Effect of treatment on serum brain–derived neurotrophic factor levels in depressed patients

Researchers have reported that serum brain–derived neurotrophic factor (sBDNF) of drug–free depressed patients are lower than those of healthy controls and proposed that low sBDNF levels might reflect failure of neuronal plasticity in depression. In this study, we compared sBDNF levels of depressed patients (n = 28) before and after 8 weeks of antidepressant treatment, with those of healthy controls (n = 18) to test the hypothesis that initially low sBDNF levels of drug–free depressed patients will increase parallel with their clinical response to antidepressant treatment. The severity of depression and response to treatment were assessed with Hamilton Rating Scale for Depression (HAM–D). sBDNF was assayed with the sandwich ELISA method. Baseline sBDNF levels of patients (mean, 20.8 ng/ml; [S.D., 6.7]) were significantly lower than those of controls (mean, 26.8 ng/ml; [S.D., 9.3]; p = 0.015), and were negatively correlated with HAM–D scores (r = –0.49, p = 0.007). After 8 weeks of treatment, sBDNF levels of patients had increased significantly (mean, 33.3 ng/ml; [S.D., 9.9]; p < 0.001) and no longer differed from those of controls. These results support the hypothesis that BDNF might play a critical role in the pathophysiology of major depressive disorder and successful antidepressant treatment increases the attenuated BDNF levels in depressed patients.     

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique: a propensity-score-matched analysis in Dutch high-volume regional hospitals

Hernia - Results of the most commonly used inguinal hernia repair techniques often originate from expert centers or from randomized controlled studies. In this study, we portray daily-practice...     

Advanced glycation end products as a biomarker for incisional hernia

Background

Incisional hernia is one of the most frequent complications after abdominal surgery, with incidences up to 30%. A reliable biomarker for the prediction of this complication is lacking. Advanced glycosylation end products (AGEs), also known as non-enzymatic collagen crosslinks, are correlated with aging, smoking, hyperglycemia, hyperlipidemia and oxidative stress. In this study the accumulation of AGEs and the relation between AGEs and incisional hernia were investigated.

Materials and methods

In an exploratory case–control study, 23 patients with incisional hernia after midline incision were compared with 17 patients without clinical or radiological signs of incisional hernia after midline incision, AGEs were measured using a Skin Auto Fluorescence (SAF)-reader.

Results

Twenty-three patients with a clinically significant incisional hernia and 17 control patients were included. The study groups had significant differences in mean BMI. There was a significant difference between mean AGEs in patients with and without incisional hernia after midline incision (3.00 ± 0.15 vs. 2.56 ± 0.11, T test p = 0.03).

Conclusion

AGE accumulation measured in the skin indirectly with autofluorescence might be associated with incisional hernia. Prospective larger trials should confirm this finding.

     

Attitudes toward mental illness: Recognition,desired social distance,expected burden and negative influence on mental health among Turkish freshmen

Summary Attitudes toward three types of disorders and a normal subject portrayed in vignettes were assessed among university students. The variables assessed were: perception of mental illness in the vignettes; desired social distance; emotional and physical burden expected; and expected negative influence on one's mental health from association with the type of persons portrayed in the vignettes. Analysis revealed that, in terms of variables assessed, the most negative ratings were recorded for the paranoid schizophrenic case and the most positive recorded for the normal subject. The simple schizophrenia and the anxiety neurosis/depression cases fell between the other two cases. Finally, with a few exceptions, all the variables assessed were significantly correlated with each other.     

Attitudes of Turkish and American clinicians and Turkish psychology students toward mental patients

A comparative study of Turkish and American clinicians and first and fourth year Turkish psychology undergraduates was carried out. The respondents' attitudes about the "behavior of a mental patient" were assessed through a semantic differential task. Statistical comparisons showed that the four groups were very similar to each other although there were some significant differences. The possibilities of Western influence, similar groups selecting the fields of psychiatry and psychology, and psychology students forming a special well-informed group were discussed. A need for further research to clarify the findings was pointed out.     

An evaluation of quality of life of mothers of children with cerebral palsy

Purpose: To evaluate the quality of life of mothers with children suffering from cerebral palsy compared with those who have children with minor health problems. Method: Forty mothers with a child suffering from cerebral palsy and 44 mothers with a child suffering from minor health problems participated in a comparative study. The Turkish version of the Medical Outcomes 36-Item Short Form Health Survey (SF-36) was used to assess a mother's quality of life. The severity of a child's motor disability was assessed using the Gross Motor Function Classification System (GMFCS). Results: With the exception of the SF-36 physical functioning subscale, the mean scores on the SF-36 subscales were significantly lower in mothers of children with CP than those of the comparison group. The quality of life scores of mothers were significantly correlated with the severity of a child's motor disability (except physical functioning subscale). Significant correlations were found between GMFCS and the role physical; vitality; role emotional; and mental health subscales of the SF-36. Conclusions: The quality of life profile of mothers of children with cerebral palsy is different from those who have a child with minor health problems. Different coping strategies and psychosocial programmes must be designed and implemented to decrease the burden of care.     

Endovascular therapeutic strategies in ruptured intracranial aneurysms

The aim of the present study was to evaluate endovascular techniques used currently which were not available at the time of ISAT inclusion period, such as balloon remodelling and flow-divertion, in order to assess whether these new technologies have improved the endovascular approach outcomes.     

Transsacral S2-S4 nerve block for vaginal pain due to pudendal neuralgia

Pudendal neuralgia is a type of neuropathic pain experienced predominantly while sitting, and causes a substantial decrease in quality of life in affected patients. Pudendal nerve block is a diagnostic and therapeutic option for pudendal neuralgia. Transsacral block at S2 through S4 results in pudendal nerve block, which is an option for successful relief of pain due to pudendal nerve injury. Herein is reported blockade of S2 through S4 using lidocaine and methylprednisolone for successful treatment of pudendal neuralgia in 2 patients with severe chronic vaginal pain. The patients, aged 44 and 58 years, respectively, were referred from the Gynecology Department to the pain clinic because of burning, stabbing, electric shock-like, unilateral pain localized to the left portion of the vagina and extending to the perineum. Their initial pain scores were 9 and 10, respectively, on a numeric rating scale. Both patients refused pudendal nerve block using classical techniques. Therefore, diagnostic transsacral S2-S4 nerve block was performed using lidocaine 1%, and was repeated using lidocaine 1% and methylprednisolone 80 mg after confirming block efficiency as demonstrated by an immediate decrease in pain scores. After 1 month, pain scores were 1 and 0, respectively, and both patients were free of pain at 6-month follow up. It is suggested that blockade of S2 through S4 using lidocaine and methylprednisolone is an effective treatment option in patients with chronic pudendal neuralgia when traditional pudendal nerve block is not applicable.