Gene/Protein Disease Symptom Drug Enzyme Compound
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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obesity is a major risk factor for cardiovascular disease. However, a direct link between these two states is difficult to establish, since obesity frequently occurs with other disease states such as diabetes, hypertension and atherosclerosis. Clinical studies have clearly shown that uncorrected obesity is associated with cardiac hypertrophy and compromised ventricular function. A number of rodent models of obesity have been studied in terms of cardiovascular adaptations. Cardiac function of the obese Zucker rat appears to be normal at a younger age. Only after several months is depression in cardiac function discernable. These animals are mildly hypertensive, but do not exhibit the characteristic increase in cardiac output associated with human obesity. A unique characteristic of JCR:LA-cp rat is that they develop atherosclerotic and myocardial lesions. Hearts from these animals will maintain normal function when perfused with physiological levels of calcium. At higher calcium concentrations, however, mechanical function becomes impaired. Dietary-induced obese rats exhibit many of the hemodynamic alterations associated with human obesity, but there is no evidence to-date that these animals will develop severe cardiac depression. Short-term weight reduction apparently has beneficial cardiovascular effects, but weight cycling may be harmful. Given the widespread occurrence of obesity, further studies are warranted to characterize the cardiac manifestations of this condition.
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PMID:Cardiovascular abnormalities associated with human and rodent obesity. 143 63

While it is clear that males and females with eating disorders share more features in common than dissimilarities, males are distinctive in their past histories of obesity, sexual identity concerns, defensive dieting, and dieting in relationship to sports participation. All adolescents with an eating disorder are likely to be guarded in terms of disclosing items affecting their psychological state. Young men may be more so. In light of this fact, diagnosis of these disorders in adolescent male patients still depends on ruling out possible organic etiologies, thoroughly assessing the adolescent's mental status, and looking for underlying psychiatric symptoms. The association between mood disorders, namely depression, and obsessive-compulsive disorder as well as other anxiety disorders is as strong in young males with eating disorders as with females. Assessment of developmental and nutritional status is key to the diagnosis and is helpful in monitoring recovery. Standards of monitoring other than weight are important and have been outlined. Lastly, family psychodynamics must be addressed in order to provide the eating-disordered young man with more control as well as more independence in order that he take more personal responsibility for a healthier lifestyle.
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PMID:The adolescent male with an eating disorder. 148 52

RU-486 or mifepristone is best known as an antiprogestin and an abortifacient, but it has broad medical applicability. The drug is also a potent blocker of corticosteroid receptors, and it has shown promise in the treatment of breast cancer, inoperable meningioma, and cushing's disease. Cushing's is a model for the symptomatology of aging which may involve enhanced response to corticosteroid. RU-486 has reversed the osteoporosis, thinning of skin, muscle atrophy, obesity, adult onset diabetes, depression, hypertension, and immunosuppression associated with this disease. RU-486 may be of value in aiding cervical dilation, lactation, and the treatment of endometriosis. In addition, breast, bowel, kidney tumors, hepatomas, endometrial cancer, and fibrosarcomas can show corticosteroid dependency, suggesting that RU-486 may have clinical value against inoperable tumors. In a preliminary 1987 phase I study, in estrogen-positive, chemotherapy-refractory breast cancer patients in Montpelier, France, Ru-486 produced objective tumor regression (6 of 22) that was prolonged (3 months) in 4 patients. Clinical relief of bone pain was observed in 7 of 23 patients with a decline in carcinoembryonic antigen (CEA) tumor makers in 8 patients. Growing in vitro data also show that RU-486 can directly inhibit breast cancer cell proliferation. RU-486 has application for HIV infection, based on data that there is a serum factor in AIDS patients that enhances corticosteroid lympholysis. IN addition, the immune restorative action of RU-486 suggests that it could counteract the immunosuppression seen in aging, in cancer, or in viral or stress-related disease, which has recently focused clinical attention on its potential in the treatment of senile dementia and depression. Scientific conferences and workshops are needed to alert scientists, physicians, and the public to the potential medical benefits of this drug.
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PMID:RU 486: how abortion politics have impacted on a potentially useful drug of broad medical application. 150 96

