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

Multi-infarct dementia (MID) and dementia of the Alzheimer type (DAT) are the main syndromes in the elderly. This study aims at evaluating the possible differentiation of these syndromes on a clinical basis. The patient population consisted of demented patients hospitalized during the period April 1, 1988-September 30, 1990 at the Department of Cerebrovascular Diseases. The study included 40 patients with MID and 25 with DAT. The clinical diagnosis of dementia included medical history, neurological examination, psychiatric interview and laboratory diagnostic investigations. The severity of the dementia symptoms was rated by many rating scales and a battery of neuropsychological tests. This model of clinical procedure permitted for differential diagnosis between vascular and degenerative dementia, according to DSM-III-R criteria. Patients with multi-infarct dementia of the Alzheimer type did not differ significantly with regard to age, mean duration of cognitive impairment and level of education. In the DAT group women outnumbered men, and this was statistically significant. It should be emphasized, that a great majority of patients with cerebrovascular lesions developed early cognitive impairment, that means within the first year after stroke. In the MID group hypertension, heart disease and smoking were statistically more frequent than in the DAT group. For the preliminary evaluation the severity of cognitive impairment was quantified by Mini-Mental State and Dementia Scale. These scales showed that the degree of dementia was significantly greater in DAT patients as compared to MID patients, whereas the severity of depression assessed by Hamilton's Scale was mild and similar in both group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and differential diagnosis of multi-infarct dementia and Alzheimer's disease]. 152 70

Arterial hypertension can badly affect coronary circulation through several mechanisms that are not mutually exclusive, namely, coronary artery disease, left ventricular hypertrophy, and microvascular disease. Theoretical and experimental data suggest that coronary microvascular disease may exist in hypertensives, in whom it can cause both a reduction of coronary flow reserve and a shift to the right of the coronary flow autoregulation curve. To address this issue, we used dipyridamole- echocardiography test, which causes ischemic-like ST segment depression with no detectable changes in left ventricular function in different subsets of patients with microvascular disease (Syndrome X; Hypertrophic cardiomyopathy; acute heart rejection). We found that dipyridamole infusion can cause a similar pattern of response (i.e., echocardiographically silent ST segment depression) in mild-moderate essential hypertensives with normal epicardial coronary arteries, without left ventricular hypertrophy, with increased forearm minimal vascular resistances and with a reduced coronary reserve. This pattern of response identifies hypertensives with higher risk of ventricular arrhythmias, is amplified by acute reduction of diastolic blood pressure and can be reversed, together with the reduction of forearm vascular resistances by chronic antihypertensive treatment. Taken together these findings suggest that microvascular coronary disease can exist in hypertensives with two adverse consequences, consistent with the experimental background: the reduction of coronary flow reserve as well as a shift to the right of the coronary flow autoregulation curve.
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PMID:Coronary microvascular disease in hypertensives. 154 Oct 47

The relationship between hypertension and emotional depression or anxiety has been long-argued. We assessed the efficacy of etizolam (an antianxiety drug) in 18 patients with essential hypertension accompanied with unspecified complaints. In the assessment of overall improvement, 4 patients (22.2%) were rated as markedly improved, 4 patients (22.2%) as moderately improved, 7 patients (38.9%) as slightly improved, 3 patients (16.7%) as unchanged, and none as worsened. Systolic and diastolic pressure decreased significantly in 13 patients (72.2%) and 10 patients (55.5%), respectively. Many subjective symptoms such as anxiety, fatigue and depression improved. No significant adverse reaction from drug was observed. These results allow us to conclude that etizolam is effective and safe for the treatment of essential hypertension accompanied with unspecified complaints.
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PMID:The efficacy of additive use of etizolam in patients with essential hypertension and unspecified complaints. 155 46

