ◽  
Angle Measurements ◽  
External Nose ◽  
Before And After ◽  
Negative Effect

Background Numerous techniques for correction of deviated noses have been described. Nevertheless, surgical management is challenging even for experienced rhinosurgeons. Often, a “residual deformity” after functional septorhinoplasty (SRP) due to a deviated pyramid syndrome may remain. Objective Therefore, the purpose of this study was to determine how frequent functional SRP in patients with a deviated nose results in “successful” straightening of the external nose based on standardized angle measurements. Possible influences having a positive or negative effect on the surgical success were identified. Methods Photo documentation of 607 patients with deviated noses (304 women, 303 men, median age 30 years) before and after nasal surgery were retrospectively analyzed using standardized angle measurements. The pre- and postoperative photos of the faces were anthropometrically measured. The median follow-up was 6 months. Results A “straight” deviated nose (I-type) was present in 225 patients (37%), a C-shaped nose (C-type) in 382 patients (63%). More than 75% of the patients presented a facial asymmetry. Based on angle measurements alone, a total of 452 (75%) noses were straightened or postoperatively improved. 155 noses (25%) still showed a biometric deviation. The I- or C-type had no relevant influence on outcome. Conclusion A purely biometric analysis of crooked noses is difficult and its importance is limited due to commonly pre-existing facial asymmetries. The risk of a “residual deviation” after rhinoplasty in patients with deviated noses must not be underestimated. This fact should be addressed as part of the informed consent. In particular, it should be mentioned that the surgical outcome can remain well below the patient’s aesthetic expectations. Not rarely, a revision surgery may be necessary.

scholarly journals The outcome of hydrodilation in frozen shoulder patients and the relationship with kinesiophobia, depression, and anxiety

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Philippe Debeer ◽  
Olivia Commeyne ◽  
Ianthe De Cupere ◽  
Dorien Tijskens ◽  
Filip Verhaegen ◽  
...  
Keyword(s):  
Psychological Factors ◽  
Frozen Shoulder ◽  
Depression Scale ◽  
Visual Analogue Score ◽  
Psychological Status ◽  
Depression And Anxiety ◽  
Before And After ◽  
The Relationship ◽  
Subjective Outcomes

Abstract Purpose The aims of this study were to (1) investigate the effect of hydrodilatation in frozen shoulder patients on objective indices of shoulder functionality and subjective outcomes of pain, mobility, kinesiophobia, depression, and anxiety, and (2) progress knowledge about the reciprocal temporal relationship between psychological parameters at baseline and objective and subjective outcomes at 3-month follow-up. Methods We evaluated the clinical and psychological status of 72 patients with a frozen shoulder before and after hydrodilatation, using the Constant Murley score, the Visual Analogue score, the Tampa Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, and the Shoulder Pain And Disability Index. Results We noted a significant improvement in functionality, pain and disability (p < .001). Depression and anxiety improved significantly (p < .001) between baseline and 3-month follow-up. Prospective analyses demonstrated that psychological factors are more likely to predict outcomes of hydrodilatation than vice versa. Conclusion Hydrodilatation followed by physiotherapy is an excellent way to treat patients with recalcitrant frozen shoulder, resulting in a continuous improvement of ROM and pain. Physiotherapists and physicians should be aware that psychological factors might have an impact on the treatment outcome.

scholarly journals Smoking, Gender, and Overweight Are Important Influencing Factors on Monocytic HLA-DR before and after Major Cancer Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Gunnar Lachmann ◽  
Clarissa von Haefen ◽  
Johannes Kurth ◽  
Fatima Yuerek ◽  
Klaus-Dieter Wernecke ◽  
...  
Keyword(s):  
Immune Function ◽  
Influencing Factors ◽  
Influencing Factor ◽  
Human Leukocyte ◽  
Estimating Equation ◽  
Major Surgery ◽  
Double Blind ◽  
Hla Dr ◽  
Before And After ◽  
And Gender

