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 newer dihydropyridine calcium antagonists are structurally related to nifedipine, but may provide greater vascular selectivity and wider clinical utility. Five new dihydropyridines-nisoldipine, nicardipine, nimodipine, felodipine and nitrendipine-are reviewed with regard to their preclinical pharmacology, haemodynamic effects and clinical indications. Nisoldipine is a potent arterial vasodilator with minimal electrophysiological and negative inotropic effects. Although data are still preliminary, the drug has shown some efficacy in both exertional angina and essential hypertension. The dosing interval is not yet clearly established, but may be twice daily. Utility in congestive heart failure awaits confirmation, but preliminary studies are promising. Nicardipine is an especially potent peripheral, cerebral and coronary arterial vasodilator that causes 10-fold less myocardial depression in animals than nifedipine, and may provide important cardioprotective effects during ischaemia. Human haemodynamic studies have confirmed nicardipine's lack of negative inotropism, its ability to reduce coronary and peripheral vascular resistance, and its lack of effect on cardiac conduction. Several controlled trials have documented its efficacy in exertional angina, vasospastic angina, and essential hypertension. Nicardipine's potential as an antiatherosclerotic agent is currently under investigation. Nimodipine is undergoing a unique clinical development programme aimed at cerebrovascular disorders. In almost all species, nimodipine selectively increases cerebral blood flow and reverses cerebral artery spasm without altering cerebral oxidative metabolism or systemic blood pressure. In humans, a large, double-blind, placebo-controlled trial in subarachnoid haemorrhage showed that nimodipine significantly reduced the severity of neurological deficits associated with delayed cerebral vasospasm. Several uncontrolled trials with larger numbers of patients support these results. Nimodipine has also proved useful in reducing cerebral artery spasm during intracranial surgery, and in the prophylactic treatment of migraine headaches. A preliminary study of nimodipine in acute stroke showed promising results in limiting neurological disability. Felodipine is a very potent systemic arterial vasodilator with negligible myocardial depressant activity. It is also a renal artery vasodilator. Unlike the other new dihydropyridines, felodipine prolongs the A-H interval on electrophysiological testing, but only to about 50% of that observed with verapamil. Felodipine is undergoing clinical trials in essential hypertension.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:'Second generation' dihydropyridine calcium antagonists. Greater vascular selectivity and some unique applications. 331 91

The history of psychosomatic medicine in the 20th century is predominantly marked by a concern with studies of major diseases (e.g., angina pectoris, bronchial asthma, diabetes mellitus, essential hypertension, neurodermatitis, rheumatoid arthritis, etc.). Traditional physicians also narrowly focus on disease--a trend that began with Morgagni in the 18th century. But disease (defined by structural alterations) is not the only cause of illness and disability. In fact, most persons seeking health care are ill without having a disease. It is only recently that this distinction has been fully made. The various manifestations of ill-health go by a variety of descriptive names--the functional or irritable bowel and hyperventilation syndromes, fibromyositis, psychophysiological, functional and somatoform or somatization disorders. They lead to loss of productivity, cost the health care system excessively, produce negative reactions in physicians, and are fertile ground for iatrogenic disease. They do not constitute discrete syndromes but overlap, each also being closely associated with anxiety and depression, sleep disturbances or marital disruption. They are the manifestations of sick persons not only of disturbances of bodily systems. They may be precipitated by unemployment, marital discord, bereavement, and job dissatisfaction. Curiously, ill-health has not been the major area of investigative interest of psychosomatic medicine. This presentation will emphasize why it should be, and why proper interventions may radically reduce the cost of medical care, prevent iatrogenic disease, and reduce the use of ill-advised procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Some unexplored regions of psychosomatic medicine. 333 83

A study of 402 individuals with marginal arterial hypertension (MAH) and patients with essential hypertension (EH), stages 1, 2 and 3, demonstrated a variety of psychopathologic syndromes (hypochondria, anxiety, hysteria, depression, cardiophobia) in 52.8, 77.3, 82.5 and 80%, respectively. Specific personality features have been identified as pertaining to MAH (hyperthymism, sthenism, demonstrativeness, psychasthenia) and EH (psychasthenia, intraversion, cycloidy).
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PMID:[Personality traits of persons with borderline arterial hypertension and patients with essential hypertension]. 356 Jun 35

A review of the literature on the comprehensive description of depressive patients revealed prominent concern with syndromic subtypes, course of illness, and personality factors, followed by severity, concomitant physical disorders, psychosocial stressors, and adaptive functioning. The descriptive value of multiaxial approaches for depression was illustrated through the application of an extended DSM-III formulation to all 3455 depressive (bipolar depression, major depression, dysthymic disorder, and atypical depression) and 7837 nondepressive patients of all ages and sexes presenting for evaluation and care at the Psychiatric Institute of the University of Pittsburgh during a period of 53 months. Twenty-six percent of the depressive patients received an additional diagnosis in axis I, the most frequent of which were substance use disorder, anxiety disorder, and condition not attributable to a mental disorder. In axis II, depressive patients presented a differentially higher frequency of dependent personality disorder and the "anxious/fearful" cluster of personality disorders. In axis III, 47% of the depressive vs. 40% of the nondepressive patients had a positive diagnosis of physical illness, with a significantly higher frequency among depressive patients attained by acquired hypothyroidism, migraine, essential hypertension, unspecified abdominal hernia, and unspecified arthropathies. Specific stressors differentially more frequent among depressive patients were those of conjugal, parenting, and occupational types and those reflecting the impact of physical illness. Overall stressor severity was at severe, extreme, or catastrophic levels for 42% of the depressive and 31% of the nondepressive patients. The highest level of adaptive functioning in the past year was good, very good, or superior for 44% of the depressive and 29% of the nondepressive patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Multiaxial characterization of depressive patients. 358 10

