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)

Risk stratification of patients presenting to the hospital with acute coronary syndrome (ACS) is usually based on ECG assessment, and several clinical and biochemical criteria, which are all intended to identify subjects with more severe disease, who might benefit from aggressive medical or interventional treatment. However, no one widely accepted jeopardy score is available. Our aim was to determine whether the initial ECG, biochemical data and past medical history correlate with the extent of coronary artery disease in patients with ACS thus identifying subjects with severe coronary artery disease (CAD) who may benefit from the early invasive strategy. Patients' data was prospectively collected and retrospectively analysed according to the result of angiography examination. Our cohort consisted of 220 consecutive patients hospitalised due to typical chest pain (> 5 min.) occurring at rest within the last 24 hours. Study group comprised of 115 patients, who were subsequently subjected to coronary angiography Blood for qualitative troponin I test (Cardiac STATus, Spectral Inc., NJ, USA), and other routine biochemistry tests was drawn and ECG was done on admission. Chi-square and Pearson correlation tests were used for statistical analysis, p < 0.05 being considered statistically significant. Stepwise forward regression analysis was used to identify variables predictive of significant coronary artery stenosis. We have identified 65 patients with significant and 5 patients with insignificant multivessel stenosis, 33 patients with significant and 7 patients with insignificant single vessel disease. Five patients had normal coronary arteries. Male sex was significantly more prevalent among patients with coronary artery disease than with normal arteries (71% vs. 40%, p = 0.02). No differences in biochemistry values were seen among the groups. There was a significant difference in the prevalence in ST segment depression (p = 0.03) among these patients and in the incidence of plasma fibrinogen levels of >380 mg% (p = 0.02), those findings being most frequently encountered in significant multi- and single-vessel disease subjects. Hypertension, myocardial infarction more than 10 days ago, history of smoking, hypercholesterolemia and diabetes were independent predictors of the presence of significant stenosis. Assessment of admitting ECG and troponin I together with patients medical history may allow for identification of ACS patients with significant CAD that may benefit from early invasive treatment.
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PMID:[Severity of coronary artery disease in patients with acute coronary syndrome without ST segment elevation]. 1616 13

Hypertension is a risk factor for mild cognitive deterioration and vascular dementia. Cognitive deterioration attributable to normal aging was distinguished from cognitive deterioration related to hypertension by means of neuropsychologic tests. Sixty hypertensive patients, aged 65-80 years, were compared with 30 normotensive individuals. Patients with a history of stroke and/or transient ischemic attacks, diabetes, atrial fibrillation, hypercholesterolemia, or bypass surgery, and those diagnosed with dementia, depression, or anxiety, were excluded. Neither gender differences, duration of hypertension (10.2+/-8.2 years), nor prescribed antihypertensive drug treatment had an influence on study results. Immediate recall was impaired in both groups. The hypertensive patients evinced impairment in all tests vs. the normotensive subjects. Mean deferred recall scores +/- SD were 5.68+/-2.6 vs. 7.13+/-2.4; p<0.01. Deficits in attention speed and executive function, as measured by nonperformance on the Trail Making Test Part B, were present in 46% of hypertensive patients vs. 13% of normotensive patients (p<0.005), with more errors made by the hypertensive patients (1.15+/-1.54 vs. 0.46+/-0.9; p<0.02). Scores on the Stroop Color and Word Test also revealed deficits in the hypertensive patients (24.7+/-7.6 vs. 32+/-10.7; p<0.005). Compared with the control group, the hypertensive participants revealed more deficits in skills involving delayed recall and prefrontal-region skills. The relevant neuropsychologic tests were sufficiently sensitive and proved easy to use in clinical practice.
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PMID:Hypertension and cognitive decline: impact on executive function. 1622 62

