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)

Generally, the benzopyrones enhanced acid protease activity levels in the oedema fluid and the extracellular compartment of the skin. This is the region where thermal injury has its greatest impact. The proteolysis induced by the drugs in this region represents a means of rapidly reducing some of the derangements which the thermal injury has caused. Levamisole also enhanced acid protease activity levels in the serum and extracellular compartment of the skin 6 hours after thermal injury, while Reparil had the same effect at 24 hours. Generally the benzopyrones had little or no effect on neutral protease levels, while levamisole and Reparil caused their depression. The later effects could possibly be attributed to serum deactivation or to inhibition of their release. The enzyme enhancing activity of these drugs has been shown to correlate remarkably well with their oedema reducing ability. Generally, those which increased enzyme activity levels the most were the most effective in reducing the oedema. The cells upon which the drugs exert their effects in thermal oedema mainly seem to be the macrophages; the fibroblasts seem to be of secondary importance. This is to be contrasted with their action in the initial stages of lymphoedema where they are believed to stimulate the neutrophils. The net result of the proteolysis is many small fragments which can rapidly leave the injured tissue thus releasing the oedema fluid.
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PMID:A comparison of the effect of benzopyrones and other drugs with anti-inflammatory properties on acid and neutral protease activity levels in various tissues after thermal injury. 98 29

A 27-year-old woman with intestinal lymphangiectasia and congenital lymphedema developed cryptococcal cellulitis as a result of her underlying depressed cell-mediated immune responsiveness. Prompt therapy with amphotericin B and 5-fluorocytosine resulted in an excellent outcome. The authors believe that the increasing population of patients with depression of cell-mediated immune response will lead to an increase in the frequency with which cryptococcal cellulitis is seen and emphasize that proper evaluation of a patient with presumptive cellulitis includes consideration of fungal, as well as bacterial, etiology.
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PMID:Cryptococcal cellulitis in congenital lymphedema. 218 41

The normal role that the macrophage plays in tissue homeostasis is presented along with the morphological and functional changes that occur to the macrophage population as the lymphoedema progresses from the latent to the chronic phase and then with the treatment with a representative benzopyrone called coumarin. Underlying the lymphoedema, there is a chronic inflammation. It is this, in association with the accumulating protein and the subsequent alterations it produces in the tissues that attract monocytes and macrophages to the affected area. Despite the fact that macrophages are facultative anaerobes, and that larger numbers than normal accumulate, the tissue conditions result in a depression in their activity levels. Apart from these tissue conditions there is the possible production of deactivating proteins such as transforming growth factor beta 1 and 2. Evidence for this deactivation comes from enzymatic studies in which levels of typical macrophage enzymes are reduced and from morphological work which has shown a reduction in pseudopods and a tendency to accumulate large amounts of lipid in their vacuoles. As a consequence of this deactivation further protein accumulation occurs thereby osmotically attracting fluid. Also there is a tendency for the tissues to become fibrotic as the balance between collagen lysis and deposition shifts towards the latter since it has been shown that macrophages have an important role in collagen lysis. The administration of coumarin stimulates the macrophages resulting to their return to normal or supranormal activity levels within the lymphoedematous tissues. As well as this there is an increase in macrophage numbers. The reasons for stimulation are uncertain, however, alterations in the fine structure of the proteins and complement which make these more attractive for phagocytosis seem the most likely. The end result is an rapid enhanced breakup of the excess interstitial protein and the removal of the osmotically attracted fluid together with a more gradual removal of the deposits of fibrotic tissue by the non-stimulated macrophage. Clinically this manifests itself as a softening of the tissues, a reduction in circumference of the lymphoedematous extremity, a return to normal tissue remodelling processes and a range of subjective improvements for the patient.
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PMID:Macrophage and tissue changes in the developmental phases of secondary lymphoedema and during conservative therapy with benzopyrone. 225 30

Chronic swelling of the arm due to lymphoedema is a common complication of breast cancer treatment. As well as deformity, the condition can cause feelings of heaviness, tightness and aching in the arm. It can also lead to anxiety or depression, and difficulties with adjustment to the cancer and in family relationships. Here, we consider how arm oedema should be managed.
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PMID:Arm oedema following breast cancer treatment. 1091 98

The literature documents that the majority of breast cancer survivors have adjusted well after their first 2 years since diagnosis. However, there is a subset of survivors reporting psychological distress, including depression and anxiety, involving approximately 30% by 4 years post-treatment, but widely ranging from 5% to 50%, depending on when diagnosed and time since treatment completion. Further, a large proportion of survivors report cancer-related problems long after treatment completion, including cancer-related distress involving body image, fear of recurrence, post-traumatic stress disorder (PTSD), and sexual problems. Those with long-term medical sequelae, such as lymphedema, have worse adjustment compared to those who do not. Future research directions are suggested.
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PMID:Psychosocial and sexual functioning of survivors of breast cancer. 1466 80

