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)

Although the use of medication has helped to cure and control disease, it has also led to serious iatrogenic illness. Toxicity is most common and severe in the elderly. Confusion, falls, depression, sedation, deterioration of function, and urinary incontinence and retention are frequently the manifestation of that toxicity. Normal ageing places older patients at risk because of changes in metabolism, distribution, and excretion of drugs, and sensitivity to drug effects is often greater in the elderly. Disease and the interactions of other drugs can increase the incidence and severity of side effects. Certain drugs should be avoided in the elderly. Those that are long acting and require hepatic metabolism, those with strong anticholinergic properties, and those that are highly sedating tend to cause the most problems. In every case, physicians must weigh the potential benefit of prescribing against the potential risk.
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PMID:Risk factors in geriatric drug prescribing. A practical guide to avoiding problems. 270 38

Our first 23 patients treated by this method were followed up by urodynamic assessment and urethrocystovaginography 13 months after the operation. Urodynamic assessment was performed according to the criteria of the International Continence Society. There was no statistically significant difference in the resting urethral closure pressure (UCP), neither at maximum point nor at 30% or 70% of the urethral functional length (UFL). The postoperative reduction of UFL was statistically significant but did not exercise any significant influence on continence. The maximum bladder volume was not affected. For assessing the urethral stress profile we calculated the depression quotient which was significantly unfavourable at 30% of UFL but not affected at 70%. The lateral urethrocystovaginogram was interpreted according to Green. Most of the parameters were significantly improved. At the time of reexamination 70% of the patients were subjectively continent, whereas in 21.7% the incontinence remained unchanged and deteriorated in 8.6%. In our opinion, this modified anterior repair is not recommended as a method to encourage a wider range of indications for the vaginal repair of incontinence. Hence, this operation method should be performed only in case of an evident insufficiency of the vesicourethrovaginal septum.
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PMID:[Urodynamic and roentgenologic changes following ventral levatorplasty]. 304 90

We examined the relationship between urinary incontinence and psychological distress in a sample of community-dwelling older adults. The data are from a probability sample of Washtenaw County, Michigan residents ages 60 years and older, who were interviewed in 1983 and 1984. A total of 747 women and 541 men were included in the analyses. Experiencing urinary incontinence, particularly in a severe form, was weakly related to depression, negative affect, and low life satisfaction. These relationships are partly explained by the fact that incontinent respondents are less healthy than are continent respondents.
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PMID:Urinary incontinence and psychological distress among older adults. 326 49

To select topics for quality assurance activities focusing on older patients, we convened a 14-member panel of physicians and experts in quality assurance. In two rounds of ratings, panelists rated 42 medical conditions (eg, pneumonia) in terms of their effects on patient outcomes, the availability of beneficial interventions, and the health benefits from improving current quality. They rated 27 health services (eg, adult day-care) on similar dimensions. The feasibility of doing quality assurance work on each condition and service also was rated. Using the ratings, the conditions selected for quality assurance work were congestive heart failure, hypertension, pneumonia, breast cancer, adverse effects of drugs, incontinence, and depression. Health care services selected were hospital discharge planning, acute inpatient care for the frail elderly, long-term-care facilities (intermediate-care facilities and skilled nursing facilities), home health care services, and case management.
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PMID:Assuring the quality of health care for older persons. An expert panel's priorities. 365

Urodynamic tests and clinical and anamnestic assessments of continence were carried out in 47 patients before and after the Marshall-Marchetti-Krantz operation. The operation resulted in a subjective cure in 35 (74.5%) of the patients; 12 women were again incontinent within a period of between 6 and 24 months. There was an insignificant postoperative rise in urethral occlusion pressure at rest. It was only possible to ensure an elongation of the urethra in the resting pressure curve. The urethral occlusion pressure at rest in patients with recurrent incontinence was considerably lower preoperatively than in postoperatively continent patients. Hence, high urethral occlusion pressure at rest signifies a good surgical prognosis. In the stress pressure curve, surgery improved the transmission factor, the depression factor, and the urethral occlusion pressure under stress. However, no clear surgical prognosis was possible on the basis of these parameters. The best postoperative results for the transmission and depression factors and the urethral occlusion pressure under stress were obtained in the stress pressure curve at 300 ml with the patient in seated position. On comparing preoperative and postoperative measurements, improvements in pressure transmission and in urethral occlusion pressure under stress were seen in particular in the proximal one-third of the urethra. Hence, the question arises whether the proximal one-third of the urethra is as important as the medial one-third in stress incontinence diagnosis by measurement.
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PMID:[Urodynamic observations on the Marshall-Marchetti-Krantz operation]. 377 Apr 15