Sleep complaints are very common among the general population and are usually accompanied by significant medical, psychological and social disturbances (Redline S, Strohl K, Otolaryngol Clin North Am, 132:303, 1999). A higher prevalence of sleep complaints has been described in the elderly (Vgontzas AN, Kales A, Annu Rev Med, 50:387-400, 1999). It is manifested by breathing disturbances during sleep, loud snoring, difficulties maintaining sleep, fatigue, daytime sleepiness, mood effects and impairment of daily activities (Lugaresi E, Cirignotta F, Zucconi M et al., Good and poor sleepers: an epidemiological survey of the San Marino population, Raven, New York, pp 1-12, 1983; Kales A, Soldatos CR, Kales JD, Am Fam Physician, 22:101-108, 1980). It has been associated with cardiovascular, endocrine and neurocognitive manifestations. Growing interest in early diagnosis and treatment has been noted in recent years based on emerging knowledge about the potential health consequences when the disease goes untreated (Nanen AM, Dunagan DP, Fleisher A et al., Chest, 121:1741, 2002). The veteran population in the mainland has a higher tendency for obesity, high blood pressure (HBP), sleep disorders and chronic alcohol consumption (Mustafa M, Erokwu N, Ebose I, Strohl K, Sleep Breath, 9:57-63, 2005). The Hispanic veteran population has never been studied in detail for sleep disorders and related conditions. We used previously validated screening tools for sleep disturbance breathing. Two hundred and forty-five questionnaires were administered. We found a higher prevalence of Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) in our population compared with data from the mainland (USA). The mean age was 64 years (+/-11). Ninety seven per cent were males. The mean body mass index was 25 kg/cm(2); mean Epworth Sleepiness Scale score was 8. Thirty-four per cent met high-risk criteria for sleep apnea, 53% for insomnia, 13% for symptoms suggestive of narcolepsy and 13% for those suggestive of restless leg syndrome. There were high incidences of alcohol consumption (37.6%), diabetes (32.7%), hypercholesterolemia (31.8%), depression (31.8%), hypertension (39.6%) and post-traumatic stress disorder (PTSD) (9.8%).
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PMID:The veteran population: one at high risk for sleep-disordered breathing. 1649 17

Acute and reversible left ventricular apical wall motion abnormalities presenting with chest pain, electrocardiographic (EKG) changes and cardiac markers release, in the absence of coronary artery stenosis, have already been identified as a possible distinct clinical entity: the so-called Tako-Tsubo syndrome. A 65-year-old man with history of hypertension, hypercholesterolemia and smoking, was admitted at the emergency room of a secondary referral institution with a severe and prolonged (45 min) chest pain, irradiated to the left arm, associated with neurovegetative syndrome. The clinical presentation suggested an acute myocardial infarction (AMI). Interestingly no coronary artery stenoses or vasospasm reaction to administration of acetylcholine could be detected. A slow flow phenomenon was present. The left ventricle angiography confirmed a mild depression of left ventricle systolic function (EF 45%), with akinesia of antero-lateral wall and the typical apical ballooning-like profile. At 3-month follow-up, the patient continued to be asymptomatic and the echocardiogram showed a progressive normalization of left ventricle segmental motion and ejection fraction with a complete restoration only after 6 months. At 1 year the coronary angiography confirmed the absence of coronary stenosis, with complete regression of the ventricular apical ballooning at left ventricle catheterization. At two-year follow-up the patient is still asymptomatic. A slow resolution of the syndrome should be included in the diagnostic criteria for apical ballooning.
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PMID:Angiographic long-term follow-up of primary apical ballooning of the left ventricle. 1653 34

Cardiovascular disease is the leading cause of death worldwide. As many as half of these death may be attributed to the unhealthy cholesterol and lipid levels. Elevated cholesterol levels could contribute to the increase in cardiovascular morbidity and mortality. Association between the coronary artery disease and mental disorder is less studied and documented, but several studies have demonstrated, that mental disorders increases the risk of developing cardiac disease, in particular coronary artery disease. Cholesterol and other lipids level were measured in 40 patients (n=40). Cholesterol and LDL levels in patients with schizophrenia were significantly higher and HDL was significantly decreased. Cholesterol level 180-200 mg/dl were determined in 35%, 200-235 mg/dl in 17,5%, >235 mg/dl 12,5%. HDL->35 mg/dl revealed in 37,5%. LDL 130-159 mg/dl were determined in 10%, >160 mg/dl - 20%. Triglycerides (Tg) from 150 mg/dl to 199 mg/dl were determined in 25%, from 200 mg/dl to 499 mg/dl in 12,5%. According to our study, patients with schizophrenia has some risk factors for cardiovascular heart disease such as, elevated levels of Tg and LDL-c, smoking, lack of exercise, psychosocial factors (depression, social isolation and lack of social support, low socioeconomic status) and so on. We can conclude that all these patients with schizophrenia may belong to the risk group of cardiovascular disease.
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PMID:Risk factors for coronary heart disease in patients with schizophrenia. 1678 66

