Exercise and severe major depression: effect on symptom severity and quality of life at discharge in an inpatient cohort.

BACKGROUND: Exercise is a potential treatment for depression. However, few studies have evaluated the role of adjunct exercise in the treatment of severely major depressed inpatients. The goal of this study was to evaluate the effects of add-on exercise on the usual treatment of severely depressed inpatients. METHODS: Fifty participants were randomized to an exercise (exercise + usual treatment) or a control (usual treatment) group. Twenty-five patients were randomly allocated to each group. The participants in the exercise group performed three sessions per week throughout the hospitalization period, with a goal dose of 16.5 kcal/kg/week plus the usual pharmacological treatment. Depressive symptoms and the Quality of Life (QoL) of the participants were assessed at the baseline, the second week, and discharge. RESULTS: A significant group × time interaction was found for depressive symptoms and the physical and psychological domains of QoL. Differences between groups occurred at the second week and discharge with respect to depressive symptoms and the physical and psychological domains of QoL. There was no difference in the remission rate at discharge (48% and 32% for the exercise and control group, respectively). An NNT of 6.25 was found. No significant baseline characteristics predict remission at discharge. CONCLUSION: Add-on exercise is an efficacious treatment for severely depressed inpatients, improving their depressive symptoms and QoL. Initial acceptance of exercise remains a challenge.

Exercise and severe depression: preliminary results of an add-on study.

BACKGROUND: Physical exercise has been extensively researched as a therapeutic option for treatment of major depression. METHODS: In a randomized controlled trial, we analyze the effects of aerobic physical exercise as an add-on strategy for treatment of severe depressed inpatients. The exercise has a "Dose" of 16.5 kcal/kg/week, three times a week during all the hospitalization. RESULTS: Our preliminary results show that there is no significant difference in scores of Hamilton in the second week between groups (Mean[SD]=8.2[5.96] × 11.18[5.03], p=0.192). However, there is a significant reduction in Hamilton scores of patients in exercise group at discharge (Mean[SD]=5.93[4.46] × 9.45[3.56], p=0.041). Regarding Quality of Life (QoL), no significant difference were found between groups in the second week in physical domain (Mean[SD]=56.98[8.96] × 54.54[9.18], p=0.511) and psychological domain (Mean[SD]=50.88[13.88] × 42.04[12.42], p=0.106). However, there is a significant difference in psychological domain (Mean[SD]=55.88[9.92] v 41.66[13.04], p=0.004) and a trend but no statistical significance in the physical (Mean[SD]=58.80[9.14] × 52.12[8.70], p=0.07) at discharge. LIMITATIONS: Many patients receive different treatment strategies, like ECT (1 patient at exercise group × 3 at control group). Other limitation is the small number of participants included until this moment. CONCLUSION: Our preliminary results suggest that physical exercise could be a feasible and effective add-on strategy for treatment of severe depressed inpatients, improving their depressive symptoms and QoL.

Improved preservation of skeletal muscle in amputated limbs using pulsatile hypothermic perfusion with University of Wisconsin solution. A preliminary study.

To determine whether pulsatile hypothermic perfusion with University of Wisconsin preservation solution is superior to topical cooling as a method for the preservation of amputated limbs, six pairs of amputated canine limbs were preserved for twelve to fifteen hours. One limb of each pair was subjected to topical cooling and the other, to pulsatile hypothermic perfusion with University of Wisconsin solution. The bioenergetic status of the limbs was monitored by 31phosphorus magnetic-resonance spectroscopy, and histological evaluation was performed to assess ischemic changes in the preserved tissue. The pH and tissue levels of adenosine triphosphate declined three times more slowly in the limbs that were preserved by pulsatile hypothermic perfusion than in the topically cooled limbs. Consistent with these findings, the perfused limbs also had less histological evidence of ischemic injury. The data from this in vitro study show that pulsatile hypothermic perfusion with University of Wisconsin solution, in combination with an optimum degree of topical cooling, is superior to topical cooling alone as a method of preserving the bioenergetic status of amputated limbs.

Risk factors for rapid progression from hairy leukoplakia to AIDS: a nested case-control study.

To determine risk factors for early progression from oral hairy leukoplakia to AIDS, this case-control study compared 27 patients who had not progressed to AIDS within 1,000 days of diagnosis of hairy leukoplakia with 28 patients who progressed rapidly. The risk factors that proved most predictive fell into two categories: (a) those reflecting sexual practices that correlated with how early in the epidemic patients were likely to have been infected, and (b) those reflecting immune competence. Hepatitis B was associated with a fourfold risk for early progression and syphilis with a nearly threefold risk. Skin test anergy for Candida species was strikingly predictive: all of 17 tested in the early progression group were anergic, compared with only two of 12 tested in the late progression group. Although skin testing has been largely supplanted by assessment of T-cell subsets, Candida species skin testing may be of particular prognostic value in otherwise apparently healthy HIV-infected persons.