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)

Cytomegalovirus (CMV) infections acquire characteristics of special severity when they occur in patients suffering primary or secondary cellular immune depression. We present a case of pneumonia with fatal evolution caused by CMV, in a female patient suffering systemic lupus erythematosus. The underlying disease, of recent onset, presented multiorgan involvement (skin, joints, kidney, blood) which could be controlled with steroids and azathioprine. The patient presented a few days after she had overcome an acute outbreak of the disease, a febrile status with rapid evolution with a diffuse pulmonary interstitial infiltrate. Circulating anti CMV antibodies were detected, of IgM class, by a enzyme-immunoassay. The necropsy showed a multiorgan infiltrate (liver, lung, skin, kidney) with cells containing cytomegalic inclusion.
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PMID:[Cytomegalic inclusion disease in a patient with systemic lupus]. 164 51

The most frequently used postoperative analgesia techniques are intramuscular injection (IM) and patient controlled analgesia (PCA). Recently, the use of epidural catheter injection (EPI) has been done with success. This study was done to prospectively compare these three techniques for postoperative analgesia after extensive operations upon the colon and rectum. Patients were randomized to one of three analgesia groups--IM, intramuscular morphine sulfate; PCA, patient controlled morphine sulfate, and EPI, epidural morphine sulfate. Data collected included age, time to first bowel movement, amount of narcotic, number achieving 75 per cent of preoperative forced vital capacity, postoperative pruritus, headache, nausea and vomiting, respiratory depression, atelectasis or pneumonitis. A visual analog pain scale was used to evaluate postoperative pain severity (0, no; 1, partial; 2, marked, and 3, total relief). Sixty-eight patients were eligible for study (IM, 19; PCA, 22; EPI, 23, and excluded, four). The EPI group required significantly less daily narcotic compared with either the IM or PCA groups (17.0 +/- 6.12 milligrams; 67.8 +/- 26.8 milligrams; 40.5 +/- 20.6 milligrams, respectively, less than 0.05 ANOVA) and total narcotic (81.3 +/- 31.3 milligrams; 355.4 +/- 147.7 milligrams; 215.3 +/- 105.4 milligrams, respectively, p less than 0.05 ANOVA). EPI achieves excellent pain control in more patients with a significantly lower dose of narcotics and significantly fewer pulmonary complications. Therefore, epidural analgesia is the optimal method of postoperative analgesia after extensive abdominal operations.
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PMID:Epidural analgesia. 173 72

Groups of 50 F344/N rats of each sex and 50 B6C3F1 mice of each sex were gavaged with corn oil or a mixture of toluene diisocyanate (TDI) in corn oil for 5 days per week for 105 or 106 weeks. Female rats and mice were given doses of 60 or 120 mg/kg body weight, while male rats received 30 or 60 mg/kg, and male mice received 120 or 240 mg/kg. The TDI reacted with the moisture in the corn oil vehicle resulting in doses that were 10% to 23% below the target dose concentrations. The chemical product used was commercial grade TDI, which was an 80%-20% mixture of the 2,4- and 2,6-isomers. Chemical disposition and metabolism studies were conducted with each of the radiolabelled TDI isomers in male rats. Absorption of both of the TDI isomers occurred, with the highest concentrations found in the stomach, cecum, large intestine, and bladder. Excretion occurred via the feces and urine. The major metabolic products from the metabolism of 2,4-TDI were shown to be identical with those from the metabolism of the carcinogen, 2,4-diaminotoluene, whereas the metabolism of the 2,6-TDI isomer yielded one major product, identified as 2,6-bis(acetylamino)toluene. Greater than 10% depression in body weight gain occurred in all dosed groups of rats throughout most of the study. The major non-neoplastic lesions that were observed in both sexes of the TDI-exposed rats were dose-related increases in acute broncho-pneumonia, characterized as chemical pneumonitis, with incidences as high as 50%. In mice mean body weight gain was depressed in dosed male and in high dose females. The principle non-neoplastic lesion in mice that was attributed to chemical treatment was cytomegaly of the kidney tubular epithelium in males. Survival in all groups of dosed rats was significantly lower than in controls. A dose-dependent pattern of mortality did not commence until 70 weeks of exposure, demonstrating that toluene diisocyanate elicited a cumulative toxic response. There was also significantly lower survival in high dose male, but not female mice, by comparison to controls. Despite the reduction of power and sensitivity in the rat studies caused by early mortality, statistically significant increases in tumor incidences were observed in many different target organs. TDI was carcinogenic in F344/N rats, causing subcutaneous fibromas and fibrosarcomas in males and females, pancreatic acinar cell adenomas in males, and pancreatic islet cell adenomas, neoplastic nodules of the liver, and mammary gland tumors in females.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The carcinogenic activity of commercial grade toluene diisocyanate in rats and mice in relation to the metabolism of the 2,4- and 2,6-TDI isomers. 166 67

