Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Older people often describe their headaches as starting with vague neck discomfort and eventually moving to the temples and forehead. These are muscle-tension headaches, by far the most common type in the elderly. Although cervical osteoarthritis often is at fault, depression can be a significant factor, patricularly when headaches are chronic. There is no sure cure for tension headache, and often, several of the many remedies-ethyl chloride spray, moist heat, massage, antidepressant drugs, analgesics, local anesthetics, etc.-must be tried before an effective one is found. But just as important to successful therapy are concern, compassion, and a willingness to listen on the part of the physician. True migraine headaches are rare in the elderly. More prevalent is the type of vascular headache associated with giant cell arteritis, which is severe and resistant to any form of analgesic except the strongest narcotics. Vascular headaches also may result from congestive heart failure (which produces venous congestion in the cranial cavity), transient ischemia, increased intracranial pressure, and a variety of metabolic disturbances.
 ...
PMID:The types of headache that affect the elderly. 95 13

The clinical features of GCA can be classified into: (1) the systemic manifestations of malaise, weight loss, fever, night sweats and depression; (2) the proximal muscle pain and stiffness of polymyalgia rheumatica; (3) arteritic manifestations of pain or tenderness due to local inflammation; and (4) arteritic manifestations of ischaemia due to narrowing or occlusion of vessels. These may occur singly or in any combination and may come and go with the passage of time. Thus GCA can result in many different clinical signs and symptoms. The feared ocular and cerebrovascular complications of the condition can be prevented by the early institution of corticosteroid treatment. Early diagnosis is therefore vital. This is a simple matter when GCA presents in the classical textbook manner, but in atypical cases diagnosis can be exceedingly difficult. The absence of a reliable way of excluding the disease means that diagnosis is often a clinical exercise. A sound knowledge of the many and varied clinical manifestations of GCA is therefore required if the physician is going to prevent the ocular and cerebrovascular complications of GCA by early diagnosis and treatment.
 ...
PMID:Clinical features of giant cell arteritis. 180 19

A 68 year-old hypertensive woman carried out, linked with the featuring complaints of temporal arteritis-polymyalgia rheumatica complex, an orthostatic hypotension caused, probably, by a spread immunocomplex damage. The presence of depression in Horton's Arteritis and its improvement with the complete recovery would show, perhaps, a central catecholaminergic failure.
 ...
PMID:[Orthostatic hypotension disclosing an autonomic deficit in a case of Horton's temporal arteritis]. 209 89

Polymyalgia rheumatica is a syndrome that occurs in the elderly and is characterized by pain and stiffness involving the neck, the shoulder girdle, and the hip girdle. The aching should be present for greater than one month. Polymyalgia rheumatica may be more common than reported. The etiology remains unknown. There is generally little found pathologically in this disease. The physical examination is often not impressive. Synovitis may be a main contributing factor to many of the symptoms seen in patients with polymyalgia rheumatica. Symptoms often do not correlate with physical findings. Polymyalgia rheumatica must be differentiated from many conditions since the diagnosis remains entirely clinical. Osteoarthritis, flu syndromes, inflammatory myopathies, fibromyalgia, and depression all have features that may mimic polymyalgia rheumatica. Malignancies and infections may also be difficult to separate from polymyalgia rheumatica. Polymyalgia rheumatica may also be extremely difficult to differentiate from seronegative rheumatoid arthritis in patients older than 50 years. Although some patients with polymyalgia rheumatica have underlying giant cell arteritis, the majority apparently do not. The distinction between polymyalgia rheumatica and giant cell arteritis cannot be made on the basis of laboratory studies and relies solely on clinical symptoms and physical findings. Although nonsteroidal antiinflammatory medications may control symptoms in patients with mild disease, most patients with polymyalgia rheumatica require low-dose corticosteroids. The tapering schedule for the corticosteroids is contingent upon the response of symptoms and laboratory parameters. Polymyalgia rheumatica usually follows a benign course with almost complete response to an adequate treatment program. Recently, there have been several studies suggesting that the course of polymyalgia rheumatica may not be as short and simple as once proposed. Nevertheless, many patients may be completely weaned from corticosteroids. Other agents have been used in this disease, but for the most part their use remains somewhat controversial. Patients must be monitored carefully. Most patients do well, and treatment is effective.
 ...
PMID:Polymyalgia rheumatica. 218 54

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.
 ...
PMID:[Steroid-sensitive cavitating pulmonary opacity in Horton's disease]. 225 38

