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)

The effect of intravaginal electrical stimulation (IVS) on the urethral pressure profile (UPP) before and during succinylcholine blockade or spinal anaesthesia was studied in patients with stress incontinence and in patients with clinically normal urethral function. During succinylcholine blockade, the UPP was lowered to 74% and during spinal anaesthesia to 39% of the original maximal UPP. IVS could not influence the UPP during succinylcholine blockade, while the UPP could be restored during spinal anaesthesia when the stimulation strength was increased 3 to 4 times. The following conclusions were arrived at: 1) The urethral effect of IVS is due to activation of somatic nerves and not to activation of nerves supplying smooth muscles or direct activation of striated and smooth muscles. 2) The more pronounced depression of the UPP during spinal anaesthesia compared to succinylcholine blockade should be caused by the loss of nervous activity of the smooth muscles. 3) The fact that the UPP could be restored during spinal anaesthesia indicates that activation of somatic efferents can compensate for the loss of striated and smooth muscle activity. Therefore, IVS can control incontinence in partial lower motor neuron lesions, provided a sufficient number of efferent neurons are preserved.
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PMID:Mechanisms for closure of the human urethra during intravaginal electrical stimulation. 30 92

Psychometric personality questionnaires were used to test 100 patients with symptoms of urinary incontinence. The following findings were recorded: Accumulation with significance of increased psychasthenic values in patients with normal urogynaecological status was higher than that recordable from patients in pathological conditions. The group of patients with mere stress incontinence differed from the group with urge or combined urge-stress incontinence by statistically secured differentiated between means values recordable from neurosis-relevant, test scales, including psychosomatic disorders, depression, neuroticism, social introversion, and phobic disorders. Reference is made to psychogenic factors and their role within a set of multifactorial conditions conducive to functional urinary incontinence of women. Consequences regarding diagnosis and therapy are discussed.
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PMID:[Psychodiagnostic examination of patients with functional urinary incontinence (author's transl)]. 54 98

Gynecologists and other primary care physicians have long recognized the occurrence of psychogenic factors in some patients with urinary incontinence, usually of the urgency or detrusor dyssynergia types. However, to the best of our knowledge this is the first report of psychiatric study of these patients. Eighteen patients were referred following complete gynecologic urology work-up including electronic urethrocystometry and chain cystography. Most of these patients were 40 to 60 years of age, were multiparous, and had had hysterectomies. Major psychiatric findings were a) severe situational problems in all 18 patients, b) chronic depression in 17, and c) hysterical personality traits in 10. Patients whose psychiatric treatment provided some relief of their situational and emotional distress also, concomitantly, had relief of urinary incontinence.
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PMID:Psychogenic aspects of urinary incontinence in women. 69 14

As part of a study of long-term institutional care of the elderly, this report presents a comparison of the characteristics, health problems, and state of mind of 193 elderly applicants for such care (Group A) with those of 141 elderly persons living independently in the community (Group I). Group A members were older, living with a spouse less often, and had low incomes. They showed much more cerebrovascular disease, incontinence, recent loss of independence in the activities of daily living, dementia, recent hospitalization, loneliness, and depression. They had had much less recent involvement in social and recreational activities, although most had not been socially isolated. They had received more extensive help from relatives and friends, and it seemed unlikely that additional help from these sources would keep many more of these elderly persons out of institutions. Community agencies and services had been used by a relatively low proportion of Group A, and hardly at all by Group I.
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PMID:Elderly applicants to long-term care institutions. I. Their characteristics, health problems and state of mind. 81 54

Normal pressure hydrocephalus (NPH) is a surgically correctable syndrome of progressive dementia, gait abnormalities, and urinary incontinence resulting from an occult hydrocephalus in association with normal cerebrospinal fluid pressure. Occurring most frequently in midlife and often idiopathic in origin, the early course of the illness may be characterized by symptoms of apathy, inattentiveness, agitation, and poverty of thought which mimic a depressive illness and may delay the recognition and treatment of the underlying structural defect. A review of the literature reveals that this association of depressive symptomatology and NPH has received little attention in the psychiatric literature, and the authors describe a case of NPH which presented as a severe, agitated depression. Clinical findings which suggest the presence of NPH are discussed, and the need to include NPH in the differential diagnosis of depression in the presenium is emphasized. The authors believe such diagnostic vigilance is necessary if the needless deterioration of potentially salvageable individuals is to be prevented.
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PMID:Depression and normal pressure hydrocephalus. A dilemma in neuropsychiatric differential diagnosis. 93 10

