The postpartum period during the COVID-19 pandemic: investigating Turkish women’s postpartum support and postpartum-specific anxiety

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Merve Kochan ◽  
Ayse Deliktas Demirci ◽  
Kamile Kabukcuoglu
Keyword(s):  
Scale Score ◽  
Psychological Health ◽  
Postpartum Period ◽  
Healthcare Services ◽  
Anxiety Scale ◽  
Postpartum Women ◽  
Exposure Level ◽  
Turkish Women ◽  
Postpartum Support ◽  
The Mean

Abstract Objectives This study aimed to examine how Turkish women were affected by the COVID-19 pandemic in the postpartum period in terms of postpartum support and anxiety variables. Methods The study was conducted with 130 women who gave birth during the COVID-19 period. Data were collected online using a personal information form, Postpartum Support Scale and Postpartum Specific Anxiety Scale. Descriptive statistics were used, with Kruskal–Wallis and regression analysis performed. Results All postpartum women stated that they were affected negatively by COVID-19. The most common issues described were feeling alone (25.51%), having economic difficulties (15.5%) and experiencing difficulties accessing health services (21.7%). The mean Postpartum Support Scale score was 102.43 ± 27.67, while the mean Postpartum Specific Anxiety Scale score was 188.07 ± 96.71. COVID-19 exposure level had a significant effect on postpartum-specific anxiety (p=0.00). The variables of having a problem during pregnancy (p=0.006), having a baby willingly (p=0.007), and partner’s educational status significantly predicted the degree of being affected by COVID-19 (p=0.025). The degree to which COVID-19 affected the women was determined by having problems during pregnancy, having a baby willingly, and a highly educated partner. Conclusions These variables may inform a resource to empower postpartum women during COVID-19. Healthcare systems need to be organised considering pandemic conditions to provide increased postpartum support, evaluate psychological health, deliver healthcare services, and consider pregnancy periods.

scholarly journals Postpartum Depression and its Associated Factors: A Community-based Study in Nepal

2019 ◽  
Vol 17 (2) ◽  
pp. 200-205
Author(s):  
Anisha Chalise ◽  
Tulsi Ram Bhandari
Keyword(s):  
Postpartum Depression ◽  
Psychological Health ◽  
Postpartum Period ◽  
Associated Factors ◽  
Economic Status ◽  
Depression Scale ◽  
Family Care ◽  
Postpartum Women ◽  
Community Based ◽  
Cross Sectional

Background: Postpartum depression is a type of mental disorder associated with childbirth during pregnancy or within the first postpartum year. It is reported as a common psychological health problem affecting 10-15% of women worldwide. The duration of postpartum depression frequently depends on its severity and the time of initiation of treatment. This study assessed depression and its associated factors among postpartum period women of Godavari municipality, Lalitpur, Nepal.Methods: A community-based cross-sectional study was conducted using Edinburg Postpartum Depression Scale among 195 mothers who were within six months of the postpartum period. The chi-square and logistic regression were applied to establish the association between postpartum depression and associated factors. Results: Out of the total 195 postpartum women, 37(19%) women suffered from depression and out of those women 2.1% had suicidal thoughts. Among the associated factors, education, occupation, the intent of pregnancy, family support and pregnancy-related problems/complications were found to be significantly associated with Postpartum depression (p<0.05). Conclusions: Nearly one-fifth postpartum women suffered from some type of depression. It is one of the public health concerns which directly or indirectly corresponds to the socio-economic condition of the women. The improved education and economic status of women, intention of pregnancy, family care and support during pregnancy and the postpartum period and early diagnosis and management of health problems could reduce the magnitude of the postpartum depression. Keywords: Associated factors of postpartum depression; edinburg postpartum depression scale; Nepal; postpartum depression.

scholarly journals Effect of touching on anxiety and practice skill of nursing students during intravenous catheterization skill trainingDokunmanın intravenöz kateterizasyon beceri eğitimi sırasında hemşirelik öğrencilerinin anksiyetesine ve uygulama becerisine etkisi

