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)

Electrocardiographic (ECG) changes during microlaryngoscopy were studied with three methods of anaesthesia. In two main groups, balanced anaesthesia was induced by Althesin (=Althesin I group) in 98 patients or by thiopentone (=thiopentone group) in 68 patients. In 23 patients, halothane anaesthesia was induced by Althesin (=Althesin II group). During the procedure, the most common ECG changes in all groups were sinus tachycardia (54-78%), junctional rhythm (28-57%), ventricular ectopic beats (12-26%), T-wave changes (9-22%) and supraventricular ectopic beats (7-17%). There was no statistically significant difference in the total number of ECG changes between the groups. There was, however, significantly more sinus tachycardia in the Althesin II group (78%) than in the thiopentone group (54%). Junctional rhythm occurred significantly more often in the Althesin II group (57%) than in the Althesin I group (31%) or in the thiopentone group (28%). Upper junctional rhythm was most common in the Althesin I group, whereas middle junctional rhythm dominated in the Althesin II group. Ischaemic S-T segment depression did not occur in the thiopentone group, whereas in the Althesin I and II groups its incidence ranged from 6 to 13%. In all patients ECG changes disappeared without any special treatment after the manipulation of the vocal cords. The results suggest that there is no decisive difference in the occurrence of ECG changes between the three methods of anaesthesia.
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PMID:Comparison of electrocardiographic changes during microlaryngoscopy under balanced anaesthesia induced by althesin or thiopentone. 746 21

A retrospective evaluation of 244 electrocardiograms obtained at rest at time of diagnosis from a population of 254 patients with intrathoracic sarcoidosis was carried out. Thirty-five (14%) were abnormal. Sinus tachycardia was present in 17 (7%), the rest encompassing various degrees of right-sided bundle branch, atrioventricular first degree block, ventricular extrasystolia and ST-depression. At follow-up after a median time of 27 years we found a significantly higher mortality risk in the group with ECG-changes compared to those without. Excess mortality was increased when comparing patients with tachycardia to those without. However, when adjusted for FEV1, the risk of death was not significantly different between the two groups.
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PMID:Electrocardiographic changes in patients with intrathoracic sarcoidosis: influence on prognosis. 761 75

Venlafaxine hydrochloride is a novel bicyclic antidepressant which inhibits the reuptake of serotonin, norepinephrine and, to a lesser extent, dopamine. A 41-year-old female ingested 4.5 g venlafaxine, 500 mg diphenhydramine, 50 mg thiothixene and subsequently experienced severe central nervous system depression requiring intubation. She also developed elevated systolic and diastolic blood pressures and sinus tachycardia. The patient was decontaminated with gastric lavage and activated charcoal. She regained consciousness within a few hours and was extubated nine hours after ingestion. This case demonstrates that severe central nervous system depression may follow venlafaxine overdose.
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PMID:A case report of venlafaxine toxicity. 762 4

Amrinone and dobutamine compare favorably in the treatment of chronic congestive heart failure. There is increasing evidence that amrinone alone or in combination with a catecholamine may be used with considerable success in treating patients who are difficult to wean from cardiopulmonary bypass or who have a low cardiac output syndrome after coronary artery bypass grafting surgery. Amrinone increases intramyocardial cyclic adenosine monophosphate and exerts positive inotropic activity in addition to being a potent vasodilator. It may also improve diastolic function by increasing sarcoplasmic reticulum reuptake of calcium during diastole. It has been administered to patients prior to weaning from cardiopulmonary bypass and has improved hemodynamics and oxygen transport. When compared with dobutamine as primary treatment for depressed myocardial function in patients being weaned from cardiopulmonary bypass after coronary artery bypass grafting surgery, it was more effective in achieving primary treatment objectives. Patients given dobutamine had a higher incidence of myocardial infarction, ventricular fibrillation, supraventricular tachyarrhythmias, sinus tachycardia, and hypertension compared to those given amrinone. It is concluded that amrinone compares favorably with dobutamine and may even be superior when used as primary treatment for treating myocardial depression in patients having coronary artery surgery supported by cardiopulmonary bypass.
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PMID:The role of amrinone in treating heart failure during and after coronary artery surgery supported by cardiopulmonary bypass. 806 35

