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At least 343 records · Page 19Linked to original sources
PubMed1996

[Therapy of post-stroke depression with fluoxetine. A pilot project].

Depression is a common but often unrecognized complication after cerebrovascular stroke. Tricyclic antidepressants (TCA) have been found to be effective in poststroke depression, but side effects such as orthostatic hypotension, arrhythmia limit their wider use. In this pilot study the effects of treatment with the specific serotonin reuptake inhibitor (SSRI) fluoxetine (20 mg) in 10 severely depressed patients (HAM-D score between 27 and 35) after cerebrovascular stroke were investigated. Four patients dropped out of the study prematurely because of worsening of their condition (n = 4) and one patient discontinued the study because of transfer to a nursing home. After 3 weeks of fluoxetine treatment there was a significant amelioration in all the measured scores (HAM-D, Beck, CGI and Barthel: P < 0.05). At the end of the study one patient with recurrent cerebrovascular lesions still had an HAM-D score of 25, but the other four patients had HAM-D scores between 6 and 11. The physical rehabilitation scores measured with the Barthel Index showed negative correlations with the HAM-D, Beck and CGI scores for most items; this has to be interpreted with caution considering the number of patients involved in this investigation. The authors suggest that future double blind trials are warranted to test the efficacy of fluoxetin therapy for poststroke depression. Methodological problems in connection with pharmacological trials in these severely ill patients are discussed.

Aged↗
PubMed2006

A pilot project for the effective delivery of HAART in rural China.

The purpose of this pilot study, conducted in rural Jilin Province in northeastern China, was to develop and test an infrastructure for the delivery of highly active antiretroviral therapy (HAART) that might be applicable to other such areas across the country. Earlier attempts to provide antiretroviral therapy in rural areas met with mixed success in large measure because of social stigma, a lack of adequate physician training, and problems with patient retention. In response to these problems, a highly integrated and family-centered approach was developed that placed emphasis on the primary care level for regimen delivery. Using this structure, a treatment naïve cohort of 22 male and 20 female (n = 42) volunteers with HIV/acquired immune deficiency syndrome (AIDS) was given government-provided HAART. After 12 months, all volunteers remained in the cohort, and there were significant changes in both CD4 levels and ability to return to work. Per patient cost for the 12-month study was Dollars 1,259.00, with Dollars 1,149 being spent on treatment and Dollars 110.00 on educational and administrative costs. This project demonstrated that HAART can be delivered successfully in resource-poor rural areas in China.

Acquired Immunodeficiency Syndrome↗