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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Physicians and paramedical personnel often find the early diagnosis and differentiation of obstructive airway diseases to be a challenging problem. The history and physical examination are often not enough to allow the physician to detect either the presence of, or determine the type of, disease present. Patterns of pulmonary function abnormality to determine the presence of obstructive or restrictive defects are discussed. Guidelines useful in the differentiation of obstructive airway diseases are presented. Once a patient with COAD is assessed, the physician needs to outline a therapeutic program after establishing goals with the patient. These goals include (1) improved ability for the patient to achieve relief from symptoms and (2) improved capacity to carry out the activities of daily living. The therapeutic modalities available for the comprehensive care of patients with COAD are discussed. These include general factors such as patient and family education, avoidance of smoking and other inhaled irritants, avoidance of infection, a minimum stress environment, high fluid intake, and proper nutrition. The appropriate use of the medications most commonly employed in the teatment of these patients, eg, bronchodilators, expectorants, antimicrobials, corticosteroids, cromolyn, digitalis, and diuretics, are individually discussed. The use of such respiratory therapy techniques as aerosol therapy, intermittent positive pressure breathing, and oxygen therapy are considered. Application of the specialty of rehabilitation medicine to patients with obstructive airway disease is described. This includes physical therapy with breathing retraining, clapping and postural drainage, and exercise reconditioning, occupational therapy with attention to energy conservation in activities of daily living, psychological considerations, and vocational rehabilitation. Definite benefits that can be demonstrated if the physician employs this type of systematic respiratory care program include a decrease in the frequency and duration of hospital admissions, socioeconomic gains from reduced hospitalizations, a reduction in anxiety, depression and somatic concern, the return of patients to positions of employment and the establishment of a better quality of life. Persistence in making sure the patient continues in a systematic program, including both pharmacological and nonpharmacological modalities, may be the means of assuring maintenance or even improvement in his health. The day-to-day treatment for the majority of patients should remain in the hands of the primary physician. However, community resources must be established to allow the primary physician to provide these patients with adequate comprehensive respiratory care. Development of three levels of care (the primary physician, community respiratory rehabilitation units, and the regional respiratory center) should make superior respiratory care available to every patient with obstructive airway disease.
JAMA 1975 Jun 23
PMID:Chronic obstructive airway diseases. Current concepts in diagnosis and comprehensive care. 80 50

Significant peripheral white blood cell depression was noted in 75% of postmastectomy patients receiving chest wall and nodal irradiation and in 50% of patients receiving only peripheral nodal irradiation. Leukopenia was documented for as long as 36 months following therapy. With the current trend to earlier institution of chemotherapy, the routine use of postoperative irradiation must be reevaluated.
JAMA 1976 Feb 16
PMID:Leukopenia after postmastectomy irradiation. 94 94

Drug addiction among physicians appears to be an occupational hazard, with chronic pain, depression, and the easy availability of drugs major factors leading to addiction. In this study of 46 cases of physician addicts handled by the Virginia State Board of Medicine, meperidine hydrochloride (Demerol) was the most frequent addictive agent. The Virginia disciplinary and therapeutic plan for addicted physicians was effective in successfully rehabilitating and returning to medical practice 72% of the 46 physician addicts reported to the board from 1949 to 1974.
JAMA 1976 Sep 20
PMID:Drug addiction among physicians. The Virginia experience. 98 93

A consecutive three-month study of alcohol-intoxicated patients admitted to the casualty ward showed 24 patients with an initial serum alcohol concentration above 110 millimols/liter. Eight patitents were excluded because of insufficient data. Eight of the remaining 16 patients showed surprisingly slight depression of the central nervous system (CNS).
JAMA 1976 Oct 04
PMID:Unusually high levels of blood alcohol? 98 33

