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)

We describe the case of a patient with psoriasis who developed severe colitis, with toxic megacolon, after a course of treatment with methotrexate. The duration of her colitis, which was eventually resolved by using conservative measures, was far greater than that of other drug-related complications, which included bone marrow depression, jaundice, and renal failure. The literature pertaining to this rare manifestation of methotrexate toxicity is reviewed. A prolonged illness and relative sparing of the distal colon appear to be characteristic of this form of colitis.
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PMID:Toxic megacolon associated with methotrexate therapy. 671 82

This study shows that referrals to psychiatry for evaluation for competence to give informed consent generally were made on patients who refused medical treatment. In this sample of referred patients, the only patients found to be incompetent to give informed consent were those with organic brain syndromes. No one with either schizophrenia or depression was found to be incompetent. It is possible that schizophrenic and depressed patients may generally be competent to give informed consent to medical treatment. This finding might be true notwithstanding the fact that many such patients have been found in other studies to be incompetent to consent to voluntary psychiatric treatment. For example, a patient may have delusions that others can read his mind and thoughts, but he still can understand that he needs dialysis for renal failure. Alternatively, it may be relatively rare that an emergency procedure is necessary before a patient's psychosis can be brought under control and consequently internists and surgeons themselves may prefer to wait. The significance of the results is unclear. Because of active interest in the doctrine of informed consent for psychiatric and medical patients by both physicians and attorneys and the few studies within this population, there is a strong need for more study regarding competence to give informed consent. Further study is especially important for psychotic patients for whom psychiatric consultation is not requested.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Competence to give informed consent for medical procedures. 674 44

Procaine esterase activity in plasma from patients with renal failure is decreased by 40%. Since cyanate is formed from urea and readily carbamylates certain blood proteins, a possible role for cyanate in the depression of plasma esterase activity in uraemic patients was considered. However, in vitro carbamylation of normal plasma in a range similar to that detected in uraemic patients did not influence procaine esterase activity. Kinetic analysis of the reaction showed that the maximal hydrolyzing capacity but not the Km in uraemic plasma was diminished (5.0 +/- 0.3 X 10(-5) moles hydrolyzed per litre of plasma per minute and a Km of 3.9 +/- 0.2 X 10(-5) mol/l in plasma from normal volunteers as compared to 3.1 +/- 0.1 X 10(-5) mol/l/min and 3.5 +/- 0.2 X 10(-5) ml/l in plasma from patients with renal failure). Therefore, not carbamylation but rather a decrease in enzyme synthesis is the likely explanation for the lower rate of procaine hydrolysis in uraemic plasma.
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PMID:Procaine hydrolysis defect in uraemia does not appear to be due to carbamylation of plasma esterases. 686 70

Identified systematically those spouses of male VA hemodialysis patients who are at risk for experiencing difficulties in adapting to their husband's chronic kidney failure and hemodialysis treatment. To this end, an exploration was made of personality variables that might enhance a spouse's ability to cope with the unique stress of living with chronic illness. Fifty-six wives of VA dialysis patients were administered the Rotter Internal-External Locus of Control Scale (I-E), the Multidimensional Locus of Control Scale (MLC), the Multidimensional Health Locus of Control Scale (MHLC), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Significant relationships were found between I-E scores and all measures of emotional adjustment (state anxiety, trait anxiety, and depression) for the entire sample of spouses in general, and also for a subgroup of home dialysis spouses who were analyzed separately. Results were discussed in terms of the role that locus of control orientation plays in mediating the stress of living with chronic illness, as well as the failure to find relationships between adjustment and the MLC or the area-specific MHLC.
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PMID:Personality variables in coping with the stress of a spouse's chronic illness. 687 77

Little is known about prognostic factors that determine outcomes after in-hospital cardiopulmonary resuscitation. We studied prospectively 294 consecutive patients who were resuscitated in a university teaching hospital. Forty-one patients (14 per cent) were discharged from the hospital; three quarters of them were still alive six months later. A multivariate analysis revealed that pneumonia, hypotension, renal failure, cancer, and a homebound life style before hospitalization were significantly associated with in-hospital mortality (P less than 0.05). None of the 58 patients with pneumonia and none of the 179 in whom resuscitation took longer than 30 minutes survived to be discharged. On the other hand, fully 42 per cent of the patients who survived for 24 hours after resuscitation left the hospital. At the time of discharge from the hospital and again six months later, 93 per cent of the survivors were mentally intact. Although depression was generally present at the time of discharge, it tended to resolve subsequently. However, all patients reported some decrease in functional capacity, often attributed to fear. This persisted at six months after discharge. Age alone did not appear to influence the prognosis for survival after cardiopulmonary resuscitation or the adjustment to chronic illness after discharge from the hospital.
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PMID:Survival after cardiopulmonary resuscitation in the hospital. 687 86

