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)

Immune responses and infections with herpes viruses were studied prospectively in 36 cardiac transplant recipients. Specific lymphocyte transformation and interferon production in response to viral antigens, viral culture results, antibody levels, responses to phytohemagglutinin, and T-cell numbers were determined. Responses to phytohemagglutinin and T-cell numbers were depressed for six to 12 weeks. Cytomegalovirus infection occurred in 100 percent of seropositive patients and in 62 percent of seronegative patients. Primary infection was more frequently symptomatic. Heart implantation from a seropositive patient wwas significantly correlated with subsequent infection in seronegative patients. Depression of transformation in response to cytomegalovirus correlated with prolonged shedding. Herpes simplex infection occurred in 95 percent of seropositive patients but decreased after 12 weeks. Asymptomatic shedding was rare, and primary infection did not occur. Return of transformation in response to herpes simplex was associated with decreased infection. Herpes zoster occurred in 22 percent during the first year, and transformation responses to varicella-zoster returned thereafter. Depression of interferon production in response to viruses did not correlate with infection as well as did lymphocyte transformation.
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PMID:Specific cell-mediated immunity and infections with herpes viruses in cardiac transplant recipients. 629 87

Herpes zoster occurs rarely in immunocompetent children and infrequently in immunocompetent young adults. However, its incidence increases with age, particularly after age 50. Reactivation of varicella-zoster virus (VZV) is characterized by a rash and is generally accompanied by considerable pain, dysesthesias, and skin hypersensitivity. Chronic pain that is sometimes experienced after the rash has healed is referred to as postherpetic neuralgia (PHN), the most common complication of herpes zoster. Postherpetic neuralgia is often severe and, unfortunately, refractory to most forms of treatment. The incidence of PHN also increases dramatically with increased age. More than 50% of zoster patients over 60 years old will develop PHN, which may persist for months and even years. Thus, established PHN is difficult to manage, often causing serious morbidity, depression, and high costs in terms of consumption of healthcare resources. Currently, early antiviral treatment with famciclovir has shown promise of reducing the duration of PHN.
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PMID:Epidemiology and management of postherpetic neuralgia. 884 Apr 11

The possible involvement of depression on cellular immunity in reactivation of varicella-zoster virus (VZV) in herpes zoster oticus was investigated. The subjects comprised 59 cases of herpes zoster oticus, 33 cases of herpes zoster sine herpete (ZSH) with facial paralysis, and 205 cases of Bell's palsy. The transformation rate of lymphocytes to phytohaemagglutinin in herpes zoster oticus tended to be lower than that in Bell's palsy. In skin tests with purified protein derivatives of tuberculin, the positivity rate in herpes zoster oticus was significantly lower than that in Bell's palsy (p < 0.015). In skin tests using VZV antigen the positivity rate in herpes zoster oticus and ZSH were significantly lower than that of Bell's palsy (p < 0.001 and p < 0.015, respectively). Thus, it was noted that cellular immunity, especially specific cellular immunity against VZV, was significantly depressed in herpes zoster oticus and ZSH. We consider that depression of specific cellular immunity plays an important role in triggering reactivation of VZV and onset of these diseases.
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PMID:Impaired specific cellular immunity to the varicella-zoster virus in patients with herpes zoster oticus. 897 52

Influenza is the best known model of bacterial-viral co-infection. Epidemics of influenza result in an increased hospital admission rate for bacterial pneumonia due to pneumococcus, Haemophilus influenzae and Staphylococcus aureus. Similarly, an increased incidence of meningococcal diseases, particularly severe forms, follows the influenza outbreaks, with a two week delay. Though the precise mechanism is not known, the depression of host's phagocytes bactericidal activity by the influenza virus seems to be involved. An increased incidence of invasive group A beta hemolytic streptococcal infections, particularly necrotizing fasciitis and toxic shock syndrome, is also observed in relation with chickenpox. The reason for this association is unclear and appears not to be limited to the disruption of the cutaneous barrier which leads to the cutaneous infections in this disease. Bacterial-viral co-infection is not a justification for a systematic antibiotic prescription in viral diseases. Severe bacterial disease will be best prevented through viral immunization, thus encouraging the development of viral vaccines and immunization campaigns.
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PMID:[Virus-bacteria co-infections]. 948 49

The most menacing complication of herpes zoster in immunocompetent elderly people is chronic pain or postherpetic neuralgia (PHN). The cardinal epidemiological feature of PHN is its striking relationship to aging. Among zoster patients over 60 years old, estimates of the occurrence of PHN, defined as pain 1 month after rash onset, vary from 27 to 68%. The pathogenesis of PHN is incompletely understood but seems to involve varicella-zoster virus (VZV)-induced damage of peripheral afferent neurons and resultant changes in central afferent neurons and efferent pain-modulating neurons. PHN improves over time in many elderly patients, but an unfortunate subset experience of debilitating pain lasts for years. They experience constant and/or intermittent spontaneous pain and stimulus-evoked pain such as allodynia or hyperpathia. The outcomes of this pain include fatigue, sleep disturbance, anorexia, depression, social withdrawal, impaired activities of daily living and profound lowering of quality of life. The management of PHN is hampered by two problems: (1) a uniformly effective treatment for PHN is not available (although tricyclic antidepressants, local or regional anaesthetics, capsaicin, opiates, anticonvulsants and physical therapies are sometimes useful); and (2) early antiviral therapy of zoster may be ineffective in preventing PHN, partly related to the fact that days of VZV replication and neuronal destruction have occurred by the time the patient reaches the doctor. A potential solution to the problem of PHN is the vaccination of elderly persons with the varicella vaccine to prevent or attenuate zoster or PHN.
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PMID:Postherpetic neuralgia in immunocompetent elderly people. 977 54