The morbidity and mortality of 11 femoral neck fractures were analyzed to compare operative and conservative management of femoral neck fractures in dialysis patients. All fractures occurred in older men with severe cardiac, pulmonary, gastro-intestinal, and neurologic conditions and with advanced renal osteodystrophy. Six of the seven operated patients survived the surgery and achieved varying degrees of ambulation. Stability of the operated hip was excellent in each case. Post-operative complications included transient confusional state related to narcotics, pneumonia, decubitus ulcers, and severe hypoalbuminemia. All four patients who were managed conservatively died from complications of the fracture. Progressive deterioration was noted in each nonoperated patient, with confusion caused by narcotics and analgesics, pneumonia, hepatic coma, decubitus ulcers, severe depression, and severe hypoalbuminemia. Therefore, operative management was superior to conservative management for femoral neck fractures of patients receiving chronic dialysis with multiple medical problems and advanced renal osteodystrophy. Narcotics must be used with great caution, and efforts should be directed toward prevention of malnutrition and decubitus ulcers.
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PMID:Femoral neck fractures in patients receiving long-term dialysis. 222 28

Continuous economic development and evolving social systems have created unique challenges for school health personnel in Taiwan. Due in part to economic growth and an improving health care system, average life expectancy has increased markedly for males and females since 1950. Traditional leading causes of death such as pneumonia, tuberculosis, and gastroenteritis have been replaced by accidents, neoplasms, and cardiovascular diseases. Schoolchildren suffer from various disorders that include hepatitis B, dental caries, and health problems related to scholastic pressure such as myopia, anxiety, and depression. However, new problems such as violence, substance use, and teen-age pregnancy may develop in the future. In response to the challenge, an extensive school health program has emerged that emphasizes school health instruction, school health services, and a healthful school environment. Increased attention has focused on teacher preparation in health education, and a cooperative approach to school health promotion emphasizes school, community, and interagency cooperation. Prompted by the establishment in 1980 of the Graduate Institute of Health Education, National Taiwan Normal University, school-based research initiatives have increased dramatically. Eighteen recommendations for further improvement are offered.
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PMID:Taiwan, R.O.C.: perspectives in school health. 224 77

We report the case of a 72 year old woman treated for seven months for Horton's disease presenting with a cavitating pneumonia of the left axillary segment associated with a deterioration of the general state, at the time of which the steroid therapy was in the course of being decreased. The radiological appearance and the clinical context of immune depression had led to a trial of a quadruple anti-tuberculous therapy in spite of the absence of any bacteriological proof. This rapid aggravation of the condition under treatment led to the suggestion of a pulmonary localisation of Horton's disease. The rapid regression of the lesions after increasing the dose of steroids and the negative cultures on Lowenstein medium pleaded in favour of this hypothesis. However the continuation of anti-tuberculous treatment seems justified in such cases in so far as the diagnosis of Horton's disease of the lung often cannot be maintained other than retrospectively in the absence of histological proof.
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PMID:[Steroid-sensitive cavitating pulmonary opacity in Horton's disease]. 225 38

