Cost and benefit in the choice of ECT schedule

1998 ◽  
Vol 172 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Baruch Shapira ◽  
Nurith Tubi ◽  
Heinz Drexler ◽  
David Lidsky ◽  
Avraham Calev ◽  
...  
Keyword(s):  
Memory Impairment ◽  
Depression Scale ◽  
Antidepressant Effect ◽  
Hamilton Depression Scale ◽  
Cognitive Effects ◽  
Weekly Treatment ◽  
Significant Difference ◽  
Before And After ◽  
Rate Of Response

BackgroundWe compared the anti-depressant and cognitive effects of up to eight sessions of bilateral, brief pulse electroconvulsive therapy (ECT) administered twice (ECT x 2) or three times weekly (ECT x 3), to confirm that ECT x 3 acts more rapidly although the two schedules are equivalent in antidepressant outcome, and to establish whether ECT x 3 is indeed associated with more severe memory impairment.MethodPatients with major depression, endogenous subtype were randomly assigned to ECT x 3 or ECT x 2 plus one simulated ECT per week, both up to a maximum of eight real ECT. Depression was evaluated by the Hamilton Depression Scale the day after each treatment and cognitive function by a test battery administered before and after the ECT series and at one month follow-up.ResultsAssessed categorically or parametrically, there was no significant difference in antidepressant outcome between the two schedules. Rate of response was significantly more rapid with ECT x 3 but was associated with more severe memory impairment.ConclusionsTwice weekly administration is an optimum schedule for bilateral ECT unless clinical indications require the more rapid antidepressant effect of three times weekly treatment.

scholarly journals Association Between Obesity and Post-stroke Anxiety in Patients With Acute Ischemic Stroke

2021 ◽  
Vol 8 ◽  
Author(s):  
Bei-Lei Zhu ◽  
Ai-Yi Hu ◽  
Gui-Qian Huang ◽  
Hui-Hua Qiu ◽  
Xian-Chai Hong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Abdominal Obesity ◽  
Depression Scale ◽  
Elevated Risk ◽  
Hamilton Depression Scale ◽  
Post Stroke ◽  
Significant Difference ◽  
Clinical Measurements

Post-stroke anxiety (PSA) is serious psychosomatic comorbidity among patients with stroke, but whether obesity could be positively associated with PSA is currently unknown. The purpose of this study was to investigate the potential association between obesity and subsequent anxiety risk in patients with stroke. A total of 441 patients with acute ischemic stroke (AIS) onset were consecutively recruited within 7 days, and PSA and post-stroke depression (PSD) were evaluated by using a 14-item Hamilton anxiety scale (HAMA) and 17-item Hamilton depression scale (HAMD) at the end of 1-month follow-up. The odds ratio (OR) with 95% CI was estimated for the incidental PSA by using logistic regression analysis. The incidence of PSA was 25.85% at the end of 1-month follow-up, with a significant difference between patients with and without abdominal obesity. Relative fat mass (RFM) and abdominal obesity were significantly associated with an elevated risk of PSA, and the crude ORs were 1.04 (95% CI: 1.01–1.08) and 1.93 (95% CI: 1.11–3.34), respectively. Even after adjustment for obesity-related risk factors and PSA-related clinical measurements, the association remained to be pronounced with abdominal obesity. However, RFM (OR = 1.03, 95% CI: 0.99–1.06, P = 0.053) and abdominal obesity (OR = 1.31, 95% CI: 0.80–2.15, P = 0.280) were not significantly associated with an elevated risk of PSD. Abdominal obesity was independently associated with the PSA instead of PSD, which may help predict PSA risk in clinical practice. Further prospective clinical studies with a long follow-up duration are warranted to verify this finding.

Melatih Kepemimpinan Perangkat Desa Kebonharjo Kulonprogo: Membangun Sikap Anti Korupsi

2018 ◽  
Vol 1 ◽  
pp. 107
Author(s):  
Adi Heryadi ◽  
Evianawati Evianawati
Keyword(s):  
Transformational Leadership ◽  
Data Collection ◽  
Paired Samples ◽  
Significant Difference ◽  
Before And After ◽  
Post Test ◽  
Sample Test ◽  
Corruption Perception ◽  
Measuring Tool

