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

Consecutive electrocardiograms were recorded in 28 stroke patients without signs of primary heart disease. Individuals with subarachnoidal haemorrhage, or electrolyte disturbances were excluded. A computerized tomography of the brain was performed in each case and showed a cerebral haemorrhage (n = 4), cortical infarction (n = 6), subcortical infarction (n = 14) and normal finding (n = 4). One patient developed atrial fibrillation but no other case of serious disturbances in rate of rhythm occurred. None developed AV block, bundle branch blocks or significant changes in QRS complexes. The most common abnormalities in ECG were transient STT changes in lateral leads, which were seen in 13 cases. The typical findings were flat or slightly negative T waves, horizontal or down-sloping ST segments and sometimes a small ST depression. In no case did ECG show typical signs of acute myocardial infarction. A transient prolonged QT interval was seen in three patients and transient U waves in four. ECG did not correlate to the location of the vascular lesion seen on CT or the clinical outcome. It is concluded that STT changes of a small magnitude are seen in about half of the cases of stroke patients without primary heart disease and that they do not resemble the typical pattern of acute myocardial ischaemia.
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PMID:Electrocardiographic changes in stroke patients without primary heart disease. 820 53

A study of literature concerning Lyme borreliosis related to animals was done. In the research work the epidemiology, pathogenesis, diagnosis and treatment of horses, cattle and dogs affected with Lyme borreliosis have been discussed. The clinical signs of Lyme borreliosis in horses are: chronic weight loss, sporadic lameness, laminitis, low grade fever, swollen joints, muscle tenderness and anterior uvetitis. In addition to these clinical sings, neurological sings such as depression, behavioral changes, dysphagia and encephalitis can be seen in chronic cases. Cattle affected with acute Lyme borreliosis often show fever, stiffness, swollen joints and decreased milk production. Chronic weight loss, laminitis and abortion are also a possible outcome of borreliosis in cattle. An early infection of Lyme borreliosis in dogs may give evidence of inapetenca, lethargy, lyphadenopathy, and an acute onset of stiffness or pain while a recurrent intermittent nonerosive arthritis is a more advanced manifestation of canine Lyme borreliosis. Glomerulonephritis and tubular damage secondary to Borrelia burgdorferi infection have been reported to occur in normally infected dogs. In an endemic area atrioventricular heart block has also been reported. The underlying pathogenesis of Lyme disease is still unknown. The diagnosis of clinical Lyme borreliosis is difficult and it depends on a successful recognition of clinical signs, a history of possible exposures to the infection and on serologic testings. The therapy of Lyme borreliosis in animals is based upon the principal therapy of this disease in human medicine.
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PMID:[The importance of Lyme borreliosis in veterinary medicine]. 826 22

Oral administration of 600 mg/day of carbamazepine to 14 arrhythmic chagasic patients with advanced myocardial damage and no signs of congestive heart failure did not alter the frequency of ventricular extrasystoles, but reduced the total number of supraventricular ectopic beats in 7/14 patients and the episodes of complex ventricular arrhythmias in up to 43% of patients. This assessment was made from 24 hour continuous Holter recording during the course of this double-blind, placebo controlled, randomized crossover study. Serum levels of carbamazepine were also determined and found within therapeutic limits. Six patients complained of minor side effects. One patient presented with iatrogenic complete AV block, another case had proarrhythmic effect and one patient had to be withdrawn from the study because of gastric irritation. No instance of contractile depression was observed. Accordingly, carbamazepine is a therapeutic alternative for treatment of symptomatic complex ventricular or supraventricular arrhythmias in chronic chagasic patients without evidence of conduction system involvement or with intolerance to other antiarrhythmic drugs.
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PMID:[The anti-arrhythmia effect of carbamazepine in chagasic patients with advanced myocardial damage]. 834 54

In the submitted study the authors evaluate the relationship of the clinical course in patients with inferior myocardial infarction (AIM) in relation to the electrocardiographic (ECG) finding in standard and dextro-lateral leads. In a group of 96 patients (mean age 65 +/- 10 years, 66 men and 30 women) according to the ECG 38 had an isolated inferior AIM (group 1), 28 had signs of extension of the inferior AIM to the posterior wall of the left ventricle (group 2) and 30 patients in group 3 had an extension of the inferior AIM to the right ventricle, i.e. an infarction of the right ventricle. All three groups differed significantly as regards the extent of the AIM according to creatine kinase values (7.1 +/- 4.4 and 18.2 +/- 7.2 resp. and 24.8 +/- 11.6 resp.), as regards mortality (0 and 14% and 37% resp.). In group 2, contrary to the other groups, the significantly most frequent complication was pulmonary oedema (36%) and ventricular tachycardia (30%) and in group 3 the significantly most frequent complication was cardiogenic shock (30%) and advanced atrioventricular block (50%). The cause of death in these patients with infarctions of the right ventricle was cardiogenic shock (n = 6), cardiac rupture (n = 3) and electromechanical dissociation (n = 2). A total of 29 (30%) patients with inferior AIM were treated by temporary pacing: in group 1 21%, in group 2 14% and in group 3 57%. The prognosis of these patients was favourable in groups 1 and 2 (1 of 12 patients died) while in group 3 with infarctions of the right ventricle 9 of 17 patients died (p < or = 0.001). The authors found moreover that patients with precordial depression of the ST segment and inferior AIM have, as compared with patients without this depression, significantly higher creatine kinase values (12.5 +/- 5.5 vs. 5.2 +/- 1.3 mu kat; p < or = 0.001) and a higher general incidence of complications. Patients with inferior AIM are thus a non-homogeneous group from which we can differentiate, based on standard ECG examination and by recording right-sided thoracic leads, patients with an increased risk and start specific treatment in time.
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PMID:[Clinical picture of various types of inferior myocardial infarcts. Clinico-electrocardiographic study]. 837 61