Background. Monocytic human leukocyte antigen D related (mHLA-DR) is essential for antigen-presentation. Downregulation of mHLA-DR emerged as a general biomarker of impaired immunity seen in patients with sepsis and pneumonia and after major surgery. Influencing factors of mHLA-DR such as age, overweight, diabetes, smoking, and gender remain unclear. Methods. We analyzed 20 patients after esophageal or pancreatic resection of a prospective, randomized, placebo-controlled, double-blind trial (placebo group). mHLA-DR was determined from day of surgery (od) until postoperative day (pod) 5. Statistical analyses were performed using multivariate generalized estimating equation analyses (GEE), nonparametric multivariate analysis of longitudinal data, and univariate post hoc nonparametric Mann–Whitney tests. Results. In GEE, smoking and gender were confirmed as significant influencing factors over time. Univariate analyses of mHLA-DR between smokers and nonsmokers showed lower preoperative levels (p=0.010) and a trend towards lower levels on pod5 (p=0.056) in smokers. Lower mHLA-DR was seen in men on pod3 (p=0.038) and on pod5 (p=0.026). Overweight patients (BMI > 25 kg/m2) had lower levels of mHLA-DR on pod3 (p=0.039) and pod4 (p=0.047). Conclusion. Smoking is an important influencing factor on pre- and postoperative immune function while postoperative immune function was influenced by gender and overweight. Clinical trial registered with ISRCTN27114642.

Coping strategies in relatives of people with schizophrenia before and after psychiatric admission

1999 ◽  
Vol 174 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Marcia Scazufca ◽  
Elizabeth Kuipers
Keyword(s):  
Coping Strategies ◽  
Expressed Emotion ◽  
Stress And Coping ◽  
Psychiatric Admission ◽  
Ways Of Coping ◽  
Care Givers ◽  
Before And After ◽  
Coping Model ◽  
And Coping

BackgroundMost research on expressed emotion (EE) has used an empirical approach to describe relatives' ways of coping with people with schizophrenia.AimsTo use the stress and coping model proposed by Lazarus and Folkman to examine how relatives coped with patients.MethodPatients with DSM–III–R schizophrenia and their relatives were assessed just after hospitalisation of the patients and nine months after discharge. Both assessments included the symptoms of the patients and the coping strategies, burden, distress and levels of EE of the relatives.ResultsFifty patients and 50 relatives were assessed at inclusion, and 31 patients and 36 relatives at follow-up. Coping strategies were used more frequently at inclusion than at follow-up. Problem-focused coping was the strategy used more often at both assessments. Avoidance coping was strongly associated with burden, distress and high EE at both assessments.ConclusionsWays of coping are influenced by relatives' perceptions of the situation with patients. Avoidance strategies seem to be less effective in regulating the distress of care-givers than problem-focused strategies.

scholarly journals Prognosis of EBV Infection in Children with Tonsillitis

2021 ◽  
pp. 100-108
Author(s):  
Reza Erfanian ◽  
Saeed Sohrabpour
Keyword(s):  
Immune Function ◽  
Adverse Reactions ◽  
Control Group ◽  
Case Group ◽  
Inflammatory Factor ◽  
Barr Virus ◽  
Ebv Infection ◽  
Before And After ◽  
Epstein Barr

Aims: Determining the prognosis of Epstein-Barr virus (EBV) infection with in children with tonsillitis. Methods: Totally 102 children with chronic tonsillitis admitted to our hospital between January 2017 and March 2019 were selected. Among them, 52 children with EBV infection were assigned to a case group, and the other 50 without EBV infection to a control group. All children were given targeted therapy. Then the two groups were compared in efficacy, defervescence time, alleviation time of tonsillar enlargement and pharyngalgia after therapy, immune function-associated indexes and inflammatory factor-associated indexes before and after therapy, incidence of adverse reactions during therapy, and recurrence times during therapy and 1-year follow-up. Results: Compared with the case group, the control group showed notably better efficacy, experienced notably shorter alleviation time of tonsillar enlargement and pharyngalgia, and presented better improvement in immune function and inflammation (all P<0.05). Additionally, the two groups were not greatly different in the incidence of adverse reactions (P>0.05), while the control group experienced notably less times of recurrence during therapy and 1-year follow-up (P<0.05). Conclusion: EBV infection will compromise the efficacy on children with tonsillitis and take its toll on their prognosis, so it is imperative to adopt a targeted and individualized therapeutic regimen for children with both diseases.

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