Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

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

Precordial ST-segment depression (PSD) in inferior wall acute myocardial infarction (IAMI), especially when maximal in leads V4-V6, has been shown to portend a higher rate of heart failure and mortality. To better understand the pathophysiology behind this phenomenon, we evaluated patients with a first IAMI by echocardiography 48-72 h after the acute event, using segmental scoring (0 = normal to 3 = dyskinesia) of left ventricle wall motion, and a dichotomous assessment of right ventricle involvement. Patients were categorized into 3 groups: I = no PSD (n = 14); II = maximal PSD in leads V1-V3 (n = 28); III = maximal PSD in leads V4-V6 (n = 8). As compared with group I, patients in groups II-III had more severe wall motion abnormalities in inferior segments (1.36 +/- 0.97 vs. 2.19 +/- 1.74, p = 0.04), and a similar trend for posterior and lateral segments (1 +/- 1.75 vs. 2 +/- 2.41, p = 0.11), translating into a worse total left ventricle score (2.36 +/- 2.34 vs. 4.25 +/- 4.05, p < 0.05). Frequency of right ventricle involvement was similar in patients with and without PSD (6 (43%) vs. 9 (25%), p = 0.37). Segmental scores for groups I, II, and III, respectively, were not different for inferior (1.36 +/- 1, 2.25 +/- 1.82 and 2 +/- 1.51, p = 0.24), posterior and lateral (1 +/- 1.75, 1.96 +/- 2.32 and 2.13 +/- 2.9, p = 0.38), and septal, anteroseptal and anterior segments (0 +/- 0, 0.04 +/- 0.19 and 0.13 +/- 0.35, p = 0.28). Right ventricle abnormalities occurred in 43, 21 and 38% of patients in groups I, II and III, respectively, p = 0.3. Thus, IAMI with PSD is associated with worse left ventricle wall motion. However, since patients with maximal PSD in leads V4-V6 do not have greater wall motion abnormalities or higher rate of right ventricle involvement, their poorer prognosis cannot be explained by worse systolic dysfunction. We propose that maximal PSD in leads V4-V6 reflects transient diffuse ischemia and altered diastolic distensibility due to extensive coronary artery disease, causing increased left ventricle end-diastolic pressure.
...
PMID:Pathophysiology of precordial ST-segment depression in inferior wall acute myocardial infarction: an echocardiographic appraisal. 919 31

Monoamine oxidase inhibitors (MAOIs) are mainly used in psychiatry for the treatment of depressive disorders and in neurology for the treatment of Parkinson's disease. While the classical, nonselective and nonreversible MAOIs, such as phenelzine and tranylcypromine, are characterised by the risk of inducing a hypertensive crisis when dietary tyramine is ingested, the selective monoamine oxidase-B (MAO-B) inhibitor selegiline (deprenyl) and, even more so, the selective and reversible monoamine oxidase-A (MAO-A) inhibitor moclobemide, are free from this potential interaction. Drug tolerability data for the elderly show that moclobemide is one of the most well tolerated compounds. Selegiline, especially when used in combination with levodopa, can cause anorexia, dry mouth, dyskinesia and, most problematic, orthostatic hypotension. For the traditional MAOIs, phenelzine and tranylcypromine, published data are insufficient to be able to give a conclusive tolerability statement regarding the use of these compounds in elderly people. Although orthostatic hypotension occurs in most patients treated with traditional MAOIs, the incidence in elderly patients with depression does not appear to be greater than that reported with tricyclic antidepressants.
...
PMID:Monoamine oxidase inhibitors. A perspective on their use in the elderly. 982 63

