Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postpartum thyroiditis (PPT) presents in approximately 5% of women. Its incidence, clinical characteristics, and evolution were studied in a nonselected population of Mediterranean women. Six hundred five healthy women, recruited between the 36th week of pregnancy and the 4th postpartum day, underwent initial clinical and biological evaluation and postpartum at 1 (n = 605), 3 (n = 552), 6 (n = 574), 9 (n = 431), and 12 (n = 444) months. PPT was diagnosed in women with transient hyperthyroidism between 1 and 3 months postpartum and/or hypothyroidism between 3 and 6 months postpartum. Permanent hypothyroidism was considered if it was overt and persisted one year after diagnosis. The incidence rate of PPT was 7.8%. Eighty-two percent of PPT patients had hormone abnormalities at the 6th month postpartum, 8.8% showed depression and 51% goiter. PPT was manifest as hyperthyroidism plus hypothyroidism in 35.5% of patients, because only transient hyperthyroidism in 22.2% and as hypothyroidism alone in 42.3%. Five patients with hypothyroidism during PPT (0.82% of the initial population, 11.1% of PPT patients, and 15.6% of hypothyroidism PPT patients) presented permanent hypothyroidism after a follow-up of 39.8 (4.2) months. PPT was found in 7.8% of general Mediterranean population. We recommend evaluation at the 6th postpartum month to diagnose the majority of PPT women and indefinite follow-up of hypothyroid PPT patients to detect permanent hypothyroidism.
 ...
PMID:Postpartum thyroiditis: epidemiology and clinical evolution in a nonselected population. 1069 16

Postpartum thyroiditis is the most common endocrinologic disorder, with an incidence that varies geographically from 5% to 10%. It has important clinical sequelae including symptoms of hyperthyroidism, hypothyroidism, and depression. Long-term follow-up of women who experience postpartum thyroiditis reveals a high recurrence rate in subsequent pregnancies. Postpartum thyroiditis is an autoimmune disorder, and thyroid antibody-positive women in the first trimester have a 33% to 50% chance of developing thyroiditis in the postpartum period. Whether or not to screen for postpartum thyroiditis remains controversial.
 ...
PMID:Recognizing, understanding, and treating postpartum thyroiditis. 1087 38

Thyroid gland ultrasonography is recommended in patients with nonspecific clinical symptoms such as fatigue, weight gain, dry skin, amnesic symptoms, depression, bradycardia, abnormal myocardial contractility, increased diastolic pressure, hypercholesterolemia, menstrual abnormalities, infertility, fibrocystic breast disease, anxiety, insomnia, tachycardia, paroxysmal atrial fibrillation and osteoporosis. Subclinical hypothyroidism or hyperthyroidism can cause any of the above mentioned symptoms. Diffusely decreased, decreased and inhomogenous thyroid gland echogenicity requires laboratory examination. Thyroid gland ultrasonography is recommended also in patients with type I. diabetes mellitus and vitiligo because of increased incidence of thyroid disorders in these patients. Clinical observation of patients treated with Lithium, Amiodaron or Interferon is also recommended. (Tab. 2, Fig. 6, Ref. 18.)
 ...
PMID:Contribution of thyroid gland ultrasound for screening of patients with suspected subclinical thyroid gland disorders. 1091 42

Hypothyroidism affects 4% to 10% of women, increasing with age. Symptoms, which are often nonspecific and subtle, can include: lethargy, mild weight gain, edema, cold intolerance, constipation, mental impairment, dry skin, depression, irregular menses, hoarseness, myalgias, hyperlipidemia, and bradycardia. TSH determination is usually warranted when some of these are present. Confirmation of diagnosis is based on laboratory tests, not symptoms. With Hashimoto's thyroiditis, the most common cause, the thyroid is usually firm and irregular to palpation. Screening is recommended by the American Thyroid Association, American Association of Clinical Endocrinologists and ACOG. Studies indicate that even slight hypothyroidism is associated with increased miscarriage, late fetal demise and lower IQ of offspring. Many believe all women intending conception or pregnancy should be screened. Most patients with even slightly elevated TSH should be treated, though controversy remains. Hypothyroidism is usually permanent, and treatment is life-long; postpartum thyroiditis may be transient. Levothyroxine is the standard treatment. Because of variable bioavailability of some levothyroxine preparations, designation of a specific high-quality brand is appropriate; TSH should be monitored to titrate the dose. The third-generation super-sensitive TSH is the most accurate test for both hypo- and hyperthyroidism. Because estrogen increases levels of thyroid binding globulin, women who are on HRT or OCs, or are pregnant, usually have total T4 levels above the reference range.
 ...
PMID:Hypothyroidism and women's health. 1208 Dec 57