A fixed orientation principle was used for the examination of 203 patients with coronary heart disease (CHD) and 123 patients with essential hypertension. Psychological adaptation mechanisms and variation therein were studied in relation to the form, severity, pattern and stage of the disease. The fixed orientation method is based on evoking illusory perception in a subject. Basic fixed orientation types are identified depending on the way one gets rid of the orientation. Variable-stable orientation mediating high motivation, dominance, impulsiveness and aggressiveness in prevalent in CHD irrespective of its form. In hypertensive patients, variable-labile orientation prevails that features impulsiveness, inconsistency, anxiety, psychasthesnia and depression. The occurrence of these parameters was unrelated to form, severity and stage of the disease. Premorbid nature of these features is postulated. The fixed orientation method is recommended as a highly informative way of identifying psychological adaptation mechanisms.
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PMID:[Characteristics of the mechanisms of psychological adaptation of patients with ischemic heart disease and hypertension]. 371 39

Prolonged low frequency stimulation of the sciatic nerve in conscious spontaneously hypertensive rats (SHR), is reported to induce a naloxone-reversible long-lasting depressor response (Yao et al. 1982a). In the present study this depressor response was compared during daytime and night-time conditions to determine whether different degrees of arousal affect this response. In addition, the effect of sciatic nerve stimulation was examined in one-clip, two-kidney renal hypertensive rats (RHR); a type of secondary hypertension which lacks the central autonomic hyper-reactivity which characterizes the SHR variant of primary hypertension. A maximal fall in blood pressure of 20 mm Hg was observed 1 h after sciatic nerve stimulation in SHR examined in daytime. We also found a significant bradycardia that lasted for 2.5 h. Neither poststimulatory depression nor bradycardia were observed in RHR examined at daytime. A short-lasting, non-significant decrease in blood pressure and heart rate was found following sciatic stimulation in SHR examined at night.
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PMID:Long-lasting cardiovascular depression induced by acupuncture-like stimulation of the sciatic nerve in unanaesthetized rats. Effects of arousal and type of hypertension. 372 43

Sixty-one male subjects with mild untreated essential hypertension were classified by renin-sodium profiling as high renin (HR--13 Subjects), normal renin (NR--33 Subjects), or low renin (LR--15 Subjects). The HR subjects reported significantly more symptoms of sensitivity, depression, anxiety, hostility, paranoia, and psychotic thought than LR subjects on the Symptom Checklist (SCL-90). The NR subjects also reported more symptomatology than LR subjects. Similar differences between HR and LR subjects were found with the Cattell 16 Personality Factor Questionnaire (16PF).
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PMID:Psychologic differences between high-, normal-, and low-renin hypertensives. 388 67

The antihypertensive effect of finoptin (verapamil) and corinfar (nifedipin) and their impact on the hemodynamics and the repolarization complex of the ECG were studied in 52 patients with essential hypertension and 48 patients with secondary arterial hypertension. The calcium antagonists were found to effectively decrease the blood pressure by reducing the peripheral resistance. Verapamil may be recommended for the monotherapy of mild and moderate forms of arterial hypertension, whereas corinfar should be used in cases of marked hypertension and at the third stage of therapy. Patients with electrocardiographic signs of myocardial ischemia show the normalization of the ST segment and a decreased depression of T wave under the impact of corinfar.
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PMID:[Treatment of arterial hypertension with calcium antagonists]. 398 59

Studies in our laboratory and by others have repeatedly shown that the mean value of the rate-constant for ouabain-sensitive sodium efflux is reduced and intracellular sodium increased in essential hypertension, but that there is considerable overlap with the normotensive population. There is a significant negative correlation between the rate constant and the diastolic blood pressure. The depression of the rate constant is most marked in those hypertensives with the most suppressed renin/angiotensin systems. Treatment of a population of essential hypertensives with thiazide diuretics returns the rate constant to normal. The serum of hypertensives depresses the rate constant of normal cells in vitro in proportion to the degree of abnormality present in the hypertensive's cells.
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PMID:Factors influencing leucocyte sodium transport in hypertension. 399 43

The relationship of the endogenous opioid system and the hypothalamic-pituitary-adrenal axis to obesity was studied. Morning levels of plasma cortisol and beta-endorphin immunoreactivity in obese patients before diet treatment were found to be no different from those in matched family members of normal weight. In 32 untreated obese patients, no relationship between weight or body mass index (a measurement of obesity) and plasma levels of beta-endorphin immunoreactivity or cortisol was found. However, plasma cortisol levels were significantly correlated with obese patient ratings on the depression subscale of the General Health Questionnaire. Dexamethasone administration failed to suppress plasma beta-endorphin levels in untreated obese patients, but this finding has been reported in normal subjects in whom a similar assay methodology was used; it suppressed plasma cortisol levels in 29 of 32. The three patients resistant to suppression also suffered from benign essential hypertension. Plasma beta-endorphin immunoreactivity was unchanged, but cortisol levels significantly decreased as weight was lost on a 400-calorie/day modified protein fast. Patients who failed to complete the 6-month diet program had significantly increased plasma beta-endorphin levels compared to those who successfully completed the program.
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PMID:Plasma cortisol and beta-endorphin immunoreactivity in human obesity. 609 83


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