We compared electrocardiographic abnormalities and plasma norepinephrine concentration in 40 patients with subarachnoid hemorrhage within the first 24 hours, at 72 hours, and after 1 week. In the 20 patients with high plasma norepinephrine concentrations within the first 24 hours, sinus tachycardia and negative T waves were more frequently seen than in the 20 patients with normal plasma norepinephrine concentrations. After 72 hours, only sinus tachycardia was found with increased frequency in the 26 patients with high plasma norepinephrine concentrations. Although 24 patients had high plasma norepinephrine concentrations after 1 week, we found no difference in the frequency of electrocardiographic abnormalities as compared with patients with normal plasma norepinephrine. QT prolongation, U waves, ST depression, and arrhythmias were found with similar frequency in patients with high and normal plasma norepinephrine concentrations. We conclude that, with the exception of sinus tachycardia and negative T waves, other electrocardiographic changes in patients with subarachnoid hemorrhage do not depend on elevated plasma norepinephrine concentrations.
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PMID:[Effect of elevated plasma norepinephrine on electrocardiographic changes in subarachnoid hemorrhage]. 826 66

We have investigated resting electrocardiograms in 1,299 athletic students and 151 sedentary control subjects. Bradycardia was significantly more common in athletes. The athletic group was divided according to a heart rate < 50, 50-100, and above 100 beats/min. Atrioventricular conduction time, prevalence of ectopic beats and other rhythms, parameters of right and left ventricular hypertrophy, ST elevation, and T wave amplitude were increased in the sinus bradycardia group. A significant negative correlation was found between heart rate and PQ duration in athletes. In the sinus tachycardia group, the PQ duration was shorter and the ST depression more prominent than in the other groups. The subjects were also divided according to PQ > or = 0.22, 0.21-0.12, and < 0.12 s. Parameters of left ventricular hypertrophy were markedly increased in athletes with PQ > or = 0.22 s, while the heart rate was only slightly decreased, suggesting an association between prolonged atrioventricular conduction time and left ventricular hypertrophy. Incomplete right bundle branch block was associated with a lower heart rate, increased duration of QRS and QTC, voltage of precordial Q waves, indices of right ventricular hypertrophy, and negative T waves. These findings are typical of right ventricular hypertrophy, indicating a close relation of incomplete right bundle branch block to right ventricular hypertrophy.
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PMID:Electrocardiographic findings of heart rate and conduction times in athletic students and sedentary control subjects. 828 43

To study acute organophosphorus (OP) poisoning cases, 190 OP-intoxicated cases admitted to Civil Hospital, Ahmedabad, were investigated in depth. The group consisted of subjects ranging from 11 to 60 years of age, with the maximum number of cases in the age group 21-30 years and a male-to-female ratio of 2.1:1. Most of the subjects (71.61%) were partially educated, 24.2% of the cases were illiterate, and only 4.2% of the cases were highly educated. Socioeconomically, 21.1% of the subjects were of low economic status, 52.6% were low middle class, 16.8% were upper middle class, and only 9.5% were upper class. With regard to marital status of the subjects, 98 cases were married and 92 were unmarried. About 67.4% of the cases had the intention of committing suicide, 16.8% of the cases were the result of occupational exposure, and 15.8% of the cases were from accidental poisoning. Social and domestic problems (37.5%), marital friction (15.6%), financial stress (15.6%), love affairs (14.1%), job problems (10.9%), chronic illness (4.7%), and failure in examination (1.6%) were observed as the precipitating factors. Muscarinic manifestations such as vomiting (96.8%), nausea (82.1%), miosis (64.2%), excessive salivation (61.1%), and blurred vision (54.7%) and CNS manifestations such as giddiness (93.7%), headache (84.2%), disturbances of consciousness (44.2%), and typical pungent odor from mouth and clothes (77.9%) were the main presenting symptoms. Cardiac manifestations such as sinus tachycardia (25.3%), sinus bradycardia (6.3%), and depression of ST segments with T-wave inversion (6.3%) were observed electrocardiographically, with hypertension (10.5%) and muscular twitching in some (2.1%) cases. Biochemical changes such as albuminuria (12.6%) and azotemia (18.9%) with inhibition of acetylcholinesterase enzyme activity in blood were recorded in 78.9% of the cases. About 89.5% of the cases recovered completely, 4.2% of the cases absconded after partial recovery, and 6.3% of the cases died. The mortality rate (6.3%) depended on various factors such as the organophosphorus compound consumed, the amount ingested, the time interval for hospitalization, and the general health of the patient. Chances of recovery were higher when the patient was hospitalized at the earliest indication.
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PMID:A clinical, biochemical, neurobehavioral, and sociopsychological study of 190 patients admitted to hospital as a result of acute organophosphorus poisoning. 832 67

