Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients...Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients. Nevertheless, few papers had been published studying the anxiety and depression scales in the treatment of CTS, either with corticosteroid injections (I) or with surgical decompression (S). Objective: To assess whether clinical improvement observed after the treatment of CTS either with I or with S correlates with an improvement in the punctuations of the Hospital Anxiety and Depression scales (HADS), at 3, 6 and 12-month follow-up. Methods: Randomized and open-label clinical trial, comparing I and S. Patients with symptoms suggestive of CTS (nocturnal paraesthesias) of at least 3 months duration and neurophysiological confirmation were included. Patients with clinically apparent motor impairment were excluded. The subjective evaluation of symptoms was carried out using the visual-analogue scale of pain (VAS-p). Clinical reviews were performed 3, 6 and 12 months after treatment. Each patient completed the HADS questionnaire and a VAS-p at 0, 3, 6, and 12 months. Statistical significance was established using the Student’s t test and the Mann-Whitney U test when necessary. A linear regression analysis was used to know the effect of the treatment adjusted for the initial score of both scales. Results: 65 patients were included (30 in group I and 35 in group S). There was no statistical difference between both groups in terms of age, gender distribution, disease duration, VAS-p, neurophysiological testing severity of CTS or the 8 subscales of HADS. Both groups improved significantly in relation to the baseline VAS-p values, in the reviews at 3, 6 and 12 months, with no significant differences between I and S. At 6 months, the reduction in the anxiety scale was around 3 points for both treatments (S = 3.6 and I = 3.2), without reaching significant differences. At 12 months, it was somewhat higher for those treated with I, but always around 3 points and without significant differences. The Depression scale score was slightly reduced at 6 months, and in a similar way for both groups (I = 1 and S = 1.19;p = 0.8). After 12 months, group I doubled the previous reduction, with group S experiencing a very slight change (I = 1.96 and S = 1.03;p = 0.3). When analysing the effect of group S on group I, the result was a reduction of 0.25 points for Anxiety (p = 0.7) and of 0.02 points for Depression (p = 0.9). Conclusions: Treatment of CTS with I or S results in a similar and discrete improvement in Anxiety scores on the HADS scale at 6 and 12 months. For both types of treatment, the Depression scores barely changed at 6 months, being somewhat higher in group I after 12-month follow-up. The independent effect of the S on both scales is small and not significant.展开更多
The main objective of this study was to investigate the causal relationship between smoking and depression/ anxiety, and specially the direction of this relationship, in order to analyze the link between the degree of...The main objective of this study was to investigate the causal relationship between smoking and depression/ anxiety, and specially the direction of this relationship, in order to analyze the link between the degree of dependence to nicotine, and the anxio-depressive levels, according to HADS test and the Fagerstrom test of nicotine dependence. Our study included 647 smokers and 400 non-smoking male. To facilitate this study, we distributed questionnaires to several private GP surgeries, to be completed by patients. In this study, we found that there is a close relationship between the level of nicotine addiction, anxiety levels and the emergence of depressive disorders. A highly depressive state implies a very strong addiction to tobacco;a high percentage of subjects showed little or no tobacco dependence. When anxiety appears (even when non-significant) dependence increases from medium to high, and very high, whereas in the absence of depression, 80% to 90% of patients show no tobacco addiction. The addiction to tobacco increases at the beginning of depression and reach her maximum in depressed patients. Thus, the anxiolytic effect of nicotine becomes an anxiogenic effect in anxious subjects, when subjects move from non-dependence to medium and very strong addiction.展开更多
Emily Dickenson’s poems have long enjoyed considerable acclaims from critics and common readers for her delicate and profound writing of life and death,love,nature,etc.Her short poem“My Life had stood—a Loaded Gun...Emily Dickenson’s poems have long enjoyed considerable acclaims from critics and common readers for her delicate and profound writing of life and death,love,nature,etc.Her short poem“My Life had stood—a Loaded Gun”is one receiving relatively few academic discussion.Among the rather few existent studies,many discuss Dickenson’s feminist ideas,religious bewilderment,literary creation views or even personal feeling in this poem.This article,instead,gives an interpretation of this poem from an ecocritical perspective.It points out that Emily Dickenson in this poem expresses her condemnation on human’s cruelty and indiffer?ence to nature.After a thorough interpretation of Dickenson’s reflection on human-nature relationship in this poem,the article fur?ther explores Dickenson’s attitudes toward nature through her personal writing background and clues in her other works to support this interpretation.展开更多
