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

Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather.
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PMID:Fibromyalgia syndrome. New associations. 146 72

The availability of methods to assess intracellular magnesium has caused great interest in the biologic role of this ion. Measurement of total intracellular erythrocyte magnesium (RBC Mg) by atomic absorption spectroscopy in 94 prospectively studied patients (87 female, age 44 +/- 12 years) with symptomatic primary mitral valve prolapse diagnosed by strict echocardiographic and clinical criteria (Perloff) identified 35 patients with normal (2.12 +/- 0.16 mmol/l) and 59 with low (1.51 +/- 0.31 mmol/l) RBC Mg (mean +/- SD). The two groups did not differ in demographic or clinical characteristics, incidence of thick mitral leaflets, joint hypermobility (by Beighton-Horan score), chest pain, fatigability, palpitations, anxiety, depression, orthostatic hypotension, autonomic test results or plasma catecholamines. Muscle cramps and migraines were more frequent in Mg-deficient patients (but p < 0.05). We postulate that the lack of differences between the groups may be due to poor correlation of RBC Mg with Mg concentration of tissue pools.
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PMID:Erythrocyte magnesium in symptomatic patients with primary mitral valve prolapse: relationship to symptoms, mitral leaflet thickness, joint hypermobility and autonomic regulation. 184 53

This case study describes a 9-year-old-girl presenting with symptoms of anxiety and depression who was found to have mitral valve prolapse syndrome. The relationship of mitral valve prolapse and anxiety and depression has been studied and a review of the literature is presented. The family history of heart and psychiatric problems is explored. The importance of the bio-psycho-social approach is stressed as well as the suggestion that mitral valve prolapse be included as part of the differential diagnosis for anxiety.
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PMID:Mitral valve prolapse and psychiatric complications: a case report. 204 70

This study was done on 113 subjects, 93 men and 20 women, whose ages ranged between 32 and 70 years (average 52.9 years). Males varied between 35 and 70 years (average 53.7) and females between 32 and 67 years (average 49.5). Our objective is: to give an account of the different discriminatory methods with mixed data usually used in medical applications, to apply these methods to all the subjects studied with the purpose of comparing their performance and, to develop a protocol for diagnosing coronary artery disease by noninvasive tests. All the subjects were referred for evaluation of chest pain, and were submitted to an exercise test on an ergometric bicycle, selective coronary angiography and left ventriculography. Patients with prior myocardial infarction, cardiomyopathy, valvular or congenital disease, mitral valve prolapse or intraventricular conduction defect were excluded. Subjects were classified as having coronary artery disease and not having coronary artery disease according to the coronarographic results. We used four clinical variables (age, sex, risk factor and chest pain) and five variables obtained from the stress test (ST depression, appearance of chest pain, appearance of arrhythmias, variations in blood pressure and R wave changes). For the analysis of this set of data we use well known univariate statistical methods, such as chi-squared test, F-test and t-test, and the following multivariate statistical methods: Fisher, Quadratic and Logistic, discriminant methods. To study the relative importance of the different variables in the discrimination of the individuals, we performed a stepwise linear discriminant analysis over the 113 subjects. Of the 9 variables tested R-wave was of little value and excluded.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnosis of ischemic cardiopathy in ambulatory care patients. Multivariate analysis of clinical and electrocardiographic data]. 207 36

Among 1150 ambulatory 24-hour ecg recordings, those taken from 67 persons no more than 40 years old, suffering from paroxysmal unconsciousness or maladies suggesting paroxysmal arrhythmias, without clinical signs of ischaemic heart disease, valve defects, cardiomyopathies or myocarditis, were chosen for further analysis. Echocardiographic signs of mitral valve prolapse (MVP) were found in 33 persons (23 females), whereas in the next 34 persons (20 females) no evidence of MVP was noted. There were no statistical differences between ages, mean heart rates and incidences of the ST segment depression greater than or equal to 2 mm in these two groups. Prolongation of the QT interval greater than 440 ms was found in 8 persons with MVP and in 3 without MVP. Appearance of the single ventricular extrasystoles, sporadic or frequent, was almost identical in both groups. Whereas polymorphic extrasystoles and/or ventricular couplets were significantly more frequent in the MVP group. Our study shows that MVP is present in about a half of persons no more than 40 years old referring to Holter ecg because of symptoms suggesting arrhythmias, without other signs of heart disease; and that complex ventricular arrhythmias in these patients with MVP are significantly more frequent than in persons with similar complaints without MVP.
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PMID:[Evaluation of 24-hour ambulatory ECG recording in patients with mitral valve prolapse]. 209 22

A corollary of the "cardiomyopathy therapy" implies that mitral valve prolapse may cause intrinsic myocardial depression. The impairment of ventricular function may not be detected in basal conditions, but could be unmasked by superimposing depressant factors. The use of beta-blockers constitutes the first choice treatment for the symptomatic management of patients with mitral valve prolapse. Therefore, we tested the hypothesis that myocardial depression could be shown during beta-blockade in the uncomplicated primary form of mitral valve prolapse. The results of echocardiographic and radionuclide angiographic evaluation of left ventricular function during basal conditions, as well as under beta-blockade with propranolol and pindolol, do not lend support to the cardiomyopathy hypothesis of the pathogenesis of primary mitral valve prolapse. However, significant decreases of heart rate, left ventricular ejection fraction and peak velocity of left ventricular systolic emptying were seen with propranolol, but not with pindolol. Beta-blockade with intrinsic sympathomimetic activity may be preferable therapeutic option for patients with mitral valve prolapse.
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PMID:[Ventricular function in mitral valve prolapse: effects of beta adrenergic blockers with and without intrinsic sympathomimetic activity]. 269 Jul 83

