Atherosclerosis and depression: is carotid intima-media thicker in patients with depression compared to matched control individuals? A systematic review and meta-analysis

OBJECTIVE

To investigate if there is an association between atherosclerosis and depression by using as imaging biomarker the carotid intima media thickness (cIMT), a surrogate marker for atherosclerosis.

METHODS

PubMed/Medline, Embase and Cochrane databases were comprehensively searched to identify studies investigating the association between cIMT and depression. The results were pooled using a random-effects statistical model, appropriate for the expected high heterogeneity. Sensitivity and subgroup analyses were conducted where data was available.

RESULTS

Overall, 22 and 13 studies met inclusion criteria for the qualitative and the quantitative synthesis, respectively, with a total of 4466 patients and 21,635 control participants. Results showed that cIMT is significantly higher in the depression, compared to the control groups with an overall mean difference of 0.07 mm (95% CI 0.04-0.10, p < 0.01). Subgroup analysis showed that diabetes could present as a confounding factor in patients with depression and an increased cIMT.

CONCLUSIONS

This study confirms a significantly increased cIMT in patients with depression, compared with controls and suggests a possible bidirectional link between atherosclerosis and depression. An early screening of cardiovascular disease in individuals suffering with depression should be considered.

The transient intraluminal filament Middle Cerebral Artery Occlusion stroke model in rats. A step by step guide and technical considerations

OBJECTIVE

Stroke is a leading cause of disability and mortality worldwide. Related research, although already providing significant insights on the underlying pathophysiology and potential treatment strategies, is far from conclusive. In this respect, stroke models are proving of extreme significance for laboratories around the world. The scope of this article is to present in detail the most popular to date focal stroke model, the tifMCAO model in rats. This model mimics reliably stroke in humans and also approximates endovascular thrombectomy.

METHODS

The tifMCAO model was performed on Wistar rats with a weight of 300-400 gr. The surgical technique is described in a step-wise manner, while pictures and/or HD video accompany each step. Complete arteriotomy of the ECA stump is introduced during the procedure.

RESULTS

We performed the tifMCAO in 65 rats (male and female) involved in various experimental protocols. Although that initial mortality was 48%, practice reduced this number to10%. The mean procedural time was 53 min (range, 38 - 85 min). Stroke was confirmed in 87.5% of the cases.

CONCLUSIONS

The tifMCAO stroke model in rats is the most commonly utilized experimental model of focal ischemia because of its clinical relevance. We revisited the procedure and divided it, for instructional purposes, in 15 consecutive distinct steps.

Anterior Cervical Discectomy and Fusion combined with thyroid gland surgery, a tailored case and literature review

Background

Nowadays, Anterior Cervical Discectomy and Fusion (ACDF) is considered a routine procedure. However, unexpected difficulties do occasionally arise, especially when anterior neck pathologies or anatomical variations are encountered. In such cases, proactive thinking will allow surgeons to tailor appropriately their approach and eliminate surgical risks.

Case presentation

We present the case of a 50-year-old male patient suffering from left upper limb radiculopathy that underwent a C7-T1 ACDF combined with a hemithyroidectomy. Excision of the right thyroid lobe was offered to the patient because of a goiter found during the preoperative work-up. Furthermore, the hemithyroidectomy provided a wide surgical field so the ACDF performed without excreting excessive traction to the adjacent neck structures.

Conclusions

The patient had an uncomplicated post-operative. To our knowledge this is the first report of a planned hemithyroidectomy being carried out as the first step towards an ACDF procedure.