Depression is increasingly recognized as an independent prognostic risk factor in patients with coronary artery disease and coronary artery bypass grafting (CABG). The use of selective serotonin reuptake inhibitors (SSRIs) for depression in patients with cardiac disease is becoming more prevalent. We examined the long-term outcomes of patients on SSRIs before CABG. We prospectively examined collected data in the Duke Databank for Cardiovascular Disease from January 1, 1999 to December 31, 2003. The median and maximum follow-up periods were 3 and 6 years, respectively. We screened patients who underwent CABG (n = 5,364) and excluded those who underwent simultaneous CABG and valvular surgery (n = 570). SSRI antidepressants included fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, escitalopram, venlafaxine, and clomipramine, and their use was determined from the inpatient pharmacy records during the index hospitalization. Outcomes included event-free survival from all-cause mortality, rehospitalization, and a composite end point of all-cause mortality or rehospitalization. Of 4,794 CABG-only patients, 246 (5.1%) took SSRIs before CABG. The SSRI group had a higher prevalence of diabetes, hypercholesterolemia, hypertension, cerebrovascular disease, peripheral vascular disease, and previous cardiovascular intervention. After adjustment for baseline differences, patients on SSRIs before CABG had increased risks of mortality, rehospitalization, and the composite end point (hazard ratio 1.61, 95% confidence interval 1.17 to 2.21, p = 0.003; hazard ratio 1.52, 95% confidence interval 1.30 to 1.77, p <0.0001; and hazard ratio 1.46, 95% confidence interval 1.26 to 1.70, p <0.0001, respectively). In conclusion, SSRI use before CABG was associated with a higher risk of long-term post-CABG mortality and rehospitalization. The explanation behind these findings requires further research.
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PMID:Prognosis of patients taking selective serotonin reuptake inhibitors before coronary artery bypass grafting. 1739 8

Since trivalent chromium (Cr(3+)) enhances glucose metabolism, interest in the use of Cr(3+)as a therapy for type 2 diabetes has grown in the mainstream medical community. Moreover, accumulating evidence suggests that Cr(3+) may also benefit cardiovascular disease (CVD) and atypical depression. We have found that cholesterol, a lipid implicated in both CVD and neurodegenerative disorders, also influences cellular glucose uptake. A recent study in our laboratory shows that exposure of 3T3-L1 adipocytes to chromium picolinate (CrPic, 10 nM) induces a loss of plasma membrane cholesterol. Concomitantly, accumulation of intracellularly sequestered glucose transporter GLUT4 at the plasma membrane was dependent on the CrPic-induced cholesterol loss. Since CrPic supplementation has the greatest benefit on glucose metabolism in hyperglycemic insulin-resistant individuals, we asked here if the CrPic effect on cells was glucose-dependent. We found that GLUT4 redistribution in cells treated with CrPic occurs only in cells cultured under high glucose (25 mM) conditions that resemble the diabetic-state, and not in cells cultured under non-diabetic (5.5 mM glucose) conditions. Examination of the effect of CrPic on proteins involved in cholesterol homeostasis revealed that the activity of sterol regulatory element-binding protein (SREBP), a membrane-bound transcription factor ultimately responsible for controlling cellular cholesterol balance, was upregulated by CrPic. In addition, ABCA1, a major player in mediating cholesterol efflux was decreased, consistent with SREBP transcriptional repression of the ABCA1 gene. Although the exact mechanism of Cr(3+)-induced cholesterol loss remains to be determined, these cellular responses highlight a novel and significant effect of chromium on cholesterol homeostasis. Furthermore, these findings provide an important clue to our understanding of how chromium supplementation might benefit hypercholesterolemia-associated disorders.
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PMID:Chromium picolinate positively influences the glucose transporter system via affecting cholesterol homeostasis in adipocytes cultured under hyperglycemic diabetic conditions. 1687 Apr 93

