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)

As opposed to acute or subacute orificial localizations, suppurative parietal endocarditis is a very rare entity (5 cases in 3,900 autopsies). More readily localized in the left heart and being generators of systemic emboli, they remain latent until anatomically verified. Two circumstances promote their occurrence : the focal point caused by the mural thrombus of a recent myocardial infarction ; septicemic infections with pulmonary localization and neighbouring thrombophlebitis within the context of intense depression of immunity.
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PMID:[Suppurative parietal endocarditides]. 97 Aug

Thirty-three cases of infective endocarditis presenting during a 6.5 year period to a district general hospital were analysed retrospectively. The annual incidence was 22 cases per million population. Twenty-two cases had pre-existing cardiac disease, mainly valvular disease-usually rheumatic (nine cases) and prosthetic valves (10 cases). Recognizable precipitants such as recent surgery were uncommon. Two cases presented after deliberate drug overdose possibly due to depression exacerbated by systemic disease. Symptoms were usually non-specific. All but two cases had murmurs and most were pyrexial. Splinter haemorrhages and clubbing were seen in about 20% of cases. Viridans-type streptococci were the commonest infecting organisms (14 cases). Staphylococcal infection (six cases) was confined to intravenous drug abusers and patients with prosthetic valves. Five cases were culture negative. Cardiac failure was present in 13 cases at presentation and developed in seven others during treatment. Acute valve replacement was necessary in eight cases, and late replacement in three. Renal impairment (plasma urea > 8 mmol/l and/or plasma creatinine > 120 mumol/l) occurred in 19 cases during the course of their illness. Embolic phenomena occurred in 12 patients and mostly involved the central nervous system. In the 8 fatal cases, the cause of death was cardiac failure in six, cerebrovascular accident in one, and myocardial infarction in one. Four of the six patients who subsequently died of cardiac failure had been referred for surgery. Both those who were not referred had coexisting medical problems. Factors associated with increased mortality were age, male sex, cardiac failure (P < 0.01), renal impairment (P < 0.05), and embolic phenomena (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Infective endocarditis in a district general hospital. 143 86

Infective aneurysm showing dilatation of all three coronary sinuses of Valsalva due to infective endocarditis is extremely rare. We present the first report of such a case complicated by left single coronary artery. The patient was a 55-year-old man with a past history of untreated diabetes mellitus, cerebral infarction, aortic regurgitation and high-grade fever. He was admitted with a complaint of easy fatigability. In a treadmill exercise test, asymptomatic ischemic depression of the ST segment was observed. Two-dimensional echocardiography revealed marked dilatation of all three sinuses of Valsalva, and a mural thrombus within the dilated right sinus of Valsalva. On magnetic resonance imaging, an abnormal signal in the markedly dilated right sinus of Valsalva was revealed. Coronary arteriography showed left single coronary artery (L1 type by Sharbaugh's classification). The histopathological features of the affected aorta were thought to represent the healing stage of infective endocarditis. With regard to the myocardial ischemia in this patient, it was thought to have arisen mainly through aortic regurgitation and coronary atherosclerosis due to single coronary artery, and partly influenced by untreated diabetes mellitus.
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PMID:A rare case of infective aneurysm involving all three sinuses of Valsalva complicated by left single coronary artery. 202 86

To find out how well informed they were about their disease and operation, 104 patients who had undergone aortocoronary bypass surgery (group A) or heart valve replacement (group B) were asked to complete a questionnaire on discharge from the operating hospital and, after patient briefing during in-hospital rehabilitation, again 3 months after the operation. The level of anxiety and presence of depression were also assessed. We found the following percentages of wrongly or inadequately answered questions (the figures in brackets are from the second questionnaire 3 months after the operation): all questions 40 (27), anticoagulation 26 (15), prophylaxis of endocarditis 54 (29), risk factors 21 (21), nutrition 56 (38), exercise 47 (32), anatomy/physiology 35 (21), postoperative course 40 (24). The learning effect was significant (p less than 0.005) for all but the risk factor questions. There were no significant differences between men and women or between group A and group B. With a proportion of 14% (13%) anxiety was a common problem which had subsided by the end of rehabilitation. With percentiles of 3% (5%), depression was rare.
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PMID:[Education of heart surgery patients--did it reach the goal?]. 281 10

Three cases of osteoarthritis due to dematiaceous fungi are reported. The first case, a Drechslera longirostrata spondylitis complicating prosthetic valve fungal endocarditis responded only to the association of Amphotericin B and Ketoconazole. The second patient had chronic osteoarthritis of the knee due to Phialophora parasitica resistant to medical and surgical treatment after renal transplantation. These two cases are the first and the second known reports of clinical infection with these fungi. The third patient had osteoarthritis of the patella complicating a skin infection by a thorn prick. This was cured by surgical excision and 3 months' medical treatment. These cases of infections osteoarthritis of the knee followed subcutaneous abscesses. Deep tissue infections with dematiaceous fungi with osteoarthritic involvement are very rare (6 cases of Drechslera and 8 cases of Phialophora have been reported). These fungi are opportunist saprophytes of plants in subtropical regions. They are characterised on culture by their brown and black pigmentation and microscopy shows septated filaments. Cutaneous effraction is the usual portal of entry in man; patients commonly have depression of their immune systems. Osteoarthritis is generally due to local extension of a subcutaneous abscess. The functional sequellae can be very serious. Treatment comprises surgical excision of the infected tissues with antifungal drugs which may have to be given in association.
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PMID:[Osteoarthritis caused by dematiaceous fungi. Apropos of 3 cases]. 406 37

