Appraisal of systematic reviews on interventions for postpartum depression: systematic review.

BACKGROUND: Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions. METHODS: An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD. RESULTS: Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, - 0.09 to 0.34), or source of funding (p = 0.19). CONCLUSION: Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.

Pre-operative CT localization for patients with subsolid opacities expecting video-assisted thoracoscopic surgery-single center experience of fluorescent iodized emulsion and hook-wire localization technique.

OBJECTIVE: To describe our clinical experience of using combination of fluorescent iodized emulsion, indocyanine green & lipiodol, and hook-wire in pre-operative CT localization of patients with subsolid lung lesions prior to video-assisted thoracoscopic surgery (VATS). METHODS: A retrospective review between June 2018 and July 2019 of consecutive Chinese patients whom underwent VATS for subsolid lung lesions with pre-operative CT localization done with combination of fluorescent iodized emulsion and hook-wire technique in a tertiary hospital (Tuen Mun Hospital, Hong Kong SAR). The duration and complications related to the localization procedure were recorded The clinical records, operative findings and pathology reports were retrieved from the hospital electronic clinical management system. RESULTS: Combination fluorescent iodized emulsion with hook-wire enabled accurate localization and resection of all subsolid lung lesions in VATS. No major complications were reported. CONCLUSION: Combination of fluorescent iodized emulsion and hook-wire placement under CT guidance is a simple, safe and cost- effective procedure that enabled accurate localization and resection of subsolid nodule in VATS. ADVANCES IN KNOWLEDGE: VATS has been the mainstay for indeterminate pulmonary nodules for diagnostic and/or curative purpose. The main problem that surgeons may encounter during operation is the difficulty in locating the target lesion particularly for subsolid lesions. Many pre-operative localization methods have been developed in this regard. With the novel technique that we described, we were able to overcome disadvantages of most described methods.