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 efficacy of adjunctive imipramine hydrochloride treatment for syndromally defined postpsychotic depression was assessed in a six-week, double-blind, placebo-controlled study. All patients had been diagnosed as having schizophrenia or schizoaffective disorder, all were receiving stable doses of fluphenazine decanoate, and all had received benztropine mesylate in an attempt to rule out neuroleptic-induced akinesia. Patients randomized to imipramine therapy fared significantly better in terms of their global improvement and in terms of individual symptoms that are components of the depression syndrome. There were no significant differences in outcome psychosis ratings or side effects. This study indicates the existence of an identifiable syndrome of secondary depression in this patient group that is likely to respond favorably to treatment with adjunctive imipramine.
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PMID:Adjunctive imipramine in the treatment of postpsychotic depression. A controlled trial. 355 86

Forty-four Parkinson patients (19 patients of the rigid-akinetic type, 13, of the rigid-akinetic-tremor type, and 12, of the tremor type) were included in a study in order to analyse correlations of the expression of the motor symptoms tremor, rigidity, akinesia, with other clinical parameters, computertomographic aspect of brain atrophy and psychometrically assessed cognitive parameters. Rigidity and akinesia are significantly positively correlated with the severity of motor dysability, stage of the disease, and brain atrophy, as is akinesia with a history of pharmacotoxic psychosis. Tremor is significantly negatively correlated with motor dysability, stage of the disease, and history of pharmacotoxic psychosis. Akinesia is correlated with visuomotor dysfunction (tested with Bender Gestalt Test) and rigidity with the depression score (Zung scale). The tremor type is favorable, the rigid-akinetic type unfavorable with respect to motor disability and psychosis.
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PMID:Prognostic implications of the motor symptoms of Parkinson's disease with respect to clinical, computertomographic and psychometric parameters. 378 47

The clinical pattern of symptoms consists of motor disorders (akinesia, tremor, rigor), emotional disorders (depression, abnormal behaviour), autonomic disorders (sweating, salivation, seborrhoea, constipation) and intellectual disorders (bradyphrenia, Alzheimer's dementia)
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PMID:[Clinical picture of Parkinson disease]. 378 88

As L-Dopa was marketed in France in 1971 for treatment of Parkinson's disease we used 1971 to divide a sample of patients into 2 groups. Group 1 (152 patients) includes patients with diagnosis made before 1971 and group 2 (264 patients) with diagnosis after 1971. The prognostic factors were motor deterioration, intellectual deterioration and death. The prognostic variables include the neuro-psychological status at the onset of the disease and at the beginning of L-Dopa treatment. The statistical analysis is based on Kaplan-Meier estimate, Log-rank test and Cox's model. In group 2, 10 years after the beginning treatment of L-Dopa, motor deterioration affected 60 p. 100 of the patients. The poor variables were akineto-hypertonic type, severe akinesia, poor clinical result after one year. Intellectual deterioration was frequent: 30 p. 100 at 10 years. The poor variables were age over 60, depression or psychotic episodes occurring during the first year. The 10 years-survival rate was 64 p. 100 and was not different from that recorded in a French population of same age and sex distribution. The poor variables were severe akinesia, presence of a Babinski sign, poor therapeutic result after one year, occurrence of psychotic episodes during the first year. The interval between the onset of the disease and the beginning of L-Dopa did not have any prognostic value, whatever the response criterion. In group 1, the same prognostic factors were pointed out. Survival and intellectual deterioration were not different in the 2 groups, but in group 1, motor deterioration appeared earlier.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Long-term study of 416 cases of Parkinson disease. Prognostic factors and therapeutic implications]. 379 24