To contribute for making early diagnosis and treatment of acute pulmonary embolism (APE), we investigated on clinical pictures of 225 patients with APE. Common underlying factors were heart disease, prolonged bed rest, post-surgical state, thrombophlebitis, malignant tumor and post-catheterization state in this order. Dyspnea, chest pain, tachycardia and shock were frequently seen as initial symptoms and signs. Blood screening showed leukocytosis, hypoxemia, hypocapnia and elevated serum LDH. Electrocardiographic findings highly demonstrated were ST.T abnormalities, such as T inversion with ST elevation in V1-3, ST depression in V4-6 and sinus tachycardia. Chest X-rays showed diminished pulmonary vascular marking and pulmonary artery dilation. Right ventricular dilatation were frequently seen on 2-dimensional echocardiograms. Pulmonary artery pressure were elevated up to 49/20 (30) mmHg. Twenty-five percent of the patients died, and the recurrence was seen in 4%. Thus, as soon as APE is suspected by above clinical findings, definitive diagnosis should be obtained by the lung perfusion scan and pulmonary arteriography, then oxygen and thrombolytic agents should be given immediately to prevent the fatal outcome.
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PMID:[Early diagnosis and management of acute pulmonary embolism: clinical evaluation those of 225 cases]. 835 37

Electrocardiographic (ECG) findings of pulmonary embolism (PE) include S1Q3T3 pattern, right bundle-branch block, right-axis deviation, and T-wave inversion in medial precordial leads. We report other uncommon ECG changes associated with various symptoms during recurrent PE as documented by computed tomography (CT) scans in a single patients. An 83-year-old woman was admitted with PE secondary to deep venous thrombosis in the left leg. During episodes of chest pain, ECG showed QTc prolongation (480 ms) with new T-wave inversion in leads III, aVF, and V1-V3, and ST-segment depression in leads V5-V6. Despite adequate anticoagulant therapy, recurrent episodes of PE occurred in the hospital. When the patient experienced sudden chest tightness, ECG showed a new S-wave notch in lead V1 and clock-wise rotation with sinus tachycardia. She also experienced transient syncope with hypotension. At this time, ECG showed transient atrioventricular junctional rhythm followed by sinus arrest, and CT scan showed a new massive embolus in the main pulmonary trunk with right ventricular dilatation, as demonstrated by echocardiography. The mechanism responsible for QTc prolongation with ST-T changes, the S-wave notch in lead V1 with clockwise rotation, or atrioventricular junctional rhythm with sinus arrest during PE may be associated with myocardial ischemia, acute right ventricular overload, or vagal reflex, respectively.
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PMID:Uncommon electrocardiographic changes corresponding to symptoms during recurrent pulmonary embolism as documented by computed tomography scans. 982 4

We present a case of prolonged myocardial ischemia in a young healthy male presenting for nasal polypectomy and tonsillectomy. Induction of anesthesia proceeded uneventfully. Immediately after surgical incision, the patient developed a sinus tachycardia with ST-segment depression in leads II and III, and ST elevation in leads aVR, aVL, aVF, and V. Depth of anesthesia was increased, esmolol was administered, which slowed the heart rate, and the procedure was terminated. However, myocardial ischemia only gradually resolved, leaving residual T-wave flattening in lead III by day 3 postoperatively. After extensive investigation to rule out other causes of ischemia, we considered cardiotoxicity due to intranasally administered cocaine with epinephrine to be the most likely precipitant. Nasal packing with gauze soaked in a solution containing cocaine 3 mg/kg and epinephrine 1 mg occurred just 40 minutes prior to induction of anesthesia. Topical intranasal cocaine is rapidly and reliably absorbed systemically, with peak plasma concentrations occurring within 30 to 60 minutes, corresponding to the time course of cocaine administration and surgical stimulation in this patient. Systemic absorption of topical intranasal cocaine has previously been reported to cause adverse cardiac sequelae, including myocardial infarction. This report reinforces the need for caution regarding the use of topical intranasal cocaine, particularly if used in combination with epinephrine.
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PMID:Prolonged perioperative myocardial ischemia in a young male: due to topical intranasal cocaine? 1052 15


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