When we die, it is only very rarely that we do so without days, weeks, or months of illness in which the suffering may be very great, sometimes from pain, often from breathlessness, impairment of consciousness, depression, anxiety, vomiting, bedsores, and incontinence. If we were able to choose our own time to die, there would be no need to suffer any of this. There should be a "right to die". It should be ethically and legally possible for the doctor attending a terminally ill patient, who asks him for help to take his own life, to put the means within his reach.
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PMID:Assisted suicide: some ethical considerations. 93 27

Impact between the brain and the cristae of the base normally results as a consequence of inertia when an obstacle is hit, followed by contusion, or intra-, sub- or extradural haematoma. The skull itself may be briken (usually at the interpilasters or the weak points of the pilasters) or dented. Denting resulted in the depression of a circular fragments or fragments, with compression of the dura mater or brain; this, in turn, may be contused, lacerated or even crushed. Spinal crash fractures usually involve the lumbar region. Neck fractures are rare. The picture may be one of clinical silence (local pain) or marked neurological involvement. Damage to the cord is expressed in the form of shock, complete flaccid para- or tetraplegia, complete loss of sensation below the lesion, loss of deep and superficial reflexes, urinary retention and rectal incontinence. Treatment is rendered complicated by profuse scalp haemorrhages, respiratory insufficiency requiring orotracheal intubation and assisted respiration, convulsions, which should be handled with care, since ordinary anti-epilepsy products may mask the onset of hypertension and haematoma. Swelling should be reduced with cortisones. Diuretics may be too brusque and lead to intracerebral haematoma. In the case of spinal injuries, particular care should be excercised in shifting the patient and conveying him to hospital. Where high neck lesions are suspected, the possibility of damage to the originating segments of the phrenic nerve must be borne in mind.
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PMID:[Aeromedical problems in cranio-vertebral injuries]. 112 65

Treatment of acute urinary incontinence should be directed toward the underlying cause, such as infection, medication side effect, atrophic vaginitis, anxiety, depression and restricted mobility. Pharmacologic treatment depends on identification of one of the four subtypes of chronic urinary incontinence: stress, urge, overflow or mixed. Stress incontinence responds to alpha-adrenergic agents, which increase sphincter tone. Urge incontinence is the most common type of incontinence in the elderly; it can be treated with anticholinergic agents, smooth muscle relaxants, estrogen replacement therapy in women and, possibly, calcium antagonists. Overflow incontinence is caused by neurologic deficits, such as diabetes, or outflow obstruction, such as from prostatic enlargement, urethral stricture and tumors. Anticholinergic agents and alpha-adrenergic agents should be considered only after existing outflow obstruction is surgically corrected or intermittent catheterization is unsuccessful.
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PMID:Urinary incontinence in the elderly: pharmacologic therapies. 821 3

Urinary incontinence affects a large percentage of persons over age 65 and predisposes them to social isolation, depression, and premature nursing home placement. Transient incontinence may be precipitated by such factors as delirium, infection, atrophic vaginitis/urethritis, medication use, and restricted mobility. Persistent incontinence may be of the urge, stress, overflow, or functional type. The patient history and simple tests such as bedside urodynamics generally isolate the cause. In this first part of a two-part article, we discuss the primary care evaluation of the older patient with urinary incontinence. In part 2 (page 37), we discuss a primary care management strategy.
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PMID:Urinary incontinence in the aged, Part 1: Patient evaluation. 159 66

Various parameters of the urethral pressure profile have been developed to improve diagnosis of genuine stress incontinence. By application of micro-tip transducers, a positive correlation between "depression ratio" and degree of incontinence as had been observed by Eberhard. The aim of this study was to examine Eberhard's observations by the use of Brown-Wickham's method. Significant differences in the parameters of the urethral pressure profile during stress, such as the urethral closure pressure, depression pressure, depression ratio, transmission ratio, and the area of continence, were found between continent and incontinent patients. Although pressure transmission and transmission ratio revealed significant differences, depression pressure and depression ratio were found to be similar in patients with mild and severe degree of incontinence. According to the results of this study, depression ratio does not reflect the degree of urinary loss, when open catheters are used.
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PMID:[The value of the urethral depression quotient in diagnosis of female stress incontinence using the Brown-Wickham method]. 159 77


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