2017 ◽  
Vol 14 (2) ◽  
pp. 1820
Author(s):  
Gül Güneş Çelik ◽  
İsmet Eşer
Keyword(s):  
Scale Score ◽  
State Anxiety ◽  
Skill Training ◽  
The State ◽  
Anxiety Scale ◽  
Control Group ◽  
The Mean ◽  
And Performance ◽  
Experimental Group ◽  
Intravenous Catheterization

Anxiety is a vague concern and discomfort that a person feels about himself because of a threat to the person's value system or security pattern. It is caused by not being able to interact fully with the environment because of the lack of sensory information and the misinterpretation of the information received through emotions. Anxiety, which has an important effect in daily life, also has important effects on education life. Stress, which shows similar features with anxiety, is an important issue in education because it has potential to inhibit learning and performance. In order to increase learning outcomes and ensure critical thinking, educators should define students’ level of anxiety and minimize it. Touching is a simple skill that can be applied by educators during the clinic training without the need for a course. Positive and appropriate contacts of the educators make them feel good to the students and students think they are important. Studies show that students are anxious before skill training and anxiety reduces the success and performance of them. The aim of this study was to determine the effect of touching on anxiety and the success of students during skill training of intravenous catheterization. The research was conducted in the skill training laboratory of a nursing faculty as using the quasi-experimental method with control group through the pre and post-test between December 2016 and January 2016. The sample was constructed from the experimental group (n=65) and the control group (n=65) as 130 people and single blinding was done. The experimental group of students’ shoulders, arms or hands were touched by educators during skill training of intravenous catheterization. In the collection of the data, The Personal Information Form, The Intravenous Catheterization Skill Practice Checklist, The State-Trait Anxiety Scale and intravenous catheterization training model were used. The mean age of the experimental group was 20.36 ± 0.76 years and the mean age of the control group was 20.20 ± 0.75 years. 89.2% of the experimental group and 93.8% of the control group consisted of women. As the personality trait, 47.7% of the experimental group and 36.9% of the control group were defined themselves as calm. It was determined that the State Anxiety Scale score of the control and experiment group decreased after skill training of intravenous catheterization but there was a significant difference between the State Anxiety Scale Score of pre and post-skill training only in the experimental group. It was detected that the success of skill was higher in the experimental group.In line with these findings, it is recommended that educators should observe anxiety of the students and they should apply simple touching to students who has high pre-skill anxiety. Extended English abstract is in the end of PDF (TURKISH) file. ÖzetAnksiyete kişinin değer sistemi ya da güvenlik örüntüsüne bir tehditten dolayı yaşanan, bireyin kendine yönelik hissettiği belirsiz bir endişe ve huzursuzluk duygusudur. Duyusal eksiklik ve duygular aracılığıyla alınan bilgilerin yanlış yorumlanmasından dolayı çevreyle tam etkileşim kuramamaktan kaynaklanır. Günlük hayatta önemli etkisi olan anksiyetenin, eğitim hayatında da önemli etkileri bulunmaktadır. Anksiyete ile benzer özellikler gösteren stres, öğrenmeyi ve performansı engelleme potansiyeline sahip olduğu için eğitimde önemli bir konudur. Öğrenme çıktılarını artırmak ve kritik düşünmeyi sağlamak için eğiticiler öğrencilerin kaygı düzeyini tanımlanmalı ve en aza indirmelidir. Dokunma klinik eğitimler sırasında eğiticiler tarafından bir kursa ihtiyaç duyulmadan uygulanabilen basit bir beceridir. Eğiticilerin pozitif ve uygun teması öğrencilere kendini iyi hissettirir ve öğrenciler önemli olduklarını düşünürler.Yapılan çalışmalar öğrencilerin beceri uygulamalarından önce anksiyete yaşadığını ve anksiyetenin öğrencilerin başarı ve performansını azalttığını göstermektedir. Bu araştırma; dokunmanın intravenöz kateterizasyon beceri uygulaması sırasında öğrencilerin anksiyetesine ve uygulama başarısına etkisini belirlemek amacıyla yapılmıştır. Araştırma Aralık 2016-Ocak 2017 tarihleri arasında kontrol gruplu ön test-son test yarı deneysel model kullanılarak bir hemşirelik fakültesinin beceri laboratuvarında yürütüldü. Örneklem, uygulama grubu (n=65) ve kontrol grubundan (n=65) 130 kişi olarak oluşturuldu ve tek körleme yapıldı. Beceri uygulaması sırasında uygulama grubu öğrencilerinin omuz, kol veya eline temasta bulunuldu. Verilerin toplanmasında; Kişisel Bilgi Formu, İntravenöz Kateterizasyon Beceri Uygulama Kontrol Listesi, Durumluk–Sürekli Kaygı Ölçeği, intravenöz kateterizasyon kol maketi kullanıldı. Uygulama grubunun yaş ortalaması 20.36±0.76, kontrol grubunun yaş ortalaması 20.20±0.75’di. Uygulama grubunun %89.2’si, kontrol grubunun %93.8’i kadınlardan oluşmaktaydı. Kişilik özelliği olarak uygulama grubunun %47.7’si ve kontrol grubunun %36.9’u kendini sakin olarak tanımladı. Uygulama ve kontrol grubunun beceri eğitimi sonrası durumluk kaygı puanın azaldığı fakat sadece uygulama grubunda beceri öncesi ve sonrası kaygı puanı arasında anlamlı fark olduğu saptandı. Beceri başarısının uygulama grubunda daha yüksek olduğu tespit edildi.Bu bulgular doğrultusunda eğiticilerin, öğrencilerin anksiyetesini gözlemlemesi ve beceri öncesi anksiyetesi yüksek olan öğrencilere basit dokunma uygulanması önerilmektedir.