We describe the case of a 39-year-old woman, heavy smoker, who received 500 micrograms i.m. of Sulprostone, a synthetic PGE2-derivative, to induce pregnancy termination. Sulprostone is usually administered either to cause abortion in preparation of an instrumental operation or to induce delivery after the intrauterine death of the fetus. This drug has a dilating effect on the cervix uteri and stimulates the uterus muscles. After about fifteen minutes the patient experienced a constrictive chest pain which progressively worsened and spread to the upper limbs. The pain disappeared for a short period and then recurred with greater intensity, accompanied by bradycardia and hypotension. The ECG showed sinus bradycardia, second- and third-degree atrioventricular block, S-T segment elevation in the inferior leads and reciprocal depression in the anterior leads. Intravenous nitroglycerin therapy induced a rapid reduction of the clinical symptoms and changes in the ECG. There was no increase in cardiac enzymes. The exercise test, the cold pressor test and the ECO-dipyridamole test were negative. The patient refused to undergo the ergonovine test and coronary angiography. We hypothesize that the Sulprostone either had a dipyridamole-like effect or that it induced a paradoxal coronary spasm.
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PMID:[Prolonged angina after the administration of a synthetic PGE2 derivative]. 840 38

Mesenteric hypoperfusion may be responsible for alterations in gut mucosa leading to necrotizing enterocolitis. Platelet-activating factor (PAF) and cocaine have been implicated in the etiology of necrotizing enterocolitis. We have demonstrated direct toxic effects of these compounds in vitro, but the in vivo mechanism of bowel damage is unknown. Newborn piglets (3.0 +/- 0.3 kg) had physiologic parameters (electrocardiogram, blood pressure, pulse, and central venous pressure) continuously monitored as well as Doppler probe recordings of superior mesenteric artery flow (Qsma). Aortic flow with calculation of cardiac index, and systemic and mesenteric vascular resistances (SVR and MVR) were also determined. Group 1 (N = 8) received PAF (0.5 microgram/kg). Groups 2 (N = 8) and 3 (N = 8) received high (17 mg/kg) and low (9 mg/kg) doses of cocaine, respectively. Each subject served as its own control. Histology demonstrated edema or early mucosal hemorrhage in all groups. PAF caused a third-degree atrioventricular block of short duration and a prolonged decrease of the cardiac index, but only a brief elevation of SVR and MVR. The cocaine groups had a sustained increase of SVR and MVR associated with a decrease of cardiac index. The decrease of Qsma paralleled the changes of MVR in each subject. These data show that both PAF and cocaine induce mesenteric ischemia. The effect of PAF is of short duration and mainly related to its cardiotoxic effects resulting in low Qsma. Cocaine causes an increase in MVR with prolonged depression of mesenteric flow.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Systemic and mesenteric vascular effects of platelet-activating factor and cocaine. In vivo effects on a neonatal swine model. 848 Sep 32

Adenosine is a purine nucleoside with a rapid onset and brief duration of action after intravenous bolus administration. Its most prominent cardiac effect is impairment or blockade of atrioventricular nodal conduction, but other effects are depression of automaticity of the sinus node and attenuation of catecholamine-related ventricular after-depolarizations. The cardiac cell surface receptor is the A1 purinoceptor. The therapeutic value of adenosine is predominantly in those arrhythmias in which the atrioventricular node forms part of a reentry circuit, as clearly demonstrated by the high success rate for termination of atrioventricular nodal reentry tachycardia and of atrioventricular reentry tachycardia involving an accessory pathway in the Wolff-Parkinson-White syndrome. Ventricular tachycardias are generally unresponsive, with the exception of right ventricular outflow tract tachycardia. A diagnostic role has emerged for adenosine. The transient blockade of the atrioventricular node that it causes can reveal important electrocardiographic features in arrhythmias, such as atrial flutter, or can unmask latent preexcitation. In wide-QRS tachycardias, adenosine can help to distinguish ventricular tachycardia from supraventricular tachycardia with QRS aberration. Unlike verapamil, adenosine is safe in ventricular tachycardia. A suggested dosing scheme is to give incremental doses at 1-minute intervals, starting at 0.05 mg/kg and continuing until complete atrioventricular block is induced or a maximum of 0.25 mg/kg is reached. Side effects are transient, sometimes uncomfortable, and not hazardous; dyspnea and chest discomfort are most frequent. A history of asthma is a relative contraindication. Aminophylline antagonizes and dipyridamole potentiates the effects of adenosine.
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PMID:The therapeutic and diagnostic cardiac electrophysiological uses of adenosine. 848 69

