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17, 17n, 24, , n, n Kreft, Jürgen, Kretzer, Max, Kugli, Ana, n Ley, Dr. Robert, leader of the German Labor Front, 60–61, Ley, Dr. Thoracic injury, Yes, 24/ (), (–), No, 58/ () . Eric J . Ley, Phone: () , Email: @ Eric J. Ley. Show more authors. Hide. Abstract . [email protected] Go. ¨ran Wallin .. Thoracic injury Yes 24/ () (–) No 58/ ().

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Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury. Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between and Patients were stratified into groups based on pre-admission beta-blocker status.

Five hundred and ninety-six patients met the inclusion criteria with A forward logistic regression model was applied and predicted lack of beta-blockade to be associated with increased risk of depression OR 2. After adjusting for group differences, patients lacking beta-blockers demonstrated an increased risk of depression AOR 3.

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Pre-admission beta-blockade is associated with a significantly reduced risk of depression following severe lry injury. Further investigation is needed to determine the beneficial effects of beta-blockade in these instances. Symptoms of depression and anxiety may occur in up to half of all patients following significant trauma, resulting in poorer let in functional recovery and quality of life [ 12 ]. Established depression is difficult to treat and a preventative measure is therefore in the interest of both patients and trauma physicians [ 3 ].

CONSEJO FEDERAL DE SEGURIDAD EN ESPECTÁCULOS FUTBOLÍSTICOS by PABLO VILTE on Prezi

During memory retrieval of traumatic events, adrenergic activity is increased in humans and is manifested as increased heart rate and skin conduction.

Lfy physiologic findings are more significant in patients diagnosed with post-traumatic stress disorder PTSD [ 5 ]. Animal studies show that noradrenaline levels in the brainstem increase with trauma and amnesia is induced in rodents that are administered systemic propranolol shortly after memory recollection [ 67 ].

In clinical studies, subjects who received metoprolol showed diminished physiologic stress responses when watching a traumatic event and had impaired memory recall [ 8 ].

BB treatment administered peri- and post-trauma has been investigated in the context of PTSD and appears to reduce such symptoms [ 9 — 12 ], but studies are limited in cohort size and conflicting results have been demonstrated [ 13 — 15 ].

The effect of pre-injury BB on the development of clinical depression has not yet been studied, which is the aim of the current work. Ethical approval for lye retrospective cohort study was obtained from the Regional Review Board Stockholm County and the study adhered to the Declaration of Helsinki.

The study cohort was identified by querying the trauma registry of Karolinska University Hospital, an urban university hospital, for patients admitted to the trauma unit with severe extracranial injuries SECI between January 1,and December 31, Additional ethical approval was obtained from the National Board of Health and Welfare Socialstyrelsen for access to the national drugs registry database.

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A retrospective review of electronic patient records was carried out for clinical information during the admission. For subsequent analysis, continuous variables were dichotomized based on cutoff points recognized as having clinical relevance in trauma outcomes: Bivariate analysis was performed based on these dichotomous variables.

A total of patients with SECI were identified from the trauma registry and of those met leey inclusion criteria.

Pre-admission BB was prescribed in Overall, depression occurred in Patient variables were entered into a bivariate analysis. In order to determine independent risk factors for depression, the seven variables 224192 subsequently entered into a multivariable forward logistic regression model. Following adjustment for significant differences between the cohorts, the relationship between lack of pre-admission BB and development of post-trauma depression was strengthened AOR 3.

The following variables were included in the multivariable analysis: The following variables were adjusted for in the regression analysis: Symptoms of anxiety and depression are common in patients following severe trauma [ 116 ]. It has been hypothesized that the catecholamine surge occurring at the time of trauma may be an underlying factor facilitating the formation of strong emotional memories that are easily maintained.

Ruminating on memories is a significant contributory factor in the development and maintenance of clinical depression [ 1718 ]. BB inhibits adrenergic receptor activity and might inhibit the consolidation of such memories [ 7 ].

