Angst Wetenschap

[Effectiveness of Psychocardiological Care in Inpatient Rehabilitation: A Pilot Study].

Psychother Psychosom Med Psychol. 2019 Dec 10;:

Authors: Priegnitz J, Langheim E, Rademacher W, Schmitz C, Köllner V

Abstract
An integrative patient-centered care concept is increasingly demanded for treatment of cardiac patients with concomitant mental disorders. The present study aims to investigate the effect of an integrated concept of psycho-cardiac care (PK) versus a monodisciplinary cardiac (K) or psychosomatic (PSO) care. Patients were examined at baseline (T0), at the time of discharge from the rehabilitation program (T1) and after 6 month (T2). General anxiety, depression (HADS), cardiac anxiety (HAF) and quality of life (SF-12) were evaluated using computer-assisted questionnaires. A total of 93 patients were included (PK: n=37, 55.5 years SD=8.0, 43.2% female; K: n=32, 53.6 years SD=8.2, 34.4% female; PSO: n=24, 55.5 years SD=5.0, 45.8% female). Patients in the PK-group showed a significant reduction of heart-focused anxiety (HAF fear p=0.004) and a significant improvement in quality of life (SF-12 physical p=0.034) during follow-up. In contrast, these parameters remained unchanged in patients in the K- and PSO-groups. The results indicate that cardiac-patients with concomitant mental disorders benefit only from an integrated psycho-cardiac treatment concept. The findings provide first data to psycho-cardiac treatment in stationary rehabilitation and support previous clinical experiences. But further research is required to show the advantage of a psycho-cardiac concept towards monodisciplinary care.

PMID: 31822029 [PubMed - as supplied by publisher]

Hippocampal HECT E3 Ligase inhibition facilitates consolidation, retrieval, and reconsolidation, and inhibits extinction of contextual fear memory.

Neurobiol Learn Mem. 2019 Dec 07;:107135

Authors: Cotes JR, Popik B, Casagrande M, Silva MO, Quillfeldt JA, de Oliveira Alvares L, E Souza TM

Abstract
Ubiquitination is involved in synaptic plasticity and memory, but the involvement of HECT E3 ligases in these processes has not yet been established. Here, we bilaterally infused heclin, a specific inhibitor of these ligases, into the dorsal hippocampus of male Wistar rats that were trained in a contextual fear conditioning. Heclin improved short-term memory, consolidation, retrieval, and reconsolidation when administered immediately post training, prior to testing, or after memory reactivation, respectively. In addition, it impaired memory extinction when administered prior to a long reactivation session. Heclin infusion was also tested for locomotor activity and anxiety-like behavior in a circular arena, but no effect was seen. Taken together, these results indicate that HECT E3 ligases are involved in the modulation of fear memory.

PMID: 31821882 [PubMed - as supplied by publisher]

Opioid receptor modulation of neural circuits in depression: What can be learned from preclinical data?

Neurosci Biobehav Rev. 2019 Dec 07;:

Authors: Puryear CB, Brooks J, Tan L, Smith K, Li Y, Cunningham J, Todtenkopf MS, Dean RL, Sanchez C

Abstract
Major depressive disorder (MDD) is a heterogeneous clinical syndrome involving distinct pathological processes. Core features of MDD include anhedonia, reduced motivation, increased anxiety, negative affective bias, cognitive impairments, and dysregulated neuroplasticity mechanisms. There are multiple biological hypotheses related to MDD, including dysfunction of the opioid system. Although opium was abandoned as an antidepressant after the introduction of monoaminergic drugs, there has been renewed interest in targeting the opioid system for MDD. In this review, we discuss the preclinical support of this idea using a neurocircuitry- and molecular neuroplasticity-based approach. This article highlights how the opioid system potently modulates mesolimbic circuitry underlying motivation and reward processing, limbic circuitry underlying fear and anxiety responses, cortical and hippocampal circuitry underlying a variety of cognitive functions, as well as broad functional and structural plasticity mechanisms. Ultimately, a more thorough understanding of how the opioid system modulates these core functional domains may lead to novel treatment strategies and molecular targets in the treatment of MDD.

