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

Of all strokes 75% occur in people over age 65, and the incidence of stroke rises with age. Because swallowing problems often result, the elderly stroke patient is at risk for dysphagia and its complications. Acute and chronic swallowing problems are associated with many complications including dehydration, malnutrition, aspiration, pneumonitis, depression and even death. These complications make swallowing problems in the aged stroke patient an important focus for nursing attention. Nurses must be aware of the complexity of normal swallowing mechanisms, knowledgeable about the aged stroke patient's risk for dysphagia, aware of the importance of early detection and treatment of dysphagia and confident about their role in dysphagia assessment and treatment regimen. This information can be used in the assessment, treatment and rehabilitation of the elderly dysphagic stroke patient.
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PMID:Dysphagia in the elderly stroke patient. 807 79

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

Geriatric failure to thrive has three elements: deterioration in the biological, psychological, and social domains; weight loss or undernutrition; and lack of any obvious explanation for the condition. It results from the combined effects of normal aging, malnutrition, and specific physical, social, or psychological precipitants (eg, chronic disease, dementia, medication, dysphagia, depression, social isolation). Failure to thrive can be managed with a commonsense approach by primary care physicians and healthcare providers such as social workers and dietitians; extensive referral is not necessary. The key to effective care is to identify all of the precipitants and intervene early to prevent progression.
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PMID:'The dwindles'. Failure to thrive in older patients. 841 33

We hypothesized that patients who complain of dysphagia without demonstrable organic abnormality may have an underlying psychological dysfunction. We thus conducted a comprehensive assessment in three groups of patients with dysphagia. Dysphagia was classified as obstructive (Obst) when an obstructive lesion was present on esophagoscopy or barium swallow, motility-related (Mot) when abnormal motility was shown on esophageal manometry in the presence of normal esophagoscopy or barium swallow, or nonobstructive, nonmotility-related (NONM) when manometry and esophagoscopy or barium swallow were both normal. We prospectively evaluated 71 patients with Obst-dysphagia, 15 patients with Mot-dysphagia and 10 patients with NONM-dysphagia with a battery of standardized psychological tests including the Minnesota Multiphasic Personality Inventory (MMPI), the Symptom Checklist-90-Revised (SCL-90-R), and the Millon Behavioral Health Inventory (MBHI). The results indicate that patients with NONM-dysphagia have psychological attributes similar to those found in patients with Obst-dysphagia or Mot-dysphagia. Combination of scores for parameters such as somatization, depression, and anxiety could not distinguish among the three groups of dysphagia patients. We thus conclude that patients with NONM-dysphagia, as a group, have similar psychological profiles compared to patients with dysphagia due to organic causes.
Dysphagia 1996
PMID:A prospective psychological evaluation of patients with dysphagia of various etiologies. 875 71

Respiratory and sleep disturbances may be important causes of morbidity in Steele-Richardson-Olszewski syndrome but the frequency and character of nocturnal abnormalities remains uncertain. A prospective study of 11 patients with Steele-Richardson-Olszewski syndrome and age-matched control subjects was undertaken using clinical assessments, a structured sleep questionnaire, spirometry, static maximum inspiratory and expiratory pressures and nocturnal oximetry. The mean age of the Steele-Richardson-Olszewski syndrome patients was 63.2 (52-70) years and mean disease duration was 4.0 (2-6) years. There was moderate to severe motor disability in nine and mild to moderate dementia in eight. In the patients with Steele-Richardson-Olszewski syndrome the following abnormalities contributed to sleep disturbances significantly more frequently than in normal controls: depression, dysphagia, frequent nocturnal awakenings (usually associated with urinary frequency), immobility in bed, difficulty with transfers, impaired dressing and feeding. There was profound impairment of voluntary respiratory control whilst automatic and limbic control were well maintained. Nocturnal respiratory abnormalities were not present even in the most severely disabled. In Steele-Richardson-Olszewski syndrome sleep abnormalities are common; they relate to the cognitive, pseudobulbar and extrapyramidal disturbances and may therefore be amenable to symptomatic control.
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PMID:Nocturnal and respiratory disturbances in Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy). 876 3

612 patients with different psychosomatic disorders of gastrointestinal tract (GIT) were examined. They included either 200 patients with organic stomach disease or with duodenal ulcer as well as 412 individuals with various functional disorders of GIT such as psychogenic vomiting, dysphagia, gastralgia and colon irritability syndrome. In 70% of all cases patientc relatives (1-3 degree of relationship) had also some psychosomatic diseases. All the patients suffered in childhood from so-called GIT-variant of children's neuropathia. Being adults they all met intensive or moderate stress and developed psychogenic depression. Two ways of psychosomatic disorders cristallization on the background of depression were observed, exactly reactivation of children's neuropathia symptomes or rapid affect somatization which were followed by psychosomatic cycles formation and by stress tolerance decrease. Several types of psychosomatic development were described: hypochondrial (78.8%), asthenic (12.4%), obsessive (2.3%), hysterical (4.4%) and paranoial (2.1%).
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PMID:[Variants of psychosomatic personality development in diseases of the gastrointestinal tract]. 878 77