Lymphedema is a chronic and incurable disease, deeply disturbing physical and psychical health of affected individuals. Lymphedema is a progressive, if left untreated. Affected patients are looking for help between physicians and therapists of different specialities. Chronic lymphedema leads to emotional disorders, depression, even to suicidal attempts--especially in young patients. In rare cases it may lead to lymphangiosarcoma--ominous neoplasm with poor prognosis. Complex interdisciplinary approach of the lymphedema team is the key to the success of lymphedema therapy. Optimal treatment of lymphedema requires close cooperation of all people involved in the therapeutic process including physicians, nurses, physiotherapists and psychologists. International Society of Lymphology (ISL) published its recommendations for lymphedema therapy, which are accepted in many countries around the world. Recommended by ISL physiotherapy consists of a manual lymphatic drainage, compressive bandaging, decongestive exercises and meticulous skin care. It is called a manual lymphedema treatment--complex physical therapy (MLT-CPT).
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PMID:The integrated and interdisciplinary treatment of chronic lymphedema. 1611 49

The present study investigated the changes of quality of life, mood, and the tumor marker CA 15-3 associated with a 3-week inpatient breast cancer rehabilitation program incorporating spa therapy. One hundred forty-nine women, 32 to 82 years, participated in the study 3 to 72 months after breast cancer surgery. Quality of life (QoL, EORTC QLQ-C30), anxiety, and depression (HADS) were measured 2 weeks before, at the end, and 6 months after rehabilitation; CA 15-3 at the beginning, end, and at 6 months follow-up. Patients received an individualized rehabilitation program incorporating manual lymph drainage, exercise therapy, massages, psychological counseling, relaxation training, carbon dioxide baths, and mud packs. Quality of life and mood improved significantly, the greatest short-term improvements found for mood-related aspects of quality of life, the most lasting improvements found for physical complaints (eg, fatigue). Also, the tumor marker CA 15-3 declined significantly to follow-up. Patient characteristics, as well as the time since surgery, moderated rehabilitation outcome to a limited extent. Older patients, nonobese patients, patients with a greater lymphedema, and patients with an active coping style showed slightly greater improvements. Hot mud packs inducing hyperthermia did not affect CA 15-3. In conclusion, the combination of inpatient rehabilitation with spa therapy provides a promising approach for breast cancer rehabilitation.
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PMID:Combined inpatient rehabilitation and spa therapy for breast cancer patients: effects on quality of life and CA 15-3. 1619 31

This article reviews qualitative and quantitative studies that evaluate health-related quality of life (HRQoL) in lymphoedema. Qualitative studies reveal a number of factors that can affect HRQoL. These include a lack of understanding of lymphoedema by health professionals and poor information provided to patients. Emotional responses include shock, fear, annoyance, frustration and negative body image. Treatment can be costly in terms of time and disruption to lifestyle. Quantitative studies show that patients with lymphoedema experience greater levels of functional impairment, poorer psychological adjustment, anxiety and depression than the general population. Increased limb volume is poorly related to the impact of lymphoedema on the patient. Factors leading to deficits in quality of life include the frequency of acute inflammatory episodes, the presence of pain, skin quality, lymphoedema in the dominant hand and reduced limb mobility. There is some evidence that the adoption of patient-centred guidelines can improve quality of life in patients with breast-cancer-related lymphoedema. HRQoL is an important outcome in the management of patients with lymphoedema. Further studies must examine how lymphoedema impacts on patients other than those with breast-cancer-related lymphoedema and the consequences to patients of different approaches to care.
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PMID:Health-related quality of life with lymphoedema: a review of the literature. 1672 53

Lymphatic filariasis, a mosquito-borne parasitic disease, can lead to lymphoedema and elephantiasis. This study describes the results of a baseline survey of a lymphoedema morbidity management programme in Togo. A convenience sample of 188 people with lymphoedema was asked about symptoms, treatment preferences and quality of life. Those with higher stage lymphoedema were more likely to have experienced an acute attack (odds ratio=1.9; P=0.002). Although only 28.2% of those surveyed reported currently using any lymphoedema treatment, 80.3% had used treatments in the past, primarily traditional products (68.1%) and scarification (38.8%). Medication was the preferred treatment for acute attacks, both currently (73.1%) and in the past (61.7%). Patients reported difficulties performing activities such as walking to the field (44%) and carrying a heavy load (63%) as a result of their lymphoedema. Patients felt avoided by their family (17%) and their community (36%). Using the Duke Anxiety-Depression scale, over 70% of patients were found to be at high risk of depression and this risk increased with lymphoedema stage (P=0.04). The survey results demonstrate the need for a morbidity management programme that will increase the use of morbidity management techniques and decrease the physical and emotional burden of this disease.
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PMID:A survey of treatment practices and burden of lymphoedema in Togo. 1711 55

The psychological states of Dominican women with chronic lymphedema and elephantiasis of the leg and the coping strategies they used to ameliorate the negative psychological effects of this condition were explored using modified precepts of grounded theory method. Qualitative data were gathered through in-depth interviewing and focus group discussions held in the Dominican Republic. Thematic results found that compounding their physical disfigurement, functional limitations, and social losses were feelings of depression, embarrassment, social isolation, and despair. Adaptive problem solving and emotion-focused coping strategies that emerged during analysis also are discussed. It is recommended that management of psychological distress should be a significant component of lymphedema management programs in developing countries.
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PMID:"Can it be that god does not remember me": a qualitative study on the psychological distress, suffering, and coping of Dominican women with chronic filarial lymphedema and elephantiasis of the leg. 1838 32


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