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

Airway mucociliary dysfunction leading to a depression of mucus transport has been demonstrated in patients with acute and chronic bronchitis, cystic fibrosis, and bronchial asthma; use of bronchodilators that might further impair mucociliary function, therefore, generally has been discouraged. Atropine and ipratropium bromide are cholinergic antagonists that are effective bronchodilators in various clinical settings. Atropine has been shown to block the production of respiratory secretions in response to cholinergic stimulation, but to have no effect on baseline secretions. Atropine has also been clearly demonstrated to depress ciliary beat frequency and to slow airway mucociliary clearance, whereas the short-term and long-term administration of ipratropium bromide at higher than clinically recommended doses seems to lack these effects. No satisfactory explanation has thus far been offered for this difference between the two cholinergic antagonists. Nevertheless, with respect to airway mucociliary function, ipratropium bromide appears to be preferable to atropine in the treatment of obstructive airways disease.
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PMID:Effect of ipratropium bromide on airway mucociliary function. 294 58

The system of mucociliary clearance has the important task to remove from the airways inhaled substances and locally formed secretions. Inborn disorders of the mucociliary transport are the result of ciliary dysfunction (primary ciliary dyskinesia) or of increased viscosity of the bronchial secretions (mucoviscidosis). By far more frequency however are acquired disturbances. Inflammation of the airways results nearly always in disorder of the mucociliary transport which in early stages is reversible. With morphologic lesions, the disturbance may become irreversible. Infectious inflammations, especially those by rhinoviruses and mycoplasma, are causing ciliostatic and ciliotoxic alterations which may disturb the mucociliary clearance up to one year following the infection. Noninfectious inflammation is at first accelerating the transport of mucus through the action of cells of the body itself, especially granulocytes and eosinophiles and mediators liberated from them. Probably, these are causing a cilioexcitation which is later followed by a long-lasting depression of the mucociliary transport caused by production of mucus with high viscosity. Therapeutic measures consist in an early anti-infectious treatment and in the stimulation of the frequency of ciliary beating by beta-adrenergic drugs.
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PMID:[Mucociliary transport and bronchial inflammation]. 306 29

This study was designed to investigate behavioral and/or affective manifestations of stress in children with cystic fibrosis (CF). Most children with cystic fibrosis are compliant with treatment and are perceived as adapting to the stresses of their illness. Recent literature has proved this to be a misperception. The Child Depression Inventory and the Conner's Parent and Teacher Rating Scales are uncomplicated, valid tools to screen for the manifestations of stress in children and adolescents. Data generated from these tools will aid in: a) determining extent of depression and/or behavioral disorder in children with CF, b) establishing a base line for a projected study of developmental changes in reactions to stress in these children, and c) evaluating the psychotherapeutic interventions.
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PMID:Stress reactions in children with cystic fibrosis. 316 9

Chloral hydrate is commonly used to sedate infants for pulmonary function tests and other investigations. However, sedation is generally not recommended for infants with acute wheezing illnesses. The commonly used dose range exceeds the maximum recommended dose; however, the effects of this dosage regimen during pulmonary function testing have not been studied. The present study shows that 70-100 mg/kg of chloral hydrate, a dose commonly used to sedate infants for pulmonary function testing, causes a fall in arterial oxygen saturation and a decrease in clinical score of infants recovering from acute viral bronchiolitis, but not in infants with clinically stable cystic fibrosis. These findings suggest that wheezy infants with baseline SaO2 less than or equal to 94% are more susceptible to central respiratory depression following sedation with chloral hydrate. The results of the present study raise serious doubts about the advisability of sedation with chloral hydrate, in the currently used doses, in wheezy infants.
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PMID:Effect of chloral hydrate on arterial oxygen saturation in wheezy infants. 322 57

Tracheal mucociliary clearance is governed by the interplay between ciliary activity and secretory functions of the epithelium. These functions are altered transiently by various physiologic and injurious stimuli, and chronically in asthma, chronic bronchitis, cystic fibrosis, and other forms of airway disease. In general, these conditions are associated with a depression in mucociliary clearance that may predispose to respiratory infections and the accumulation of secretions.
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PMID:Mucociliary clearance in the trachea. 352 72

The principles guiding the inpatient treatment of adolescents with anorexia nervosa or bulimia are no different than those guiding the treatment of adolescents with cystic fibrosis, leukemia, or depression. The patient is treated first and foremost as an adolescent, avoiding reinforcement of the sick role. Biologic, psychologic, and social needs must all be considered. Further, the family must be included in the treatment, since the vast majority of patients will be returning to their families after discharge from the hospital. Hospitalization may be required for a number of reasons. Regardless of the indications for admission to the hospital, a consistent, individualized, positively reinforcing plan for evaluation and treatment needs to be developed and executed. By so doing, the hospital team is in a unique position to help the patient and the family develop more healthy patterns of acting and interacting.
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PMID:Inpatient management of anorexia nervosa and bulimia. 360 23

