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)

CASE DESCRIPTION A 3-year-old sexually intact male rabbit (Oryctolagus cuniculus) was evaluated because of a 1-day history of signs of anorexia and depression. CLINICAL FINDINGS Clinical examination revealed signs of depression, hunched posture, low skin elasticity (suggesting dehydration), slightly distended abdomen, and penile and preputial edema. The owner reported that the rabbit had been fed a routine diet, received water via a sipper bottle, and was allowed free movement around the home. It had been observed by the owner to bite and chew gypsum-based plaster from the walls of the home. Abdominal radiography and ultrasonography revealed radiopaque material in the urinary bladder, irregular thickening of the urinary bladder wall, and gaseous distention of the cecum. Urinalysis revealed mild hematuria and proteinuria. Results of the physical examination and other diagnostic tests were consistent with urolithiasis, cystitis, and gastrointestinal stasis. TREATMENT AND OUTCOME At clinical examination, numerous small uroliths originating from the urethral orifice were removed and submitted for composition analysis via infrared and Raman spectrometry and polarized microscopy. Laparotomy-assisted flushing of the urinary bladder and urethra was performed, and the rabbit recovered without complication. Results of composition analysis indicated the uroliths were composed of calcium sulfate dihydrate. CLINICAL RELEVANCE This is the first report of calcium sulfate urolithiasis in a rabbit, which was attributed to dehydration (possibly due to inadequate water provision) and excessive dietary intake of sulfur in the form of gypsum-based plaster. Rabbits should be prevented from consuming plaster and other potential extradietary sources of sulfur and provided an appropriate water supply.
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PMID:Calcium sulfate dihydrate urolithiasis in a pet rabbit. 2820 16

Urinary incontinence (UI) is a common symptom affecting almost one-third of adult women. UI can occur because of hypermobility or intrinsic sphincter deficiency of the urethra. Regardless its etiology, it is associated with poor quality of life and most of the incontinent women develop symptoms such as anxiety, depression, and social isolation over time. The synthetic midurethral sling (MUS) was first introduced in 1995 and quickly became the gold standard treatment for women with stress UI because of intrinsic sphincter deficiency and/or urethral hypermobility. This session addresses the indications, preoperative preparation, surgical steps, postoperative care, and complications related to synthetic MUSs. Owing to the exponential increase in the prevalence of mesh-related complications, we also developed a rational evidence-based algorithm that will help urologists to diagnose and manage this specific subset of patients.
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PMID:Midurethral Slings. 2977 19

Tubal ligation (TL) is an effective and common method of fertility control. In the year 2009, over 24,000 were performed in Canada alone. Migration of Filshie clips used during TL is estimated to occur in 25% of all patients; 0.1-0.6% of these patients subsequently experience symptoms or extrusion of the clip from anatomical sites such as the anus, vagina, urethra, or abdominal wall. Migrated clips may present as chronic groin sinus, perianal sepsis, or chronic abdominal pain. These symptoms can occur as early as 6 weeks or as late as 21 years after application. We present the case of a 49-year-old female with a 3.5-year history of intermittent dull nonradiating left upper quadrant (LUQ) pain lasting on average 2-3 days. There were no other associated symptoms, and the longest pain-free period was 4 days. Her past medical history includes COPD, GERD, IBS, and depression. Current medications are only remarkable for Symbicort. Pertinent past surgical history includes laparoscopic tubal ligation with Filshie clips in 1999, followed by a vaginal hysterectomy in 2013. Migrated tubal ligation clip was noted on an abdominal X-ray. The patient was then referred for surgical management. Subsequent CT scan confirmed a solitary clip present adjacent to the left lobe of the liver. No other abnormalities were reported. Patient underwent laparoscopy for removal of the clip, which was identified to be underneath the left lobe of the liver embedded in the gastrohepatic omentum. Please see the video link provided. Postoperative pathology report confirmed the presence of a Filshie clip. Patient reported complete resolution of her LUQ pain at a 5-week and 3.5-month follow-up. This case shows that although symptomatic clip migration is a rare phenomenon, it should be given special consideration in women with unexplained chronic abdominal pain and a history of TL. Additionally, removal of clip can provide resolution of symptoms.
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PMID:Migrated Tubal Ligation (Filshie) Clip as an Uncommon Cause of Chronic Abdominal Pain. 3209 7

Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Autonomic dysreflexia (sometimes called autonomic hyperreflexia) is the most serious medical complication that occurs in women with SCIs and is found in 85% of patients with lesions at or above T6 level. It is important to avoid stimuli that can lead to autonomic dysreflexia, such as distension or manipulation of the vagina, bladder, urethra, or bowel. Women with SCIs may give birth vaginally. Although pain perception is impaired in women with SCIs at or above T10, neuraxial anesthesia is the treatment of choice to reduce the risk of autonomic dysreflexia because it blocks neurologic stimuli arising from the pelvic organs. Adequate anesthesia, spinal or epidural if possible, is needed for cesarean births in all patients with SCIs. In addition to routine postpartum care, obstetrician-gynecologists and other obstetric care professionals should ensure that perineal and cesarean wounds are examined appropriately because of concerns for delayed wound healing in patients with SCI. Depression, suicide, alcoholism, and a wide variety of other mental health problems all occur at higher rates in women with SCIs. Therefore, screening and treatment for postpartum depression and other maternal mental health disorders are especially important in this population.
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PMID:Obstetric Management of Patients with Spinal Cord Injuries: ACOG Committee Opinion Summary, Number 808. 3233 12

Approximately 17,730 new spinal cord injuries (SCIs) occur per year in the United States. Effective rehabilitation and modern reproductive technology may increase the number of these patients considering pregnancy. Obstetrician-gynecologists and other obstetric care professionals who care for such patients should be familiar with problems related to SCIs that may occur throughout pregnancy and during the postpartum period. Autonomic dysreflexia (sometimes called autonomic hyperreflexia) is the most serious medical complication that occurs in women with SCIs and is found in 85% of patients with lesions at or above T6 level. It is important to avoid stimuli that can lead to autonomic dysreflexia, such as distension or manipulation of the vagina, bladder, urethra, or bowel. Women with SCIs may give birth vaginally. Although pain perception is impaired in women with SCIs at or above T10, neuraxial anesthesia is the treatment of choice to reduce the risk of autonomic dysreflexia because it blocks neurologic stimuli arising from the pelvic organs. Adequate anesthesia, spinal or epidural if possible, is needed for cesarean births in all patients with SCIs. In addition to routine postpartum care, obstetrician-gynecologists and other obstetric care professionals should ensure that perineal and cesarean wounds are examined appropriately because of concerns for delayed wound healing in patients with SCI. Depression, suicide, alcoholism, and a wide variety of other mental health problems all occur at higher rates in women with SCIs. Therefore, screening and treatment for postpartum depression and other maternal mental health disorders are especially important in this population.
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PMID:Obstetric Management of Patients with Spinal Cord Injuries: ACOG Committee Opinion, Number 808. 3233 18


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