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

As disclosure of the truth gathers in acceptance, so does the importance of treating depression in cancer patients. Nevertheless, the choice of antidepressant tends only to be decided empirically and this is further complicated by the characteristics of advanced cancer, including: (i) a comparatively higher proportion of reactive and mild depression; (ii) frequent bowel obstruction and dysphagia; and (iii) high physical exhaustion. Therefore, we have developed an algorithm to guide the treatment of major depression in patients with advanced cancer based on psychopharmacological literature. This selects medication according to severity of depression and drug delivery route, while keeping methylphenidate as an option.
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PMID:Algorithm for the treatment of major depression in patients with advanced cancer. 1056 Sep 1

Due to genetic defects in apical membrane chloride channels, the cystic fibrosis (CF) intestine does not secrete chloride normally. Depressed chloride secretion leaves CF intestinal absorptive processes unopposed, which results in net fluid hyperabsorption, dehydration of intestinal contents, and a propensity to inspissated intestinal obstruction. This theory is based primarily on in vitro studies of jejunal mucosa. To determine if CF patients actually hyperabsorb fluid in vivo, we measured electrolyte and water absorption during steady-state perfusion of the jejunum. As expected, chloride secretion was abnormally low in CF, but surprisingly, there was no net hyperabsorption of sodium or water during perfusion of a balanced electrolyte solution. This suggested that fluid absorption processes are reduced in CF jejunum, and further studies revealed that this was due to a marked depression of passive chloride absorption. Although Na+-glucose cotransport was normal in the CF jejunum, absence of passive chloride absorption completely blocked glucose-stimulated net sodium absorption and reduced glucose-stimulated water absorption 66%. This chloride absorptive abnormality acts in physiological opposition to the classic chloride secretory defect in the CF intestine. By increasing the fluidity of intraluminal contents, absence of passive chloride absorption may reduce the incidence and severity of intestinal disease in patients with CF.
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PMID:Abnormal passive chloride absorption in cystic fibrosis jejunum functionally opposes the classic chloride secretory defect. 1284 66

The key points of this article are anorexia and cachexia are: A major cause of cancer deaths. Several drugs are available to treat anorexia and cachexia. Dyspnea in cancer usually is caused by several factors. Treatment consists of reversing underlying causes, empiric bronchodilators, cortico-steroids--and in the terminally ill patients-opioids, benzodiazepines,and chlorpromazine. Delirium is associated with advanced cancer. Empiric treatment with neuroleptics while evaluating for reversible causes is a reasonable approach to management. Nausea and vomiting are caused by extra-abdominal factors (drugs,electrolyte abnormalities, central nervous system metastases) or intra-abdominal factors (gastroparesis, ileus, gastric outlet obstruction, bowel obstruction). The pattern of nausea and vomiting differs depending upon whether the cause is extra- or intra-abdominal. Reversible causes should be sought and empiric metoclopramide or haloperidol should be initiated. Fatigue may be caused by anemia, depression, endocrine abnormalities,or electrolyte disturbances that should be treated before using empiric methylphenidate. Constipation should be treated with laxatives and stool softeners. Both should start with the first opioid dose.
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PMID:Common symptoms in advanced cancer. 1583 69

Pancreatic cancer is one of the most lethal malignancies. An estimated 32,300 patients will die of pancreatic cancer in year 2006. It is the tenth most common malignancy in the United States. Despite recent advances in pathology, molecular basis and treatment, the overall survival rate remains 4% for all stages and races. Palliative care represents an important aspect of care in patient with pancreatic malignancy. Identifying and treating disease related symptomology are priorities. As a physician taking care of these patients it is essential to know these symptoms and treatment modalities. This review discusses symptom management and supportive care strategies. Common problems include pain, intestinal obstruction, biliary obstruction, pancreatic insufficiency, anorexia-cachexia and depression. Success is needed in managing these symptoms to palliate patients with advanced pancreatic cancer. Pancreatic cancer is a model illness to learn the palliative and supportive management in cancer patient. It is important for oncologists to recognize the importance of control measures and supportive measures that can minimize the symptoms of advanced disease and side effects of cancer treatment.
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PMID:Supportive and palliative care of pancreatic cancer. 1735 51

An acute intestinal obstruction caused by a torsion of the descending colon with incarceration and strangulation of the apex of the cecum was diagnosed in a mature Holstein cow. The clinical signs manifested were acute anorexia, depression, signs of abdominal pain, and absence of feces. Rectal examination revealed a sharp decrease in luminal size of the descending colon and taut bands at that level. The final diagnosis was obtained by exploratory celiotomy. Although surgical correction was attempted, the cow died of acute fecal peritonitis 18 hours postoperatively.Acute intestinal obstruction caused by torsion of the descending colon in the cow has not been reported in the literature.
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PMID:Torsion of the descending colon in a cow. 1742 57