Episodic mitral regurgitation due to ischaemia of one or both papillary muscles was studied in a review of 39 cases with complementary investigations and compared with previously reported data. The condition occurred after myocardial infarction in 69 p. 100 of cases (usually after inferior infarction: 54 p. 100) associated with ischaemia of the controlateral territory; there was no history of myocardial infarction in 31 p. 100 of cases. The patients were usually elderly (73 years), often hypertensive (77 p. 100) and diabetic (62 p. 100). The clinical syndrome was that of severe anginal pain, mitral regurgitation and left ventricular failure which was critical in some cases. The ECG showed typical ST depression (4.1 +/- 1.6 mm) especially in the antero-lateral leads; left bundle branch block (28 p. 100) with left axis deviation (18 p. 100), sometimes associated with changes of chronic infarction (64 p. 100) was also recorded. Mitral regurgitation and left ventricular failure regressed almost completely in typical cases between attacks, whilst the ECG showed slight residual sub-endocardial ischaemia (ST depression of 1.5 +/- 0.4 mm) in 30 cases and/or subepicardial ischaemia observed in the anterolateral leads in 13 cases. Phonomechanographic recordings (n = 32) showed moderate mitral regurgitation (1-2/6), usually parasystolic (47 p. 100) or early and mid systolic (36 p. 100) in 87.5 p. 100 of cases between attacks, aggravated by handgrip exercise and improved by trinitrin administration. Echocardiography (n = 27) only showed mitral valve changes in 2 patients (increased density of the papillary muscle in 1 case and prolapse of the anterior leaflet in 1 case); however, segmental wall hypokinetic (51 p. 100) or dyskinetic (15 p. 100) motion, was common with increased left ventricular end diastolic dimensions (mean 56.3 +/- 8.0 mm) and decreased fractional shortening (mean 0.30 +/- 0.07) (67 p. 100). Left atrial dimensions were increased (mean 39.7 +/- 6.4 mm) in 52 p. 100 of patients. Thallium 201 myocardial scintigraphy (n = 32) showed hypofixation in 57 (36 p. 100) and a lacuna in 23 (14 p. 100) of the 160 segments analysed. Left ventricular angioscintigraphy (n = 27; 135 segments) showed hypokinesia in 72 segments (53 p. 100); 2.7 segments per patient), akinesia in 19 segments (15 p. 100; 0.7 segment per patient) and dyskinesia in 2 segments (1.5 p. 100); 0.1 segment per patient). The global ejection fraction was 46 +/- 13 p. 100. Coronary angiography (n = 8) showed significant diffuse atherosclerosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Paroxysmal mitral insufficiency caused by ischemic dysfunction of the papillary muscles. Apropos of 39 cases]. 391 82

The authors report their experience of 2D echocardiography in the acute stage of myocardial infarction. One hundred patients, 60 men and 40 women, aged 60 +/- 4.5 years (range 32 to 69 years) were admitted to hospital with an uncomplicated inferior myocardial infarction and underwent 2D echocardiography on admission and coronary angiography 15 days later. Ten patients were excluded because unsatisfactory quality of the echocardiographic images. Forty-seven patients had initial ST depression of at least 1 mm in leads V1 to V4 (Group I) and 43 patients did not show these electrical changes (Group II). There were no significant differences in the clinical findings or in the cardiovascular risk factors between the 2 groups. On the other hand, inaugural necrosis was commoner in Group II (p less than 0.03) and cardiomegaly and CPK elevation greater in Group I (p less than 0.02). 2D echocardiography demonstrated the same degree of posterior wall hypokinesia or akinesia in the 2 groups. Septal hypokinesia was observed twice as commonly in Group I (p less than 0.03) both at echocardiography and ventriculography. Haemodynamic and angiographic data showed that double and triple vessel disease was commoner (p less than 0.05), that left anterior descending disease was more severe (p less than 0.03), left ventricular end diastolic pressure was higher (p less than 0.02) and the ejection fraction lower (p less than 0.02) in Group I, compared with Group II.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Detection of disease of the anterior interventricular artery by 2-dimensional echocardiography in acute inferior infarction. Comparison with the electrocardiographic data]. 393 21