The intensity of gastrointestinal and visual symptoms together with hyperkalemia and the characteristic ECG features make diagnosis of acute digitalis intoxication relatively easy. Death results mainly from ventricular fibrillation or from ventricular asystole or pump failure. Mesenteric infarct may also occur in elderly patients. Previous assessment of outcome has shown that mortality increases in patients exhibiting five prognostic factors: 1) advanced age; 2) heart disease; 3) male sex; 4) high-degree atrioventricular block; 5) hyperkalemia. Conventional treatment includes gastric lavage, activated charcoal and supportive care. First-line antiarrhythmic therapy is usually atropine, because of bradycardia-induced arrhythmia. Ventricular pacing is a toxicodynamic treatment that may be helpful in both bradycardia-induced arrhythmia and high-degree atrioventricular block. Pacing is difficult to handle and can result in serious adverse effects. Immunotherapy has two advantages. First, a strong toxicodynamic effect due to quick reversal of digitalis-induced dysrhythmias, hyperkalemia, and myocardial depression, by reactivation of membrane ATPases. Second, a toxicokinetic effect due to accelerated renal excretion of Fab-digitalis complexes. Since this therapy is well tolerated and efficient, we recommend early administration of Fab fragments as soon as poor prognostic factors are identified.
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PMID:Clinical features and management of digitalis poisoning--rationale for immunotherapy. 849 40

To determine the electrophysiological effects of propofol and to explain the potential mechanism(s) whereby it causes bradyarrhythmias, 10 closed-chest pigs weighing 20-25 kg were studied. Each animal was premedicated by intramuscular administration of ketamine hydrochloride, intubated, and mechanically ventilated. Femoral arterial and venous catheters were placed, and a comprehensive electrophysiologic evaluation was performed at baseline and after two doses (1 mg/kg i.v. bolus and 0.1 mg/kg/min infusion and an extra 1- mg/kg i.v. bolus and 0.2 mg/kg/min infusion) of propofol. The electrophysiological effects obtained on low-and high-dose propofol were compared to baseline values. Propofol caused a dose-related decrease in sinus cycle length (baseline 565 +/- 36 ms, low-dose propofol 541 +/- 28, high-dose propofol 527 +/- 26 ms; p < 0.05), a prolongation of the corrected sinus node recovery time (baseline 119 +/- 35 ms, low-dose propofol 126 +/- 32, high-dose propofol 130 +/- 30 ms; p < 0.01), and an increase in the His-ventricular interval (baseline 33 +/- 4 ms, low-dose propofol 36 +/- 4, high-dose propofol 40 +/- 3 ms; p < 0.005). All other electrophysiological parameters remained unchanged, and there were no cases of spontaneous atrioventricular block or sinus pauses. We conclude that propofol causes dose-related depression of sinus node and His-Purkinje system functions, but has no effect on the atrioventricular node function and on the conduction properties of atrial and ventricular tissues in normal pig hearts.
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PMID:Electrophysiological effects of propofol on the normal cardiac conduction system. 879 67

To confirm the usefulness of head-up tilt test (HUT) in neurocardiogenic syncope (NCS) with complicating clinical features, retrospective analysis were done on 12 selected children. The age at onset was 12.7 +/- 1.9 (mean +/- SD) years. Associated clinical features were postoperative congenital heart disease (PO CHD) in 3, coexistent arrhythmia in 8 (persistent ventricular arrhythmia during exercise in 3, premature ventricular contractions in 2, ventricular couplets in 1, sinoatrial exit block in 1 and resting sinus bradycardia in 1) and ST segment depression during exercise in 1. Four of them had a history of exercise-related syncope. All 3 patients with PO CHD had arrhythmia (ventricular tachycardia in 1, sinus bradycardia in 1 and atrioventricular block in 1). HUT provoked NCS in 8 (2 during baseline tilt, 6 during isoproterenol infusion). In one each, ventricular tachycardia and loss of consciousness without hypotension and bradycardia were induced. Atenolol was tried in 5 with improvement of NCS in 4 and aggravation of dizziness in 1. During follow-up, 7 became asymptomatic (2 with atenolol) and 5 were stationary. In conclusion, HUT was valuable in diagnosing NCS even in children with complicating clinical features such as arrhythmias or PO CHD. HUT could be done as apart of initial diagnostic tests if the past history suggests NCS, regardless of associated clinical features. In some cases, the unexpected results of the test turned out useful in managing children with syncope or dizziness.
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PMID:Head-up tilt test in complicated neurocardiogenic syncope in children. 914 59


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