Geriatric failure to thrive has three elements: (1) deterioration in the biologic, psychologic, and social domains; (2) weight loss or undernutrition; and (3) lack of any obvious explanation for the condition. It results from the combined effects of normal aging, malnutrition, and specific physical, social, or psychologic precipitants (e.g., chronic disease, dementia, medication, dysphagia, depression, or social isolation). Failure to thrive can be managed with a common sense approach by primary care physicians and health care providers such as social workers and dietitians; extensive referral is not necessary. The key to effective care is to identify all of the precipitants and intervene early enough to prevent progression.
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PMID:The dwindles: failure to thrive in older patients. 891 75

A retrospective study of 200 endoscopies performed on 168 children (90 girls and 78 boys) aged 3 months to 18 years (median 6 years) is reported. All procedures were completed successfully in an adult endoscopy unit in a comprehensive health centre. Most children of less than 6 months and above 12 years of age needed no intravenous sedation. One child developed respiratory depression and was successfully resuscitated. Indications for endoscopy were: small intestinal biopsy, 78 (46%); recurrent abdominal pain, 40 (24%); acute epigastric pain, 13 (8%); persistent vomiting, 12 (7%); haemorrhage, 10 (6%); caustic substance ingestion, six (4%); and dysphagia, four (2%) children. Positive diagnoses were obtained in 123 (62%) procedures. Coeliac disease (26 cases) was the most common histological diagnosis, followed by gastritis (19 cases), oesophagitis (18 cases), duodenitis (16 cases), duodenal ulcer (11 cases), hiatus hernia (six cases), gastric ulcer (three cases) and oesophageal stricture (two cases). Where specialized paediatric endoscopy units are not feasible, e.g. in developing countries, endoscopic services for children can be safely provided by paediatric endoscopists as part of an adult endoscopy service, provided that suitable resuscitation equipment is available and the necessary modifications to meet the medical and psychological needs of children and their parents are taken into consideration.
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PMID:Paediatric upper gastro-intestinal endoscopy in developing countries. 898 32

Swallowing function may be impaired by a number of conditions involving primary or associated emotional distress. When psychogenic dysphagia is suspected, routine investigation using radiological and manometric examination is inappropriate. These cases demand an evaluation of the individual as a whole, comprising the disease as well as the patient's personal problems and concerns. Five cases of patients complaining of swallowing difficulty and showing concurrent emotional distress were studied. Four individuals were anxious and one was depressed. Because of our approach a close medical-patient relationship was established. Afterwards, an explanation about the normal swallowing mechanisms and the role of the emotions was provided. All patients showed improvement of the symptom in the next 24 hours. Dysphagia can be found in anxiety, depression and conversion hysteria, with high incidence in the urban population of the third world countries. However, several professionals are unaware of these disorders. Our results suggest that this simple approach is an useful tool in managing dysphagic patients and its has validity even in individuals bearing dysphagia due to comproved organic disease. The results also emphasize the importance of the medical-patient relationship and the utility of a hollistic evaluation of the disease.
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PMID:[Dysphagia and emotional distress]. 910 70

Adult-onset myasthenia gravis is an acquired autoimmune disorder of neuromuscular transmission in which acetylcholine receptor antibodies attack the postsynaptic membrane of the neuromuscular junction. Although the cause of this disease is unknown, the role of immune responses in its pathogenesis is well established. Circulating acetylcholine receptor antibodies are present in 80% to 90% of patients with the generalized form of myasthenia gravis. Most patients have ptosis, diplopia, dysarthria and dysphagia. The weakness and fatigue worsen on exertion and improve with rest. Respiratory muscle and limb weakness are rare at the onset of the disease. For the past two decades, there has been considerable progress in understanding the diagnosis and management of myasthenia gravis. The diagnosis is based on clinical presentation, neurologic examination, and confirmation by means of electrophysiologic testing and immunologic studies. Myasthenia gravis mimics many neuromuscular diseases and even illnesses such as depression and chronic fatigue syndrome. One should always exclude drug-induced myasthenia gravis for all patients. With the introduction of new modalities of treatment, particularly immunosuppressive or immunomodulating drugs, plasma exchange and thymectomy, the morbidity and mortality of myasthenia gravis have decreased dramatically to the point that myasthenia gravis should not be considered as serious a disease as it once was. Although the several therapeutic options are usually effective and have meant independence in daily life to many patients with myasthenia gravis, well-designed, controlled, prospective studies are still lacking.
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PMID:Myasthenia gravis. 911 87


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