Reactions to oral contraceptive therapy tend to be maximal during the first few months of use. They include nausea or epigastric discomfort, malaise, dizziness, nervousness, fatigue, weakness, leg cramps, headache, and depression. The estrogenic component is thought to be the cause. There may also be a psychogenic basis reflecting apprehension. Breast tenderness is an occasional complaint and intermenstrual spotting or breakthrough bleeding is often reported. Increasing dosage has reduced this symptom. Dysmenorrhea prior to treatment may be improved but occasionally it is aggravated. Drug-induced amenorrhea presents a double problem in that failure to resume medication 7 days after completion of a cycle results in a risk of conception. Episodes of severe uterine bleeding in patients discontinuing use after several months or years have been reported. Other side effects include a skin reaction resembling acne, pruritus, hirsutism, thinning of scalp hair, increased skin pigmentation, and weight gain or loss. Serious vascular complications and hepatic dysfunction have been shown and deviation of thyroid function may be shown by increase of serum protein-bound iodine (PBI). Clinical signs of hyperthyroidism have not been described. Oral contraception is associated with elevated plasma cortisol (hydrocortisone) levels and decreased urinary levels of 17-hydroxycorticosteroids (17-OCHS). Suppression of ovarian activity by oral contraceptives is rapidly reversible. Fear of carcinogenesis has caused much alarm but no proof as of the present time. Safety of long term use will require additional years of experience.
 ...
PMID:Side-effects and possible complications of oral contraceptive drugs. 1225 41

Although atrial fibrillation is not widely known by the general public, in developed countries it is the most common arrhythmia. The incidence increases markedly with advancing age. Thus, with the growing proportion of elderly individuals, atrial fibrillation will come to represent a significant medical and socioeconomic problem. The consequences of atrial fibrillation have the greatest impact. The risk of thromboembolism is well known; other outcomes of atrial fibrillation are less well recognised, such as its relationship with dementia, depression and death. Such consequences are responsible for diminished quality of life and considerable economic cost. Atrial fibrillation is characterised by rapid and disorganised atrial activity, with a frequency between 300 and 600 beats/minute. The ventricles react irregularly, and may contract rapidly or slowly depending on the health of the conduction system. Clinical symptoms are varied, including palpitations, syncope, dizziness or embolic events. Atrial fibrillation may be paroxysmal, persistent or chronic, and a number of attacks are asymptomatic. Suspicion or confirmation of atrial fibrillation necessitates investigation and, as far as possible, appropriate treatment of underlying causes such as hypertension, diabetes mellitus, hypoxia, hyperthyroidism and congestive heart failure. In the evaluation of atrial fibrillation, cardiac exploration is invaluable, including electrocardiogram (ECG) and echocardiography, with the aim of detecting cardiac abnormalities and directing management. In elderly patients (arbitrarily defined as aged >75 years), the management of atrial fibrillation varies; it requires an individual approach, which largely depends on comorbid conditions, underlying cardiac disease, and patient and physician preferences. This management is essentially based on pharmacological treatment, but there are also nonpharmacological options. Two alternatives are possible: restoration and maintenance of sinus rhythm, or control of ventricular rate, leaving the atria in arrhythmia. Pharmacological options include antiarrhythmic drugs, such as class III agents, beta-blockers and class IC agents. These drugs have some adverse effects, and careful monitoring is necessary. The nonpharmacological approach to atrial fibrillation includes external or internal direct-current cardioversion and new methods, such as catheter ablation of specific foci, an evolving science that has been shown to be successful in a very select group of atrial fibrillation patients. Another serious challenge in the management of chronic atrial fibrillation in older individuals is the prevention of stroke, its primary outcome, by choosing an appropriate antithrombotic treatment (aspirin or warfarin). Several risk-stratification schemes have been validated and may be helpful to determine the best antithrombotic choice in individual patients.
 ...
PMID:Atrial fibrillation in the elderly: facts and management. 1242 93

