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)

Twenty-two patients screened from a sample of 391 having coronary artery bypass grafting (CABG) showed significant declines on the Mini-Mental State Examination (MMSE) administered preoperatively and four days postoperatively. The MMSE is a 30-point cognitive function screening instrument for dementia and delirium. These patients were compared with 22 matched control subjects who exhibited intact cognitive function postoperatively. The study assessed the association between postoperative cognitive dysfunction and socioeconomic status, potential effects of selected surgical/anesthetic factors, and preoperative anxiety and depression (Zung Anxiety and Center for Epidemiologic Studies-Depression [CES-D] self-rating scales). The results indicate that a higher preoperative level of depression reported on the CES-D (mean score of study patients 22.1 versus 12.7 for controls) is significantly associated with the development of postoperative cognitive dysfunction (P less than .01). The educational and occupational levels of study patients were significantly below those of controls (P less than .01, P less than .02). Occurrence of a postoperative complication was the only surgical/anesthetic factor found to be significantly associated with cognitive dysfunction (P less than .01). These findings suggest that preoperative depression significantly increases the risk for immediate postoperative cognitive dysfunction, and that lower socioeconomic status may confer greater risk for postoperative cognitive morbidity.
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PMID:Cognitive dysfunction after coronary artery bypass surgery: a case-controlled study. 325 87

Delirium, dementia, or depression is frequently seen in association with severe medical illness. Usually transient, it is precipitated by the stress of systemic illness and the medications used to treat the underlying disease. Unrecognized, it may invalidate the informed consent required for the provision of emergency dental care services.
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PMID:Consent for dental therapy in severely ill patients. 327 65

Mg deficiency is a frequent complication of inflammatory bowel disease (IBD) demonstrated in 13-88% of patients. Decreased oral intake, malabsorption and increased intestinal losses are the major causes of Mg deficiency. The complications of Mg deficiency include: cramps, bone pain, delirium, acute crises of tetany, fatigue, depression, cardiac abnormalities, urolithiasis, impaired healing and colonic motility disorders. Serum Mg is an insensitive index of Mg status in IBD. Twenty-four-hour urinary excretion of Mg is a sensitive index and should be monitored periodically. Parenteral Mg requirements in patients with IBD are at least 120 mg/day or more depending upon fecal or stomal losses. Oral requirements may be as great as 700 mg/day depending on the severity of malabsorption.
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PMID:Magnesium and inflammatory bowel disease. 329 19

Ten (17%) of 58 patients with chronic viral hepatitis treated with a four- to 12-month course of recombinant human interferon alfa developed psychiatric side effects. The psychiatric side effects fell into three categories: an organic personality syndrome characterized by irritability and short temper; an organic affective syndrome marked by extreme emotional lability, depression, and tearfulness; and a delirium marked by clouding of consciousness, agitation, paranoia, and suicidal potential. These psychiatric side effects appeared after one to three months of therapy, usually improved within three to four days of decreasing the dose of interferon alfa, and invariably resolved once therapy was stopped. The organic personality and affective syndromes tended to occur in patients who received the highest dose of interferon alfa, who had relatively mild hepatitis, and who lost weight during interferon treatment. Delirium tended to occur in patients with severe hepatitis who had previous evidence of organic brain injury or dysfunction or previous drug and alcohol abuse. Failure to recognize these side effects quickly and to treat them with supportive therapy and modification of the dose of interferon alfa could result in limitation of therapy and serious personal and interpersonal consequences.
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PMID:Psychiatric complications of long-term interferon alfa therapy. 330 72

Psychotropic drug use in the patient with cancer is reviewed from the perspective of the practicing oncologist and the consulting psychiatrist. Guidelines are offered for use of psychotropic agents for specific symptoms, such as nausea and vomiting, pain control, treatment of depression, delirium, anxiety, and psychosis. The importance of careful assessment and treatment of the causes of psychiatric symptoms is stressed. Recommendations for use of specific psychotropic agents are reviewed, including dosage range and route of administration as well as possible drug interactions and other factors affecting the use of these agents in patients. Anecdotal uses of these agents are also considered.
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PMID:Psychotropic medications in patients with cancer. 331 44