The validity of the Melancholia Scale (MES) in predicting outcome of antidepressants in chronic idiopathic pain disorders

1991 ◽  
Vol 6 (3) ◽  
pp. 119-125 ◽  
Author(s):  
D Loldrup ◽  
M Langemark ◽  
HJ Hansen ◽  
M Kastrup ◽  
K Jeppesen ◽  
...  
Keyword(s):  
Construct Validity ◽  
Scale Score ◽  
Anxiety Scale ◽  
Full Recovery ◽  
Hamilton Depression Scale ◽  
Depressed Patients ◽  
Idiopathic Pain ◽  
Hamilton Anxiety Scale ◽  
Structure Evaluation ◽  
Hamilton Anxiety

SummaryIn patients with chronic idiopathic pain disorders we have analysed the construct validity of the Melancholia Scale as compared to the results with the scale in primary depression. The patients (n= 253) were treated in a placebo controlled trial with either clomipramine or mianserin independently of the Melancholia score. The construct validity of the Melancholia Scale was further analysed by the testing of the intensity model of depression versus anxiety using the Beck Depression Inventory, the Hamilton Anxiety Scale, the Spielberger State-Trait Anxiety Scale, and the Melancholia Scale. The construct validity in terms of scale homogeneity was analysed by Loevinger coefficients which can be considered as a latent structure evaluation. The Melancholia Scale showed acceptable homogeneity, while the Hamilton Anxiety Scale lacked sufficient homogeneity. In total, 33% of the patients had a score of 10 or more on the Melancholia Scale (corresponding to 13 or more on the Hamilton Depression Scale). The predictive validity of the Melancholia Scale was evaluated using active treatment versus placebo response after 6 weeks of therapy. It was shown that in patients with a Melancholia Scale score of 10 or more (corresponding to “less than major depression”) 72% had full recovery when treated with clomipramine, while 36% of the placebo treated patients obtained a full recovery (P≤0.05). The patients treated with mianserin obtained a full recovery in 52%. The group of patients with a Melancholia Scale score of 10 or more scored higher also on the anxiety scales indicating that the relation between depression and anxiety is a matter of severity. The depressed patients had significantly lower imipramine binding sites than the non-depressed patients.

