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)

In the former western part of Germany, in 1989 about three million people claimed social costs because of urinary incontinence. 80 percent of them were women. The psychic situation of these women is mainly determined by social consequences of their incontinence. Behavioural changes to avoid incontinence lead to social isolation. A coherence between incontinence or urgency and agony or depression is acknowledged. Especially in elderly people, who have to change their well-known environment due to nursing problems, incontinence is a major problem, which often deteriorates with the new situation. Incontinence also leads to avoidance of sexuality. Women are mostly more irritated than their partners. On the other hand incontinence is used to avoid sexuality and thus may be a sign of a sexual conflict.
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PMID:[The psychological status of the female with urinary incontinence]. 836 33

This prospective randomised study involved 52 female patients suffering from recurrent stress urinary incontinence, objectively confirmed by means of clinical incontinence tests and urodynamic examinations. They alternatively underwent colposuspension according to Burch or suburethral sling procedure surgery. Urodynamic and sonographic examinations were carried out before and 2.5 years (i.e. within a range of 2-3) after surgery according to Burch or suburethral sling procedure. There was no significant difference between the two methods with respect to subjective and objective rate of cure, which amounted to 85% of the cases involving colposuspension and 88% of cases involving the suburethral sling procedure. Both methods resulted in a significant improvement of the depression quotient and a significant elevation of the internal urethral meatus (p < 0.05). Apart from an aggravation of urge symptoms in both groups, the patients with surgery according to Burch tended towards enterocele and rectocele in the medium range, whereas urination disorders had to be accepted in the patients operated on according to the sling procedure in the long term.
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PMID:[Surgical treatment of recurrent stress incontinence: Burch versus lyodura sling operation--a prospective study]. 837 Apr 87

Demographic trends reveal the elderly to be the fastest growing segment of the population. Physicians can therefore anticipate encountering increasing numbers of older patients with alcohol-related problems. These problems include liver disease, dementia, confusion (masquerading as dementia), peripheral neuropathy, insomnia, late-onset seizure disorder, poor nutrition, incontinence, diarrhea, myopathy, inadequate self-care, macrocytosis, depression, fractures, and adverse reactions to medications. Despite the prevalence of alcohol use in older people, their risks and problems are often unrecognized. We reviewed published literature on the determinants and consequences of alcohol-related problems in persons aged 65 years and older and the usefulness of available screening measures. Thirteen of 25 eligible studies on determinants and consequences met quality criteria and were reviewed. Nine additional studies on screening tests were also evaluated. Determinants include history of alcohol use and abuse, social isolation, and reduced mobility; consequences consist of risks of hip fracture from falls, neoplasms, and psychiatric illness. Currently accessible screening tests focus on high levels of alcoholic beverage use and abuse and dependence. They are not useful in screening for hazardous consumption that may result from relatively low levels of alcohol use alone or in combination with medications, medical illness, or preexisting diminished physical, emotional, or social function. Research is needed on the consequences of lower levels of alcohol consumption on the physical and psychosocial health of older individuals and on methods for distinguishing alcohol-related from age-related problems. Existing screening tests should be expanded or new screening methods developed in anticipation of a growing public health problem.
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PMID:Alcohol-related problems in older persons. Determinants, consequences, and screening. 900 85

Forty-four women with stress urinary incontinence (SUI) were interviewed in order to investigate sexual activities, sexual function and satisfaction one month before and one year after either one of two possible surgical interventions. The findings were related to sexual response cycle, size of urinary leakage, duration of incontinence and depression. There was no significant difference in sexual activity before and after surgery. One or two sexual dysfunctions within the desire, excitement, orgasmic and resolution phases were reported by the majority both before and after intervention independently of surgical method. Neither the magnitude of the leakage nor the duration of SUI influenced the sexual experiences significantly while continence after surgery promoted sexual desire. The discrepances between the prevalence of sexual dysfunctions and the relatively high level of sexual satisfaction as well as the non-influencing parameters indicate the complexity of human sexuality.
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PMID:Some sexological characteristics of stress incontinent women. 883 53

Although memory disorders and the aphaso-apraxo-agnosic syndrome are the most relevant clinical symptoms in dementia, behavioral changes, mood-related disturbances and sleep disorders are the major cause of institutionalization and caregiver concern. In the present study we have investigated the frequency and progression of cognitive and noncognitive symptoms in Alzheimer's disease (AD) as well as the APOE-related frequency of clinical symptoms in dementia. Memory decline (100%), aphasia (94%), apraxia (99%), agnosia (94%) and motor dysfunction (90%) appeared in practically all cases with mild (GDS-3), moderate (GDS 3-4) and severe (GDS 6-7) dementia. The most frequent noncognitive symptoms include anxiety (76%), depression (68%), behavioral changes (67%), psychotic symptoms (43%), sleep disorders (43%), incontinence (23%) and cerebrovascular symptoms (75%). Anxiety, depression, behavioral changes, psychotic symptoms, motor dysfunction and cognitive deterioration paralleled the severity of dementia, increasing their frequency from mild to severe dementia. The most important sleep disorders were irregular sleep-wake pattern (67%) and insomnia (47%). Disorientation (90%) and drug administration (88%) appeared to be the most important factors in causing sleep disorders in dementia. Disorientation, agitation and motor disorders were slightly more frequent in patients with APOE-4/4, while anxiety and sleep disorders appeared more frequently in APOE-3/4. Behavioral changes and psychotic symptoms did not show any clear association with specific APOE subtypes. In conclusion, our results suggest that noncognitive symptoms are very important clinical events in the disease progression and in decision making for therapeutic intervention and institutionalization. Furthermore, it is likely that some brain dysfunctions leading to particular clinical symptoms might be associated with specific AD genotypes.
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PMID:APOE-related frequency of cognitive and noncognitive symptoms in dementia. 912 Dec 26