This study aims to prove whether transformational leadership training is effective for building anti-corruption attitudes of villages in Kebonharjo village, subdistrict Samigaluh Kulonprogo. This research is an experimental research with one group pre and posttest design.Subject design is 17 people from village of 21 candidates registered. Measuring tool used in this research is the scale of anti-corruption perception made by the researcher referring to the 9 anti-corruption values with the value of reliability coefficient of 0.871. The module used as an intervention made by the researcher refers to the transformational leadership dimension (Bass, 1990). The data collected is analyzed by statistical analysis of different test Paired Sample Test. Initial data collection results obtained sign value of 0.770 which means> 0.05 or no significant difference between anti-corruption perception score between before and after training. After a period of less than 1 (one) month then conducted again the measurement of follow-up of the study subjects in the measurement again using the scale of anti-corruption perception. The results of the second data collection were analysed with Paired Samples Test and obtained the value of 0.623 sign meaning p> 0.05 or no significant difference between post test data with follow-up data so that the hypothesis of this study was rejected.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

A Comparison of the Effects of Veau-Wardill-Kilner Palatoplasty and Furlow Double-Opposing Z-Plasty Operations on Eustachian Tube Function

2000 ◽  
Vol 37 (3) ◽  
pp. 266-270 ◽  
Author(s):  
Ethem Güneren ◽  
Zafer Özsoy ◽  
Mithat Ulay ◽  
Erhan Eryilmaz ◽  
Haluk Özkul ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Eustachian Tube ◽  
Soft Palate ◽  
Surgical Anatomy ◽  
Eustachian Tube Function ◽  
Secretory Otitis Media ◽  
Significant Difference ◽  
Before And After ◽  
Tube Function

Objective The purpose of this study was to compare the effects of Veau-Wardill-Kilner (VWK) two-flap palatoplasty and Furlow double-opposing Z-plasty operations on eustachian tube (ET) opening in patients with cleft palate (CP). Design Twenty-six patients underwent CP repair between 1993 and 1997. VWK and Furlow operations were used in 13 patients each. All patients were examined by the otorhinolaryngologist before and after the operations; mean follow-up time was 27.3 months. Secretory otitis media (SOM), as identified by tympanograms, was the comparison criterion used. Results The prevalence of SOM was 69% (n = 18) in all CP patients pre-operatively. Among those with preoperative SOM, we did not find any statistically significant difference in the frequency of postoperative SOM between the two techniques. Conclusion This study suggests that there is no difference in postoperative ET function between patients undergoing either VWK or Furlow operations, in spite of the differences in muscle positioning in these operations. We discuss the implications of this finding in relation to surgical anatomy and histology of the soft palate muscles.

scholarly journals Is It Necessary to Reduce Thoracolumbar Compression Fractures  with Intermediate Screws in the Fractured Vertebra?

2021 ◽  
Author(s):  
ZeJun Xing ◽  
Shuai Hao ◽  
XiaoFei Wu
Keyword(s):  
Blood Loss ◽  
Body Height ◽  
Pedicle Screws ◽  
Operation Time ◽  
Short Segment ◽  
Compression Fractures ◽  
Significant Difference ◽  
Before And After ◽  
Screw Group

Abstract PurposeTo compare the efficacy and safety of percutaneous short-segment pedicle screws fixation (PPSF) with or without intermediate screws (IS) for the treatment of thoracolumbar compression fractures.MethodsFrom January 2016 to March 2019, a retrospective study of 38 patients with thoracolumbar compression fractures conducted. The patients were divided into a 4-screw group (without IS) and a 6-screw group (with IS) according to whether pedicle screws were placed in the fractured vertebrae. Combined positional reduction effects with the technique of pre-contoured lordotic rods were used to reduce the fracture by lengthening the anterior column of the fractured vertebrae. The posterior structure of the fractured vertebrae was undertaken as the fulcrum point for both groups. The operation time, intra-operative blood loss, visual analogue scale (VAS), anterior vertebral body height (AVBH), segment kyphosis（SK）before and after operation and complications were recorded.ResultsAlthough the operation time and blood loss in the 6-screw group were higher than in the 4-screw group, difference was not significant (P＞0.05). There was no significant difference in VAS, AVBH and SK between the two groups (P＞0.05). Nevertheless, these results were significant differences between the preoperative and the immediate postoperative, between preoperative and follow-up groups (P < 0.001). No neurologic injury was observed in either groups. ConclusionsIn the treatment of thoracolumbar compression fractures, percutaneous short-segment pedicle screws fixation without intermediate screws in the 4-screw construct may obtain the same clinical effect as that in the 6-screw construct.

scholarly journals 79 Relationship Between Depression and Nutritional Status Among the Elderly Attending Selected Primary Healthcare Centers in Lagos