Failure to recognize and treat the psychiatric complications of myocardial infarction (MI) may aggravate the underlying cardiac condition and interfere with its treatment. The timing and manifestations of several distinct psychiatric conditions that commonly accompany the acute phase of MI (anxiety, depression, delirium, and behavioral abnormalities secondary to a person's premorbid character style) will be reviewed. In addition, the importance of psychological risk factors for the development of coronary artery disease (e.g., life stress and the Type A behavior pattern) and the impact of denial on the cardiac patient's condition will be discussed. Management strategies that include nonpharmacologic (i.e., support, reassurance, brief psychotherapy and cardiac rehabilitation) and psychopharmacologic interventions (e.g., the rational use of benzodiazepines, antidepressants and neuroleptic agents) for psychiatric conditions in the MI patient will be provided. Postdischarge issues that occur in both the patient and his or her family are outlined, and the enrollment in cardiac rehabilitation programs is encouraged.
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PMID:Psychiatric management of acute myocardial infarction in the coronary care unit. 332 71

Psychiatric management of elderly patients is a challenging task because of the many age-related physiologic changes and medical problems in this population. Thorough patient evaluation is essential to rule out somatic disorders and determine underlying causes. Somatic complaints must be taken seriously, even if a patient is receiving treatment for a psychiatric disorder. Psychotropic therapy is used mainly for controlling depression, agitation, and psychotic symptoms. If psychiatric symptoms persist or become worse, psychotropics should be discontinued to prevent possible drug toxicity (eg, anticholinergic delirium) and psychiatric consultation should be requested.
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PMID:Psychiatric disorders in the elderly. Psychopharmacologic management. 333 12

The author examined 60 patients with attack-form schizophrenia whose clinical picture was predominantly characterized by definite compulsions (dromomania, kleptomania, suicidomania, homicidomania, compulsive sexual disturbances, compulsion in relation to eating). Compulsions were most often first manifested at the age of 14 to 30 years. The results have shown that in the majority of cases compulsions developed in the presence of affective states in the form of melancholic, dysphoric, apathetic or adynamic depression, less commonly in the structure of affective delirious syndromes.
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PMID:[Psychopathology and clinical picture of impulsive tendencies during schizophrenia]. 342 83

In a double-blind, crossover study, mazindol (1 mg) at breakfast, lunch, and 4:00 PM was compared with a placebo to determine its efficacy for symptom control in 30 terminal cancer patients. In 26 evaluable patients, intensity of pain and analgesic consumption were significantly improved after mazindol, while anxiety, appetite, and food consumption were significantly worse. Activity and depression were not modified by mazindol. After the completion of the trial, mazindol was chosen as a more effective drug by the patients in ten cases (38%) and by the investigators in nine (35%); placebo was chosen by the patients in seven cases (27%) and by the investigators in 11 (42%). Two patients (7%) developed delirium that required discontinuation of treatment. At the present time, there are no clearcut indications for mazindol in terminal cancer patients.
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PMID:Double-blind evaluation of the effects of mazindol on pain, depression, anxiety, appetite, and activity in terminal cancer patients. 351 80

Although the medical and psychosocial problems posed by acquired immune deficiency syndrome (AIDS) are unique, interventions to treat AIDS-related psychiatric disorders are currently available. The depression, delirium, and denial that occur in medically hospitalized patients with AIDS respond to standard psychotherapeutic and psychopharmacological approaches. Outpatients with AIDS or AIDS-related complex benefit from clarification, abreaction, and support if the therapist accepts the regression associated with the sick role, focuses initially on somatic rather than on psychological concerns, and overcomes unwarranted fears of contagion. Patients with AIDS-related dementia are helped considerably by early diagnosis and planning, and patients with antibodies to the AIDS virus require a psycho-educational approach that includes stress inoculation and problem-solving techniques. The authors describe the above interventions as well as common countertransference responses that impede their implementation.
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PMID:Psychiatric interventions for AIDS-spectrum disorders. 353 Sep 57


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