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)

An association between the ingestion tryptophan and a syndrome characterized by scleroderma-like skin abnormalities, fasciitis, and eosinophilia has recently been recognized in the United States. We report the clinical and histopathological findings in nine patients and the results of biochemical analyses of tryptophan metabolism in seven patients with this syndrome. Edema of the extremities, frequently accompanied by pruritus, paresthesia, and myalgia, developed in the nine patients (six women and three men; age range, 30 to 66 years) 1 to 18 months after the start of therapy with tryptophan (1.5 to 3.0 g daily) for insomnia, depression, or obesity. Five patients were taking drugs (benzodiazepines) known to inhibit hypothalamic-pituitary-adrenal function, and one had adrenal insufficiency. All had blood eosinophilia in the acute phase of their illness (mean eosinophil count [+/- SD], 3.62 +/- 2.87 X 10(9) cells per liter). All had histopathological changes in the dermis and subcutaneous tissue typical of scleroderma, and seven patients had eosinophils. The fascia was inflamed and fibrotic, and adjacent skeletal muscle often showed perifascicular inflammation. Tryptophan was discontinued in all patients, and eight received prednisone. The cutaneous symptoms improved, but only two patients had complete resolution of their illness. The patients had plasma levels of tryptophan before and after an oral dose of tryptophan that were similar to those in normal subjects. Plasma levels of L-kynurenine and quinolinic acid, which are metabolites of tryptophan, were significantly higher in four patients with active disease than in three patients studied after eosinophilia had resolved or in five normal subjects (P less than 0.001)--findings consistent with the activation of the enzyme indoleamine-2,3-dioxygenase. This illness resembles eosinophilic fasciitis and probably represents one aspect of the recently reported eosinophilia-myalgia syndrome. The development of the syndrome may result from a confluence of several factors, including the ingestion of tryptophan, exposure to agents that activate indoleamine-2,3-dioxygenase, and possibly, impaired function of the hypothalamic-pituitary-adrenal axis.
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PMID:Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan. 231 25

Principal objectives in obesity management comprise the prevention of weight gain, the promotion of weight loss, and the treatment of obesity-related complications, including diabetes, hypertension, and depression. Serotonin agonists reduce food intake. The resultant weight loss is variable and there appears to be no way of predicting good responders, nor is there evidence that additional weight loss attributable to drug therapy is sustained once treatment is discontinued, although nonpharmacological strategies for preventing weight regain are worthy of exploration. Serotonin agonists are of clinical value if there is a short-term need for weight reduction or if long-term pharmacotherapy can be justified. This implies that sometimes the dangers of the obese state outweigh the potential hazards of drug treatment. Clearly, if the same agent also improves diabetic control, blood pressure, or depression then a longer term usage is more readily justified. The extent to which this may be achieved by the currently available 5-HT agonists is discussed.
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PMID:Appraisal of the clinical value of serotoninergic drugs. 172 33

Vigorous physical activity can improve the health of both adults and children. Among adults, regular physical activity can reduce risk for chronic diseases such as coronary heart disease, hypertension, noninsulin-dependent diabetes mellitus, colon cancer, and depression, as well as lower all-cause death rates (1,2). Among children, regular physical activity can reduce chronic disease risk factors such as obesity, elevated cholesterol, and hypertension (3). Physical activity patterns established during childhood may extend into adulthood (4). This report examines the prevalence of vigorous physical activity among U.S. students in grades 9-12.
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PMID:Vigorous physical activity among high school students--United States, 1990. 173 Nov 78

Adiposis dolorosa or Dercum's disease consists of a painful progressive localized state of obesity with four cardinal symptoms: a) painful circumscribed or diffuse fatty deposits, b) generalized obesity in women usually of menopausal age, c) asthenia, weakness and frequently tendency to fatigue and d) mental phenomena including emotional instability, depression, epilepsy, mental confusion and true dementia. Only a few cases in men have been described. The pain may be treated with intravenous administration of lignocaine or oral mexitil while no causal treatment is known. An illustrative case is reported.
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PMID:[A case of adiposis dolorosa--Dercum's disease]. 150 54

Female hormonal contraceptives, introduced commercially in 1959, contained 10 mg of norethynodrel and .15 mg of mestranol. The estrogen and progesterone doses were progressively reduced over time. In 1989, approximately 60 million couples used oral contraceptives (OCs) ranging from 1% in Japan to 40% in the Netherlands. The monophasic pill contains .01 - .04 mg of ethinyl estradiol (EE), and the biphasic pill contains increasing doses of progesterone and estroprogesterone in the course of the menstrual cycle. Triphasic combined pills contain an initially dominant estrogen dose. In oral sequential pills, estrogen is given on days 14-16 followed by a estroprogesterone for 5-7 days. Micropills with progesterone, injectables with medroxyprogesterone, and 3rd-generation OCs such as gestoden with a low progesterone dose of .04 mg/day and reduced androgenic activity are among other OCs. The OCs are administered in 21-22 day packets. Absolute contraindications include history of venous thrombosis, atherogenic lipid profile, hormone-dependent cancer, and allergy. Relative contraindications include arterial ailments, smoking, hypertension, older age, obesity, and familial history of cardiovascular and cerebrovascular accidents. Interactions with antibiotics (ampicillin and tetracycline) occur as the modified intestinal flora reduces the level of deconjugated EE. Most frequent side effects are depression, modification of libido, ocular disorders, headache, and urinary infection. Benefits include favorable modification of menstrual cycle, and reduction of endometriosis and endometrial and ovarian cancer. Systemic risks such as cardiovascular and blood coagulation effects occur mainly with high-dose OCs. Further topics addressed are the cancer risk and protective effect of OCs, postcoital OCs, traditional contraception, the IUD, RU-486, implants, vaccination with the human antigonadotropine, and the vaginal ring.
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PMID:[Family planning with different contraceptive methods]. 182 14