In the present study, the role of pentacyclic triterpenes, lupeol and its ester lupeol linoleate, was studied in relation to hepatic oxidative abnormalities and lipoprotein peroxidation in hypercholesterolemic rats. Hypercholesterolemia was induced in male Wistar rats by feeding them with high cholesterol diet (4% cholesterol + 1% cholic acid; HCD) for 30 days. Pentacyclic triterpenes, lupeol and lupeol linoleate were supplemented (50 mg/kg body wt/day) during the last 15 days. After the experimental period, there was a significant depression in hepatic activities of antioxidant enzymes, SOD (38.39%), CAT (25.03%) and GPx (30.26%) along with a marked fall in the levels of non-enzymic antioxidant molecules GSH (31.39%), vitamin C (46.07%) and vitamin E (42.28%), with a concomitant increase (p<0.001) in lipid peroxidation and in the activities of serum alkaline phosphatase, lactate dehydrogenase and aminotransferases when compared to controls. Treatment with triterpenes decreased lipid peroxidation and reverted the activities of antioxidants (p<0.001 and p<0.01) and marker enzymes to near control. Histopathological findings further confirmed the hepatoprotective nature of triterpenes by showing the normal architecture in treated rats, as against the fatty cellular changes in HCD fed rats. Further, the susceptibility of apo-B containing lipoprotein to oxidation by copper and Fenton's reagent was increased in in vitro condition in HCD fed rats, whereas the lipoproteins were less susceptible to oxidation in triterpenes treated animals. Therefore, it may be concluded that lupeol and its ester afford protection against the hepatic abnormalities and lipoprotein peroxidation in hypercholesterolemic rats.
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PMID:Mitigating role of lupeol and lupeol linoleate on hepatic lipemic-oxidative injury and lipoprotein peroxidation in experimental hypercholesterolemia. 1693 29

Previous research has assessed the relationship between blood lipid levels and depression with contradictory results. Several studies have linked low cholesterol levels with impulsive, aggressive and suicidal behaviours. The aim of this pilot study was to examine serum lipids in a sample of patients suffering from seasonal affective disorder (SAD). We conducted a retrospective analysis of data on total serum cholesterol and serum triglycerides in 39 SAD patients and 40 non-seasonally depressed or schizophrenic control subjects. Study subjects had to be free of psychotropic drugs for at least 2 weeks. Analysis of covariance (ANCOVA) was performed to assess group differences. After adjustment for significant covariates SAD patients had significantly lower total cholesterol levels (5.21 +/- 1.14 mmol/l) than control subjects (5.94 +/- 1.11 mmol/l; p = 0.013). Moreover, hypercholesterolemia (total cholesterol > 5.20 mmol/l) was significantly less frequent in the SAD group (46.2%) than in the control group (75.0%; p = 0.012). Total serum triglycerides did not differ significantly between SAD patients (1.54 +/- 1.07 mmol/l) and controls (1.56 +/- 0.96 mmol/l; p = 0.126). The results of this study support the idea that low cholesterol levels may be of pathogenetic importance in SAD. Further study in larger clinical samples is warranted to clarify our findings.
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PMID:Serum lipid levels in seasonal affective disorder. 1714 38

Erectile dysfunction is a common, multifactorial disorder that is associated with aging and a range of organic and psychogenic conditions, including hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular disease, and depression. Penile erection is a complex process involving psychogenic and hormonal input, and a neurovascular nonadrenergic, noncholinergic mechanism. Nitric oxide (NO) is believed to be the main vasoactive nonadrenergic, noncholinergic neurotransmitter and chemical mediator of penile erection. Released by nerve and endothelial cells in the corpora cavernosa of the penis, NO activates soluble guanylyl cyclase, which increases 3',5'-cyclic guanosine monophosphate (cGMP) levels. Acting as a second messenger molecule, cGMP regulates the activity of calcium channels as well as intracellular contractile proteins that affect the relaxation of corpus cavernosum smooth muscle. Impaired NO bioactivity is a major pathogenic mechanism of erectile dysfunction. Treatment of erectile dysfunction often requires combinations of psychogenic and medical therapies, many of which have been only moderately successful in the past. The advent of oral phosphodiesterase type 5 (PDE-5) inhibitors, however, has greatly enhanced erectile dysfunction treatment; patients have demonstrated high tolerability and success rates for improved erectile function. The efficacy of the PDE-5 inhibitors also serves to illustrate the importance of the NO-cGMP pathway in erectile function since these agents counteract the degradation of NO-generated cGMP. Because not all patients respond to PDE-5 inhibitors, additional therapies are being investigated, such as soluble guanylyl cyclase activators and NO donors, which act on NO-independent and NO-dependent pathways, respectively.
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PMID:The role of nitric oxide in erectile dysfunction: implications for medical therapy. 1717 Jun 6


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