scholarly journals Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040819
Author(s):  
Pontus Rygh ◽  
Ina Asklund ◽  
Eva Samuelsson
Keyword(s):  
Urinary Incontinence ◽  
Cohort Study ◽  
Real World ◽  
Short Form ◽  
Pelvic Floor Muscle ◽  
Controlled Trial ◽  
Healthcare Services ◽  
International Consultation ◽  
The Mean

ObjectivesThe efficacy of app-based treatment for stress urinary incontinence (SUI) has been demonstrated in a randomised controlled trial (RCT). In this study, we investigate the user characteristics and the effectiveness of the same app when freely available, and compare these results with the RCT.DesignProspective cohort study.ParticipantsDuring a 17-month period, 24 602 non-pregnant, non-postpartum women older than 18 years downloaded the app and responded anonymously to a questionnaire. Of these, 2672 (11%) responded to the 3-month follow-up.InterventionThree months’ use of the app Tät, containing information, a pelvic floor muscle training programme and lifestyle advice.Main outcome measuresChange in symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF)) and subjective improvement (Patient Global Impression of Improvement (PGI-I)).ResultsOf the respondents, 88% lived in Sweden and 75% (18 384/24 602) were incontinent with a mean age of 45.5 (SD 14.1) years. The UI types, based on symptoms, were SUI (53%), urgency UI (12%), mixed UI (31%) and undefined (4%). The mean ICIQ-UI SF score was 8.2 (SD 4.0) at baseline. The mean ICIQ-UI SF score reduction at follow-up was 1.31 (95% CI: 1.19 to 1.44) with a larger reduction in those with more severe incontinence at baseline (severe/very severe 3.23 (95% CI: 2.85 to 3.61), moderate 1.41 (95% CI: 1.24 to 1.59) and slight 0.24 (95% CI 0.06 to 0.42). When the results were weighted to match the distribution of severity in the RCT, the ICIQ-UI SF score reduction was 2.2 compared with 3.9 in the RCT. Regarding PGI-I, 65% experienced improvement compared with 92% in the RCT.ConclusionsThe app Tät was effective for self-management of UI even in the real world. Although the reduction in incontinence symptoms was less than in the RCT, two-thirds of the users improved. App-based treatment reaches many women without requiring resources from ordinary healthcare services.

scholarly journals Hemodynamic Status During Endovascular Stroke Treatment: Association of Blood Pressure with Functional Outcome

2021 ◽  
Author(s):  
Min Chen ◽  
Dorothea Kronsteiner ◽  
Johannes Pfaff ◽  
Simon Schieber ◽  
Laura Jäger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Functional Outcome ◽  
Scale Score ◽  
Endovascular Therapy ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Vessel Occlusion ◽  
Stroke Treatment ◽  
The Mean

