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

The effects of therapeutic acupuncture on gastric acid secretion on pain relief in chronic duodenal ulcer patients were studied. Ten adult Nigerian patients with clinical, endoscopic as well as radiological evidence of duodenal ulcer constituted the "Ulcer Group." Four other patients who gave history of dyspepsia formed the "Dyspeptic Group." Pentagastrin stimulation test was performed on all subjects pre- and post-acupuncture therapy. The classical Chinese acupuncture loci were employed. The mean Basal Acid Output (BAO) in the duodenal ulcer group was markedly reduced from 4.04 +/- 1.01 mMols/hour to 1.05 +/- 2.5 mMols/hour. The mean Maximal Acid Output (MAO) was lowered from 34.72 +/- 13.81 mMols/hour to 15.34 +/- 4.01 mMols/hour. The difference was statistically significant (P less than 0.001). It is more probable, therefore, that the relief of pain is attributable to the therapeutic inhibition of gastric hyperacidity in our patients. Thus, though pain relief has been previously demonstrated in response to acupuncture, the results of this investigation have gone further to show that acupunture achieves symptomatic relief through therapeutic gastric depression in duodenal ulcer patients.
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PMID:Acupuncture and gastric acid studies. 4 32

With regard to the superimposed concept "psycho-somatic correlation" we describe the psychopathological mark "Alexithymia" and the related psychodynamic processes (object loss which cannot be mastered, together with following narcissistic insult and aggression defense). In the frame of the psychosomatic pathology are outlined the psychodynamic processes in patients suffering from functional gastrointestinal disorders, duodenal ulcer and ulcerative colitis. With regard to the superimposed concept "soma-to-psychic correlation" we describe the secondary-psychic reactions following the patient's perception of a failure of his bodily functions, namely: reactive anxieties and depression as well as dependency wishes and denial-work. The psychotherapeutic possibilities in psychosomatic patients concern the modifications of the classical psychoanalytic techniques, namely: psychoanalytically orientated group therapy, psychotherapeutic consultation, supportive psychotherapy on the one hand and the behavior therapy on the other hand. In contrast to it, in patients suffering from secondary-psychic reactions particularly the principle of the doctor's and nurses' emotional presence is indicated. However, the ability to realize the emotional presence function presupposes a special advanced training.
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PMID:[Psychosomatics in gastroenterology]. 34 4

Transient neutropenia developed in a 62-year-old, white male on maintenance hemodialysis being treated with cimetidine for an in tractable duodenal ulcer. The probable mechanism was peripheral destruction of the granulocyte series, unlike the marrow depression reported with metiamide, another histamine H2 receptor antagonist.
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PMID:Transient neutropenia in a patient receiving cimetidine. 89 66

An attempt was made to relate the outcome of surgery to psychosocial factors in an unselected series of 30 male patients with duodenal ulcer. Though statistically significant differences did not emerge on the psychosocial parameters studied, patients with good surgical results were less likely to give histories of preoperative anxiety or depression or to show evidence of these at interview. They also had lower ratings on Hamilton Rating and Deprivation Scales, and were more likely to have hopeful expectations of operation and positive attitudes towards previous medical treatment. Patients with psychiatric illness or psychological deprivation having sugery for chronic duodenal ulceration, can expect almost as good a surgical result as those without these difficulties. They are unlikely to show increased psychiatric morbidity, postoperatively.
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PMID:Psychological factors as a prediction of success in duodenal ulcer surgery. 106 33

