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

The studies were carried out on patients with cerebral and spinal pathology (transient disturbances of cerebral circulation, post-traumatic epilepsy, cervical myelopathy with segmental disorders, etc.). Despite the absence of the clinical manifestations of the pyramid syndrome most patients showed diversely directed shifts of the amplitude of the soleus muscle H-reflex, absence of the depression of this response on high-frequency stimulation, presence of the H-potential in the foot muscles, and an increase of the amplitude of the H-reflex (withdrawn by needle electrodes) of the anterior tibial muscle. It has been concluded that of greater diagnostic value for revealing subclinical forms of the pyramid-extrapyramid insufficiency are electrophysiological findings characterizing the state of the spinal inhibition mechanisms, rather than tests characterizing the level of the motor neuron activity.
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PMID:[Diagnosis of subclinical manifestations of the pyramidal syndrome by stimulation electromyography]. 52 15

Part 1 of this paper, published in the last issue, dealt with the sequence of emotional reactions of patients in the Spinal Cord Injury Center at New York University Hospital. Part 2, presented here, considers the reactions of family members and staff through these same stages of shock, denial, anger, and depression, and further discusses implications for treatment.
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PMID:Emotional reactions of patient, family, and staff in acute-care period of spinal cord injury: part 2. 59 70

The purpose of this study was to attempt to collect sufficient data to substantiate the clinical impression that the degree of depression in the paraplegic and his past history are correlated. It was hypothesised that the poorer the past history, the greater the degree of depression in paraplegic individuals. This study was conducted on ten paraplegic subjects from the Spinal Cord Clinic at Columbia Presbyterian Medical Center, Department of Rehabilitation Medicine, based on data obtained from the administration and scoring of the Depression Scale (D-scale) of the Minnesota Multiphasic Personality Inventory (MMPI) and by the clinical observation by the consulting psychiatrist with the Spinal Injury Clinic. Past history was assumed measurable as 'favourable' to 'poor' by the use of an original questionnaire. The results of this investigation suggested a relationship between a paraplegic individual's past history and the degree of depression. The study was deemed significant in presentation of an original past history questionnaire and in the prediction of future difficulties in the rehabilitation of paraplegics so that preventive measures could be instituted.
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PMID:Past history and degree of depression in paraplegic individuals. 73 90

In the Spinal Cord Injury Center at New York University Hospital, designed for optimal application of acute-care methods to the newly spinal cord injured, social workers have had the opportunity to observe the various emotional reactions of patients, family members, and staff during the crisis period. Four different types, or stages, of reactions have been identified: shock, denial, anger, and depression. Description and analysis of these stages are presented here with implications for treatment, as well as their significance in the long-term rehabilitation period that usually follows. Part 1 of this paper presents introductory material and description of the patients' reactions. Part 2, in the succeeding issue, will present reactions of family and staff.
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PMID:Emotional reactions of patient, family, and staff in acute-care period of spinal cord injury: part 1. 91 17

Neurologic manifestations of vitamin B12 deficiency are protean, including neuropathy, depression, and dementia. We present evidence to dispel confounding myths about vitamin B12 deficiency. Hematologic indices are normal in up to 30% of patients with vitamin B12 deficiency, and results of the Schilling test may be normal in patients with symptoms of deficiency. Isolated neuropathy or myelopathy may occur independently, but often appear concurrently. The neuropathy is primarily axonal and predominantly sensory. Myelopathy is caused by demyelinated areas in posterior and lateral columns. After therapy, recovery from neuropathy is incomplete or may extend for several years. Vitamin B12 replacement should not be withheld from patients with borderline vitamin B12 levels, since the consequences of allowing myelopathy, neuropathy, dementia, and mental disorders to worsen clearly outweigh any disadvantage of therapy.
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PMID:Myths about vitamin B12 deficiency. 174 82

We investigated the efficacy of interferon-alpha (IFN-alpha) treatment in 5 patients with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). Treatment with IFN-alpha yielded clinical improvement of gait, and sensory and/or sphincter disturbance in 4 out of the 5 HAM patients. IFN-alpha treatment did not bring about uniform changes in lymphocyte subsets or anti-HTLV-I antibody titer of peripheral blood. Although the stimulation indexes to phytohemagglutinin, concanavalin A, and pokeweed mitogen were decreased in the culture of the peripheral blood lymphocytes (PBL) in the 5 HAM patients before the treatment, the stimulation indexes to these mitogens were significantly increased except in 1 case after the IFN-alpha treatment. These changes were based primarily on the depression of the spontaneous proliferation of PBL without mitogen. These results appear to point out a very important phenomenon for the investigation of the pathogenesis of HAM.
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PMID:The efficacy of interferon-alpha treatment in human T-lymphotropic virus type-I-associated myelopathy. 227 19