A closed-claim analysis of anesthetic-related deaths and permanent injuries in the dental office setting was conducted in cooperation with a leading insurer of oral and maxillofacial surgeons and dental anesthesiologists. A total of 13 cases occurring between 1974 and 1989 was included. In each case, all available records, reports, depositions, and proceedings were reviewed. The following were determined for each case: preoperative physical status of the patient, anesthetic technique used (classified as either general anesthesia or conscious sedation), probable cause of the morbid event, avoidability of the occurrence, and contributing factors important to the outcome. The majority of patients were classified as American Society of Anesthesiologists (ASA) status II or III. Most patients had preexisting conditions, such as gross obesity, cardiac disease, epilepsy, and chronic obstructive pulmonary disease, that can significantly affect anesthesia care. Hypoxia arising from airway obstruction and/or respiratory depression was the most common cause of untoward events, and most of the adverse events were determined to be avoidable. The disproportionate number of patients in this sample who were at the extremes of age and with ASA classifications below I suggests that anesthesia risk may be significantly increased in patients who fall outside the healthy, young adult category typically treated in the oral surgical/dental outpatient setting.
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PMID:Major morbidity or mortality from office anesthetic procedures: a closed-claim analysis of 13 cases. 183 16

The present study compared the relative effectiveness of a therapist-supported maintenance condition with a minimal contact maintenance condition in preventing relapse following an obesity treatment program. Thirty-two subjects who completed an initial 12-week cognitive/behavioral plus aerobic exercise treatment program were matched on absolute weight loss and randomly assigned to one of two maintenance conditions. Subjects were assessed at pretreatment, posttreatment, and 3, 6, and 12 months following posttreatment using measures of weight, blood pressure, and depression. Three- and six-month follow-up results indicated that subjects who participated in the therapist-supported maintenance group continued to lose weight and/or maintained therapy-induced weight loss to a greater degree than control subjects. At the 12-month follow-up assessment therapist-supported subjects maintained therapy-induced weight loss better than the control subjects. These findings suggest that maintenance programs which provide continued contact emphasizing relapse prevention training may be an important adjunct in the maintenance of therapy-induced weight loss.
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PMID:Preventing relapse in obesity through posttreatment maintenance systems: comparing the relative efficacy of two levels of therapist support. 187 5

Waist to hip ratio (WHR) was measured in 487 middle-aged women participating in the Healthy Women Study. Upper body fat distribution was found to be associated with numerous behaviors that affect cardiovascular risk, including smoking, low exercise levels, weight gain during adulthood, and higher caloric intake. Moreover, WHR was also associated with higher levels of anger, anxiety, and depression and lower levels of perceived social support. Women with upper body fat obesity had higher systolic blood pressure, total cholesterol, low density lipoprotein cholesterol, triglycerides, and apolipoprotein B and lower levels of high density lipoprotein (HDL) and the HDL subfractions 2 and 3. These associations remained significant after adjusting for body mass index. Among 108 women who had repeat measurements of WHR, changes in WHR over a 3-year period were significantly correlated with changes in activity and with decreases in HDL2. Thus, WHR appears to be an integral component of the cardiovascular risk profile. WHR is related to those behaviors and psychosocial attributes that influence cardiovascular risk.
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PMID:Waist to hip ratio in middle-aged women. Associations with behavioral and psychosocial factors and with changes in cardiovascular risk factors. 191 10

A neural mechanism may underlie the divergent weight gain patterns of rats fed a high-energy diet; half develop diet-induced obesity (DIO), whereas the rest are diet resistant (DR). Male rats were fed chow (n = 14) or a high-energy diet for 3 mo with the development of DIO (n = 11) or DR (n = 12). DIO rats had 159-219% heavier retroperitoneal fat pads and 158% higher plasma insulin levels than chow-fed and DR rats, but plasma glucose levels were equal. Rats were trained to drink glucose after an overnight fast and were tested for local cerebral glucose utilization using 2-deoxy-D-[14C]glucose autoradiography in the presence or absence of 0.15% saccharin substituted for glucose. Saccharin intake increased 2-deoxyglucose uptake in the rostral nucleus tractus solitarius of DR but not DIO or chow-fed rats. Also, DIO rats had reduced basal 2-deoxyglucose uptake in the central amygdaloid nucleus. High-energy diet intake was associated with saccharin-induced depression of 2-deoxyglucose uptake in the inferior olive and increased utilization in the medial amygdaloid nucleus of both DR and DIO rats. Thus DIO rats have diminished basal and food-related neuronal activity in certain brain areas involved in food intake and autonomic function. Furthermore, dietary content affects glucose utilization in areas not usually associated with these functions.
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PMID:Defective cerebral glucose utilization in diet-induced obese rats. 192 25

A 53-year-old man with cushingoid appearance--obesity, osteoporosis causing lumbar and thoracic vertebral collapse and a past history of hypertension and depression presented with symptoms and signs of adrenocortical insufficiency. He denied the use of corticosteroid medication. However, it was eventually discovered that he had used clobetasol propionate (Dermovate), a potent topical steroid cream, for five years. The development of adrenal insufficiency symptoms coincided with the withdrawal of the cream.
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PMID:Unrecognised Cushing's syndrome and adrenal suppression due to topical clobetasol propionate. 193 50


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