Panic disorder, comprising also agoraphobia for the purpose of this review, has a prevalence of 1.2-8.4 per cent, affecting females twice as frequently as males, and has a mean age of onset of 25. It is one of the more familial diseases in Psychiatry in that 2/3 of cases have relatives affected with the same condition, and the risk to first degree relatives is approximately 3-4 times the rate of the general population. Although some family studies have suggested an overlap in the transmission of panic disorders and depression, and a common diathesis hypothesis has been proposed, depression is more common in the families of depressives, as in panic disorder in the families of probands with panic disorder. Twin studies of anxiety disorders, although limited in number, report a 30-40 per cent concordance among MZ twins, against 0-4 per cent among DZ twins, which supports a genetic predisposition. The mode of transmission is uncertain. Studies which have used the 'ancestral pairs' method (which examines the incidence of the condition in maternal versus paternal forebears, on the assumption that single locus transmission is favored by unilateral clustering, and polygenic theories are favored by a more even spread) have favored single locus transmission, although such unilateral clustering can still be accommodated within a multifactorial-polygenic hypothesis. Potential biological markers for the condition are reviewed. The observation that lactate infusion can precipitate panic attacks in predisposed individuals is well established. The association with mitral valve prolapse suggests that perhaps 38 per cent of patients presenting with symptoms of panic disorders have mitral valve prolapse on echocardiography. The possibility of an endogenous anxiety-producing agent that binds to the benzodiazepine receptor is discussed.
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PMID:The genetics of panic disorder and agoraphobia. 286 87

The conventional "stepped-care" approach to the treatment of hypertension deserves revision. Rational therapy considers a variety of factors to obtain maximum efficacy, safety, tolerability, compliance, and neutralization of neural tone for the prevention of sudden death. The patient's age, gender, race, behavior profile, hemodynamic and neurohumoral status (plasma renin activity, norepinephrine/epinephrine ratio), and quality of life will help determine the choice of antihypertensive agent. Concomitant risk factors (smoking, obesity, diabetes, hypercholesterolemia), the presence of sequelae (left ventricular hypertrophy and/or failure, renal failure), and the existence of other disorders (mitral valve prolapse, depression, anxiety) must also be considered when initiating treatment. In addition, the cost of ancillary expenses (laboratory tests, hospitalizations, and emergency room visits) must be weighed against the potential benefits of therapy. Beta blockers are effective, well tolerated, and versatile for the treatment of concomitant cardiovascular disorders and as behavior modifiers. Calcium channel blockers and angiotensin converting enzyme inhibitors also show promise and merit consideration as therapy for specific groups of hypertensive patients.
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PMID:The 1980s: a patient-specific therapeutic approach in hypertension. 288 36

Women have a notoriously high rate of false positive exercise test results. Since the exercise ST segment response has low specificity in predicting CAD in women, we examined additional exercise parameters in 200 women with a history of chest pain compatible with angina and having ST segment depression greater than or equal to 1 mm recorded during a Bruce treadmill test. All subsequently had coronary arteriography. Two groups were compared: group A (n = 80) with CAD (greater than or equal to 70 percent stenosis of one or more coronary artery) and group B (n = 120) with angiographically confirmed normal coronary arteries (normal or minimal placquing). The exercise criteria analyzed included: (1) chest pain during exercise, (2) percent target heart rate, (3) extent of ST shift, (4) morphology of the ST segment slope, (5) time to normalization of the ST segment, and (6) total exercise duration. Multivariate analysis (using a stepwise logistic regression model) identified four independent exercise variables associated with the likelihood of CAD: (absence of MVP, p = .003; exercise duration less than 5 min, p = .02; ability to reach target heart rate, p = .027; time to ST normalization greater than or equal to 6 min, p less than .001). False positive exercise test results were more likely to occur when the following exercise test variables were present: ability to exercise to stage 3 of the Bruce protocol and a rapid (less than or equal to 4 minutes) normalization of ST shift after cessation of exercise. Attention to these additional exercise variables allows more careful selection of women requiring more definitive (and expensive) testing.
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PMID:Exercise testing in women with chest pain. Are there additional exercise characteristics that predict true positive test results? 290 29

To clarify and test the cerebellar-vestibular (CV) basis of fears/phobias, responses of 4000 learning disabled children, adolescents, and adults with neurological and electronystagmographic (ENG) evidence of CV-dysfunction were analyzed for anxiety-related symptoms. Of this sample, 64.6% indicated fears/phobias; females were significantly more predisposed; mixed-handedness was significantly related to fears of heights and reduced vestibular response or asymmetric vestibular functioning. Also, adults had a higher incidence of the specific fears/phobias characterizing agoraphobia than children and adolescents. Analysis of factors reported as triggering the fears/phobias led to (1) a classification and theory of fears/phobias, obsessions/compulsions, and related anxiety symptoms based on realistic or traumatic, neurotic, and CV- or other CNS-based mechanisms rather than on DSM-III--R surface descriptions; (2) an understanding of the relationships between mitral valve prolapse, agoraphobia and panic episodes, as well as depression; and (3) new insights into differential diagnosis and selective treatment.
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PMID:A cerebellar-vestibular explanation for fears/phobias: hypothesis and study. 292 69


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