Pathological hyperprolactinaemia (PH) is significantly associated with: (1) paternal deprivation during childhood, (2) depression, (3) non-specific symptoms including obesity and weight gain. The clinical onset of the symptoms often follows pregnancy or a loss. Prolactin is an insulin antagonist which does not promote weight gain. Hyperprolactinaemia and increased metabolic efficiency are parts of a system of interdependent behavioural and metabolic mechanisms necessary for the care of the young. We call this system, which is available as a whole package, maternal subroutine (MS). An important number of cases of PH are due to activation of the MS that is not induced by pregnancy. The same occurs in surrogate maternity and in some animal models. Most women with PH developed a malignant symbiotic relationship with their mothers in the setting of absence, alcoholism or devaluation of the father. These women may regress to early developmental stages to the point that they identify themselves both with their lactating mother and with the nursing infant as has been found in psychoanalysed patients and in the paradigmatic condition of pseudopregnancy. Such regression can be associated with activation of the MS. Prolactinomas represent the extreme of the spectrum of PH and may result from somatic mutations occurring in hyperstimulated lactotrophs.
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PMID:Hyperprolactinaemia as a result of immaturity or regression: the concept of maternal subroutine. A new model of psychoendocrine interactions. 151 20

Over the past decade we have seen a shift in the strategy for the treatment of hypertension, from stepped therapy--involving a highly structured, unvarying series of steps--to recommendations for more individualized treatment. How shall we accomplish that goal? Severe hypertension provides a clear indication to bypass earlier recommendations. Demographic data such as age, gender, and race, often cited, have proved less helpful. Concomitant medical problems, which are found in greater than 50% of hypertensive patients, are most often the crucial determinants in the selection of antihypertensive therapy. Concurrent coronary artery disease, diabetes mellitus, heart failure, azotemia, asthma, chronic obstructive pulmonary disease, borderline cognitive dysfunction, anxiety, and depression are all common. Each has implications for antihypertensive therapy. Moreover, blood pressure reduction is a surrogate for our real goal, which is reduction of cardiovascular risk. Thus, consideration of concomitant medical problems has extended to left ventricular hypertrophy, obesity, hyperlipidemia, and insulin resistance as additional risk factors in hypertension. Consideration of all of these factors makes it possible to individualize antihypertensive therapy in most patients.
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PMID:Evolution of the treatment of hypertension: what really matters in the 1990s? 151 35

Physicians examined 216 women who presented at Chittaranjan Seva Sadan College of Obstetrics, Gynaecology, and Child Health in Calcutta, India, and had undergone surgical sterilization at least 2 years earlier. Endometrial biopsies during the late secretory phase in the 32 cases with excessive bleeding during the late menstrual period found proliferative changes: dilated glands in 28 cases and poor secretory phase in 4 cases. The 12 ovarian biopsies revealed cortical stromal hyperplasia in 1 case. None of the control cases (i.e., those with no menorrhagia) had any ovarian changes. Observed pelvic pathologies included in the order of frequency: cystic ovaries, hydrosalpinx, uterine fibroids, pelvic endometriosis, uterine prolapse, chronic cervicitis, and scar endometriosis. Most of the 216 women were 25 to 35 years old and the youngest was 22 years old. Menorrhagia was the most common complaint (59.2%) and 30 to 35 year old women suffered from it the most. Among women who had no pelvic pathology, dysfunctional uterine bleeding was responsible for menorrhagia. Dysmenorrhea was the next most frequent complaint (29.6%). Intermenstrual bleeding, abnormally infrequent menstruation, and secondary amenorrhea were other menstrual disturbances (5.56%, 4.17%, and 1.39%, respectively). Other relatively common symptoms associated with surgical sterilization were abdominal pain (25%), abdominal discomfort and backache (14.8%), and whitish, viscid vaginal or uterine discharge (12.03%). Less frequent symptoms were obesity, painful scar, insomnia, irritability, depression, and regret. Proper preoperative and postoperative counseling would have prevented many of the complications.
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PMID:Aftermaths of surgical sterilisation with special reference to menstrual disturbances. 153 7

