Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied remifentanil and propofol for analgesia and sedation during the placement of an ophthalmic block. Eighty ASA I or II patients undergoing elective cataract surgery under a retrobulbar block in a rural camp setting were included in the study. Patients were randomly divided into four groups and received different drug combinations as follows: Group I--remifentanil 1 microg/kg, Group II--remifentanil 0.5 microg/kg and propofol 0.5 mg/kg, Group III--remifentanil 1 microg/kg with propofol 0.5 mg/kg and Group IV--saline 0.1 ml/kg. Patients were observed for degree of movement, sedation, pain, recall and respiratory depression. No patient in the study groups reported pain or displayed movement whereas most of the patients in the control group had significant pain during the placement of the block. Also, seven (35%) patients in the control group showed significant movement which may have led to failure of block in two patients and retrobulbar haemorrhage in one patient. Incidence of significant respiratory depression was maximum in Group III patients (60%), followed by Group I (20%) and least in Group II (5%). All patients in the study groups remained cooperative and obeyed commands except four patients in group III (OAA/S-4). Postoperatively, other than the control group, recall was maximum in Group I (55%) and least in Group II (5%). Hence, a combination of remifentanil 0.5 microg/kg with propofol 0.5 mg/kg as a bolus was considered to provide excellent relief of pain and anxiety with least adverse effects for the placement of ophthalmic blocks.
 ...
PMID:Remifentanil and propofol sedation for retrobulbar nerve block. 1471 39

A 37-year-old ophthalmologist had bilateral simultaneous laser in situ keratomileusis (LASIK) for moderate myopia with astigmatism using the Alcon Summit LADARVision laser; an ablation zone of 5.5 mm was used. Five months after surgery, the uncorrected visual acuity was 20/20 and 20/25 but despite regular corneal topographies, the patient experienced prominent ghost images under photopic and scotopic conditions. To elucidate the nature of the problem, automated static perimetry was performed, which revealed a significant depression between 10 degrees and 30 degrees compared with a baseline study obtained 3 years earlier. The patient started brimonidine 0.2% 1 drop in both eyes every morning, which caused 1.5 to 2.0 mm of pupillary miosis (tonic pupil size 3.0 to 4.0 mm in dim light) and eradicated the ghost images. Repeat perimetry showed significant improvement in all indices. The mechanism of improvement is unclear but may be due to elimination of light scatter from the transition zone between the ablated and unablated cornea. The issue of perimetric changes after refractive surgery deserves more attention; postoperative testing may be indicated for patients in whom the ablation zone diameter is close to the mesopic or scotopic pupil size to provide an accurate lifetime baseline visual field.
J Cataract Refract Surg 2002 Oct
PMID:Iatrogenic ring scotoma after laser in situ keratomileusis. 1238 42

In the past few years, there have been many changes in ophthalmic anaesthesia. Application of drugs in general anaesthesia with excellent controllability enhances patient safety and allows a more efficient OR-management. Regional anaesthesia is gaining widespread use for ophthalmic surgery, especially topical anaesthesia for cataract surgery. Patients for ophthalmic surgery concomitantly often display high age and a high level of co-morbidity and, therefore, belong to the anaesthesiological risk groups ASA III-IV. Life-threatening adverse events including cardiovascular depression are associated with general and regional anaesthesia. Intervention by anaesthesiologists is frequently required for treatment of hypertension or dysrhythmias, and sedation. Thus, monitored anaesthesia care ("standby") is justified. Drugs applied for regional and general anaesthesia may change intraocular pressure. There are a lot of publications about the impact of anaesthesia on intraocular pressure (IOD), however, few on the effects of anaesthesia on pulsatile ocular blood flow. it has to be kept in mind that the effects of anaesthesia on intra-ocular pressure and pulsatile ocular blood flow may diverge. To avoid an increase of the IOD, especially during anaesthesia induction, drugs, such as succinylcholin, rocuronium and opiates, in particular remifentanil, can be applied. In addition, the use of the laryngeal mask may be advantageous compared to general anaesthesia associated with laryngoscopic tracheal intubation. The management of patients treated with anticoagulants and antiplatelet agents, has to be taken on the balance of risks. There are risks not only in continuing therapy, but also in discontinuing it perioperatively. Postoperative nausea and vomiting (PONV) remains a distressing and common problem after strabismus repair in particular in children. The incidence of PONV depends on the type of ophthalmic surgery and drugs applied. To reduce PONV in ophthalmic surgery, application of long-lasting opiates should be avoided, and non-opiate analgesics and, depending on the kind of operation, antiemetic prophylactics are recommended.
 ...
PMID:[What's new in ophthalmic anaesthesia?]. 1470 36

