Changes in the SF-12 among Depressed Elders Six Months after Discharge from an Inpatient Geropsychiatric Unit

Using the SF-12 to measure physical and mental functioning, the authors examine the intra-individual changes in health-related quality of life (HRQOL) 6 months post-discharge for depressed older adults. In addition, they examine three sets of predictors that might influence these changes. The sample of depressed older adults was recruited from an inpatient geropsychiatry unit. Although their physical and mental health scores on the SF-12 were lower than comparable norms, the sample showed an average increase in their mental functioning but a decrease in the physical functioning over the 6 months. Negative life-events were significant predictors of people who reported no change in their mental health functioning and decreases in their physical health functioning. Interestingly, those who experienced positive life events were more likely to report declines and younger participants were more likely to report no change in their physical functioning. The findings indicate that the effects of depression on HRQOL can have enduring effects on a sample of previously hospitalized older adults. The significance of life event changes might signify the importance of taking into account non-traditional areas of medical interventions. Further, the findings indicate the usefulness of the SF-12 quantifying HRQOL outcomes.     

The Effects of Depressed Affect on Functional Disability Among Rural Older Adults

This study investigates functional disability among some of the nation's most vulnerable older adults: rural Medicaid recipients. Data were provided by 221 older adults (mean age = 75.9 years; 82% women) who were receiving community-based long-term care services through Medicaid. Participants self-reported functional ability involving the completion of six basic activities of daily living (BADLs), three cognitive instrumental activities of daily living (IADLS), and four physical IADLs. Self-reports of depressed affect and the number of physical health conditions were also obtained. Path analysis was used to examine all of the associations among age, gender, number of chronic health conditions, depressed affect and functional disability. The tested model was significant [chi2 (DF = 3, n = 221) = 5.052, p = 0.168; TLI = 0.945; CFI = 0.992; RMSEA = 0.056] and explained 45.1% of the variance in BADL disability. Depressed affect significantly predicted disability in cognitive IADLs and physical IADLs, which predicted disability in BADLs. Age and gender had indirect effects on BADL, through their association with cognitive IADLs and physical IADLs. The number of chronic health conditions exerted both indirect and direct effects on BADL disability. Results are discussed within the context of the growing literature that suggests the importance of psychological variables as predictors of functional disability. Moreover, we discuss whether community-based long-term care is appropriate for older adults with high levels of functional disability.     

Chronic administration ofl-sulpiride at non-neuroleptic doses reduces the duration of immobility in experimental models of “depression-like” behavior

It has been shown that long-term administration ofl-sulpiride induces a down-regulation of receptor-associated adenylate cyclase activity in the frontal cortex of rats, an adaptive response that is typically associated with the chronic administration of antidepressants. Here we show that in two animal models of depression-like behavior (forced swim in rats and tail suspension in mice), the long-term (21 days) administration ofl-sulpiride at a non-neuroleptic dose (2 mg/kg IP twice a day) significantly decreases the duration of immobility, the effect being similar to that of desipramine (20 mg/kg IP). The same dose (2 mg/kg) ofl-sulpiride, acutely administered, has no effect at all. On the other hand, either chronic (21 days) or acute administration of neuroleptic doses ofl-sulpiride have an opposite effect, and indeed increase the duration of immobility. These results are an in vivo support to the in vitro findings suggesting that low doses ofl-sulpiride may have antidepressant-like activity.     

Breastfeeding in Depressed Mother-Infant Dyads

Depressed versus non-depressed mothers were interviewed on their breastfeeding practices and perceptions of their infants' feeding behavior when their infants were eight-months-old. The depressed mothers less often breastfed, they stopped breastfeeding their infants significantly earlier in infancy and they scored lower on a breastfeeding confidence scale. Independent of maternal depression, mothers who breastfed rather than bottle fed their infants had higher confidence levels and rated their infants as less alert and less irritable during feedings.     

Lay Midwifery- Still an 'Illegal' Profession

This article reviews the process by which a health collective has organized the home birth service. The legal and political problems and ramifications of the Collective's actions are discussed.     

早期胃癌中凹陷型比率的临床分析

目的探索以凹陷型病灶为主的胃癌漏诊原因,统计早期胃癌中凹陷型的比率。方法 2007年1月～2010年12月的4年间,胃癌切除患者2 431例,统计经切除标本病理学证实的早期胃癌例数及凹陷型形态的早期胃癌的比率。结果 2 431例胃癌切除中,466例为早期胃癌(19.17%);其中Ⅱc型早期胃癌278例(59.66%),Ⅲ型早期胃癌83例(17.81%),复合凹陷型早期胃癌8例(1.72%),凹陷型早期胃癌总计369例,占早期胃癌总数的79.18%。结论早期胃癌的形态分型中以表浅凹陷及溃疡型居多,因而临床漏诊的几率亦增多。提高对凹陷型胃癌特别是早期胃癌病灶的识别能力至关重要。     