Endogenous thyroid receptor hormones 3,5,3',5'-tetraiodo-l-thyronine (T(4), 1) and 3,5,3'-triiodo-l-thyronine (T(3), 2) exert a significant effects on growth, development, and homeostasis in mammals. They regulate important genes in intestinal, skeletal, and cardiac muscles, the liver, and the central nervous system, influence overall metabolic rate, cholesterol and triglyceride levels, and heart rate, and affect mood and overall sense of well being. The literature suggests many or most effects of thyroid hormones on the heart, in particular on the heart rate and rhythm, are mediated through the TRalpha(1) isoform, while most actions of the hormones on the liver and other tissues are mediated more through the TRbeta(1) isoform of the receptor. Some effects of thyroid hormones may be therapeutically useful in nonthyroid disorders if adverse effects can be minimized or eliminated. These potentially useful features include weight reduction for the treatment of obesity, cholesterol lowering for treating hyperlipidemia, amelioration of depression, and stimulation of bone formation in osteoporosis. Prior attempts to utilize thyroid hormones pharmacologically to treat these disorders have been limited by manifestations of hyperthyroidism and, in particular, cardiovascular toxicity. Consequently, development of thyroid hormone receptor agonists that are selective for the beta-isoform could lead to safe therapies for these common disorders while avoiding cardiotoxicity. We describe here the synthesis and evaluation of a series of novel TR ligands, which are selective for TRbeta(1) over TRalpha(1). These ligands could potentially be useful for treatment of various disorders as outlined above. From a series of homologous R(1)-substituted carboxylic acid derivatives, increasing chain length was found to have a profound effect on affinity and selectivity in a radioreceptor binding assay for the human thyroid hormone receptors alpha(1) and beta(1) (TRalpha(1) and TRbeta(2)) as well as a reporter cell assay employing CHOK1-cells (Chinese hamster ovary cells) stably transfected with hTRalpha(1) or hTRbeta(1) and an alkaline phosphatase reporter-gene downstream thyroid response element (TRAFalpha(1) and TRAFbeta(1)). Affinity increases in the order formic, acetic, and propionic acid, while beta-selectivity is highest when the R(1) position is substituted with acetic acid. Within this series 3,5-dibromo-4-[(4-hydroxy-3-isopropylphenoxy)phenyl]acetic acid (11a) and 3,5-dichloro-4-[(4-hydroxy-3-isopropylphenoxy)phenyl]acetic acid (15) were found to reveal the most promising in vitro data based on isoform selectivity and were selected for further in vivo studies. The effect of 2, 11a, and 15 in a cholesterol-fed rat model was monitored including potencies for heart rate (ED(15)), cholesterol (ED(50)), and TSH (ED(50)). Potency for tachycardia was significantly reduced for the TRbeta selective compounds 11a and 15 compared with 2, while both 11a and 15 retained the cholesterol-lowering potency of 2. This left an approximately 10-fold therapeutic window between heart rate and cholesterol, which is consistent with the action of ligands that are approximately 10-fold more selective for TRbeta(1). We also report the X-ray crystallographic structures of the ligand binding domains of TRalpha and TRbeta in complex with 15. These structures reveal that the single amino acid difference in the ligand binding pocket (Ser277 in TRalpha or Asn331 in TRbeta) results in a slightly different hydrogen bonding pattern that may explain the increased beta-selectivity of 15.
 ...
PMID:Thyroid receptor ligands. 1. Agonist ligands selective for the thyroid receptor beta1. 1269 76