The effects of the beta adrenergic stimulant drug, "Nylidrin", and the beta adrenergic blocking agent, "Propranolol", on human basal gastric acid secretion were studied in 20 healthy volunteer subjects and 10 chronic D.U. cases. Nylidrin increased gastric acid secretion and volume. All effects of nylidrin were blocked by prior administration of beta adrenergic inhibitor propranolol. Propranolol diminished both acid secretion and volume in both normal and D.U. cases. The presence of beta adrenergic receptors in the human stomach was suggested. The effects of beta adrenergic blocking agent propranolol on gastric secretion, stimulated with histamine, were studied in 10 normal subjects and 10 cases of chronic duodenal ulcer patients. Pretreatment with propranolol produced a signigicant depression of the 90 minute acid response to histamine in both volume and acidity in normals and duodenal ulcer cases. It is concluded that propranolol has an antisecretory effect, not only on basal gastric secretion but also on histamine stimulated secretion in man. Reserpine stimulated gastric acid secretion and volume in normals but showed no similar effect in D.U. cases. After pretreatment with propranolol it reduces the gastric acid secretion and volume in normals and D.U. cases.
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PMID:Beta-adrenergic receptors and the effect of beta-adrenergic blocking agent propranolol on histamine and reserpine stimulated gastric acid secretion in man: normals and duodenal ulcer cases. 126 68

To clarify the interactions between stressful life events and other risk factors in the development of duodenal ulcer disease, we studied 33 patients with active ulcer, symptomatic for less than or equal to 6 months and untreated during the previous year, using the Paykel Interview for stressful life events, the Minnesota Multiphasic Personality Inventory (MMPI), and Zung's Anxiety and Depression scales. MMPIs were abnormal in 64% of the patients, and 61% showed some degree of depression. The 16 patients whose symptoms had been preceded by severe stress and more pathological MMPIs, especially on paranoia and dependency scales; were more depressed; and had used less nonsteroidal anti-inflammatory drugs than those without (p less than 0.05). They were somewhat more likely to be single, to be of low social class, and to have recently increased use of cigarettes, alcohol, or coffee (though their absolute level of alcohol consumption was low). Anxiety levels did not differ between stress and nonstress groups. Correspondence analysis yielded four clusters of patients, characterized by (a) alcohol/cigarette use, personality disorder, chronicity; (b) early onset, neurosis; (c) depression, life events; (d) late onset, psychosocial stability. The analysis changed little according to whether life events were or were not considered in cluster formation. We conclude that ulcer patients who become ill under stress from a distinct subgroup, that depressed mood and stress-related increases in use of alcohol and cigarettes may mediate between stress and ulcer formation, and that life events are a quantitatively minor factor in ulcerogenesis.
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PMID:Life events, personality, and physical risk factors in recent-onset duodenal ulcer. A preliminary study. 156 96

Gastric and duodenal ulcer healing and scarring were evaluated with a highly magnifying endoscope. The appearance of scar was classified into three types: Sa, with a depression at the center; Sb, with a pattern of regenerated mucosa reaching the center; and Sc, with a uniform pattern throughout. The relationship between regenerative mucosal patterns and histologic findings of biopsy specimens was investigated in 58 patients with gastric ulcer. Mucosal regeneration was sufficient in 26.7% of patients with Sa pattern, 79.2% of patients with Sb pattern, and 100% with Sc pattern. From prospective endoscopic follow-up observations, the relationship between endoscopic findings of ulcer scars and ulcer relapses was investigated in 80 patients with gastric ulcer and 56 patients with duodenal ulcer. As a result, patients who completed the cycle of ulcer healing from Sa pattern through Sb to Sc patterns had rarely relapse. In contrast, patients with a Sa pattern of mucosal scar showed a high rate of recurrence: 88.8% for gastric ulcer, and 88.0% for duodenal ulcer. Our method of evaluation of gastric and duodenal ulcer healing with a highly magnifying endoscope may have important prognostic and therapeutic implications. It may indicate a population of patients (with Sa scarring pattern) with a high risk of ulcer recurrence and therefore requiring prolonged prophylactic treatment.
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PMID:Evaluation of peptic ulcer healing with a highly magnifying endoscope: potential prognostic and therapeutic implications. 194 Jan 87