This inhibition, in turn, could blunt the emotional effect of traumatic events and prevent post-injury depression [ 8 ]. Interestingly, the use of pindolol together with serotonergic antidepressants has previously demonstrated a synergistic effect on negative moods [ 19 ]. Regular BB intake also appears to have a protective role in reducing emotional distress and depressive thoughts in the context of cancer diagnoses as well as following percutaneous coronary intervention in ischemic heart disease [ 2021 ].

These studies support the current findings that BB may play a role in the prevention of post-traumatic depression. The current study shows that The incidence of clinical depression was lower in the group exposed to BB prior to the traumatic event 8.

The average prevalence of patients prescribed antidepressant therapy in the county of Stockholm during the studied period — varied between 9. This suggests that trauma patients have an increased risk of developing depression post-trauma. Furthermore, our findings suggest that depression is a significant comorbidity in the trauma population and provides data that BB might be effective at prevention. The mechanism of post-trauma depression is likely to be multifactorial, and this 244192 identifies four independent risk factors.

Further, low GCS on admission, more severe injury and requiring surgery were associated with increased risk of post-traumatic depression. Additionally, the observed protective effect of BB in this lwy increased when adjustment was made for significant group differences in the logistic regression model, strengthening the observed impact of BB on the risk of depression.

While our findings provide support for a possible BB effect on post-trauma depression, the current retrospective design does not establish a direct causal link. A subsequent study subgrouping different types of BB might therefore be of value. The authors have no conflicts of interest to report and have received no financial support in relation to this manuscript. National Center for Biotechnology InformationU. World Journal of Surgery. Published online Mar 6. Author information Copyright and License information Disclaimer.

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Abstract Background Approximately half of trauma patients develop post-traumatic depression. Methods Patients were identified leey retrospectively reviewing the trauma registry at an urban university hospital between and Results Five hundred and ninety-six patients met the inclusion criteria with Conclusions Pre-admission beta-blockade is associated with a significantly reduced risk of depression following severe traumatic injury. Introduction Symptoms of depression and anxiety may occur in up to half of all patients following significant trauma, resulting in poorer outcomes in functional recovery and quality of life [ 12 ].

Materials and methods Ethical approval for this retrospective cohort study was obtained from the Regional Review Board Stockholm County and the study adhered to the Declaration of Helsinki. Results A total of patients with SECI were identified from the trauma registry and of those met the inclusion criteria. Open in a separate window. Discussion Symptoms of anxiety and depression are common in patients following severe trauma [ 116 ]. Compliance with ethical standards Conflict of interest The authors have no conflicts of interest to report and have received no financial support in relation to this manuscript.

Contributor Information Rebecka Ahl, Phone: Incidence 2412 depression, anxiety and stress following traumatic injury: Major depression following traumatic brain injury. Diagnosis and definition of treatment-resistant depression Biol Psychiatry.

Handbook of emotion and memory: Effect of post-retrieval propranolol on psychophysiologic responding during subsequent script-driven traumatic imagery in post-traumatic stress disorder. Increased noradrenaline levels in the rostral pons ldy be reversed by M1 antagonist in a rat model of post-traumatic stress disorder.

Attenuation of emotional and nonemotional memories after their reactivation: Stimulation of the noradrenergic system enhances and blockade reduces memory for lfy material in man.

Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Effect of acute posttrauma propranolol on PTSD outcome and physiological responses during script-driven imagery. Trauma reactivation under the influence of propranolol: Durably low physiological responding during subsequent script-driven traumatic imagery.

Prereactivation propranolol fails to reduce skin conductance reactivity to prepared fear-conditioned stimuli.

Pharmacotherapy to prevent PTSD: Pharmacological blockade of memory reconsolidation in posttraumatic stress disorder: Posttraumatic stress disorder in the national comorbidity survey. Neural correlates of rumination in depression. Cogn Affect Behav Neurosci. 24129

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Pindolol augmentation of serotonin reuptake inhibitors for 42192 treatment of depressive disorder: Beta-blockers may reduce intrusive thoughts in newly diagnosed cancer patients. Accessed 23 Oct Depression in general intensive care unit survivors: J Intensive Care Med.

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