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
B A Akodu ◽  
S O Akinwunmi ◽  
A Onajole
Keyword(s):  
Nutritional Status ◽  
Primary Healthcare ◽  
Living Arrangement ◽  
Depression Scale ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Categorical Variables ◽  
Antidepressant Effect ◽  
Significant Difference ◽  
Primary Healthcare Centers

Abstract Introduction Depression causes and worsens malnutrition. The prevalence of malnutrition in the elderly of the developed world was about 22.6% and about 40% of hospitalized elderly are malnourished while about 4.8% have one major depressive episode in people aged 50 and above. Food rich in omega-3 has antidepressant effect and its low intake is linked with dementia. Decrease dietary folate has been linked with depression. This study was aimed at determining the relationship between depression and nutritional status among the elderly in selected primary healthcare centers (PHC) in Lagos Nigeria. Method A descriptive cross-sectional study was conducted using multi-stage technique to select 219 participants by systematic sampling method from the selected PHC centers. Data was collected using structured interviewer-administered questionnaires. Nutritional status and Depression were assessed using Mini-Nutritional Assessment and Geriatric Depression Scale respectively. Data analysis was carried out using Epi-info 7.1. Associations were tested using Chi-square for categorical variables while t-test and analysis of variance were used for continuous variables. Associations were statistically significant if two-tailed probability was less than 5% (0.05). Results It was found that 57.9% and 47.1% were malnourished and depressed respectively. There was a statistically significant association between the sex of the participants and the nutritional status (p = 0.048). Statistically significant association existed between sex (p = 0.024), marital status (p = &lt;0.001), educational qualification and depression. Statistically significant association between monthly income (p = &lt;0.001), living arrangement (p = 0.002) and depression was demonstrated. There was a statistically significant association between family support (p = &lt;0.001), nutritional status (p = &lt;0.001) and depression. There was statistically significant difference between the height (p = 0.00885), weight (p = 0.00052, waist-hip ratio (p = 0.036) and the nutritional status. Remarkably, there was statistically significant difference between the waist (p = 0.023) and hip circumference (p = 0.047) and their level of depression. Conclusion A high prevalence of poor nutritional status and depression existed among the elderly primary healthcare centers.

scholarly journals SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  
Keyword(s):  
Wound Healing ◽  
Local Anaesthetic ◽  
Surrogate Endpoints ◽  
Incision And Drainage ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After ◽  
The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p &lt; 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

scholarly journals Impact of IVC Filter Guidelines, Registry, and Clinic on Filter Retrieval.

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Brandon Kiley, BS ◽  
Lisa Hollister, MSN, RN ◽  
T. Eric White, MD ◽  
Emily Keltner, BS, MA ◽  
Thein Zhu, MBBS, FACE, FRCP ◽  
...  
Keyword(s):  
Complication Rate ◽  
Dwell Time ◽  
Filter Placement ◽  
Vein Thrombosis ◽  
Retrieval Rate ◽  
Filter Retrieval ◽  
Significant Difference ◽  
Before And After ◽  
Deep Vein

Background and hypothesis: Deep vein thrombosis (DVT) and pulmonary embolism (PE), collectively referred to as venous thromboembolism (VTE), are serious medical conditions that affect up to 900,000 Americans yearly, accounting for up to 100,000 deaths. The first line treatment for VTE is anticoagulation; however, in patients who experience a contraindication to, or failure of anticoagulation, an IVCF may be used. There are two types of IVCFs, permanent and retrievable. Retrievable filters are indicated when the contraindication to anticoagulation is transient, and they may be removed once the contraindication has passed. Retrievable filters have become associated with serious complications such as filter fracture, migration, and IVC perforation. Subsequently, they have become the subject of litigation. As such, strategies should be undertaken to reduce filter dwell time and improve filter retrieval rates. We hypothesize that implementation of IVCF guidelines, registry, and clinic will reduce dwell time while increasing retrieval rate. Methods: This study was a mixed retrospective and prospective chart review of patients who received an IVCF before and after implementation of IVCF guidelines, registry, and clinic. The guidelines, registry, and clinic were established in July 2017. Cases were analyzed during the years 2014-2015 (n=191) and 2017-2018 (n=103) beginning in July 2017. Data was obtained on filter retrieval rate, dwell time, filter-associated complications, and indication for placement. Results: There was a significant decrease in dwell time (p<.001) and a significant increase in retrieval rate (p<.001). There was no difference in complication rate, and there was a decrease in filter placement in patients with ‘soft’ indications, though this difference was not statistically significant (p=.109). Conclusion and potential impact: Implementation of dedicated efforts to increase patient follow-up and filter retrieval were effective in reducing dwell time and retrieval rate. Although there was no significant difference in complication rate, these efforts may be protective against litigation for patients who experience a filter-associated complication.