Many studies of age-related cognitive decline have failed to distinguish between usual and successful aging. Although some degree of cognitive impairment is associated with aging, when one looks at average performance, there is great variability among individuals, with many showing little or no deleterious effects of aging on intellectual abilities. Many of the risk factors for dementia and for conditions associated with cognitive impairments can be treated or controlled. Among the preventable causes of cognitive decline are the following: AIDS, Alcohol and drug abuse, Cerebrovascular disease, Exposure to organic solvents or lead, Head trauma, Overmedication, Syphilis. Other conditions that may cause cognitive decline can be controlled or treated: Atherosclerosis, Depression, Diabetes, Emphysema, High blood pressure, Obesity, Sleep disorders, Thyroid dysfunction. In addition, it may be possible to enhance the cognitive performance of even healthy elderly people through changes in diet and lifestyle. Recent data raise the possibility that improved prenatal and perinatal care and greater access to educational opportunities may result in a decreased incidence of dementia in future generations of older adults. Although they are rapidly becoming more numerous, the efficacy of cognitive training programs in preventing or slowing cognitive decline has not yet been demonstrated. Nevertheless, such programs may ameliorate cognitive impairment by reducing the psychiatric disabilities associated with anxiety and depression. The general principle underlying these strategies for limiting cognitive impairment with age is to maximize brain reserve and minimize brain damage.
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PMID:Preventing cognitive decline. 157 76

This paper selectively reviews available evidence concerning psychological characteristics associated with obesity, psychological changes accompanying very-low-calorie diets (VLCDs), and the influence of certain psychological factors on response to VLCD treatment. The obese population as a whole does not show an elevated incidence of psychopathology. Treatment-seeking obese do show more psychiatric disturbance, at a level comparable to other medical/surgical patients. There appear to be no global personality traits or profiles that are associated with obesity. However, obese people differ from non-obese groups on psychological and behavioral variables related to weight and eating and more frequently display perceptual and emotional body image anomalies. Binge eating appears rather common among obese groups. VLCDs have generally neutral to positive effects on hunger, depression, and anxiety. New data on body image suggest that VLCDs are associated with post-treatment underestimation of body size. Finally, recent data on possible psychological and behavioral correlates of VLCDs outcome are presented.
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PMID:Psychological aspects of obesity and very-low-calorie diets. 161 81

Psychiatrists at Emory University Hospital in Atlanta, Georgia examined a 37-year old divorced woman suffering from refractory depression. She reported her 1st bout of depression to be at 9-10 years old (onset of menses). She tried to kill herself at ages 11 and 17. The only time she remembered not being depressed was when she was using oral contraceptives (OCs). She 1st took them for oligomenorrhea at age 14. She suffered from oligomenorrhea off and on ever since then. The next time she took OCs was in her early 20s while she was married. She stopped taking them after she had her son. An outpatient psychiatrist had been treating her for the last 10 years. 3 years before this visit to Emory, psychotic depression and a suicide attempt sent her to a hospital. 5 years before coming to Emory, she gained 40 lbs and developed hirsutism, acne, and a low-pitched voice. 8 months before coming to Emory, a physician diagnosed acanthosis nigricans which is dark hyperpigmentation of the epidermis in body fold areas. 6 months prior to coming to Emory, an endocrinologist evaluated her for oligomenorrhea, obesity, and hirsutism and prescribed 0.25 mg dexamethasone/day to inhibit androgen production, regulate menses, and reduce facial hair. 3 months before admission, she experience severe depression. Her psychiatrist treated her with bupropion, amitriptyline, buspirone, and lithium and continued the same dexamethasone treatment. At Emory, her glucose tolerance tests were abnormal and her insulin levels were elevated. Emory psychiatrist stopped all psychotropic medications and dexamethasone. They and some endocrinologists diagnosed HAIR-AN syndrome (hyperandrogenism, insulin resistance, and acanthosis nigricans). They prescribed OCs and within several weeks her mood improved. 2 months later she was fine and had lost 25 lbs. The primary disturbances of HAIR-AN syndrome are insulin resistance and hyperandrogenism. These 2 disturbances together cause acanthosis nigricans.
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PMID:Organic mood disorder associated with the HAIR-AN syndrome. 855 59

Regular exercise is an effective nonpharmacologic therapy for stress, sleep disorders, depression, and anxiety, as well as such chronic conditions of aging as hypertension, obesity, diabetes mellitus, coronary artery disease, hyperlipidemia, and constipation. Pre-exercise office assessment of cardiac risk, possible limitations, and contraindications is advised. A balanced fitness training program includes activities to increase flexibility, strength, and cardiovascular endurance. The most effective exercise prescription begins with a type of aerobic activity the patient enjoys. A prescribed schedule of stepwise increments in frequency, duration, and intensity gradually leads to a maintenance level of fitness.
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PMID:Prescribing physical activity for older patients. 163 24


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