Eighty patients undergoing abdominal surgery were studied to evaluate ECG changes in perioperative period and also identify the factors influencing the incidence and the severity of postoperative ventricular arrhythmia. Holter ECG was recorded with CM5 and NASA leads from the night before operation to the night of the 2nd postoperative day. Tachycardia (greater than or equal to 100 beats.min-1) was found in 46.3% of the patients preoperatively and in 55% postoperatively. Bradycardia (less than or equal to 50 beats.min-1) was found in 30% of the patients mostly in the night prior to the operation, while only 1 patient (1.3%) demonstrated bradycardia postoperatively. SVPCs were observed in high incidence ranging from 75% preoperatively to 85% postoperatively. Two patients had paroxysmal supraventricular tachycardia postoperatively. VPCs were observed in 42.5% of the patients preoperatively and in 53.8% postoperatively. Warning arrhythmias which were ranked as more dangerous than Lown 2 were observed in 15% of the patients preoperatively, in 11.3% intraoperatively and in 23.8% postoperatively. Serious arrhythmias which needed immediate treatment were found in 6.3% of the patients preoperatively, in 10% intraoperatively and in 11.3% postoperatively. ST depression was recorded in 11 patients at CM5 and 2 patients at NASA leads. Chi-square and Hayashi's multidimensional quantification analyses were applied to determine the relationship between postoperative VPCs and pre- and intra-operative clinical factors. Factors such as age, type of surgery, intraoperative VPCs, ASA classification, ischemic changes in preoperative ECG, intraoperative blood loss, operation time, Goldman score, untreated hypertension as well as ischemic heart disease and abnormal findings of Master ECG were considered to be contributing to the high incidence and the severity of post-operative VPCs. When multidimensional quantification analysis is applied to the data, the occurrences of no VPCs, occasional VPCs, warning VPCs and serious VPCs could be predicted in postoperative patients.
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PMID:[Holter electrocardiographic findings in surgical patients during the perioperative period]. 156 May 81

It has been reported that after 40 minutes of stimulation of the medullary reticular formation (MORF), widespread significant increase by 1.4% to 2.8% in brain water content occurs in white matter of the injured hemisphere. Recent studies indicate that centrally released arginine vasopressin (AVP) influences water permeability of the brain in both normal and pathological conditions. The present study was carried out to clarify the effect of electrical stimulation of MORF on centrally released AVP. The cats were divided into three groups. In group A (16 cats), electrical stimulation of MORF (1msec, 5V, 50Hz) was carried out for 80 minutes in normal cats. In group B (11 cats), stimulation was started 17 hours after cold injury under the same conditions and carried out for 80 minutes. In group C (10 cats), angiotensin II was administered to elevate blood pressure to the same degree as during MORF stimulation 17 hours after cold injury. AVP concentrations in the cerebrospinal fluid (CSF), plasma and brain tissue of the injured and non-injured white matter were measured by radioimmunoassay. Plasma osmolality was also determined by the freezing point depression method. Normal values (mean +/- S. D.) of CSF and plasma AVP were 4.0 +/- 2.2 and 9.9 +/- 3.6 pg/ml respectively. Plasma AVP and osmolality did not show significant changes before and at the end of experiments in all groups. There were no significant changes in CSF AVP by induced hypertension for 80 minutes (Group C). Stimulation of the medullary reticular formation resulted in significant and progressive increase in CSF AVP in normal and injured brain (Group A, B).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Changes in centrally released arginine vasopressin by stimulation of the medullary reticular formation]. 156 84

This study measured the prevalence of chronic medical conditions in 4,549 middle aged persons attending three large general practices in Dublin over the course of a calender year. The prevalence of the following conditions were measured: coronary heart disease, hypertension, stroke, diabetes, asthma, chronic bronchitis, rheumatic disorders, dyspepsia, depression, anxiety disorders, psychoses, and cancer. In order to obtain a valid denominator for the study a second community based study was carried out in the same areas to determine what proportion of persons visit their general practitioner over the course of a year. Overall 40.5% of males and 44% of females suffered from a least one of the twelve conditions, with rheumatic disorders having the highest prevalence (14.5%) and psychotic disorders the lowest (0.75%).
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PMID:General practice estimates of the prevalence of common chronic conditions. 147 57

Many studies of age-related cognitive decline have failed to distinguish between usual and successful aging. Although some degree of cognitive impairment is associated with aging, when one looks at average performance, there is great variability among individuals, with many showing little or no deleterious effects of aging on intellectual abilities. Many of the risk factors for dementia and for conditions associated with cognitive impairments can be treated or controlled. Among the preventable causes of cognitive decline are the following: AIDS, Alcohol and drug abuse, Cerebrovascular disease, Exposure to organic solvents or lead, Head trauma, Overmedication, Syphilis. Other conditions that may cause cognitive decline can be controlled or treated: Atherosclerosis, Depression, Diabetes, Emphysema, High blood pressure, Obesity, Sleep disorders, Thyroid dysfunction. In addition, it may be possible to enhance the cognitive performance of even healthy elderly people through changes in diet and lifestyle. Recent data raise the possibility that improved prenatal and perinatal care and greater access to educational opportunities may result in a decreased incidence of dementia in future generations of older adults. Although they are rapidly becoming more numerous, the efficacy of cognitive training programs in preventing or slowing cognitive decline has not yet been demonstrated. Nevertheless, such programs may ameliorate cognitive impairment by reducing the psychiatric disabilities associated with anxiety and depression. The general principle underlying these strategies for limiting cognitive impairment with age is to maximize brain reserve and minimize brain damage.
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PMID:Preventing cognitive decline. 157 76