In a study of 50 family caregivers of elderly Chinese patients with dementia in Singapore, 28 (56%) scored five points or more on the 28-item General Health Questionnaire (GHQ). The GHQ scores correlated significantly with duration of care; presence of delusion, hallucination, depression, insomnia, incontinence and agitation; and the total score of the Behavioural Pathology in Alzheimer's Disease Rating Scale. On multiple regression analysis the only variables to achieve a significant relationship with the GHQ scores were duration of care, depression and the total behavioural score.
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PMID:Stress of caregivers of dementia patients in the Singapore Chinese family. 917 51

This study investigated the changes in quality of life following a randomized controlled 6-week trial of bladder training in 123 older women with urinary incontinence. Both clinical (diary, pad test) and quality of life measures (Incontinence Impact Questionnaire (IIQ), Center for Epidemiological Studies-Depression Scale (CES-D)) and visual analog scales on symptom burden were obtained at baseline, 6 weeks and 6 months following treatment. All subscales and the composite scale of the IIQ and the visual analog scales were significantly improved following bladder training, with effects maintained 6 months later. No changes were observed in CES-D scores. Women with genuine stress incontinence and those with detrusor instability with or without concomitant stress incontinence had similar improvements. We conclude that bladder training is effective in improving the quality of life of incontinent women regardless of urodynamic diagnosis.
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PMID:Quality of life following bladder training in older women with urinary incontinence. 944 1

Although drug-drug interactions constitute only a small proportion of adverse drug reactions, they are important because they are often predictable and therefore avoidable or manageable. Their frequency is related to the age of the patient, the number of drugs prescribed, the number of physicians involved in the patient's care and the presence of increasing frailty. The most important mechanisms for drug-drug interactions are the inhibition or induction of drug metabolism, and pharmacodynamic potentiation or antagonism. Interactions involving a loss of action of one of the drugs are at least as frequent as those involving an increased effect. It is likely that only about 10% of potential interactions result in clinically significant events and, while death or serious clinical consequences are rare, low-grade, clinically unspectacular morbidity in the elderly may be much more common. Nonspecific complaints (e.g. confusion, lethargy, weakness, dizziness, incontinence, depression, falling) should all prompt a closer look at the patient's drug list. There are a number of strategies that can be adopted to decrease the risk of potential clinical problems. The number of drugs prescribed for each individual should be limited to as few as is necessary. The use of drugs should be reviewed regularly and unnecessary agents withdrawn if possible, with subsequent monitoring. Patients should be encouraged to engage in a 'prescribing partnership' by alerting physicians, pharmacists and other healthcare professionals to symptoms that occur when new drugs are introduced. Physicians with a responsibility for elderly people in an institutional setting should develop a strategy for monitoring their drug treatment. For those interactions that have come to clinical attention, it is important to review why they happened and to plan for future prevention. Clinicians should also report, via the appropriate postmarketing surveillance scheme, any drug-drug interactions they have encountered. Finally, multidisciplinary education about the nature of physiological aging and its effect on drug handling, and the possible presentations of drug-related disease in older patients, is an important element in reducing interactions in the elderly.
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PMID:Important drug-drug interactions in the elderly. 963 96

The available data about the hypothesis that psychological conditions cause urinary incontinence are contradictory. This study was based on a group of patients undergoing urodynamic investigation to define the type of incontinence. Patients were submitted to a battery of psychological tests, including STAXI, CES-D and IBQ (in their Italian version). Patients suffering from urge incontinence showed higher degrees of inner anger and anger trait than those suffering from stress or mixed incontinence. Neither group showed signs of depression. The conviction of illness was greatest in patients suffering from stress or mixed incontinence, whereas irritability and general hypochondria prevailed in patients suffering from urge incontinence. Such patients tend to develop psychosomatic reactions that may contribute to the severity of their symptoms.
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PMID:Psychological investigation in female patients suffering from urinary incontinence. 1020 68

Women utilizing the free provision and home delivery of urinary incontinence pads by the Swedish health services were sent a questionnaire concerning their quality of life and pad use. Evaluable and complete replies were received from 460 of 521 women. The incontinence was chronic and moderate to severe, considerably restricting general and professional activities. Feelings of anxiety, isolation and depression were common, their prevalence rising with incontinence grade. Satisfaction with the supplied pads was generally good, with absorptive and antiodor properties most appreciated. The threatened introduction of charges for the pads was reported as a dominant anxiety. A drawback of free supply may be that, as in 24% of the present series, women primarily use the pads as a solution to the problem of incontinence, without a doctor's intervention and before a trial of continence-promoting or curative measures.
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PMID:Quality of life and urinary incontinence pad use in women. 969 36


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