The clinical course of 40 patients with significant quantities of mixed cryoglobulins, but without lymphoproliferative, collagen-vascular or chronic infectious diseases, is presented. These cases comprise 51.3 percent of all mixed and 31.7 percent of all types of cryoglobulins evaluated by us over the period 1960--1978. A characteristic clinical syndrome, consisting of recurrent palpable purpura (100 percent), polyarthralgias (72.5 percent) and renal disease (55 percent), was seen. Biopsy specimens of skin lesions showed cutaneous vasculitis, and half had immune reactants in vessel walls. Seventy percent of patients had evidence of hepatic dysfunction, often subclinical, and more than 60 percent of those tested had serologic evidence of prior infection with hepatitis B virus. Hepatic lesions ranged from minimal triaditis to chronic active hepatitis and/or cirrhosis. All 22 patients in whom clinical renal disease developed had significant proteinuria; 63.6 percent had diastolic hypertension, 77.3 percent edema, 45.5 percent renal failure and 22.7 percent were nephrotic. Glomerular disease associated with deposition of immunoglobulin G, immunoglobulin M and complement, often with coexistent renal arteritis, was confirmed pathologically in 15 cases. All cryoglobulins had rheumatoid factor activity and consisted of IgM and polyclonal IgG; five also contained IgA. Thirteen had a monoclonal IgM kappa component. Serum protein electrophoresis was unremarkable or showed diffuse hyperglobulinemia. Striking depression of early complement components was noted but did not correlate well with the cryoprotein concentration, renal involvement or clinical course. Follow-up for periods up to 21 years from onset of symptoms revealed that renal involvement has a deleterious effect on prognosis. Postmorten examinations of nine patients demonstrated widespread vasculitis in addition to renal involvement. Preterminal infection was found in eight.
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PMID:Mixed cryoglobulinemia: clinical aspects and long-term follow-up of 40 patients. 699 82

The cell-mediated immunodeficiency secondary to renal failure is well established and is largely dependent on toxic or inhibitory serum factors. Our approach was to investigate the effect of so-called middle molecules (MM) on in vitro and in vivo immunological functions. A crude fraction of MM isolated from the serum or urines of uremic patients by chromatography on Sephadex G-25 fine was shown to markedly inhibit the lymphocyte proliferation induced in vitro by various phytomitogens or by allogeneic cells. A marked depression of the graft-versus-host reaction was demonstrated in vivo. When rats were continuously infused with MM, a significant delay of skin allograft rejection was obtained. From these results it is clear that the MM fraction contains a potent inhibitor of several T lymphocyte functions.
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PMID:Effect of middle molecules on immunological functions. 702 6

As part of a study of "Adaptation to home dialysis" we have examined psychological, physiological, and social factors influencing the success of 136 patients on home hemodialysis, followed for greater than 18 months. The study has demonstrated specific physical, psychological, and stress factors associated with increased probability of failure on home hemodialysis. In those under 45 years of age, the profile of failure is of higher diastolic blood pressure in training, more frequent episodes of congestive heart failure, higher levels of stress associated with varying health and loss of sleep and greater anxiety and depression. In the older age group failure was associated with higher levels of depression and self depreciation, and higher levels of stress associated with fear of death, pain during dialysis and blood clotting. On the other hand, higher denial levels were positively correlated with success. There were no significant differences between profiles of those patients who succeeded and those who died. Although analysis is based on a retrospective study, the time sequence between data collection and end points suggests that patient profiling can be used in a predictive manner. The study emphasizes the importance of psychological and social factor analysis in the overall management of the patient with renal failure.
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PMID:Psychological and physiological factors predicting the outcome on home hemodialysis. 706 72

366 charts are reviewed of patients admitted to the ICU of the Lausanne University Department of Medicine during 5 consecutive years for psychotropic drug overdose and treated by supportive management. 25% were severely intoxicated and 46 patients required ventilatory support either for aspiration pneumonia or CNS depression. The mortality rate was 0.5% and mean stay in the ICU 2.8 days. Neither the two deaths nor the complications (already established upon admission or within 6 hours of presentation) could have been prevented by hemoperfusion. The efficiency of conservative management raises questions about the value of extrarenal clearance technics in the absence of concurrent renal failure.
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PMID:[Prognosis of acute psychotropic drug poisoning. The Lausanne experience]. 711 64

A prospective study on the epidemiology of adverse drug reactions (ADR) in the 200 neonates consecutively admitted to a newborn intensive care unit had shown that 136 ADR occurred in 60 babies (incidence = 30%). 20 of these ADR (14.7%) were major (life-threatening), 34 (25%) were moderate (prolonged hospital stay) and 82 (60.3%) were minor (resolved spontaneously, no therapy required). Respiratory depression, cardiac arrhythmias, renal failure, metabolic abnormalities (hyperglycemia, electrolyte imbalance) and gastrointestinal bleeding were the most common major and moderate ADR. Hematologic (eosinophilia, thrombocytopenia) and metabolic (lipemia, hyperglycemia) were the most frequent minor ADR. The case fatality rate is 5%. Most commonly suspected drugs associated with the ADR were cardiovascular drugs (tolazoline, digoxin, methoxamine), antibiotics, diuretics and components of intravenous nutrition solutions.
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PMID:Epidemiology of adverse drug reactions in the newborn. 715 49


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