PMID: 31821832 [PubMed - as supplied by publisher]

Hemoptysis from the Perspective of People with Cystic Fibrosis.

Clin Respir J. 2019 Dec 10;:

Authors: Roman C, Loughlin H, Aliaj E, Fay R, Tran Q, Borowitz D

Abstract
INTRODUCTION: People with cystic fibrosis (CF) are living longer, thus complications associated with age, such as hemoptysis, are increasing. The Institute of Medicine has emphasized the importance of patient-centeredness. Although guidelines about hemoptysis in people with CF are available, these focus on management of the complication and not the patient perspective.
OBJECTIVE: We sought to understand hemoptysis from the point of view of those who have experienced it.
METHODS: We fielded an 11-question survey to adults with CF and asked those who had hemoptysis to respond. Four questions had open-ended options: 1) the person's first experience with hemoptysis, 2) how that experience affected the way they approach their CF, 3) how they deal with hemoptysis when it occurs outside the home, and 4) a free text box for general comments.
RESULTS: Thirty-one of 132 adults with CF who were sent a survey completed it (23% response rate); 63% F), indicated that they had experienced hemoptysis and described their triggers. In response to open questioning, 77% of respondents found their first experience with hemoptysis to be "scary", "frightening", "worrying" or "jarring". Half of respondents reported quality of life being negatively affected by worsening stress or anxiety, fear of bleeding in public, or other life impacts.
CONCLUSIONS: Focusing on how to cope with future episodes of hemoptysis and the associated anxiety can be helpful to patients. Proactive communication and sensitivity to patient experience may deepen physician-patient rapport, increase self-efficacy to cope with future episodes and lead to more comprehensive care of hemoptysis.

PMID: 31821725 [PubMed - as supplied by publisher]

The use of mentholated popsicle to reduce thirst during preoperative fasting: a randomised controlled trial.

J Clin Nurs. 2019 Dec 09;:

Authors: Aroni P, Fonseca LF, Ciol MA, Margatho AS, Galvão CM

Abstract
AIMS AND OBJECTIVES: To compare mentholated popsicle with usual care (absolute fasting) in the change of thirst intensity and discomfort of patients in the preoperative fasting.
BACKGROUND: Thirst is defined as the desire to drink water and it is considered to be a multifactorial symptom. In the preoperative fasting, the patient may experience intense thirst, often for a long time, that can lead to feelings of suffocation, desperation, fear, and anxiety.
DESIGN: A randomised controlled trial.
METHODS: Forty patients, age between 18 and 60 years, were randomised to mentholated popsicle group or absolute fasting group (twenty in each). The primary outcomes were thirst intensity, evaluated by a numeric scale ranging from 0 (no thirst) to 10 (the worst possible thirst), and discomfort from thirst (evaluated by the Perioperative Thirst Discomfort Scale), both measured twice (baseline and after 20 minutes of intervention). The CONSORT checklist was used to report this study.
RESULTS: Mean age were similar in both groups (38 years in the mentholated popsicle group and 39 in the absolute fasting group). At baseline, the mentholated popsicle group had higher median for the scales of intensity (6.5) and discomfort (7.5) from thirst than the absolute fasting group (5.0 and 5.0, respectively). At the end of 20 minutes, the popsicle group had a statistically significant decrease in intensity and discomfort from thirst (median decreases of 5.0 and 7.0 points, respectively) when compared to the absolute fasting group (median increases of 0.5 and 1.0 points, respectively).
CONCLUSIONS: The use of mentholated popsicle decreased the intensity and discomfort from thirst, and it is a viable strategy for management of thirst in the preoperative fasting.
RELEVANCE TO CLINICAL PRACTICE: In the preoperative fasting, making mentholated popsicles available to patients is an easy strategy to manage thirst, which might lead to better care.

PMID: 31820515 [PubMed - as supplied by publisher]