In the older age, all body systems show decrements in physiological reserves. Degenerative process starts in this age and complications and sequelae of chronic long-term diseases eg, hypertension and diabetes make their appearance. In the elderly multiple pathologies are often encountered. Common disease conditions found in the elderly are: Parkinson's disease, depression, ischaemic heart disease, chronic obstructive lung disease, tuberculosis and cancer of the lung, osteo-arthritis of various joints, diabetes, hypertension, cataract, hearing loss and so on. While suggesting food for the elderly, one should take into account the small amounts of food with minimum sugar and fats but lots of fresh vegetables and fruits taken in small quantities but more frequently. Physical activity and exercise is good at all ages including old age. Psychological problems frequently arise among the elderly. They result from many factors eg, difficulties with memory, loss of hearing, financial difficulties, feeling of insecurity, chronic unrelieved pain, diffuse atrophy of the brain, etc. Depression is the commonest of the psychological problems of the aged. Alzheimer's disease, dementia are some other problems often arise out of the ageing process. All old people and not-so-old ones should be encouraged to continue stimulating mental activity with the same vigour as we advise them to continue physical activity.
 ...
PMID:Approach to the problems of the aged. 1520 Feb 3

A 65-year-old woman had undergone cataract extraction with implantation of an intraocular lens (IOL) in the left eye 5 years previously. The eye remained irritated and she did not regain useful vision. She had pain and foreign body sensation in that eye for 3 months that became especially severe in the 3 days prior to presentation. On examination, the optic and one haptic of an IOL protruded through a small fistula in a leukomatous cornea. The tip of the other haptic was embedded in the fistula. The surgical scar was intact and there was a circular depression on the superior cornea identical in size and shape to the optic. There was no history of trauma or rheumatoid arthritis. The IOL, barring one haptic, may have extruded through the site of a perforated corneal ulcer and remained impacted on the corneal surface, allowing healing under it. This is an extremely unusual presentation of an extruded IOL.
 ...
PMID:Gradual extrusion of implant: an unusual complication after intraocular lens implantation. 1530 62

Previous studies have demonstrated that administration of pyruvate prevents cataract formation in diabetic rats. It is known that the induction of cataractous process in this case is initiated by aldose reductase (AR) catalyzed synthesis and accumulation of excessive sorbitol in the lens fibres and epithelium and their consequent osmotic hydration. Synthesis of this and other polyols is competitively inhibited by pyruvate. The objective of the present investigations was hence to determine whether pyruvate would have a similar protective effect in species where cataract formation is relatively independent of sorbitol synthesis such as in humans where the lens AR activity is extremely low, especially with glucose as a substrate. The Km of AR for glucose is known to be very high. The possible protective effect of pyruvate in the low AR models was conceived on the basis of our previous findings suggesting that it can also exert substantial antiglycating as well as antioxidant effects. The present studies have hence been conducted with mice, a species known to be low in lens AR, similar to that in humans. As stipulated, pyruvate administration has indeed been found to offer a significant protection against development of diabetic cataract in this model also. The effect correlated with the inhibition of protein glycation as well as of oxidative stress. The latter was apparent by the prevention of the loss of glutathione known to be associated with diabetes. Although there was a small but noticeable increment in the sorbitol content of the diabetic lenses, this was osmotically insignificant. Even this increase was prevented by pyruvate. The magnitude of the elevation in the contents of glycated proteins and the depression in the level of glutathione were, on the contrary, highly pronounced, suggesting a more prominent role of the latter factors. In addition, the possibility of a direct metabolic support it could offer to the tissue is also imminent by its effect on the maintenance of ATP, as shown earlier. The present studies are therefore considered more relevant to the pathogenesis of cataract in human diabetics and its possible prevention by endogenous compounds with antiglycating and antioxidant properties. Inhibition of cataract formation by pyruvate in an animal model with low lens AR, similar to that in humans, has been shown for the first time.
 ...
PMID:Prevention of cataract by pyruvate in experimentally diabetic mice. 1578 23