Abstract Background Optimal blood pressure (BP) management during endovascular stroke treatment in patients with large-vessel occlusion is not well established. We aimed to investigate associations of BP during different phases of endovascular therapy with reperfusion and functional outcome. Methods We performed a post hoc analysis of a single-center prospective study that evaluated a new simplified procedural sedation standard during endovascular therapy (Keep Evaluating Protocol Simplification in Managing Periinterventional Light Sedation for Endovascular Stroke Treatment). BP during endovascular therapy in patients was managed according to protocol. Data from four different phases (baseline, pre-recanalization, post recanalization, and post intervention) were obtained, and mean BP values, as well as changes in BP between different phases and reductions in systolic BP (SBP) and mean arterial pressure (MAP) from baseline to pre-recanalization, were used as exposure variables. The main outcome was a modified Rankin Scale score of 0–2 three months after admission. Secondary outcomes were successful reperfusion and change in the National Institutes of Health Stroke Scale score after 24 h. Multivariable linear and logistic regression models were used for statistical analysis. Results Functional outcomes were analyzed in 139 patients with successful reperfusion (defined as thrombolysis in cerebral infarction grade 2b–3). The mean (standard deviation) age was 76 (10.9) years, the mean (standard deviation) National Institutes of Health Stroke Scale score was 14.3 (7.5), and 70 (43.5%) patients had a left-sided vessel occlusion. Favorable functional outcome (modified Rankin Scale score 0–2) was less likely with every 10-mm Hg increase in baseline (odds ratio [OR] 0.76, P = 0.04) and pre-recanalization (OR 0.65, P = 0.011) SBP. This was also found for baseline (OR 0.76, P = 0.05) and pre-recanalization MAP (OR 0.66, P = 0.03). The maximum Youden index in a receiver operating characteristics analysis revealed an SBP of 163 mm Hg and MAP of 117 mm Hg as discriminatory thresholds during the pre-recanalization phase to predict functional outcome. Conclusions In our protocol-based setting, intraprocedural pre-recanalization BP reductions during endovascular therapy were not associated with functional outcome. However, higher intraprocedural pre-recanalization SBP and MAP were associated with worse functional outcome. Prospective randomized controlled studies are needed to determine whether BP is a feasible treatment target for the modification of outcomes.

Retroclival Epidural Hematomas

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 404-407 ◽  
Author(s):  
R. Shane Tubbs ◽  
Christoph J. Griessenauer ◽  
Todd Hankinson ◽  
Curtis Rozzelle ◽  
John C. Wellons ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Pediatric Patients ◽  
Motor Vehicle ◽  
Coma Scale ◽  
Presenting Symptoms ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND Retroclival epidural hematomas (REDHs) are infrequently reported. To our knowledge, only 19 case reports exist in the literature. OBJECTIVE This study was performed to better elucidate this pathology. METHODS We prospectively collected data for all pediatric patients diagnosed with REDH from July 2006 through June 2009. Data included mechanism of injury, Glasgow Coma Scale score, neurological examination, treatment modality, and outcome. Magnetic resonance imaging was used to measure REDH dimensions. RESULTS Eight children were diagnosed with REDH, and the hematomas were secondary to motor vehicle–related trauma in all cases. The mean age of patients was 12 years (range 4–17 years). The mean REDH height (craniocaudal) was 4.0 cm, and the mean thickness (dorsoventral) was 1.0 cm. At presentation, the mean Glasgow Coma Scale score was 8 (range 3–14), and there was no correlation between hematoma size and presenting symptoms. Two patients died soon after injury, and 2 additional patients had atlanto-occipital dislocation that required surgical intervention. No patient underwent surgical evacuation of the REDH. The mean follow-up was 14 months. At most recent follow-up, 4 patients are neurologically intact, 1 patient has a complete spinal cord injury, and 1 patient has mild bilateral abducens nerve palsy. CONCLUSION To our knowledge, this study of 8 pediatric patients is the largest series of patients with REDH thus far reported. Based on our study, we found that REDH is likely to be underdiagnosed, atlanto-occipital dislocation should be considered in all cases of REDH, and many patients with REDH will have minimal long-term neurological injury.

SOME ASPECTS OF ACUTE CEREBROVASCULAR PATHOLOGY IN POSTPARTUM WOMEN

Vestnik ◽  
2021 ◽  
pp. 51-56
Author(s):  
Д.А. Митрохин ◽  
Ж.Б. Дюсембаева ◽  
М.М. Ибрагимов ◽  
А.А. Оспанов ◽  
А.Н. Сембинова ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Postpartum Period ◽  
Cerebrovascular Accident ◽  
Hemorrhagic Stroke ◽  
Speech Disorders ◽  
Cerebral Stroke ◽  
Postpartum Women ◽  
Bioelectrical Activity ◽  
Acute Cerebrovascular Accident ◽  
Epileptiform Discharges

