Depression Treatment: Natural History, Predictors and Outcomes of Depression After Stroke: Systematic Review and Meta-Analysis.

Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis.

Filed under: Depression Treatment

Br J Psychiatry. 2013 Jan; 202: 14-21
Ayerbe L, Ayis S, Wolfe CD, Rudd AG

Depression after stroke is a distressing problem that may be associated with other negative health outcomes.To estimate the natural history, predictors and outcomes of depression after stroke.Studies published up to 31 August 2011 were searched and reviewed according to accepted criteria.Out of 13 558 references initially found, 50 studies were included. Prevalence of depression was 29% (95% CI 25-32), and remains stable up to 10 years after stroke, with a cumulative incidence of 39-52% within 5 years of stroke. The rate of recovery from depression among patients depressed a few months after stroke ranged from 15 to 57% 1 year after stroke. Major predictors of depression are disability, depression pre-stroke, cognitive impairment, stroke severity and anxiety. Lower quality of life, mortality and disability are independent outcomes of depression after stroke.Interventions for depression and its potential outcomes are required.
HubMed – depression


Sternal traction: simple technique to prevent tamponade/compression of the heart.

Filed under: Depression Treatment

Asian Cardiovasc Thorac Ann. 2012 Dec; 20(6): 751-3
Kandakure PR, Ramodass N, Rani U, Chakravarthy S, Rao IM, Kona SM

Routine closure of the sternum after cardiovascular surgery sometimes causes severe cardiac depression because of tamponade, leading to cardiogenic shock. We describe a full-thickness chest wall traction suture taken parasternally and tied to an intravenous fluid stand. Upward (outward) traction is applied to the anterior chest while the sternum is primarily closed, which allows physiologic improvement equivalent to delayed sternal closure. It is a safe and easily reproducible technique.
HubMed – depression


Systematic Monitoring and Treatment of Physical Symptoms to Alleviate Fatigue in Patients With Advanced Cancer: A Randomized Controlled Trial.

Filed under: Depression Treatment

J Clin Oncol. 2013 Jan 2;
de Raaf PJ, de Klerk C, Timman R, Busschbach JJ, Oldenmenger WH, van der Rijt CC

PURPOSESeveral guidelines on the treatment of cancer-related fatigue recommend optimizing treatment of accompanying symptoms. However, evidence for this recommendation from randomized clinical trials is lacking. We investigated whether monitoring and protocolized treatment of physical symptoms alleviates fatigue. PATIENTS AND METHODSIn all, 152 fatigued patients with advanced cancer were randomly assigned to protocolized patient-tailored treatment (PPT) of symptoms or care as usual. The PPT group had four appointments with a nurse who assessed nine symptoms on a 0 to 10 numeric rating scale (NRS). Patients received a nonpharmacologic intervention for symptoms with a score ? 1 and a medical intervention for symptoms with a score ? 4. Fatigue dimensions, fatigue NRS score, interference of fatigue with daily life, symptom burden, quality of life, anxiety, and depression were measured at baseline and after 1, 2, and 3 months. Differences between the groups over time were assessed by using mixed modeling. RESULTS: fatigue dimensions “reduced activity” and “reduced motivation,” fatigue NRS, symptom burden, interference of fatigue with daily life, and anxiety (all P ? .03). CONCLUSIONIn fatigued patients with advanced cancer, nurse-led monitoring and protocolized treatment of physical symptoms is effective in alleviating fatigue.
HubMed – depression


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