Congenital urinary tract obstruction is a common cause of renal failure accounting for up to 20% of end-stage renal disease cases. Intrauterine obstruction often results in parenchymal loss and renal dysfunction. The pathophysiology of obstructive nephropathy and its further depression of renal function is related to severe renal vasoconstriction, which is in large part angiotensin mediated. Signs suggestive of urinary obstruction in the newborn may include an abdominal mass, hypertension, oligoanuria/polyuria, urosepsis, and hyperchloremic acidosis. The combination of renal ultrasound, diuretic renal scans, and voiding cystourethrogram are the main diagnostic modalities in infants with hydronephrosis. Nonsurgical management of ureteropelvic junction obstruction has become more popular, particularly in mild to moderate cases. Early fulguration or bypassing the obstruction of urethral valves is essential and a decrease in serum creatinine to below 1 mg/dL within 1 month of relief of obstruction is a favorable prognostic sign. Obstruction complicated by infection is dangerous and requires prompt intervention. Any newborn with a urinary tract infection, regardless of sex, should be presumed to have urinary obstruction or reflux until proven otherwise.
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PMID:Urinary tract obstruction and infection in the neonate. 157 69

The dissociation of cardiovascular (arterial hypertension) and respiratory (depression) reactions to severe cerebral ischemia seems to be inconsistent with the usual cooperative behavior of the two systems and their role in managing disturbances in the central chemical environment. In the present study the Cushing reaction was elicited by transient increase of the intracranial pressure 4-11 times in each experiment. The pressor response and changes in the vertebral sympathetic nerve discharge (SND) were compared with the respiratory reaction and with changes in the phrenic nerve activity. The reaction in both nerves developed in two phases. In the phrenic nerve, an initial hyperactivity (increased discharge amplitude and frequency) coincided with augmentation of the rhythmic SND (phase 1) and complete nerve depression developed when the SND was desynchronized (phase 2). The transition in both systems correlated in their latencies and the severity of the ischemia needed for their stimulation. Repetition of the ischemic stimuli increased the occurrence of the respiratory-related rhythmicity in the SND and later changed its character from rhythmic amplitude modulation to respiratory-related high-frequency bursting SND coinciding with the inspiration. It is concluded that, despite the apparent dissociation between the cardiovascular and respiratory reactions, there is a parallel response between the neurophysiological correlates of the two systems to increasing severity of cerebral ischemia.
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PMID:Coordination between cardiovascular and respiratory control systems during and after cerebral ischemia. 159 53

In order to examine the validity of the distinction between generalized anxiety disorder (GAD) and panic disorder (PD) we compared 41 subjects with GAD and 71 subjects with PD. The GAD subjects had never had panic attacks. In contrast to the symptom profile in PD subjects suggestive of autonomic hyperactivity, GAD subjects had a symptom pattern indicative of central nervous system hyperarousal. Also, subjects with GAD had an earlier, more gradual onset of illness. In terms of coexisting syndromes, GAD subjects more often had simple phobias, whereas PD subjects more commonly reported depersonalization and agoraphobia. GAD subjects more frequently had first-degree relatives with GAD, whereas PD subjects more frequently had relatives with PD. A variety of measures indicated that our GAD subjects had a milder illness than those with PD. Also, fewer GAD subjects gave histories of major depression than did PD subjects. Among GAD subjects, coexisting major depression was associated with simple phobia and thyroid disorders and among PD subjects, comorbid depression was associated with social phobia and hypertension. Our findings indicate that the separation of GAD from PD is a valid one. They also indicate that, within disorders, unique patterns of comorbidity may exist that are important both clinically and theoretically.
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PMID:Generalized anxiety disorder vs. panic disorder. Distinguishing characteristics and patterns of comorbidity. 143 31


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