Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An efficient narco-analgesia is given by the association of two drugs: -- diazepam (Valium): a benzodiazepine with an anxiolytic and myoresolutive effect, inducing sleep and giving amnesia; -- lysine acetylsalicylate (Aspegic) giving an analgesia inferior to that of morphinomimetic drugs but not inducing respiratory depression. These two drugs are given in an intravenous catheter. Their effects last about 20 minutes - vomiting is rare. The authors report their experience of 50 cases and think that this technique is recommended in remote medical units for moderately painful and short duration operations.
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PMID:[Valium-aspegic association. Its value in a remote medical unit (author's transl)]. 678 84

The effectiveness of chlormethiazole in providing basal sedation was studied using a two-stage infusion regimen consisting of an initial loading dose of 60 mg min-1 for 25 min (in the lateral position) followed by a maintenance constant-rate infusion of 10 mg min-1 for 60 min (in the supine position). The regimen was evaluated in five healthy young volunteers who were all moderately sedated throughout most of the infusion, lapsing into sleep when left undisturbed, yet awakened easily to obey commands. Varying periods of amnesia, corresponding with a mean chlormethiazole ethanedisulphonate blood concentration of 10.3 mg litre-1 (SD 3.8) were obtained. Light sedation occurred during the first 10 min and the last 20 min of the total infusion period, corresponding to chlormethiazole blood concentrations of 7.9 mg litre-1 (SD 1.9) and 7.4 mg litre-1 (SD 2.3) respectively. Adverse side-effects were transient nasal irritation, flushing and a coryza-like syndrome. Other side-effects of tachycardia and hypertension may be beneficial in counteracting cardiovascular depression associated with central neural blockade. A high total body clearance of chlormethiazole (mean 1.39 litre min-1, SD 0.58) was found and would contribute to the brief duration of action after termination of the infusion.
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PMID:Two-stage infusion of chlormethiazole for basal sedation. 732 65

Tramadol-HCl was used clinically in the form of a continuous infusion as the analgesic component of a balanced anaesthetic technique. In over 90% of the anaesthetics a further injection of barbiturate and/or supplementary muscle relaxant was necessary because the patients did not tolerate the operative procedure. Although a higher dosage of Tramadol reduces significantly the supplementary barbiturate dosage per kilogram bodyweight per minute which is required, it has no effect on the incidence of reflex movements, nor does it prevent the marked intraoperative rise of diastolic blood pressure. The balanced anaesthetic with Tramadol-HCl is characterized by prompt awakening, total amnesia, good post-operative analgesia and minimal side effects (occasional nausea). In particular, there was no case in which there was noticeable respiratory depression. As insufficient analgesia and hypnosis is provided by Tramadol-HCl, making the administration of muscle relaxants and barbiturates obligatory, there is no significant advance in our technique of using Tramadol-HCl, despite the advantages which have been outlined.
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PMID:[The clinical usefulness of Tramadol-infusion anaesthesia (author's transl)]. 733 89

Reconstruction is clinically valuable for the patient and fundamental for the analyst. The analyst will inevitably use reconstruction in order to comprehend the patient and to understand how that adult has remained a disturbed child with that particular psychopathology. Although not necessarily specified, reconstruction remains a very important dimension of psychoanalytic technique that is regaining analytic attention. After reviewing reasons for the shift of attention away from reconstruction, the signifcance of reconstruction is emphasized for restoring personality continuity and cohesion and for explaining neurotic repetition as it has developed in life and in the analytic transference. This utilization of reconstruction is illustrated in a case of anniversary depression, demonstrating the linkage between historical events and their intrapsychic interpretation and response, as well as the linkage between past and present, childhood and adult disorder. Reconstruction does not always automatically follow from the transference and analytic work. It is an inferential and integrative act which may overcome resistance and amnesia, which synthesizes memories and genetic interpretations in addition to substituting for missing memory and gaps in history. Without reconstruction, the personal and familial myths of the past may be joined by current analytic myth. The reconstructive integration identifies patterns and interrelationships rather than isolated conflicts and experiences, and the intrapsychic configurations, consequences, and developmental influences are far more important than actual historical facts. The past is transformed to new meanings and reorganized on new levels of development. Reconstruction leads to consideration and investigation of the mental processes of childhood and early infancy. It has had a significant role in the development of psychoanalysis, and reconstruction contributes to the formation, testing, and validation of psychoanalytic theory. For clinical research, it will be particularly rewarding to reconstruct the different phases of the psychoanalytic process.
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PMID:The value of reconstruction in adult psychoanalysis. 736 36

This communication surveys 398 consecutive head injury patients who were in regular full-time employment at the time of injury and who were examined in connection with a claim for compensation. In uncomplicated cases there was a close correlation between the duration of posttraumatic amnesia and the length of time off work. Some common causes of prolonged organic disability are mentioned. The recovery rate of patients suffering from posttraumatic emotional disorders, such as depression or anxiety, was proportional to the initial severity of injury, whereas the indefinite invalidism associated with so-called 'accident neurosis' was found to be rare in severely injured patients. 'Accident neurosis' also was more common in manual workers sustaining accidents at work than in the same occupation group after road accidents, or in non-manual workers. It is concluded that posttraumatic emotional disorder and 'accident neurosis' are not the extremes of a spectrum but separate and distinguishable conditions.
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PMID:Posttraumatic amnesia, post-concussional symptoms and accident neurosis. 738 58