Many of the character traits that contribute to physician success can become risk factors to depression when amplified. Only reluctantly do some physicians attend to and express personal needs. The preemptory desire to satisfy the demands of his patients and colleagues may further subvert self-awareness and appropriate self-indulgence. Ultimately, frank depression emerges. Too often, depression remains unrecognized or untreated until the physician's self-destructive pattern compromises his capacity to care for his patients. The author discusses clues to the early recognition of depression as well as strategies in the prevention and treatment of the depressed physician.
JAMA 1976 Oct 11
PMID:Reaching out to the depressed physician. 98 18

Dantrolene sodium (Dantrium) is a skeletal muscle relaxant, unique in that it acts on the muscle itself. It should be considered for use in patients with skeletal muscle spasticity who are in a stable neurological state. After careful adjustment of the dose, a substantial number of such patients will experience one or more of the following benefits: (1) a reduction in pain, (2) an increased ability to make use of residual motor function, (3) a reduction in the level of nursing care required, (4) an increased ability to utilize devices, and (5) an increased ability to participate in rehabilitation. The drug should not be used when reduced spasticity will decrease functional ability. The adverse effects generally are transient; some are the result of central nervous system depression.
JAMA 1975 Feb 24
PMID:Evaluation of a muscle relaxant: dantrolene sodium (Dantrium). 108 67

Clinical and roentgenographic findings were compared in patients 40 years of age and over and in those under 40 who were treated for acute unilateral pneumothorax. Dyspnea and anxiety were pominent in the older individuals, although pneumothoraces were usually small. Because physical findings were often unreliable, roentgenograms were required. In the presence of pulmonary emphysema, loss of retractility prevented total collapse of the underlying lung. Increased intrapleural pressure caused over-expansion of the chest wall and the depression of the diaphragm without much mediastinal shifting. Partial collapse of emphysematous lobes demonstrated bullae that were not previously obvious. Respiratory failure developed in five patients over 40 years of age, but four of them recovered after relief of the pneumothorax. Mortality for the group was low and related to associated pulmonary diseases.
JAMA 1975 Oct 27
PMID:Pneumothorax complicating pulmonary emphysema. 117 69

In nine cases of phencyclidine hydrochloride poisoning, early signs of overdose included drowsiness, nystagmus, miotic pupils, blood pressure elevation, increased deep tendon reflexes, ataxia, anxiety, and agitation. In more severe cases, seizures, spasticity, and opisthotonos were seen in addition to deep coma and respiratory depression. Treatment included removal by emetics or lavage, hydration, and a quiet, reassuring environment. Spasticity, agitation, and ocular manifestions responded to diazepam. Psychiatric intervention was instituted after the patients were stable and no longer agitated.
JAMA 1975 Nov 03
PMID:Phencyclidine. Nine cases of poisoning. 124 71

The relation of hopelessness to levels of depression and suicidal intent was explored both psychometrically and clinically. The results of an investigation of 384 suicide attempters support previous reports that hopelessness is the key variable linking depression to suicidal behavior. This finding has direct implications for the therapy of suicidal individuals. By focusing on reducing the sources of a patient's hopelessness, the professional may be able to alleviate suicidal crises more effectively than in the past.
JAMA 1975 Dec 15
PMID:Hopelessness and suicidal behavior. An overview. 124 27

We made an evaulation of the double two-step exercise test in the diagnosis and prognosis of coronary artery disease, on the basis of the findings among 3,325 male applicants for life insurance who were given the test and observed for an average of nine years. The results suggest that (1) ischemic ST segment depression of any amount after exercise is pathognomonic of coronary insufficiency, for all practical purposes; (2) the amount of ischemic depression is related to the severity of the coronary insufficiency and the prognosis; (3) ischemic depression in multiple leads denotes widespread coronary insufficiency; (4) a nonischemic response practically excludes coronary disease of a type that will cause premature death; and (5) the exercise test is more reliable than the medical history in the diagnosis of silent coronary disease.
JAMA 1975 Nov 17
PMID:Appraisal of the double two-step exercise test. A long-term follow-up study of 3,325 men. 124 53


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