We arbitrarily define "isolated weight loss" as the loss of at least 10 p. 100 of body weight over less than one year, without any single cause being disclosed by questioning, physical examination and such paraclinical examinations as blood electrolytes, blood count and differential, routine dipstick urinalysis and X-ray of the chest. Among the 105 patients we studied, the causes of isolated weight loss were: (1) psychic disorders (chiefly depression) in 60 p. 100 of the cases; (2) a variety of organic diseases in 29 p. 100, including gastrointestinal diseases (8 p. 100), cardiovascular and respiratory diseases (6 p. 100), Horton's disease (4 p. 100), Portuguese amyloidosis (1 p. 100), unexplained inflammatory syndrome (1 p. 100), endocrine disease (hyperthyroidism, 4 p. 100) and intoxication with medicines, alcohol or heroin (5 p. 100); (3) no definite cause could be found in 11 p. 100 of the cases. We suggest a diagnostic approach involving a limited number of examinations, viz.: erythrocyte sedimentation rate, measurement of transaminases, gamma GT and alkaline phosphatase enzymes, abdominal ultrasonography and ultra-sensitive TSH assay. We consider it important to switch from useless paraclinical tests to the detection and management of psychic disorders. Weight loss is a frequent motive of consultation, but its diagnostic value is often misunderstood. The purpose of this study was to provide data for the artiological diagnosis of isolated weight loss--a relatively frequent problem in internal medicine.
 ...
PMID:[Clinical study of 105 cases of isolated weight loss in internal medicine]. 322 12

Patients with facial pain, without overt dental disease, are often seen in both medical and dental practice. The differential diagnosis includes (a) cluster headache, in which patients have severe unilateral pains lasting 30 to 120 minutes that respond to verapamil, corticosteroids or lithium; (b) migraine, in which attacks are longer and are often accompanied by nausea and visual disturbance, and can be managed using anti-inflammatory analgesics, with or without metoclopramide, or sumatriptan, although frequent attacks are best suppressed by continuous propranolol or pizotifen; (c) trigeminal neuralgia, knifelike unilateral pains usually responsive to carbamazepine; and (d) temporal arteritis, a steadier pain very responsive to corticosteroids. There is no evidence that continuous 'idiopathic facial pain' is a result of malocclusion (i.e. the way in which the teeth fit together), and its aetiology remains obscure, although there is some biochemical evidence linking it to depression. Many patients respond to simple analgesia and firm reassurance from the physician, although antidepressant therapy (e.g. nortriptyline or dothiepin) is often of great value.
 ...
PMID:Orofacial neuralgia. Diagnosis and treatment guidelines. 769 15

Temporal arteritis is an insidious disease which, if not recognized and treated with high-dosage oral prednisone or intravenous prednisolone, can result in unilateral or even total blindness due to anterior ischemic optic neuropathy (AION) or closure of the central artery of the retina. Unfortunately, the symptoms and clinical signs of temporal arteritis mimic those of a number of other conditions including angle-closure glaucoma, hypertension, migraine, trigeminal neuralgia, temporomandibular joint syndrome, carotid artery occlusive disease, Foster-Kennedy syndrome, and nonarteritic AION. When a patient complains of a severe pain in the temporal region, along with scalp tenderness and a feeling of malaise or depression--with or without episodes of transient loss of vision--he or she should be referred for a diagnostic work-up which includes an erythrocyte sedimentation rate and a temporal artery biopsy. We present here a review of the recent literature concerning temporal arteritis, followed by a report of an unusual case in which high-dosage prednisone therapy was effective in relieving the patient's symptoms and lowering the sedimentation rate in spite of a negative temporal artery biopsy.
 ...
PMID:Diagnosis and management of temporal arteritis: a review and case report. 823 73

Polymyalgia rheumatica (PMR) is a disease of unknown etiology characterized by severe myalgia and stiffness at shoulder girdle and pelvic girdle muscles and by normal serum creatine kinase levels. Marked elevation of erythrocyte sedimentation rate, acute onset within two weeks, and appearance in the aged are also additional characteristics of PMR. Ten to 50% of PMR patients have a concomitant temporal arteritis (TA)(giant cell arteritis). For the differential diagnoses of PMR, rheumatoid arthritis, polymyositis, fibromyalgia, malignancies, infections and depression should be considered. PMR without TA is treatable successfully with small amount of steroids (15-20 mg/day of prednisolone). For the PMR patients with TA should be treated with large amount of steroids (40-60 mg/day of prednisolone) or steroid pulse therapy.
 ...
PMID:[Polymyalgia rheumatica]. 1007 7

Rembrandt van Rijn (1606-1669) left behind the largest collection of self-portraits in the history of art. These portraits were painted over a period of 41 years, using a realistic technique. To evaluate Rembrandt's aging process we studied 25 uncontested Rembrandt oil self-portraits by means of objective and descriptive techniques. By measuring brow position changes through the years, we demonstrated that brow descent started in the second half of the third decade and began to level out in the fourth decade. Based on Rembrandts' aging physiognomy, from age 22 to 63, we believe that Rembrandt did not suffer from temporal arteritis, hypothyroidism, rosacea, or rhynophima and that no other facial signs of systemic diseases are evident, contrary to the opinions expressed by other medical professionals. We suggest that Rembrandt suffered from melancholia or mild depression, and propose the possibility of chronic lead poisoning as a theoretical illness that he might have had.
 ...
PMID:Rembrandt--aging and sickness: a combined look by plastic surgeons, an art researcher and an internal medicine specialist. 1734 73


1 2 Next >>