Vagotomy was performed in 238 consecutive patients with duodenal ulcer since 1977. Electron microscopy of parietal cells from gastric body mucosa, gastric acid secretory test, and serum gastrin evaluation were done in randomly selected 15 PCV and 13 SV+A cases before and after vagotomy. It was found that 2-6 weeks after the surgery, the ultrastructure of parietal cells presented the feature of secretory depression and gastric acid output was decreased. One to ten years after PCV, the ultrastructure gradually regained its preoperative morphology, serum gastrin level was also increased, though acid output remained on low level. During the same period, patients undergoing SV+A were characterized with the feature of depressed secretion in gastric mucosa ultrastructure, and constantly low level of gastric acid output and serum gastrin. These results, in the authors' belief, may explain low gastric acid output after vagotomy and provide theoretical basis for the application of vagotomy in surgical treatment of duodenal ulcer.
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PMID:[Parietal cell ultrastructure and acid secretory function before and after vagotomy]. 236 13

A randomized, double-blind, 1-year pilot study of prednisolone treatment for primary biliary cirrhosis was undertaken. Nineteen patients received 30 mg prednisolone per day initially, with a maintenance dose of 10 mg per day. Seventeen patients received placebo. The groups were matched for age, menopausal status, hepatic histological stage and bilirubin. Treatment was well tolerated without dropouts. Two patients receiving prednisolone developed diabetes, one a duodenal ulcer and one depression. One patient receiving placebo died for liver failure after 3 months. Cholestatic symptoms (itch and fatigue) improved on prednisolone. There was significant (prednisolone vs. placebo) improvement in transaminase (p = 0.0214), alkaline phosphatase (p = 0.0032), procollagen III peptide (p = 0.0103), immunoglobulin G (p = 0.0012) and liver histology (p = 0.016); these changes were greatest among noncirrhotic patients. No patient developed skeletal symptoms. Fifty-seven per cent had abnormal triolein breath tests prior to treatment, and 65% had abnormally low calcium absorption tests. Calcium absorption increased significantly in the treated group vs. placebo at 2 weeks (p less than 0.02), but not at 1 year. Femoral photon absorptiometry fell in the prednisolone group after 1 year (-3.5% vs. placebo +0.5%, p less than 0.05), as did trabecular bone volume (-6% vs. -2.8%, p less than 0.005) and resorption surface (-11% vs. +2%, p less than 0.02) on serial bone biopsy. Prednisolone seems to exert a favorable hepatic effect in primary biliary cirrhosis but at the expense of increased bone loss to approximately twice the expected rate. Prednisolone treatment merits further assessment in primary biliary cirrhosis over a longer period, with attention to selection of patients most likely to benefit and continuing observation of bone mass to better establish the "cost/benefit" ratio.
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PMID:A pilot, double-blind, controlled 1-year trial of prednisolone treatment in primary biliary cirrhosis: hepatic improvement but greater bone loss. 277 3

The evidence that duodenal ulcer is a psychosomatic disorder is reviewed. A variety of both experimental stressors and differing states of emotional arousal (anxiety and anger in particular) are associated with increased acid and pepsin secretion. Furthermore, chronic life stressors predispose to duodenal ulcer, presumably by way of symptomatic anxiety or depression, while poor social support may comprise another risk factor. Subjects with high levels of trait anxiety or neuroticism are more prone to stress-induced anxiety and its physiological consequences. There is minimal acceptable evidence to support more specific personality-related theories, including Type A behaviour, alexithymia or the earlier psycho-analytic theories of Alexander. Nonetheless, it is concluded that Alexander's inclusion of duodenal ulcer as one of a handful of classic psychosomatic disorders has been confirmed. Since some 40% of duodenal ulcer patients relapse in the first year after medical treatment, there may be some role for psychological treatments (especially in the domain of stress/anxiety management) for those patients who relapse and have co-existing high state or trait anxiety or exposure to chronic stressors.
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PMID:Psychosocial causes of duodenal ulcer. 304 60


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