AIDS causes severe depression of the immune system through selective infection of CD4+ T lymphocytes. As such, certain infections and neoplasms occur in these patients often with ocular involvement. Among these, cytomegalovirus retinitis is by far the most common and remains a leading cause of visual loss. Intravenous ganciclovir and foscarnet, the two Food and Drug Administration-approved treatments for cytomegalovirus retinitis, are effective in most cases, but recurrences are the rule. In addition, these virustatic drugs require lifelong administration and dose-limiting toxicity affects many of these patients. Ongoing investigation into current and alternative therapies has produced some promising developments which are discussed here. Also reviewed are recent findings associated with other opportunistic pathogens and neoplasms that affect the eye in AIDS, including varicella-zoster virus, Toxoplasma gondii, and lymphoma.
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PMID:Ocular manifestations of AIDS. 1016 Apr 24

Herpes zoster (shingles) is a localized infection that begins in the dorsal root ganglla of the cranial or spinal nerves and spreads as a rash over the corresponding dermatome. It usually is caused by reactivation of latent varicella-zoster virus remaining from childhood chicken pox. Postherpetic neuralgia (PHN) is a chronic neuropathic pain syndrome that occurs as a complication of shingles, most commonly in older persons. Acute zoster and PHN can be severe conditions associated with impaired sleep, decreased appetite, depression, anxiety disorder, and diminished libido. Management of zoster-related pain should begin as soon as possible after the onset of symptoms. Combination therapy--including antiviral, antidepressant, corticosteroid, opioid, and topical agents--provides the most effective analgesia.
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PMID:Herpetic neuralgia. Use of combination therapy for pain relief in acute and chronic herpes zoster. 1176 59

Appropriate preconception health care improves pregnancy outcomes. When started at least one month before conception, folic acid supplements can prevent neural tube defects. Targeted genetic screening and counseling should be offered on the basis of age, ethnic background, or family history. Before conception, women should be screened for human immunodeficiency virus and syphilis infection and begin treatment to prevent the transmission of disease to the fetus. Immunizations against hepatitis B, rubella, and varicella should be completed, if needed. Women should be counseled on ways to prevent infection with toxoplasmosis, cytomegalovirus, and parvovirus B19. Environmental toxins such as cigarette smoke, alcohol, and street drugs, and chemicals such as solvents and pesticides should be avoided. In women with diabetes, it is important to optimize disease control through intensive management before pregnancy. Medications for hypertension, epilepsy, thromboembolism, depression, and anxiety should be reviewed and changed, if necessary, before the patient becomes pregnant. Counseling about exercise, obesity, nutritional deficiencies, and the overuse of vitamins A and D is beneficial. Physicians may also choose to discuss occupational and financial issues related to pregnancy and to screen patients for domestic violence.
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PMID:Preconception health care. 1261 25

Postherpetic ophthalmic neuralgia is the final stage of a varicella zoster infection. Many years after chickenpox infection, patients can develop herpes zoster in one or more specific dermatomal regions. The ophthalmic branch of the trigeminal nerve and the thoracic nerves are most commonly affected. Younger patients are less prone to postherpetic neuralgia than the older. Patients with a depression in cell-mediated immunity are more susceptible to develop postherpetic pain. Postherpetic ophthalmic neuralgia is a neuropathic pain and can be treated by anticonvulsants and tricyclic antidepressants. Neurodestructive procedures are not recommended as they enhance destruction and neuropathic pain. Sympathetic nerve blocks can be helpful. Neurostimulation is the last therapeutic resort.
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PMID:Postherpetic ophthalmic neuralgia. 1244 39

Post-herpetic neuralgia (PHN) is a chronic pain syndrome associated with the reactivation of a primary infection with varicella zoster virus (chicken pox), which leads to a chronic infection of the dorsal root ganglia. Under various clinical circumstances, including immunosuppressive diseases or treatments and certain cancers, reactivation of the infection can occur in adults as shingles. Other factors such as psychological distress and stressful life events also appear to play a role in the onset of shingles and the development of PHN. The most common risk factor for shingles and its potential sequela, PHN, is advanced age. For a significant number of patients, the pain following healing of shingles can persist for months to years; this pain is classified as PHN if it persists longer than 3 months. PHN often leads to depression, disrupted sleep, decreased functioning and increased healthcare utilization. Prompt use of antiviral therapy appears to reduce the period of pain following an episode of shingles by about half and may possibly reduce the overall incidence of PHN. Damage to a variety of neurologic pathways as a result of herpes zoster reactivation suggests that intervention with multiple agents having divergent mechanisms of action is an appropriate treatment approach. Current treatment options aimed at relieving the symptoms of PHN include antidepressants, opioids, anticonvulsants and topical analgesics. It is important for the clinician to establish a baseline pain intensity and character as well as quality of life measures against which to judge the effectiveness of any treatment. This review article features a case study of a patient with PHN to illustrate current diagnostic and treatment approaches.
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PMID:Post-herpetic neuralgia case study: optimizing pain control. 1506 19


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