Nutrition in acute spinal cord injury is complicated. Not every aspect of nutrition as it relates to the acutely injured spinal cord patient is known. The stress response to injury, fever, infection, sepsis, and surgery alter nutritional needs, as does the spinal cord injury itself. The sequelae of spinal cord injury, including denervation atrophy and paralysis, glucose intolerance, skin and wound breakdown, poikilothermy, anemia, respiratory paralysis, pneumonia, paralytic ileus, gastrointestinal ulcers and hemorrhage, neurogenic bowel and bladder, and depression, all affect the nutritional needs of the patient. Orthopedic appliances, pharmacologic agents, and other injuries can also alter nutritional requirements. Nutritional assessment in acute spinal cord injury is also complex. It should include medical and diet history, physical examination, intake and output measurements, prediction of energy expenditure and protein requirements, or--even better--measurements of energy expenditure with indirect methodology, using the metabolic cart or pulmonary artery catheter. Application of computerized tomography and radioisotope studies may prove valuable in the future. Finally, the direct relationship between nutrition and physiologic alterations of acute spinal cord injury necessitates that the critical care nurse incorporate nutrition-focused thinking into many aspects of the acute spinal cord--injured patient's care.
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PMID:Nutrition in acute spinal cord injury. 226 60

The lung is directly affected by HIV virus early in the disease and is the site of a specific lymphocytic alveolitis. Neoplastic pulmonary disease linked to the virus occurs (Kaposi sarcoma, lymphoma and epidermoid tumour) but it is principally following opportunistic infections that patients with AIDS come under the care of a respiratory physician. Certain of the responsible infectious agents causing opportunistic pneumonia are probably present in a latent fashion before the disease presents and are reactivated by the immuno-depression. They may occur successively such as tuberculosis, toxoplasmosis (in this case pulmonary), infection to CMV and pneumocystis. Other infectious agents are transported by the environment and lead to recurrent bacterial infections, mycotic infections or infections with atypical mycobacteria. The clinical management of these different diseases has advanced greatly from a diagnostic therapeutic prophylactic and curative viewpoint.
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PMID:[Clinical management by the respiratory physician of patients with HIV infections]. 227 Mar 40

The diagnosis of drug-induced pneumonitis is generally difficult, and it is made clinically by Tamura's criteria. We experienced 12 cases (7 definite and 5 possible cases) of antimicrobial drug-induced pneumonitis (one of case was the first case caused by carbapenem). Symptoms such as fever (11/12), cough (10/12) and dyspnea (10/12) and laboratory data such as eosinophilia (7/12), elevation of IgE (4/6) and hypoxia (11/12) were commonly seen in these patients, although they were not specific. Lymphocyte stimulation test (5/11) and provocation test (4/8) were quite suggestive of drug allergy. Bronchoscopy has been used for confirmation of pneumonitis. Transbronchial lung biopsy revealed alveolitis (4/9) or alveolar fibrosis (3/9), and bronchoalveolar lavage showed lymphocytosis (6/6) and depression of OKT4/T8 ratio (3/5). The combination of bronchoscopic and immunological examinations were more confirmative for diagnosis.
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PMID:Clinical evaluation of 12 cases of antimicrobial drug-induced pneumonitis. 227 3

Herpes type infections in AIDS patients tend to be more severe, generalized and have a torpid evolution. We present here two cases of intravenous drug addicts with a clinical picture of ulcerative lesions with a scar in the perioral and ungual regions with an evolution of several months an which were diagnosed of Herpes Simplex by a histopathological study. They were treated with intravenous Acyclovir achieving a complete remission; one patient developed a pneumocystis carinii pneumonia a month later. We want to highlight the importance of this case as a clinical sign of profound cellular immunity depression as well as the risk of developing more severe conditions.
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PMID:[Herpes simplex infections in patients with AIDS]. 237 75


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