Lumbar Microdiscectomy and Lumbar Decompression Improve Functional Outcomes and Depression Scores.

Lumbar microdiscectomy and lumbar decompression improve functional outcomes and depression scores.

Evid Based Spine Care J. 2012 Nov; 3(4): 65-6
Tharin S, Mayer E, Krishnaney A

Study design: ?Retrospective review. Introduction: ?Lumbar radiculopathy and claudicant leg pain are common degenerative spinal conditions often treated by elective microdiscectomy or decompression. Published outcome data for these procedures have focused on improvement in pain scores, and not on grounded functional outcome or depression scores.1,2,3 Moreover, depression is considered by many surgeons to be a red flag for poor outcome for surgical treatment. We asked what effect lumbar microdiscectomy and laminectomy procedures had on functional outcome and depression scores in our clinical population. Methods: ?Beginning in January 2010, the following outcome data were prospectively gathered before and after surgery from all patients at the Cleveland Clinic undergoing either lumbar microdiscectomy or lumbar decompression: EQ-5D (EuroQOL, quality-of-life measure), PHQ-9 (measure of depressive symptoms), PDQ (pain disability questionnaire), and Rankin scores (disability or dependence in daily activities). Results: ?The mean EuroQOL scores improved by 35% (from 0.4-0.75 of a maximum of 1.0) for both microdiscectomy and lumbar laminectomies. The mean PHQ-9 scores (measure of depressive symptoms) significantly improved for most patients undergoing either procedure. In line with previously published reports, we also found improvement in Rankin scores and Pain Disability Questionnaire scores. Conclusions: ?Our outcome data indicate that microdiscectomy and lumbar decompression not only reduce disability and pain but also improve depressive symptoms and overall quality of life for patients. These findings support operative treatment of lumbar radiculopathy and neurogenic claudication including treatment performed in the depressed population. HubMed – depression


Stress Management, Depression and Immune Status in Lower Income Racial/Ethnic Minority Women Co-infected with HIV and HPV.

J Appl Biobehav Res. 2013 Mar 1; 18(1): 37-57
Lopez CR, Antoni MH, Pereira D, Seay J, Whitehead N, Potter J, O’Sullivan M, Fletcher MA

The stress of co-infection with HIV and Human Papillomavirus (HPV), in race/ethnic minority women, may increase depression and immune decrements. Compromised immunity in HIV+ HPV+ women may increase the odds of cervical dysplasia. Thus we tested the efficacy of a 10-wk cognitive behavioral stress management (CBSM) group intervention and hypothesized that CBSM would decrease depression and improve immune status (CD4+ T-cells, natural killer [NK] cells). HIV+HPV+ women (n=71) completed the Beck Depression Inventory (BDI) and provided blood samples, were randomized to CBSM or a control condition, and were re-assessed post-intervention. Women in CBSM revealed less depression, greater NK cells, and marginally greater CD4+ T-cells post-intervention vs. controls. Stress management may improve mood and immunity in HIV+HPV+ lower income minority women. HubMed – depression


Efficiency of Conservation Management Methods for Subdivided Populations under Local Adaptation.

J Hered. 2013 Mar 22;
Sánchez-Molano E, Caballero A, Fernández J

Computer simulations were used to investigate the efficiency of management methods for the conservation of a structured population when local adaptation exists. A subdivided population, with subpopulations adapted to different optima for a quantitative trait under stabilizing selection, was managed in order to maintain the highest genetic diversity in a 10-generation period. Two procedures were compared. For the first, minimum coancestry contributions were carried out independently for each subpopulation, and random migration of individuals was accomplished thereafter. For the second, minimum coancestry contributions from individuals were globally implemented, including an optimal migration design. This optimal method can be adjusted to control local inbreeding to different extents. Adaptation to local optima implies a reduction in the efficiency of the management methods because of the effective failure in the established migrations. For strong selection, the optimal design can be very inefficient, even more than the random migration scheme because the intended migrants have usually low fitness in the recipient subpopulations. However, for more realistic moderate or weak selection, the optimal method is more efficient than random migration, especially if inbreeding depression on fitness is also taken into account. It is concluded that the optimal management method can be recommended in conservation programs with local adaptation of subpopulations, but this issue should be accounted for when designing the management strategies. HubMed – depression



Depress Anxiety. 2013 Mar 22;
Nye JA, Purselle D, Plisson C, Voll RJ, Stehouwer JS, Votaw JR, Kilts CD, Goodman MM, Nemeroff CB

BACKGROUND: Deficits in serotonergic neurotransmission have been implicated in the pathogenesis of depression and suicidality. The present study utilized a novel positron-emission tomography (PET) ligand to quantitate and compare brain regional serotonin transporter (SERT) binding potential in depressed patients with a past history of suicide attempts to that of healthy comparison subjects. METHOD: We used [(11) C]-ZIENT PET to label SERT in the serotonergic cell body rich brainstem, and forebrain projection fields. Quantitative PET emission data from 21 adults (10 healthy controls and 11 drug-free patients with major depression) was used for group comparison. SERT binding potential (BPND ) in eight MRI-based brain regions of interest (ROI) were compared in high-resolution PET images. RESULTS: SERT binding potential was significantly decreased in the midbrain/pons (P = .029) and putamen (P = .04) of depressed patients with a past suicide attempt relative to comparison subjects. Forebrain SERT binding was also reduced in the patient sample, though these region effects did not survive a multiple comparison correction. CONCLUSION: These results suggest that decreased availability of the brainstem and basal ganglia SERT represents a biomarker of depression and thus confirm and extend the role of dysregulation of brain serotonergic neurotransmission in the pathophysiology of depression and suicide. HubMed – depression



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