Despite numerous studies, the significance of precordial ST-segment depression in inferior wall acute myocardial infarction (AMI) remains unclear. No clinical studies have used 2-dimensional (2-D) echocardiography to compare AMI location in patients with or without so-called reciprocal ST changes. Therefore, the clinical, electrocardiographic, echocardiographic and angiographic features of 22 patients with their first transmural inferior AMI were prospectively examined. During the first day of AMI an echocardiographic mapping of the area of necrosis was obtained using all conventional views and a ventricular segmentation related to anatomic landmarks. Patients were categorized according to the presence (group I, n = 13) or absence (group II, n = 9) of precordial ST-segment depression, defined as more than 1 mm, measured 80 ms after the J point in at least 2 of the leads V1 to V4. Basal posterolateral akinesia was observed in 11 of the 13 patients in group I and in no patient in group II (p less than 0.001). Posterior right ventricular free wall akinesia was more frequent in group II (p less than 0.02). There was no difference in the prevalence of significant left anterior descending artery (LAD) narrowing (group I, 4 patients; group II, 3 patients). Posterolateral involvement should be strongly considered in the presence of precordial ST-segment depression in association with transmural inferior AMI.
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PMID:Significance of precordial ST-segment depression in inferior acute myocardial infarction as determined by echocardiography. 394 81

The initial two-dimensional echocardiogram (2DE) and electrocardiogram (ECG) of 50 consecutive patients with chest pain and a possible acute non-Q wave myocardial infarction (MI) were compared to each other to determine the value of 2DE in this type of acute MI. The ECG markers for a non-Q wave MI were (1) greater than or equal to 0.15 mV ST segment depression, (2) ST segment elevations with reciprocal ST segment depression, and (3) new symmetrical deep T wave changes as compared to a recent preadmission ECG. The 2DE was considered positive for MI if akinesia, dyskinesia, or severe hypokinesia was seen in one or more left ventricular segments. The sensitivity, specificity, and predictive value of the 2DE as compared to the ECG was 66% and 52%, respectively (sensitivity); 91% and 95%, respectivity (specificity); and 91% and 94%, respectively (predictive value). Statistically, there were no differences in the proportion of patients who had a positive 2DE as compared to the proportion of patients who had a positive ECG (p greater than 0.2). The ECG and 2DE results were combined and the sensitivity increased to 76% but the specificity decreased to 86%. Myocardial infarction size was not significantly different in infarcted subjects who had a positive 2DE (395 +/- 125 IU/L) as compared to those who had a negative 2DE (727 +/- 187 IU/L, p greater than 0.1).
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PMID:Two-dimensional echocardiography versus surface electrocardiography for the diagnosis of acute non-Q wave myocardial infarction. 401 89

Classical antipsychotic drugs such as haloperidol produce akinesia and catalepsy, whereas clozapine and related atypical antipsychotics fail to elicit these behaviors even at relatively high doses. Despite these behavioral differences, a cataleptic dose of haloperidol (2.0 mg/kg) produces changes in neuronal activity in the neostriatum and nucleus accumbens comparable to those produced by a non-cataleptic dose of clozapine (20.0 mg/kg). To further elucidate the brain mechanisms underlying the differential behavioral response to these drugs, an electrophysiological analysis was extended to neurons in the rat amygdaloid complex. Whereas an intraperitoneal injection of 2.0 mg/kg haloperidol generally failed to alter the firing rate of amygdaloid neurons, 20.0 mg/kg clozapine typically produced a prolonged increase in activity. Similarly, clozapine, but not haloperidol, reversed the depression of firing rate produced by 1.0 mg/kg d-amphetamine. The results suggest that neurons in the amygdaloid complex are more responsive to antipsychotic drugs devoid of extrapyramidal side effects than to antipsychotics which elicit parkinsonian-like motor dysfunctions.
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PMID:Differential actions of classical and atypical antipsychotic drugs on spontaneous neuronal activity in the amygdaloid complex. 611 Feb 10

Most extrapyramidal side effects of neuroleptics are easily recognized and cause little problem in diagnosis and treatment. The exceptions are those which mimic psychopathology: akathesia and akinesia. Akathesia resembles anxiety. Akinesia is similar to depression, residual schizophrenia, and demoralization. Differential diagnosis may require interruption of the neuroleptic. Whether neuroleptics can cause depression not associated with akinesia has never been established. The first obligation of the clinician is to be sure that the depressive symptoms are not concomitants of akinesia, before treating with antidepressants which may not be the appropriate treatment. There is no convincing evidence that one neuroleptic drug is more likely to cause akinesia than another, although this had not been studied extensively using a broad definition of akinesia.
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PMID:The risks of long-term neuroleptic treatment of schizophrenia: especially depression and akinesia. 611 30


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