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

Jejunoileal bypass operation was originally done to promote weight loss for treatment of morbid obesity. We used such a model to determine if dietary vitamin absorption is compromised by such an operation. Six rats were subjected to a jejunoileal bypass, 6 control rats were pair-fed to bypassed rats; and 6 were fed ad libitum. Vitamin content of folic, B6, riboflavin, nicotinate, pantothenate, thiamin, biotin, B12, vitamins A, E, and carotene in blood and liver was determined after 8 postoperative weeks. Aside from riboflavin, blood vitamin levels were significantly depressed in bypassed rats. The deepest depression was seen for B12, carotene and vitamin E. Liver vitamin stores of folate, riboflavin, thiamin, B12, clearly were significantly depressed in the bypassed animals compared to the pair-fed and ad libitum-fed controls. This model can serve for rapidly studying micronutrient depletion due to malabsorption without dietary manipulation or antibiotics for gut sterilization.
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PMID:A jejunoileal bypass rat model for rapid study of the effects of vitamin malabsorption. 158 7

One hundred thirty-one patients who gave a history of childhood sexual abuse were seen in a general medical practice decades after the event and were compared with a control group. The subject patients were found to be distinct for chronic depression, morbid obesity, marital instability, high utilization of medical care, and certain psychosomatic symptoms, particularly chronic gastrointestinal distress and recurrent headaches. It is clear that these remote events can underlie difficult chronic medical problems. Questions about childhood sexual abuse must become part of the practitioner's review of systems in these difficult cases, if not routinely.
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PMID:Long-term medical consequences of incest, rape, and molestation. 160 4

p-[(R)-3-[bis-[(R)-beta-hydroxyphenethyl]amino]butyl]benzamide (Ro 16-8714/000) is one of the most effective compounds, of a new series of calorigenic bis-phenethanolamine derivatives, which combine anti-obesity and antidiabetic qualities. Ro 16-8714 exhibited potent stimulation of oxygen consumption in normal rats and obese mice and rats. Calorigenesis appeared to be directly mediated by beta-adrenoceptors. Ro 16-8714 stimulated brown adipose tissue (BAT) thermogenesis in vitro and increased BAT calorigenic capacity in obese rodents during prolonged treatment. Furthermore, the compound induced fat mobilization and oxidation in normal and obese rats. Subchronic treatment of obese mice revealed potent antidiabetic effects which were mainly due to stimulation of carbohydrate oxidation. Prolonged treatment of obese mice and rats resulted in inhibition of body weight gain and depression of body fat content while body protein was maintained. The compound may, therefore, offer a new approach to the treatment of morbid obesity and maturity-onset diabetes.
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PMID:Phenethanolamine derivatives with calorigenic and antidiabetic qualities. 653 94

The authors present results of a prospective, controlled longterm follow-up study of patients undergoing a gastric procedure for morbid obesity. Pre-operatively the gastric surgery group (GS) was compared with a group of normal weighted (NC) and obese (OC) individuals participating in self-help weight reduction groups. The GS group was assessed at 3-months, 6-months and one year or more post-operatively. All groups were examined by a structured self-rating schedule reflecting personal characteristics and family history, current attitudes and experiences related to personal weight, and an extensive exploration of eating habits. Moreover, the groups completed the Minnesota Multiphasic Personality Inventory (MMPI), the Katz Adjustment Scale and the Zung Self-rating Depression Scale. The results demonstrated major differences between the GS and the NC and OC groups initially, and at follow-up; the GS demonstrated major weight loss without major psychopathologic reactions. The GS did not show, however, major alterations in eating habits, but clearly showed behavioural change subsequent to weight loss.
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PMID:Behavioural changes following gastric surgery for morbid obesity: a prospective, controlled study. 666 17

Twenty consecutive patients undergoing gastric bypass for morbid obesity were evaluated psychologically preoperatively and postoperatively by Minnesota Mulitphasic Personality Inventory (MMPI) assessment, a Problem Index designed for the study, and semistructured interviews. Patients were classified into categories based on the extent of psychopathology demonstrated preoperatively, and into categories based on the presence or absence of postoperative complications. Eighty percent of the patients continue to do well or improve psychologically. Patients with postoperative complications showed no significant change in psychological status. Patients who did not experience postoperative complications showed significant improvement in depression, hysteria, poor morale, psychoticism, phobias, and health concerns. Psychological changes with surgery did not correlate with weight loss. All patients with complications were unmarried and more likely to be moderately or severely disturbed on preoperative MMPI assessment.
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PMID:Gastric bypass for morbid obesity: preoperative and postoperative psychological evaluation of patients. 735 Aug 83