В данной статье, представлены результаты обследования 17 женщин, перенесших острое нарушение мозгового кровообращения в послеродовом периоде, с 2017 по 2021 годы, в возрасте от 19 до 39 лет. Показано, что у женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, выявлено преобладание ишемического инсульта над геморрагическим, что составило 64,7% и 35,3% соответственно. Неврологические признаки церебрального инсульта в послеродовом периоде характеризуются двигательными, речевыми расстройствами, нарушением чувствительности, а также часто психоэмоциональными проявлениями. Генерализованные тонико-клонические приступы чаще наблюдались у пациенток с геморрагическим инсультом (33,3%), в сравнении с ишемическим инсультом (9,1%). У женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, наиболее значимыми факторами риска являются: наличие хронических заболеваний, в том числе отягощенный акушерско-гинекологический анамнез, прием пероральных контрацептивов, а также курение. Биоэлектрическая активность головного мозга характеризовалась выраженной дельта и тета активностью, эпилептиформными разрядами в виде острых волн, спайков и комплексов «пик-волна», с преобладанием у пациенток с геморрагическим инсультом. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. Отмечено повышение интегрального индекса диапазона медленно-волновой активности и преобладание процентного отношения спектральных мощностей медленных волн (дельта, тета) к быстрым волнам (альфа, бета), особенно выраженное у больных с геморрагическим инсультом (р < 0,05), в сравнении с ишемическим инсультом. Наиболее тяжелое течение послеродового периода наблюдалось у пациенток с геморрагическим инсультом, именно в этом случае было 2 летальных исхода. This article presents the results of a survey of 17 women with acute cerebrovascular accident in the postpartum period, from 2017 to 2021, aged 19 to 39 years. It is shown that the period in women in the postpartum period, who underwent acute cerebrovascular accident, revealed the prevalence of ischemic stroke over hemorrhagic, which amounted to 64,7% and 35,3%, respectively. Neurological signs of cerebral stroke in the postpartum period are characterized by movement, speech disorders, impaired sensitivity, and often psychoemotional manifestations. Generalized tonic-clonic seizures were more often observed in patients with hemorrhagic stroke (33,3%) in comparison with ischemic stroke (9,1%). In postpartum women who have suffered acute cerebrovascular accident, the most significant risk factors are: the presence of chronic diseases, including a burdened obstetric and gynecological history, taking oral contraceptives, as well as smoking. The bioelectrical activity of the brain was characterized by pronounced delta and theta activity, epileptiform discharges in the form of sharp waves, spikes and peak-wave complexes, with a predominance in patients with hemorrhagic stroke. A more significant increase in the coherence index in the delta and theta ranges in patients after hemorrhagic stroke may indicate more severe interhemispheric disorders in comparison with ischemic stroke. An increase in the integral index of the range of slow-wave activity and a predominance of the percentage of the spectral powers of slow waves (delta, theta) to fast waves (alpha, beta), especially pronounced in patients with hemorrhagic stroke (p <0,05), in comparison with ischemic stroke. The most severe postpartum period was observed in patients with hemorrhagic stroke, in this case there were 2 deaths.

Abstract P087: Association of Psychological Well-Being With Cardiac Repolarization

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Amit J Shah ◽  
Robert Carney ◽  
Elsayed Z Soliman ◽  
Viola Vaccarino
Keyword(s):  
Psychological Health ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Well Being ◽  
Left Ventricular ◽  
Morbidity And Mortality ◽  
Psychological Well Being ◽  
Psychological Wellness ◽  
Increased Risk ◽  
The Mean