Nephrotic syndrome is a most unusual complication of infective endocarditis. We report a case of Streptococcus sanguis endocarditis of the tricuspid valve in a patient with a small congenital ventricular septal defect who developed this complication. Severe myocardial depression also occurred and the clinical behaviour and subsequent recovery of this closely paralleled that of the nephrotic syndrome. These unusual associations, their possible interactions and pathogeneses are discussed.
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PMID:Myocardial depression and nephrotic syndrome in Streptococcus sanguis endocarditis. 409 56

Three patients with endocarditis due to Candida species were treated with 5-fluorocytosine. One had endocarditis imposed on senile aortic sclerosis and survived and two had infections on prosthetic valves and died. In the latter two patients chemotherapy failed to eradicate the infection and was associated with marrow depression and possibly hepatic necrosis.
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PMID:Candida endocarditis treated with 5-fluorocytosine. 521 81

Drug-addicts frequently suffer from pulmonary diseases, particularly those who practice self-injection of the drugs intravenously. Emphasis is at present laid on the various excipients which are thought to induce acute alveolitis with subsequent acute pulmonary oedema in heroin-addicts. It has also been suggested that the deep ventilatory depression that precedes pulmonary oedema may play a part and this is interesting since the depression can now be prevented with naloxone. Infectious lesions, such as septic pulmonary embolism or endocarditis, are easier to explain. The ever increasing use of tablets crushed for injection is responsible for peri-arteriolar granulomas of the lung with possibly severe sequelae. Finally, the almost generalized consumption of marihuana in the United-States has led to the discovery of new properties of this drug, including ventilatory stimulation and broncho-dilatation. However, this is mostly of theoretical interest. The psychotropic effects of marihuana and its irritant effect on the bronchi when inhaled make it unlikely that it will be ever be used for therapeutic purposes.
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PMID:[Pneumopathies in drug addicts]. 663 69

We have reviewed the risks and benefits of anticoagulation for cardiac valve disease before and after valve surgery. Though the absence of standardized reporting of complications and the paucity of well-designed comparative studies mandate careful consideration of the variables of individual cases, we have made the following general recommendations: Unoperated patients with rheumatic mitral valvular disease and atrial fibrillation should be chronically treated with warfarin, regardless of the hemodynamic severity of their valvular lesion. The presence of right- or left-sided heart failure is an indication for warfarin treatment, in the absence of significant contraindications. There is emerging evidence that platelet-suppressant therapy may be of benefit in diminishing the thromboembolic risk of at least a subset of patients with rheumatic valvular disease and decreased platelet survival. Until platelet-survival studies are more readily available and larger-scale studies can be performed, however, we do not recommend routine treatment with platelet-active agents. We recommend chronic warfarin anticoagulation in all patients with mechanical prostheses in either the aortic or mitral position, regardless of cardiac rhythm or prosthesis model. We do not routinely add platelet-active agents except in the case of embolism despite adequate anticoagulation with warfarin. Patients with aortic bioprostheses generally do not require warfarin treatment for more than 3 months following valve replacement. The presence of atrial fibrillation and marked depression of postoperative ventricular function are indications for chronic anticoagulation. In the case of mitral bioprostheses, we recommend indefinite warfarin treatment for patients with atrial fibrillation, depressed ventricular function, or low cardiac output. We consider a preoperative history of embolism or an operative finding of left atrial thrombus to be an additional indication for anticoagulation, in the absence of significant contraindications. Patients on anticoagulant therapy should be followed closely--when possible in specialized anticoagulation clinics--to minimize the risks of treatment. Specific recommendations are made for management of anticoagulation during infective endocarditis, pregnancy, and noncardiac surgery.
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PMID:Anticoagulation in valvular heart disease preoperatively and postoperatively. 672 54

The systemic infections caused by E. rhusiopathiae and reported in literature are very rare, majority evolving with endocarditis. The authors present a child with acute leukemia, to whom the blood culture during a high temperature episode allows to isolate this bacterium, without valvular lesions. The case is interesting because of the arisen bacteriological diagnosis problems and because of the pathogenic aspects of the infection. An animal source contact being absent, we took in account the intestinal carriage which, under the profound depression of the defence (the underlaying disease and the cytostatic therapy) could result in a persistent bacteremia. The treatment with cefazolin allows the infection to be cured.
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PMID:[Erysipelothrix rhusiopathiae bacteremia in a child with acute leukemia]. 1075 59


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