A 15-year review of children's hospital patients with cystic fibrosis (CF) who underwent surgery yielded 578 cases in 210 patients (mean 2.7 per patient). The median age was 16 years (range newborn to 43 years). Four hundred procedures were done under general anesthesia and 176 under local. There was one anesthetic complication, respiratory depression in a patient whose MediPort (Cormed, Inc, Medina, NY) was inserted using local anesthesia and sedation. The most frequent procedure was nasal polypectomy, with 165 procedures in 50 patients. The second most common procedures were vascular access procedures: 75 central lines and 29 MediPorts were implanted in 57 patients, complicated by two pneumothoraces. Thoracic procedures included 32 bronchoscopies, 8 lobectomies, 2 pneumonectomies, and 30 pleural strippings. There were three reoperations for bleeding in the pulmonary resection patients. Thirteen newborns underwent a total of 26 procedures for meconium ileus and its complications, with two deaths secondary to respiratory failure and sepsis. These, and one death postlobectomy were the only operative deaths in the entire series of 578 cases (0.5% mortality rate). There were four slings for rectal prolapse; two required removal secondary to infection. Eight patients underwent central splenorenal shunts for portal hypertension, 15 underwent cholecystectomy, 5 underwent Nissen fundoplication, 16 underwent inguinal herniorrhaphy, 2 underwent umbilical herniorrhaphy, 3 underwent orchidopexies, and 4 underwent miscellaneous pediatric surgical procedures. Eleven patients underwent appendectomy for appendicitis; four were ruptured at the time of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgery in patients with cystic fibrosis. 361 55

Utilizing a literature survey we reviewed dates of the intellectual and psychosocial developmental milestones of children suffering from mucoviscidosis. We analyzed the intellectual abilities and social behavior of these children in school as well as their position in the family. The sickness of the child leads to considerable difficulties in intrafamilial communication. The way the patient, the siblings and the parents cope with the sickness is reviewed. We find a changing in self-image of the child as well as changing in self-confidence of the parents, who often react with depression and withdrawal.
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PMID:[Coping with illness in families of children with mucoviscidosis]. 378 31

Stress and adjustment in mothers of children with cystic fibrosis was compared with that in a control group of mothers of healthy children. Mothers of children in four age groups were included: preschool, middle childhood, early adolescence, and late adolescence. Mothers of children with cystic fibrosis did not report significantly higher levels of stress than did the control group mothers; nor did they report greater feelings of inadequacy as parents. However, mothers of children with cystic fibrosis in two age groups, preschool and early adolescence, scored higher on a measure of depression than did mothers of healthy children in the same age groups. The relationship of illness severity to maternal stress and adjustment was examined in the cystic fibrosis group. The mother's subjective rating of the child's illness severity was a better indicator of her reported stress than was the Schwachman clinical rating. It appears that many mothers are able to adapt to the presence of cystic fibrosis in the family, although certain periods in the child's life and perceived increases in illness severity are associated with increased maternal distress.
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PMID:Cystic fibrosis and family stress: effects of age and severity of illness. 380 96

The drive and performance of breathing during hypercapnia, isocapnic hypoxia, and transient hyperoxia were studied in 20 normal children (mean age 12.3 years), in ten children with asthma, and in ten children with cystic fibrosis (CF) matched by sex and age. These latter two groups of patients had had obstructive respiratory symptoms since infancy and their pulmonary disease was of moderate severity as documented by their pulmonary function studies. During hypercapnia, normal children had a linear increase in minute ventilation (delta VE), in tidal volume (delta VT) and in the inspiratory drive (VT/Ti). The drive of breathing was evaluated by the occlusion pressure (P0.1) at functional residual capacity. The P0.1 response to PaCO2 was linear. Patients with asthma and CF showed a blunted ventilatory response (delta VE, delta VT, VT/Ti) to Co2 but a normal response in P0.1. In normal subjects, the test of isocarbic hypoxia demonstrated an exponential type of increase in delta VE, delta VT, and P0.1 as PAO2 decreased from 110 to 40 torr. With severe hypoxia (PAO2 less than 50 torr), children with CF (but not asthmatic patients) experienced a paradoxical decrease in delta VE while the drive (P0.1) remained above normal in both groups of patients. Finally, the transient O2 inhalation test caused a decrease in VE of 26%, 21%, an 34%, respectively, in normal subjects, in asthmatic children, and in children with CF. It is concluded that the CO2 and O2 drive of normal children resembles that described for adults and that the CO2 and O2 command of breathing is normal in children with asthma and CF. However, the ventilatory response in children with chronic obstructive pulmonary disease is subnormal probably due to the impairment of the respiratory mechanics. Finally the respiratory depression induced by severe hypoxia in children with CF is unexplained, but it may reflect the high dependency of their respiratory muscle on oxygen supply.
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PMID:Neural drive and ventilatory strategy of breathing in normal children, and in patients with cystic fibrosis and asthma. 726 24


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