综合康复疗法联合解郁安神颗粒干预对产后抑郁的疗效分析

目的 观察综合康复疗法联合解郁安神颗粒干预对产后抑郁的疗效以及对血清中瘦素水平的影响.方法 选择110例产后抑郁产妇为研究对象,根据住院号单双数分为对照组与综合组,其中对照组给予包括心理干预和放松训练的综合康复疗法,综合组在对照组基础上服用解郁安神颗粒治疗,两组连续治疗8周.比较治疗前、后两组汉密尔顿抑郁量表-17(HAMD-17)评分、匹兹堡睡眠质量指数(PSQI)评分、爱丁堡产后抑郁量表(EPDS)评分及抑郁自评量表(SDS)评分.检测并比较两组血清瘦素水平.结果 治疗后,综合组HAMD量表各因子评分[焦虑(2.97±0.33)分、昼夜(0.68±0.09)分、睡眠障碍(2.21±0.24)分、体质量(0.20±0.04)分、绝望感(2.09±0.23)分、认知障碍(6.17±0.08)分、阻滞(4.68±0.07)分]明显低于对照组[焦虑(4.12±0.62)分、昼夜(1.17±0.15)分、睡眠障碍(3.61±0.43)分、体重(0.71±0.09)分、绝望感(3.88±0.46)分、认知障碍(8.15±1.02)分、阻滞(7.30±0.09)分](P<0.01).治疗4周和8周后,综合组患者的PSQI[(7.52±0.09)分、(5.99±0.07)分]、EPDS[(13.32±1.66)分、(11.77±1.37)分]及SDS[(54.88±6.27)分、(43.30±4.86)分]评分显著少于对照组同期(P<0.01).治疗后4周和8周,综合组患者血清中瘦素水平[(361.34±38.26)pg·mL-1、(291.63±32.08)pg-1]显著低于对照组,差异有统计学意义(P<0.01).结论 综合康复疗法联合解郁安神颗粒干预对产后抑郁的疗效显著,抑制患者血清中瘦素水平可能与其治疗效果有关.     

自体脂肪移植矫正凹陷性瘢痕的技巧

目的探讨采用自体脂肪移植矫正凹陷性瘢痕的效果与注射移植技巧。方法自2009年7月至2014年3月,共接诊21例（24处）凹陷性瘢痕患者。移植前1d以生理盐水注射法评估注射量。用注射针头往返穿刺松解受区瘢痕粘连,然后行多层面、多隧道自体脂肪注射移植。结果21例（24处）患者注射盐酸肾上腺素生理盐水5～40ml,自体脂肪注射移植量为6～48ml,注射后凹陷畸形得到矫正,局部稍隆起;1个月后有部分吸收,隆起消退,注射处与周围皮面相平;6个月后,局部基本平坦,患者均满意。所有患者均未出现硬结、囊肿、感染等并发症。结论只要患者病情适合,注射方法得当,自体脂肪移植是矫正凹陷性瘢痕的良好方法。     

Not Infrequent K-ras Mutations in Depressed-type Early Colorectal Carcinomas Larger than 10 mm

The aim of this study was to elucidate whether K- ras (codons 12 and 13) mutations occur in depressed-type early colorectal carcinomas (DECas) larger than 10 mm in size. Thirty-four cases of DECas including 27 larger than 10 mm were examined for K- ras mutations by means of microdis-section, PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism), and direct sequencing. Although K- ras mutation was infrequent (1/7, 14%) in small (less than 10 mm) DECas, 16/27 (59%) and 17/27 (63%) of DECas larger than 10 mm revealed codon 12, or either codon 12 or 13 mutations, respectively. None of the evaluated pathological factors except size showed a correlation with K- ras mutation. These data indicate that although K- ras mutation could not be involved in the early stage of the progression of DECas, it might play a role at a later stage when the tumor size is over 10 mm.     

Depressed Mononuclear Cell Function in Advanced Neoplastic Disease

ABSTRACT: The ascites fluids from 9 patients with invasive gynecologic neoplasms were examined to determine the immunocompetence of the mononuclear ascites cells and the immunoregulatory properties of the cell-free ascitic fluid. Blood mononuclear cells (from 5 patients) were also tested. The mononuclear cells from the cancer patients responded poorly to stimulation with polyclonal mitogens; only the blood mononuclear cell response to pokeweed mitogen was not significantly less than that of normal subjects. The addition of autologous serum or cell-free ascitic fluid to the cell cultures enhanced the response of the cells to phytohemagglutinin and pokeweed mitogen, had little effect on the response to concanavalin-A, and greatly depressed the response to succinyl-concanavalin-A. We found no evidence for the presence of suppressor cells in the ascites cell populations. The data are consistent with the thesis that the depressed immune responses are the result of malnutrition associated with advanced malignant disease.