Psychotropic drugs are frequently employed to treat the wide range of neuropsychiatric syndromes that patients infected with the human immunodeficiency virus (HIV) may develop. In order to administer these agents properly, physicians should take certain factors into account: the central nervous systems of these patients are often impaired, the patients tend to suffer from medical illnesses, and they may be taking various other drugs. The possible interactions between substances taken by these patients may sometimes make it necessary to adjust the dosage of psychotropic agents administered. In addition, some of the antimicrobial, antifungal and antiviral agents used in the management of HIV infection may have adverse effects that include neuropsychiatric symptoms. The use of antipsychotic agents in these patients frequently results in the development of extrapyramidal symptoms. Tricyclic antidepressants are not well tolerated by patients with AIDS, due to the anticholinergic effects of these agents. The new antidepressants, which have fewer and milder adverse effects, are safer and have shown their efficacy in the treatment of the depressive episodes often seen in HIV-infected patients. Benzodiazepines must be prescribed with caution in patients with HIV infection and organic brain syndrome, since they can produce amnesia, confusion, lack of inhibition and paradoxical reactions. The indications for the use of psychostimulants in certain clinical situations, such as HIV-associated dementia and depression, is open to debate. Opiates are indicated in pain treatment, and in methadone maintenance programmes. Lithium and carbamazepine are advisable only in very restricted situations.
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PMID:Use of psychotropic drugs in patients with HIV infection. 751 59

We conducted a series of experiments to evaluate possible molecular mechanisms by which electroconvulsive therapy, a commonly used treatment for depression, may exert its adverse effects such as amnesia. We assessed the effects of repeated electroconvulsive shocks (ECS) alone and in combination with low-level radiograph irradiation on DNA single-strand breaks in cells in the rat brain, using a sensitive alkaline microgel electrophoresis assay method. Our results show that ECS, when administered alone, had no significant effects on DNA single-strand breaks in cells in either the hippocampus or the rest of the brain. However, repeated ECS when combined with a low-level radiograph irradiation produced a small but significant increase in DNA single-strand breaks in rat brain cells.
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PMID:Effects of ECS on DNA single-strand breaks in rat brain cells. 755 50

Neurobehavioral sequelae of strokes can limit a patient's ability to describe or express emotion, can cause him to give "yes" answers to the clinician who expects them, or can directly cause apathy or crying spells. Also, anosognosia for depressive signs can cause the patient to deny depressive signs that are objectively observable. These diagnostic confounders have not been adequately assessed in previous research on poststroke depression; thus many studies are of doubtful validity, as shown by studies of the dexamethasone suppression test for melancholia in stroke patients. Future studies on depression after stroke must prospectively rule out fluent aphasia, motor aprosody, and amnesia before relying on diagnostic information from the psychiatric interview, and the interview should always be supplemented by direct observation of vegetative signs and other behavior. With this extended information, major depression can and should be diagnosed using accepted symptom and duration criteria.
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PMID:Diagnosing depression after stroke. 759 71

We studied 8 patients with frontal or temporolimbic neoplasms who had psychiatric presentations to clarify diagnostic criteria for distinguishing psychiatric disease from structural brain lesions and to examine brain-behavior relationships associated with cerebral neoplasms using modern neuroimaging techniques. Medical records were retrospectively reviewed for evidence of neurobehavioral and neurologic manifestations, tumor histologic features, and the results of treatment. Clinical presentations were correlated with tumor location as determined by computed tomography and magnetic resonance imaging. Patients with frontal lobe tumors presented with abulia, personality change, or depression, whereas those with temporolimbic tumors had auditory and visual hallucinations, mania, panic attacks, or amnesia. After treatment, neurobehavioral syndromes abated or resolved in 7 of 8 patients. We recommend that any patient 40 years of age or older with a change in mental state, cognitive or emotional, should have neuroimaging of the brain. Any patient with a psychiatric presentation who has specific neurobehavioral or neurologic findings or an unexpectedly poor response to psychopharmacologic treatment should also have brain imaging. These case reports extend and update observations on the importance of frontal and temporolimbic systems in the pathogenesis of neurobehavioral disorders.
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PMID:Neurobehavioral presentations of brain neoplasms. 766 78

Memory loss and other cognitive dysfunctions, although common in elderly persons, are not universal features of old age. Instead they herald the presence of various neuropsychiatric diseases, which are first recognized as syndromes. The two most common neuropsychiatric syndromes, dementia and delirium, produce global changes in cognition and other capacities. They are differentiated by the patient's level of consciousness, which is impaired in delirium but intact in dementia. Delirium is generally reversible and often indicates serious physical illness. Although dementia is occasionally reversible, the mainstays of its management and treatment are palliative. Comorbid psychiatric symptoms are common in patients with both delirium or dementia, and their recognition and treatment constitute an important task for the geropsychiatrist. The differential diagnosis of primary dementing illness and other psychiatric illnesses such as depression is complex, because symptoms of the two kinds of disorders often coexist and common pathogenetic mechanisms may underlie both syndromes.
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PMID:Diagnosis and management of memory loss and cognitive disorders among elderly persons. 789 18


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