The authors report the underestimated cognitive, mood, and behavioral complications in patients who have undergone bilateral contemporaneous pallidotomy, as seen in their early experience with functional neurosurgery for Parkinson's disease (PD) that is accompanied by severe motor fluctuations before pallidal stimulation. Four patients, not suffering from dementia, with advanced (Hoehn and Yahr Stages III-IV), medically untreatable PD featuring severe "on-off" fluctuations underwent bilateral contemporaneous posteroventral pallidotomy (PVP). All patients were evaluated according to the Core Assessment Program for Intracerebral Transplantations (CAPIT) protocol without positron emission tomography scans but with additional neuropsychological cognitive, mood, and behavior testing. For the first 3 to 6 months postoperatively, all patients showed a mean improvement of motor scores on the Unified Parkinson's Disease Rating Scale (UPDRS), in the best "on" (21%) and worst "off" (40%) UPDRS III motor subscale, a mean 30% improvement in the UPDRS II activities of daily living (ADL) subscore, and 60% on the UPDRS IV complications of treatment subscale. Dyskinesia disappeared almost completely, and the mean daily duration of the off time was reduced by an average of 60%. Despite these good results in the CAPIT scores, one patient experienced a partially regressive corticobulbar syndrome with dysphagia, dysarthria, and increased drooling. No emotional lability was found in this patient, but he did demonstrate severe bilateral postoperative pretarsal blepharospasm (apraxia of eyelid opening), which interfered with walking and which required treatment with high-dose subcutaneous injections of botulinum toxin. No patient showed visual field defects or hemiparesis, but postoperative depression, changes in personality, behavior, and executive functions were seen in two individuals. Postoperative abulia was reported by the family of one patient, who lost his preoperative aggressiveness and drive in terms of ADL, speech, business, family life, and hobbies, and became more sleepy and fatigued. One patient reported postoperative mental automatisms, such as compulsive mental counting, and circular thoughts and reasoning during off phases; postoperative depression was found in two patients. However, none of the patients demonstrated these symptoms during intraoperative microelectrode stimulation. These findings are compatible with previous reports on bilateral pallidal lesions. A progressive lowering of UPDRS subscores was seen after 12 months, consistent with the progression of the disease. Bilateral simultaneous pallidotomy may be followed by emotional, behavioral, and cognitive deficits such as depression, obsessive-compulsive disorders, and loss of psychic autoactivation-abulia, as well as disabling corticobulbar dysfunction and apraxia of eyelid opening, in addition to previously described motor and visual field deficits, which make this surgery undesirable even though significant improvement in motor deficits can be achieved.
...
PMID:Bilateral contemporaneous posteroventral pallidotomy for the treatment of Parkinson's disease: neuropsychological and neurological side effects. Report of four cases and review of the literature. 1070 52

Degenerative diseases of the basal ganglia, such as Huntington's disease (HD), Parkinson's disease, and Wilson's disease, are characterized by motor, cognitive, and psychiatric manifestations. HD, in particular, can be considered a paradigmatic neuropsychiatric disorder that has all three components of the "Triadic Syndromes": dyskinesia, dementia, and depression. The authors examine the phenomenology, prevalence, and management of psychiatric disturbances occurring in diseases of the basal ganglia. They address psychiatric conditions such as depression, mania, psychosis, obsessive-compulsive disorders, aggression, irritability, apathy, sexual disorders, and delirium, discussing subtleties of diagnosis, and making reference to more unusual disorders of the basal ganglia, such as postencephalitic parkinsonism and Fahr's disease.
...
PMID:Neuropsychiatry of Huntington's disease and other basal ganglia disorders. 1066 65

The pathogenesis of the alterations in motor response that complicate levodopa therapy of Parkinson's disease remains obscure. Several experimental and clinical observations strongly suggest that changes in striatal activity may be crucial for this physiopathological condition. Accordingly, it has been postulated that dyskinesia might be due to abnormal activity of the corticostriatal pathway. Here, we review the physiological and pharmacological mechanisms underlying glutamatergic regulation of striatal neurons by the corticostriatal projection. In particular, we discuss the role of both (RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-methyl-D-aspartate (NMDA) glutamate receptors in the control of the short- and long-term efficacy of corticostriatal transmission. Indeed, repetitive cortical activation can generate either long-term depression or long-term potentiation (LTP) at corticostriatal synapses depending on the subtype of glutamate receptor activated during the induction phase of these forms of synaptic plasticity. Dopamine plays an important function in the regulation of both forms of synaptic plasticity. Dopamine denervation abolishes the physiological corticostriatal plasticity by producing biochemical and morphological changes within the striatum. We have recently observed a 'pathological' form of LTP at the corticostriatal synapse during energy deprivation. We speculate that this 'pathological' LTP, depending on the activation of NMDA glutamate receptors located on spiny striatal neurons, might play a role in the generation of levodopa-induced dyskinesia.
...
PMID:Levodopa-induced dyskinesia: a pathological form of striatal synaptic plasticity? 1076 33

During the last half of the 20th century, medical treatment for Parkinson's disease (PD) showed remarkable progresses, resulting in marked prolongation of life and self-dependency of patients. In Japan, peak of ages of PD patients visiting all medical institutions was between 75 and 84 years of age(1993), with which course of illness is predicted to exceed twenty years in a large number of patients. As exploration of neuroprotective therapies for PD has not been successful yet, continuous progress in neuronal cell death in the substantia nigra result in loss of efficacy of medication, motor fluctuations and CNS side effects such as dyskinesia and psychosis in the long course of dopaminergic supplementation therapies. Future development of medical therapies for PD is expected in different ways. First, elaboration in controlled-release of DCI/levodopa, utilization of dopamine(DA) receptor agonists with different profiles in affinity to DA receptor subtypes and half-time of blood concentration, and utilization of COMT inhibitors. Second, neuroprotection with MAO-B inbitators or DA receptor agonists. Neuroprotective function is expected in animal studies for these substances but clinical usefulness should be verified with randomised controlled trials. Third, treatment for extra-motor symptoms such as dementia, cognitive disorders, depression, autonomic disturbances such as orthortatic hypotension and bladder disturbances, which is essential for maintenance of quality of life of patients with long course of illness. Gene therapy, neuroprotection before development of symptoms in PD may be attained within the first few decades of the next century. In this respect, establishment of preclinical diagnosis with neuroimaging and sensitive motor and psychological tests is imperative.
...
PMID:[A prospect of treatment for Parkinson's disease in the 21st century]. 1106 33

