A Prospective, Multicenter Study of Ventricular Assist Device Infections.

A Prospective, Multicenter Study of Ventricular Assist Device Infections.

Filed under: Depression Treatment

Circulation. 2013 Jan 11;
Gordon RJ, Weinberg AD, Pagani FD, Slaughter MS, Pappas PS, Naka Y, Goldstein DJ, Dembitsky WP, Giacalone JC, Ferrante J, Ascheim DD, Moskowitz AJ, Rose EA, Gelijns AC, Lowy FD

BACKGROUND: Ventricular assist devices (VADs) improve survival and quality of life in patients with advanced heart failure, but their use is frequently complicated by infection. There are limited data on the microbiology and epidemiology of these infections. METHODS AND RESULTS: 150 patients scheduled for VAD implantation were enrolled (2006-2008) at 11 U.S. cardiac centers and followed prospectively up to transplantation, explantation for recovery, death, or for one year. 86 (57%) patients received Heartmate II® devices. Data were collected on potential pre-, intra-, and post-operative risk factors for infection. Clinical, laboratory, and microbiologic data were collected for suspected infections and evaluated by an infectious diseases specialist. 33 (22%) subjects developed 34 VAD-related infections with an incidence rate of 0.01 per 100 person-days (95% CI, 0.073-0.142). The median time to infection was 68 days. The driveline was the most commonly infected site (n=28); 18 (64%) were associated with invasive disease. Staphylococci were the most common pathogen (47%), but Pseudomonas or other Gram-negative bacteria caused 32% of infections. A history of depression and elevated baseline serum creatinine were independent predictors of VAD infection (HR(adj)=2.8,P=0.007 and HR(adj)=1.7,P=0.023, respectively). The Heartmate II® was not associated with a decreased risk of infection. VAD infection increased one-year mortality (HR(adj)=5.6, P<0.0001). CONCLUSIONS: This prospective, multicenter study demonstrates that infection frequently complicates VAD placement and is a continuing problem despite the use of newer, smaller devices. Depression and renal dysfunction may increase the risk of VAD infection. VAD infection is a serious consequence as it adversely affects patient survival. CLINICAL TRIAL REGISTRATION INFORMATION: clinicaltrials.gov. Identifier: NCT01471795. HubMed – depression

Alteration in plasma corticosterone levels following long term oral administration of lead produces depression like symptoms in rats.

Filed under: Depression Treatment

Metab Brain Dis. 2013 Jan 12;
Haider S, Saleem S, Tabassum S, Khaliq S, Shamim S, Batool Z, Parveen T, Inam QU, Haleem DJ

Lead toxicity is known to induce a broad range of physiological, biochemical and behavioral dysfunctions that may result in adverse effects on several organs, including the central nervous system. Long-term exposure to low levels of lead (Pb(2+)) has been shown to produce behavioral deficits in rodents and humans by affecting hypothalamic-pituitary-adrenal (HPA) axis. These deficits are thought to be associated with altered brain monoamine neurotransmission and due to changes in glucocorticoids levels. This study was designed to investigate the effects of Pb(2+)exposure on growth rate, locomotor activity, anxiety, depression, plasma corticosterone and brain serotonin (5-HT) levels in rats. Rats were exposed to lead in drinking water (500 ppm; lead acetate) for 5 weeks. The assessment of depression was done using the forced swimming test (FST). Estimation of brain 5-HT was determined by high-performance liquid chromatography with electrochemical detection. Plasma corticosterone was determined by spectroflourimetric method. The present study showed that long term exposure to Pb(2+) significantly decreased the food intake followed by the decrease in growth rate in Pb(2+)exposed rats as compared to control group. No significant changes in open field activity were observed following Pb(2+)exposure while significant increase in anxiogenic effect was observed. Increased plasma corticosterone and decreased 5-HT levels were exhibited by Pb(2+)exposed rats as compared to controls. A significant increase in depressive like symptoms was exhibited by Pb(2+)exposed rats as compared to control rats. The results are discussed in the context of Pb(2+) inducing a stress-like response in rats leading to changes in plasma corticosterone and brain 5-HT levels via altering tryptophan pyrrolase activity.
HubMed – depression

Depression in heart failure.

Filed under: Depression Treatment

Curr Opin Cardiol. 2013 Jan 9;
Moudgil R, Haddad H

PURPOSE OF REVIEW: This review aims to provide a general overview of the recent advances in understanding of depression as it pertains to heart failure. The focus is to impart an up to date knowledge in this field. RECENT FINDINGS: The mortality associated with heart failure remains high despite recent pharmacologic interventions that have improved survival. The situation is complicated by recent recognition of depression being widespread in this population. Depression is a hard diagnosis, as some of the features coincide with the symptoms of heart failure. Recently the psychological sequelae of depression have been under major scrutiny, as it has been associated with increased morbidity. In addition, current data are quite compelling on prevalence of depression in heart failure patients. Therefore, it is imperative to highlight the recent challenges and to recognize areas requiring future research. SUMMARY: Despite the prevalence of depression in heart failure, we remain abysmal in detecting, diagnosing and treating depression, which remains an independent predictor of mortality. Therefore, more research and more awareness are required in this arena.
HubMed – depression

Midwest Center! Lucinda Basset, Attacking Stress, Anxiety and Depression! Master Kit, 2008 Edition!
Attacking Stress Anxiety & Depression The Midwest Center Master Kit! 2008 Edition Product Reatails for over 500 Dollars! Get it he…

Living with a Black Dog: His Name Is Depression
One in four women and one in six men will suffer from depression at least once in their life. Few are immune. It was the greatly a…

Overcoming Depression in Teens and Pre-Teens: A Parent’s Guide (Dr. T’s Living Well Series)
The treatment modalities for pre-teen and teenager depression require a multi-factorial approach. Cognitive-behavioral therapy in …

Related Depression Treatment Information…