scholarly journals Use of digital game therapy among elderly persons undergoing dialytic treatment: cognitive aspects and depressive symptoms

2018 ◽  
Vol 21 (4) ◽  
pp. 447-455
Author(s):  
Sirlei Ricarte Bento ◽  
Ana Carolina Ottaviani ◽  
Allan Gustavo Brigola ◽  
Vânia Paula de Almeida Neris ◽  
Fabiana de Souza Orlandi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Intervention Program ◽  
Depression Scale ◽  
Elderly Persons ◽  
Post Intervention ◽  
Therapeutic Game ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Objective :to evaluate the presence of depressive symptoms and cognitive disorders before and after an intervention program with a digital therapeutic game among elderly persons undergoing hemodialysis. Method: a quasi-experimental study was carried out with 26 elderly patients on hemodialysis. For the data collection, a questionnaire relating to sociodemographic and health conditions, the Geriatric Depression Scale - 15 items and Addenbrooke’s Cognitive Examination Revised were used. The intervention with the digital therapeutic game was performed over 5 sessions. Results: of the participants, 80.8% were male, with a mean age of 66.7 (± 5.8) years. The mean pre-intervention depressive symptom score was 3.9 (± 3.0) while post-intervention it was 2.8 (± 2.9), representing a statistically significant difference (p = 0.005). Regarding cognitive function, there was no statistically significant difference before and after the intervention. There was a statistically significant difference in the mean of the depressive symptom scores, which were lower after the intervention. In addition, there was no statistically significant difference in the mean of the cognitive assessments. Conclusion: intervention studies with patients undergoing hemodialysis treatment are still scarce and this study describes the positive results of an intervention with a digital therapeutic game, demonstrating improvement in the depressive symptoms of the participants.

Cognitive behavioral therapy for chronic migraine

2017 ◽  
Vol 41 (S1) ◽  
pp. s500-s500 ◽  
Author(s):  
O. Onur ◽  
D.H. Ertem ◽  
D. Uludüz ◽  
Ç. Karşıdağ
Keyword(s):  
Chronic Migraine ◽  
Psychological Treatment ◽  
Treatment Options ◽  
Depression Scale ◽  
Migraine Treatment ◽  
Hamilton Depression Scale ◽  
Post Traumatic Stress ◽  
Current Standard ◽  
Significant Difference ◽  
Hamilton Anxiety

AimAlthough current standard treatment for migraine headache is medication, high levels of psychological comorbidity has led to migraine influencing by cognitive, emotional and environmental factors, as well as biological. Viewing migraine in a biopsychosocial framework introduces the possible utilisation of psychological treatment options, such as cognitive behavioural therapy (CBT). The aim of this study was to evaluate the efficacy of CBT for chronic migraine.MethodologyThirty-five participants diagnosed as chronic migraine were recruited from Headache Clinic. According to inclusion criteria 14 participants, underwent bi-weekly lasting 30 minutes CBT sessions for 6 months, were administered Hamilton Anxiety Scale, Hamilton Depression Scale, Visual Analog Scale (VAS) and the Migraine Disability Assessment Scale (MİDAS) before and after CBT.FindingsNine of the participants were female and 5 male. Mean age of group was 34.35 ± 8.17. Duration of illness was 13.07 ± 7.18 and 12 of participants had the history of a psychiatry illness whose diagnoses were depression (7), anxiety disorder (4) and post-traumatic stress disorder (1). Nine of the patients had prophylactic migraine treatment. There were statistically significant difference in Hamilton Depression scores between before CBT (29.07 ± 7.74) and after CBT (14.21 ± 7.7); in Hamilton Anxiety scores before CBT (26.8 ± 11.7) and after CBT (11.7 ± 2.6); in VAS scores before CBT (8.07± 0.91) and after CBT (3.71 ± 1.32); in frequency of migraine attacks between before CBT (10.85 ± 3.50 day) and after CBT (4.92 ± 2.70 day) and in MİDAS before CBT (55.5 ± 20.4) and after CBT (20.12 ± 16.6) (P < 0.05).ConclusionCBT might reduce the severity of symptoms in migraine patients especially with the comorbidity of psychiatric illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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