Depression of metabolism by hypothyroidism decreases oxidant production and thus protects tIssues against oxidant damage. Moreover, it is well-known that abnormal gut motility is a common manifestation in hypo/hyperthyroidism. In this study, we aimed to investigate the putative beneficial effects of methimazole on oxidative injury and dysmotility in a rat colitis model. Methimazole (0.04%) was administered in drinking water starting 15 days prior to induction of colitis. Colitis was induced by intracolonic administration of trinitrobenzene sulfonic acid (30 mg/ml; 0.8 ml) in ethanol. Six days after the induction of colitis, the fecal output was measured and used as an index for colonic motility. All rats were decapitated on the seventh day. The distal colon was weighed and the mucosal lesions were scored. Colonic lipid peroxidation (LP) and glutathione (GSH) measurements were performed. The macroscopic score, the colonic wet weight and LP values of the euthyroid colitis group were found to be higher than those of the control group (P<0.05-0.001). All these parameters were reduced in the methimazole-treated colitis group (P<0.01-0.001). The decrease in colonic GSH levels in the colitis group was completely abolished in the methimazole-treated colitis rats (P<0.01). Induction of colitis increased the average fecal output compared with the control group (P<0.05) and methimazole in the colitis group exaggerated the fecal output (P<0.001). In conclusion, methimazole reduces colonic oxidative injury probably due to hypometabolism, which is associated with a decrease in the production of reactive oxygen intermediates and an increase in the response of antioxidant systems.
 ...
PMID:Methimazole-induced hypothyroidism in rats ameliorates oxidative injury in experimental colitis. 1277 28

Subclinical hypothyroidism is associated with aspecific complaints such as tiredness, cognitive and depressive complaints, subtle disturbances in lipid values, an increased risk of cardiovascular disease, ovulatory dysfunction and a negative effect on foetal psychomotor development and pregnancy outcome. Subclinical hyperthyroidism is associated with atrial fibrillation, osteoporosis and dementia. Not enough prospective randomised studies with hard outcomes are available to provide evidence-based general recommendations. Therefore, the decision as to whether or not a patient should be treated needs to be made on an individual basis. For subclinical hypothyroidism it is advisable to consider treatment in the case of positive thyroid peroxidase antibody tests, a TSH concentration higher than 10 mU/l, the presence of one or more risk factors for cardiovascular disease, infertility on the basis of ovulatory dysfunction, and pregnancy. In the case of complaints of tiredness and certainly in the case of depression or cognitive dysfunction, a 3-month trial treatment can be considered. This leads to a decrease of the complaints in about 25% of cases. As negative effects are associated with the treatment, we advise an expectant approach in all other cases with a yearly monitoring of the TSH concentration. For subclinical hyperthyroidism it is advisable to consider treatment in the case of a nodular goitre, and especially in the case of atrial fibrillations. If subclinical hyperthyroidism persists in the absence of nodular thyroid disease, an expectant approach appears to be justified.
 ...
PMID:[Subclinical functional disorders of the thyroid gland]. 1284 32

Thyroid dysfunction is extremely common in women and has unique consequences related to menstrual cyclicity and reproduction. Even minimal hypothyroidism can increase rates of miscarriage and fetal death and may also have adverse effects on later cognitive development of the offspring. Hyperthyroidism during pregnancy may also have adverse consequences. Accordingly, thyrotropin (TSH) determination is warranted for all women planning pregnancy or those already pregnant. Replacement doses should be carefully monitored throughout pregnancy because the increased renal iodine loss and estrogen-induced rise in thyroxine-binding globulin (TBG) often result in a higher dose requirement. Although thyroid abnormalities are part of the standard differential diagnosis of menstrual disorders, recent studies indicate that these are relatively infrequent causes. Nonetheless, TSH is still required as part of the laboratory evaluation of women with abnormal cycles. The incidence of postpartum thyroiditis is high--6%-8% in various studies. A TSH should be performed in all postpartum patients who are depressed, who complain of unusual fatigue or anxiety or have any of the classical symptoms of hyperthyroidism or hypothyroidism. Practitioners providing health care for women should be alert to thyroid disorders as possible etiological factors in nonspecific symptoms such as fatigue and depression. However, most women with these symptoms are euthyroid; replacement therapy for them is not indicated. The long-standing dogma of thyroidology that replacement with levothyroxine alone is satisfactory for all hypothyroid patients has recently been questioned but results of trials are inconclusive. Nonetheless, satisfactory regimens can be found for the vast majority of patients.
 ...
PMID:Thyroid dysfunction and women's reproductive health. 1567


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