Background: Abnormal frontal T-axis is an independent predictor of mortality, and may be influenced by increased sympathetic tone and cardiovascular disease risk factors. Factors related to poor psychological health, such as depression, are associated with increased risk of CVD morbidity, although the mechanisms are not clear. We tested the hypothesis that: 1) reduced psychological wellness is associated with abnormal T-axis and 2) this association may help to explain the excess risk of CVD morbidity and mortality related to poor psychological health. Methods: We studied 4485 community-based adults aged 25–65 years without a history of CVD from NHANES I (1971–75) who were monitored for CVD hospitalization and death until 1993. Those with ECG evidence of previous MI, left ventricular hypertrophy, and major ventricular conduction defects (QRS interval ≥ 120 ms) were excluded. Frontal T-axis was obtained through 12-lead ECG, and a deviation of ≥ 30° from normal (45°) was considered abnormal. Psychological well-being was measured with the General Well-Being Scale (GWB). Results: The mean ± SD age was 43.1 ± 11.5 years and 55% were women. The mean ± SD GWB score was 80.5 ± 17.3, the median frontal T-axis was 51°, and 13% had an abnormal T-axis. In cross-sectional analysis adjusting for age, sex, and race, a 1-SD decrease in GWB was associated with an OR of 1.12 for abnormal T-axis (p=0.01). This effect was unchanged after adjusting for systolic blood pressure, smoking, diabetes, total cholesterol, and BMI. Abnormal T-axis was associated with CVD hospitalization/death (adjusted HR 1.29, p=0.01), as was GWB (adjusted HR 1.104 per 1-SD decrease, p=0.01). When both factors were included in the model, the HR of GWB decreased by 8% to 1.096 (p=0.02). Conclusion: Abnormal frontal T-axis is modestly but significantly associated with reduced psychological wellness. Although this association may help understand neurocardiac relationships, it does not substantially explain morbidity and mortality associated with reduced psychological wellness.

Long-term Follow-up of Blister Aneurysms of the Internal Carotid Artery

Neurosurgery ◽  
2013 ◽  
Vol 73 (6) ◽  
pp. 1026-1033 ◽  
Author(s):  
M. Yashar S. Kalani ◽  
Joseph M. Zabramski ◽  
Louis J. Kim ◽  
Shakeel A. Chowdhry ◽  
George A. C. Mendes ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Scale Score ◽  
Glasgow Outcome Scale ◽  
Internal Carotid ◽  
Radiology Reports ◽  
The Mean ◽  
Operative Notes

Abstract BACKGROUND: Blister aneurysms of the internal carotid artery (ICA) are uncommon. There is a paucity of data on the long-term outcomes of patients. OBJECTIVE: To review our experience with the treatment of these lesions. METHODS: We retrospectively reviewed all aneurysms treated at our institution between 1994 and 2005. Relevant operative notes, radiology reports, and inpatient/outpatient records were reviewed. RESULTS: Seventeen patients (3 male, 14 female) with 18 blister aneurysms of the ICA were identified. The mean age was 44.6 years (range, 17–72; median, 42 years). Twelve patients (70.6%) presented with aneurysmal subarachnoid hemorrhage. The mean admission Glasgow Outcome Scale score was 4.3 (range, 2–5; median, 5). All patients were initially treated using microsurgical technique with direct clipping (n = 15; 83.3%) or clip-wrapping with Gore-Tex (n = 3, 16.7%). There were 4 cases of intraoperative rupture, all associated with attempted direct clipping; all 4 cases were successfully clipped. Two cases rebled post-treatment. Both rebleeding episodes were managed with endovascular stenting. Follow-up angiography was available for 14 patients and revealed a new aneurysm adjacent to the site of clipping in 1 patient and in-stent stenosis in 2. At the mean follow-up of 74.5 months (median, 73; range, 7–165), the mean Glasgow Outcome Scale score was 4.6 (range, 2–5; median, 5). CONCLUSION: Microsurgical treatment of blister aneurysms of the ICA results in excellent outcome. In the evolution of treating these friable aneurysms, we have modified our clip-wrapping technique and use this technique when direct clipping is not feasible.

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