A three year old Charolais bull was examined because of anorexia and depression of five days duration and progressive abdominal distention. Intestinal obstruction was diagnosed. A right flank celiotomy allowed diagnosis and correction of a herniated jejunoileal loop through the right lateral ligament of the bladder. An annular constriction located in mid-ileum was by-passed by ileocecal side-to-side anastomosis. The bull's appetite and fecal production returned to normal within 72 hours of surgery. Ten months following discharge the bull was reported to be well.
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PMID:Herniation of small intestine through the right lateral ligament of the bladder in a bull. 1742 90

This prospective study was initiated to document the success rate obtained in the treatment of colonic atresia in calves, identify factors that influence survival rate, and to report the histopathological appearance of the proximal blind end of the ascending colon. Forty-three calves with intestinal obstruction due to colonic atresia were admitted to the Ontario Veterinary College between September 1982 and May 1986. Parameters recorded prospectively in this study included age, breed, sex, history, vital signs, acid-base and electrolyte status, location of intestinal atresia, medical and surgical management, and outcome. The typical history and clinical signs included failure to pass meconium or feces, decreased appetite, and progressive depression and abdominal distension. The most common site of colonic atresia was the midportion of the spiral loop of the ascending colon (n = 25). Of the 43 calves, three (7%) were euthanized at surgery, 21 (49%) died in the hospital, and 19 (44%) survived and were discharged from the hospital. Four of the surviving calves died subsequent to discharge giving an overall long-term (mean 15.9 months) survival rate of 35%. No significant risk factors were identified, although experienced surgeons showed a trend towards increased survival rate.
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PMID:Colonic atresia in cattle: A prospective study of 43 cases. 1742 41

Patients with evolutive and terminal desease often present 4 to 5 annoying symptoms, linked to the desease and implying a rigorous assessment as well as a treatment of the cause whenever possible. When all etiologic treatments have been used, the symptomatic treatments often allow to relieve the patient. This demands allying care and medication as well as mastering the available therapeutics so as to adapt the prescriptions at best. The present work essentially approaches the etiologies and symptomatic treatments of nausea and vomiting, hiccup, constipation, bowel obstruction, dyspnoea, congestion and death rattle and neuropsychic disfunctionning, in particular anxiety, depression and delirium. For the situations where the oral, transdermic and intravenous routes become difficult or impossible, medication to be administrated through subcutaneous routes are listed, with prudence, for not regulated.
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PMID:[Symptomatic treatments (pain management excluded) for adults in palliative care]. 1964 34

Associated with the intoxication of intestinal obstruction there exists a definite impairment of the excretory function of the kidneys. The degree of functional depression corresponds roughly with the intensity of the clinical intoxication. The decrease in the urea ratio and in the capacity of the kidneys to excrete sodium chloride is more marked than is the percentage decrease of phenolsulfonephthalein elimination. The great increase in the non-protein nitrogen of the blood usually observed in acute intestinal obstruction, which has hitherto been explained as being due entirely to an increased rate of protein catabolism, is due in part to retention of the products released from the injured cell protein. It is probable that the impaired renal function is due to direct action of the toxic substances upon the renal epithelium. The actual demonstration of this renal injury is perhaps the strongest evidence so far obtained to prove the presence of an actual toxic substance in the blood during intestinal obstruction. This obscure disability of the kidneys during the height of the intoxication of acute ileus should always be considered in the clinical management of this condition. It may also serve as a guide to indicate the degree of intoxication.
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PMID:I. RENAL FUNCTION INFLUENCED BY INTESTINAL OBSTRUCTION. 1986 27

The injection of the toxic proteose obtained from the contents of the obstructed small intestine causes a definite impairment of the eliminative function of the kidneys as shown by a decreased capacity to excrete urea, sodium chloride, and phenolsulfonephthalein. This involvement of the renal function is similar to that shown by the preceding report (1) to accompany the intoxication of intestinal obstruction. The observed depression of function is readily demonstrable even when large amounts of fluid and urea, dye, or salt are injected directly into the blood stream. There is in all probability a temporary injury of the kidney cells, since the most important extrarenal factors have been largely eliminated in the above experiments. There is no appreciable impairment of the renal function following the injection of a number of other proteose preparations from a variety of sources. This study affords new evidence in favor of the view that the function of an organ can be profoundly disturbed for a time without any demonstrable anatomical lesions. The repair of this type of injury promptly follows the disappearance of the intoxication and is functionally and anatomically perfect.
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PMID:II. RENAL FUNCTION INFLUENCED BY PROTEOSE INTOXICATION. 1986 28


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