Hospital Discharge on the First Compared With the Second Day After a Planned Cesarean Delivery: A Randomized Controlled Trial.

Hospital discharge on the first compared with the second day after a planned cesarean delivery: a randomized controlled trial.

Filed under: Depression Treatment

Obstet Gynecol. 2012 Dec; 120(6): 1273-82
Chiong Tan P, Jin Norazilah M, Zawiah Omar S

: To compare patient satisfaction and exclusive breastfeeding rates for patients discharged from the hospital on postcesarean day 1 (next day) or day 2.: Healthy women admitted for planned cesarean delivery were randomized to day 1 or day 2 discharge. Postoperative assessment for suitability for discharge was based on defined criteria. Primary outcomes were patient satisfaction with their discharge timing assessed at 2 weeks and reported exclusive breastfeeding at 6 weeks after discharge. Analyses were based on intention-to-treat and per-protocol discharge.: Of the 360 women randomized, results of 170 compared with 172 and 142 compared with 148 (day 1 compared with day 2) were available for intention-to-treat and per-protocol analyses, respectively. Nine women fulfilled discharge criteria but declined day 1 discharge, and 12 women allocated to day 2 discharge took their own discharge on day 1. Intention-to-treat analysis showed that satisfaction with discharge protocol was expressed by 148 of 170 (87.1%) compared with 147 of 172 (85.5%) (relative risk 1.1, 95% confidence interval [CI] 0.6-2.1, P=.75) and exclusive breastfeeding (at 6 weeks) was reported by 76 of 170 (44.7%) compared with 77 of 172 (44.9%) (relative risk 1.0 95% CI 0.7-1.5 P=.99 for day 1 compared with day 2 discharges, respectively). All secondary outcomes assessed at up to 6 weeks after discharge including unscheduled maternal or infant medical consultations, rehospitalizations, maternal antibiotic use, and maternal well-being, anxiety, and depression status, were similar. Results on per-protocol analysis were also similar.: Day 1 discharge compared with day 2 discharge after a planned cesarean delivery resulted in equivalent outcomes.: ISRCTN Register, ISRCTN.org, ISRCTN27523895.: I.
HubMed – depression

 

Depression: a major public health problem in need of a multi-sectoral response.

Filed under: Depression Treatment

Indian J Med Res. 2012 Oct; 136(4): 537-9
Jacob KS

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Limb compressive load does not inhibit post activation depression of soleus H-reflex in indiviudals with chronic spinal cord injury.

Filed under: Depression Treatment

Clin Neurophysiol. 2012 Nov 17;
Tseng SC, Shields RK

OBJECTIVE: We investigated the effect of various doses of limb compressive load on soleus H-reflex amplitude and post activation depression in individuals with/without chronic SCI. We hypothesized that SCI reorganization changes the typical reflex response to an external load. METHODS: Ten healthy adults and 10 individuals with SCI received three doses of compressive load to the top of their knee (10%, 25%, and 50% of the body weight, BW). Soleus H-reflexes were measured before (baseline) and during the loading phase. RESULTS: With persistent background muscle activity across all testing sessions, segment compressive load significantly decreased post activation depression in the control group, but did not change the post activation ratio in the SCI group. Normalized H2 amplitude significantly increased according to load (50%>25%>10%) in the control group whereas was minimally modulated to load in those with SCI. CONCLUSIONS: Segment compressive load inhibits post activation depression in humans without SCI, but minimally modulates the reflex circuitry in people with chronic SCI. These findings suggest that spinal cord reorganization mitigates the typical response to load in people with chronic SCI. SIGNIFICANCE: Early limb load training may impact the reorganization of the spinal cord in humans with acute SCI.
HubMed – depression

 

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