Acquired Immune Deficiency Syndrome (AIDS) has been spreading in Africa and other continents of the world. While there is a dearth of information on AIDS-related neuro-psychiatric disorders in the African population, data from Europe and America indicate that patients with AIDS experience a lot of psycho-social difficulties and suffer from a variety of psychiatric syndromes such as anxiety state, depression, manic illness and schizophreniform disorder. Neurological sequelae of AIDS include acute and sub-acute encephalitis, meningitis, myelopathy, chorioretinitis and peripheral neuropathy. These changes may occur from direct neuropathic effects of human immuno-deficiency virus (HIV) or secondary to opportunistic infections and neoplasms involving the central nervous system. It is suggested that psychiatrists need to be fully involved at all levels of clinical care, education and research on AIDS. Attention should be focussed on the neuro-psychiatric consequences of AIDS in the African population to allow for cross-cultural comparison. In addition, the need to incorporate information and education programmes on AIDS into the primary health care programmes of developing countries is emphasised.
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PMID:Neuro-psychiatric manifestations of acquired immune deficiency syndrome (AIDS). 228 34

The meaning of a low serum cobalamin level when the classic findings of pernicious anemia are lacking is undergoing reevaluation. We therefore studied the neurologic status of 11 patients who had low cobalamin levels without definite hematologic evidence of deficiency. Neurologic evaluation included pattern-shift visual and median and posterior tibial nerve somatosensory evoked potentials. None of the patients had megaloblastic changes in the blood or bone marrow, although 7 of the 11 had subtle cellular cobalamin disturbances demonstrated by an abnormal deoxyuridine suppression test result. Seven patients had normal Schilling test results and 2 had borderline results; however, 2 of the 5 patients tested further had food-cobalamin malabsorption, while a third had prepernicious anemia. The patients displayed a variety of neurologic problems, including dementia, depression, myelopathy, neuropathy, and seizure disorder; 1 patient was neurologically normal by clinical criteria. Evoked potential abnormalities were demonstrable in 8 of the 9 patients with subtle cobalamin deficiency, and in at least 5 cases the disturbance was central. In contrast, both patients whose low serum cobalamin levels were found on evaluation to be spurious had normal evoked potentials. Evoked potential abnormalities improved in the one patient retested after cobalamin therapy. These findings demonstrate that neurologic deficits occur not only in classic cobalamin deficiency but also in subtle or atypical cobalamin deficiency states in which anemia is absent and Schilling test results are normal. Electrophysiologic evidence of neurologic impairment is often present, even in patients without obvious clinical neurologic abnormalities.
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PMID:Neurologic and evoked potential abnormalities in subtle cobalamin deficiency states, including deficiency without anemia and with normal absorption of free cobalamin. 239 29

Anterior stabilization with combined plate and bone fusion was performed after neural decompression on ten patients for spondylotic cervical myelopathy, and for radiculopathy or trauma in three patients. Medial corpectomy was performed at one to four levels. Iliac crest or fibular bone grafts were secured by plates anchored to the graft and adjacent vertebral bodies. All patients were placed in Minerva braces postoperatively. There was successful fusion in all cases, and no graft dislodgement or kyphosis. Early initiation of rehabilitation was achieved. Morbidity occurred in patients with severe spondylotic cervical myelopathy. This include respiratory depression requiring reintubation in 2/13 procedures, dysphagia (2/13) from loosening of the screws or prominent hardware and graft, and screw loosening (2/13). Neurological improvement was present in 85% (11/13) of patients. There was no deterioration of neurological function in any case. We conclude from this early follow-up that anterior bone fusion with supplemental plates provides effective stabilization for the unstable cervical spine. Greater morbidity risk exists in patients with severe spondylotic cervical myelopathy and spastic quadriparesis who required multilevel medial corpectomies and fusion.
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PMID:Cervical stabilization by plate and bone fusion. 338 10

During a two-year period we admitted 13 respirator-dependent quadriplegic patients to the spinal cord injury service at Wood VAMC for weaning from a mechanical ventilator, and rehabilitation. The patients were sent to the Spinal Cord Injury Center because initial weaning attempts from the respirator at other medical centers were unsuccessful. We successfully weaned them from the respirator, and at the time of discharge, only two patients required an indwelling tracheostomy tube for suction. The time required for weaning off the respirator varied from two days to 14 months. Most of the patients were discharged and many of them could independently perform the activities of daily living. We conclude that are four main factors which influence the successful weaning of dependent quadriplegics from the mechanical ventilator: alleviation of patient's anxiety and depression; family support; close working relationship between staff; prevention of complications such as pneumonia and urinary tract infections.
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PMID:Respirator-dependent quadriplegics: problems during the weaning period. 384 80


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