Our discussion focuses on theoretical and applied considerations for psychological care of the morbidly obese patient presenting for surgical correction of this refractory condition. Observations are gleaned from a biomedical literature review and our clinical experiences in the design and implementation of the psychological component in our extant multidisciplinary bariatric surgery program at Universal Medical Center, Plantation, Florida. The clinical sample includes 401 patients receiving vertical banded gastroplasty, Roux-en-Y gastric bypass and silastic ring gastroplasty from September of 1986 to May of 1994. Beyond a consideration of the psychological sequelae of depression, anxiety and addictions, we discuss the specific impact of psychosocial stress and implications of the morbid obesity archetype, with particular emphasis on iratrogenic medical stereotype. Owing to the nature of this report, and the literature review, our impressions are anecdotal and clinical. However, when considered against the undeserved and misconceived needs of the morbidly obese patient, we propose that a comprehensive multidisciplinary program incorporating psychological service is not only of critical benefit in enhancing patient co-operation, but also in securing patients' dramatic quality of life change. Recommendations for future research and the development of standardized psychological care models for the morbidly obese patient conclude the discussion.
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PMID:The Psychology of Bariatric Surgery. 1074 3

Eighteen out of 22 consecutive patients undergoing vertical banded gastroplasty were reviewed with regard to preoperative psychological assessment and postoperative outcome. Each patient was initially evaluated by a consultant liaison psychiatrist with regard to previous or ongoing psychological disturbance, and suitability for bariatric surgery. Patients could be grouped into three broad categories: Group A (seven patients) those with no psychiatric abnormality; Group B (six patients) those with minor psychiatric disorders such as sociopathic teenage behavior, outpatient treatment for depression; and Group C (five patients) those with a history of major psychiatric disturbance such as depressive psychosis and drug dependency. Psychiatric morbidity had no adverse effect in terms of postoperative outcome or weight loss. Mean weight loss of 26%, 30% and 33% was recorded in groups A, B and C respectively after a mean follow-up period of 33 months following gastroplasty. The occurrence of postoperative psychiatric problems correlated closely with none of seven patients in group A but in four of the five patients in Group C requiring psychiatric management. Our findings indicate that psychiatric illness is not associated with poor outcome following surgery for morbid obesity and such patients should not be excluded if psychiatric support is available before and after surgery.
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PMID:Psychological Profile and Outcome in Patients Undergoing Gastroplasty for Morbid Obesity. 1077 13

Double pituitary adenomas are rare in surgical specimens and the most common clinical feature in reported patients has been acromegaly. We report 3 cases of double pituitary lesions in patients who presented with Cushing's disease. In a 22-year-old man (case 1) with delayed puberty and low testosterone levels, mild hyperprolactinemia was diagnosed and treated with dopamine agonist therapy that reduced the prolactin (PRL) levels to normal. Over a 1-year period Cushing's disease developed gradually and was confirmed with classical endocrine testing. In a 27-year-old woman (case 2) who initially presented with severe depression and morbid obesity there was a gradual onset of Cushing's disease; initially she had minimally elevated serum PRL. In a 33-year-old woman (case 3) there was a 2-year history of Cushing's disease characterized by hirsutism, hypertension and weight gain; serum PRL was normal. Magnetic resonance imaging in all 3 patients revealed a microadenoma that was successfully removed by transsphenoidal pituitary surgery. Histology and immunocytochemistry in case 1 and case 3 revealed a corticotroph cell adenoma and a PRL cell adenoma in separate areas of the pituitary. In case 3 the PRL cell adenoma was "silent" but in case 1 the PRL cell adenoma may have been the cause of the mild hyperprolactinemia. In case 2 nodular corticotroph hyperplasia was the cause of Cushing's disease and a "silent" PRL cell adenoma was also identified. We conclude from these cases and a literature review that double pituitary lesions may occur in patients with Cushing's disease. The corticotroph part of the double lesion may consist of a corticotroph cell adenoma or, as reported in this study, of corticotroph nodular hyperplasia. The counterpart of the double lesion may consist either of a "silent" PRL cell adenoma or a functional PRL cell adenoma causing hyperprolactinemia.
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PMID:Double pituitary lesions in three patients with Cushing's disease. 1138 80

The prevalence of obesity is increasing world wide, resulting in morbidity, mortality, and reduced quality of life. The aim of this study was to assess comorbidities and complaints of subjects with morbid obesity in comparison to milder forms of overweight. Therefore, 299 patients visiting our obesity consultation were examined and surveyed prospectively. 41% of the subjects were morbidly obese showing a significantly higher prevalence of arterial hypertension, edema, dyspnea, eczema and depression. Additionally, sleepiness, reduced work capacity, physical inactivity, disadvantages in social life and disturbed eating habits were observed more frequent. Evaluation of subjects with morbid obesity should include a large spectrum of complications, in order to be able to offer a comprehensive support and treatment.
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PMID:[Comorbidity and physical complaints in morbid obesity]. 1159 22

All patients who are candidates for laparoscopic fundoplication for the treatment of gastroesophageal reflux disease (GERD) should have a symptom review, barium swallow imaging, endoscopy, esophageal manometry, and ambulatory pH monitoring. The presence of a typical primary symptom, an abnormal 24-hour pH score, and a good response to acid-suppression therapy are predictive of a successful surgical outcome. The surgeon should be particularly wary of the following types of patients who may be referred for fundoplication but not have GERD: those who do not respond to proton pump inhibitors, those without esophagitis, those with only atypical symptoms, those in whom pH monitoring was done without previous manometry, and those with a borderline reflux score, severe vomiting, severe dysphagia and heartburn, unusual symptoms, severe depression, or morbid obesity.
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PMID:Preoperative evaluation of patients with gastroesophageal reflux disease. 1181 22


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