Data from a sample of 532 patients seen within seven days of an acute stroke has been analysed to compare the prognostic importance of urinary incontinence with that of a history of any depression of consciousness. Urinary incontinence was more specific and had a higher predictive value. Considering conscious patients with moderate or severe initial disability, after six months 53 per cent of incontinent patients had died and 57 per cent of the survivors were still moderately or severely disabled whereas only 19 per cent of continent patients had died and 80 per cent of survivors made a good recovery. We conclude that early urinary incontinence is an important indicator of poor prognosis, identifying patients who may need extra attention.
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PMID:Outlook after an acute stroke: urinary incontinence and loss of consciousness compared in 532 patients. 405 7

The clinical presentation of three patients with meningiomas at different frontal sites is described. They had been ill for 3, 25, and 43 years before the tumour was demonstrated radiologically. Apathy, incontinence, dementia, and fits were seen in association with middle and superior frontal lesions, and may be mistaken for symptoms of involutional depression or presenile cerebral atrophy. In contrast, excitement and hallucinosis were seen in association with a basal frontal lesion, and may mimic psychotic syndromes like hypomania and schizophrenia, particularly if the tumour encroaches on the third ventricle and adjacent structures. Irreversible loss of myelin and axons in the frontal areas of brain surrounding the tumour may have contributed to the clinical picture of the syndrome shown by these patients.
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PMID:Three cases of frontal meningiomas presenting psychiatrically. 496 22

Examination of 163 nursing home residents revealed chronic brain syndrome of different amount in 84%. Demented patients with clinical evidence of arteriosclerosis had significantly higher values of emotional incontinence, dysphoria, depression and vegetative complaints than those without evidence of arteriosclerosis. Correlation of single psychopathologic parameters with other psychopathologic, neurologic and somatic variables resulted in very different correlation profiles for the following symptoms: emotional incontinence, apathy, dysphoria and euphoria. These changes in personality should be considered to a higher degree in dementia research intending more homogeneous subgroups.
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PMID:[Psychopathology of senile dementias in nursing home residents]. 647 86

Wheelchair bound paraplegics tend to spend a sedentary life. They seem to be vulnerable to prolonged strenuous exertion because of their many physical handicaps such as metabolic depression, cardiovascular instability, urinary incontinence, pressure sores and so on. In commemoration of The International Year of the Disabled, The First Oita International Wheelchair Marathon was held in Autumn of 1981. This paper is to review the results of an experiment made at this half marathon. The course length was 21.1 km. Ten competitors were selected at random as the subjects for measuring energy expenditure during the race. As a preliminary examination, a work load test was performed by using a wheelchair treadmill to obtain a regression equation of the individual relationship between oxygen uptake and heart rates. The oxygen uptake of individuals during the race was estimated from the heart rates which were recorded by the small memory box fixed beneath the wheelchair. Six subjects were successfully examined. The results revealed that paraplegics safely tolerated the prolonged strenuous exercise. Their average oxygen uptake, mean heart rate and the lap time during the race were 34.17 +/- 8.11 ml/kg/min (mean +/- SD), 167.6 +/- 15.8 beats/min and 87.1 +/- 9.1 min respectively. Heart rate of the subjects was always very high during the race, although oxygen consumption was fairly low in comparison to able-bodied elite marathon runners.
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PMID:Energy expenditure of paraplegic marathon runners measured during a wheelchair marathon. 648 67

The mental state, demographic details, dependency level and presence of problem behaviours have been recorded for 438 (82%) of the residents of the 12 Part III homes, managed by the London Borough of Camden, using standard interview. One third of the residents were suffering from severe dementia, another third from mild to moderate dementia and one third were free of dementia. Of the latter two groups, 38% were depressed. The prevalence rate of dementia increased with the age of the resident and was higher among females. Depression was associated with the presence of visual handicap and incontinence, and was commoner when the resident had been admitted from his own home or belonged to a minority religion. A third of residents needed daily help with dressing and use of the lavatory, one quarter were incontinent each day. Depression and dementia both were associated with increased rates of dependency and of problem behaviours (incontinence, wandering, aggression). This survey has revealed evidence of sufficient psychiatric morbidity in these homes to support a re-appraisal of their current aims, staffing and health-care provision.
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PMID:Psychiatric illness in residential homes for the elderly: a survey in one London borough. 649 36


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