We examined the impact of the subthalamic nuclei (STN) deep brain stimulation (DBS) on the health-related quality of life (QoL) of patients with advanced Parkinson's disease (PD). Seventeen consecutive patients with refractory motor fluctuations and dyskinesia were included in the study (mean age, 60.9 +/- 7.7 years [range, 43-74 years]; disease duration, 16.4 +/- 8.5 years [range, 7-38 years]; mean off-medication Hoehn and Yahr stage, 4.23 +/- 0.66 [range, 2.5-5]). Each patient's assessment was carried out using common rating scales, following the Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol. Dyskinesia and emotional state were evaluated through the Abnormal Involuntary Movement Scale (AIMS) and the Hospital Anxiety and Depression Scale (HAD). QoL was assessed by means of the Parkinson's Disease Questionnaire Spanish version (PDQ-39). Significant benefit was obtained in the motor manifestations and complications of disease, as well as in the functional state and mood (P < 0.001). Some QoL dimensions (mobility and activities of daily living) and the PDQ-39 Summary Index (PDQ-39SI) showed a significant improvement (P < 0.001). Benefit was modest (P < 0.05) for three other domains (emotional well-being, stigma, bodily discomfort) and nil for the rest. There was no correlation between the change obtained in the QoL (PDQ-39SI) and in the other variables. As measured by the PDQ-39, STN-DBS significantly improves important aspects of QoL in patients with advanced PD.
...
PMID:Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's disease. 1192 Nov 26

The aim of the study was to evaluate the frequency of depression in patients with Parkinson's disease. The authors recruited 85 patients with idiopathic Parkinson's disease, 42 males and 43 females aged 34-82 years (mean age 68.7). Age at onset ranged 24-79 (mean 60.9 years). Disease duration ranged from 3 month to 20 years (mean 7.86 years). In 62 patients (72.94%) mixed type of the disease was diagnosed, in 14 (16.47%) tremor and in 9 (10.59%) rigidity predominated. UPDRS was used to evaluate the severity of the disease (results ranged 28-90, mean 51.4). Activity of daily living was estimated according to Schwab and England Scale (range 40-90, mean 68.1). Depression was evaluated with Hamilton, Beck and Montgomery-Asberg scales. The results were analysed with Spearman correlation. Depression was diagnosed in 53 (62.35%) patients [in 7 (8.24%) light; in 14 (16.47%) middle; in 19 (22.35%) heavy; in 13 (15.29%) very heavy]. The results acquired with all three scales were not statistically different. There were significant positive correlations between depression and female sex, severity of the disease, dyskinesia as side effect of.
...
PMID:[Depression in Parkinson disease: own experience]. 1509 43

The objective of this study was to evaluate possible relationships between quality of life (QoL) of Polish patients with long-lasting Parkinson's disease and various demographic and clinical factors. The study comprised 141 patients of Movement Disorders outpatient clinics in Warsaw and Gdansk with at least 5 years of the disease duration. Mean age of patients was 68.09 +/- 8.51 years, mean duration of disease was 11.87 +/- 5.14 years. To assess the quality of life, the Parkinson's Disease Questionnaire (PDQ-39) was used. Additional questions concerned duration of disease, initial and current treatment and expenses associated with therapy. Self-perceived symptoms of depression were in our study the most important factor determining QoL. Duration of the disease and expenses related to the treatment also have a significant impact on the QoL. Patient's age and presence of dyskinesia seem to be irrelevant to the quality of life.
...
PMID:Quality of life in Polish patients with long-lasting Parkinson's disease. 1519 5

One-third of the 149 people recruited 15 to 18 years ago in the Sydney Multicenter Study of Parkinson's disease have survived. The original study compared low-dose levodopa with low-dose bromocriptine. We now report the problems experienced by people who survive 15 years from diagnosis. The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms. Falls occur in 81% of patients, and 23% sustained fractures. Cognitive decline is present in 84%, and 48% fulfill the criteria for dementia. Hallucinations and depression are experienced by 50%. Choking has occurred in 50%, symptomatic postural hypotension in 35%, and urinary incontinence in 41%. No patient is still employed, and 40% of patients live in aged care facilities. Although approximately 95% have experienced L-dopa-induced dyskinesia/dystonia and end of dose failure of medication, in the majority, these symptoms are not disabling. Dyskinesia and dystonia were delayed by early use of bromocriptine, but end-of-dose failure appeared at a similar time once L-dopa was added. The rate of disease progression is similar in both arms of the study. We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa. Neuroprotective interventions in Parkinson's disease should be judged by their ability to improve non-L-dopa-responsive aspects of the disease, rather than just by their capacity to delay the introduction of L-dopa or reduce its associated side effects.
...
PMID:Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years. 1555 31


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>

---