文摘Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients. Nevertheless, few papers had been published studying the anxiety and depression scales in the treatment of CTS, either with corticosteroid injections (I) or with surgical decompression (S). Objective: To assess whether clinical improvement observed after the treatment of CTS either with I or with S correlates with an improvement in the punctuations of the Hospital Anxiety and Depression scales (HADS), at 3, 6 and 12-month follow-up. Methods: Randomized and open-label clinical trial, comparing I and S. Patients with symptoms suggestive of CTS (nocturnal paraesthesias) of at least 3 months duration and neurophysiological confirmation were included. Patients with clinically apparent motor impairment were excluded. The subjective evaluation of symptoms was carried out using the visual-analogue scale of pain (VAS-p). Clinical reviews were performed 3, 6 and 12 months after treatment. Each patient completed the HADS questionnaire and a VAS-p at 0, 3, 6, and 12 months. Statistical significance was established using the Student’s t test and the Mann-Whitney U test when necessary. A linear regression analysis was used to know the effect of the treatment adjusted for the initial score of both scales. Results: 65 patients were included (30 in group I and 35 in group S). There was no statistical difference between both groups in terms of age, gender distribution, disease duration, VAS-p, neurophysiological testing severity of CTS or the 8 subscales of HADS. Both groups improved significantly in relation to the baseline VAS-p values, in the reviews at 3, 6 and 12 months, with no significant differences between I and S. At 6 months, the reduction in the anxiety scale was around 3 points for both treatments (S = 3.6 and I = 3.2), without reaching significant differences. At 12 months, it was somewhat higher for those treated with I, but always around 3 points and without significant differences. The Depression scale score was slightly reduced at 6 months, and in a similar way for both groups (I = 1 and S = 1.19;p = 0.8). After 12 months, group I doubled the previous reduction, with group S experiencing a very slight change (I = 1.96 and S = 1.03;p = 0.3). When analysing the effect of group S on group I, the result was a reduction of 0.25 points for Anxiety (p = 0.7) and of 0.02 points for Depression (p = 0.9). Conclusions: Treatment of CTS with I or S results in a similar and discrete improvement in Anxiety scores on the HADS scale at 6 and 12 months. For both types of treatment, the Depression scores barely changed at 6 months, being somewhat higher in group I after 12-month follow-up. The independent effect of the S on both scales is small and not significant.
文摘The main objective of this study was to investigate the causal relationship between smoking and depression/ anxiety, and specially the direction of this relationship, in order to analyze the link between the degree of dependence to nicotine, and the anxio-depressive levels, according to HADS test and the Fagerstrom test of nicotine dependence. Our study included 647 smokers and 400 non-smoking male. To facilitate this study, we distributed questionnaires to several private GP surgeries, to be completed by patients. In this study, we found that there is a close relationship between the level of nicotine addiction, anxiety levels and the emergence of depressive disorders. A highly depressive state implies a very strong addiction to tobacco;a high percentage of subjects showed little or no tobacco dependence. When anxiety appears (even when non-significant) dependence increases from medium to high, and very high, whereas in the absence of depression, 80% to 90% of patients show no tobacco addiction. The addiction to tobacco increases at the beginning of depression and reach her maximum in depressed patients. Thus, the anxiolytic effect of nicotine becomes an anxiogenic effect in anxious subjects, when subjects move from non-dependence to medium and very strong addiction.
文摘Emily Dickenson’s poems have long enjoyed considerable acclaims from critics and common readers for her delicate and profound writing of life and death,love,nature,etc.Her short poem“My Life had stood—a Loaded Gun”is one receiving relatively few academic discussion.Among the rather few existent studies,many discuss Dickenson’s feminist ideas,religious bewilderment,literary creation views or even personal feeling in this poem.This article,instead,gives an interpretation of this poem from an ecocritical perspective.It points out that Emily Dickenson in this poem expresses her condemnation on human’s cruelty and indiffer?ence to nature.After a thorough interpretation of Dickenson’s reflection on human-nature relationship in this poem,the article fur?ther explores Dickenson’s attitudes toward nature through her personal writing background and clues in her other works to support this interpretation.