A case is reported of nail gun injury due to suicide attempt involving both orbits, frontal lobe and abdomen, which resulted in an unusual posterior perforation of the left globe. Injury was inflicted with a total of eight nails. Three nails entered the left orbit, one of which perforated the posterior aspect of the left globe. One nail entered the right orbit involving the optic nerve and crossed the midline to finish in the left sphenoid sinus. Three nails entered the frontal lobe near the midline and the final nail pierced the left lobe of the liver. The left eye underwent primary repair, lensectomy and vitrectomy with silicone oil and achieved a visual acuity of 6/60, 3 months post removal of oil with sutured posterior chamber intraocular lens. The right eye suffered traumatic optic neuropathy and currently has a visual acuity of 6/36 due to senile cataract formation. No other serious sequelae resulted from the other injuries and the patient has recovered from his episode of depression.
 ...
PMID:Suicide-related perforating injury of globe with nail gun. 1593 35

It is well known that the incidence of cataract is higher in diabetics as compared to non-diabetics. Its rate of maturation is also faster in the diabetics. The precise mechanism of this acceleration is not clearly understood. It is hypothesized that this could be a result of the combination of the metabolic and oxidative stress induced by glycemia itself with the age-associated increase in ambient generation of oxyradical species. In the current studies, we have investigated this possibility using the galactose cataract model. Galactosemia was induced by feeding rats a 50% galactose diet. The increased susceptibility of the glycemic lenses to physiological damage by reactive oxygen species (ROS) was studied by incubating them in Tyrode in the absence and presence of menadione. The resulting physiological damage to the lens was assessed initially in terms of its ability to maintain Na+-K+ ATPase dependent active transport of potassium ions, as represented by the uptake of rubidium ions. Subsequently, the level of ATP, indexing the general metabolic status, and the level of glutathione (GSH), indexing the status of antioxidant reserve, were also determined. The uptake of rubidium in the normal lenses incubated in the presence of the quinone was depressed to more than 50% of the controls run in the basal medium. A similar depression existed in the galactosemic lenses in comparison to the normal lenses. However, in the presence of menadione, the inhibition of the uptake was accentuated further in the case of galactosemic lenses, the uptake here being only 20% of the normal controls. Similarly, the galactosemic lenses were also more susceptible to menadione dependent decrease in ATP and GSH.
 ...
PMID:Combination of glycemic and oxidative stress in lens: implications in augmentation of cataract formation in diabetes. 1603 27

We report on clinical, histological and genetic findings in two patients carrying novel heteroplasmic mutations in the mitochondrial cytochrome c oxidase subunit genes COII and COIII. The first patient, a 35 year-old man had a multisystemic disease, with clinical symptoms of bilateral cataract, sensori-neural hearing loss, myopathy, ataxia, cardiac arrhythmia, depression and short stature and carried a 7970 G>T (E129X) nonsense mutation in COII. A sudden episode of metabolic encephalopathy caused by extremely high blood lactate lead to coma. The second patient developed exercise intolerance and rhabdomyolysis at age 22 years. A heteroplasmic missense mutation 9789 T>C (S195P) was found in skeletal muscle, but not in blood and myoblasts pointing to a sporadic mutation. Our report of two patients with isolated COX deficiency and new mutations in COX subunit genes may help to draw more attention to this type of mtDNA defects and provide new aspects for counselling affected families.
 ...
PMID:Mutations in mtDNA-encoded cytochrome c oxidase subunit genes causing isolated myopathy or severe encephalomyopathy. 1628 75

To assess anxiety induced by a planned cataract surgery and to evaluate the correlations of rated anxiety and depression with optical acuity pre- and post-operatively, 278 patients ages 65 years or older were tested. Patients were divided into two groups: first-eye and second-eye cataract surgery. Anxiety and depression were evaluated using the Hamilton's Rating Scales for Anxiety and Depression, respectively. Pre-operatively, first-eye patients showed significantly higher anxiety than second-eye patients (F1,251 = 75.39, p < .001). First-eye patients rated peak anxiety on the day of the surgery, while patients scheduled for second-eye cataract surgery presented no fluctuations in rated anxiety (F1,251 = 49.60, p < .001). There was no correlation of preoperative anxiety or depression with the outcome of surgery (F(1,251)s = .83 and .58, respectively, p > .05). Postoperatively, anxiety and depression in patients without any improvement in their vision were rated significantly higher than in those presenting improved visual acuity after surgery (F1,251 = 566.17 and 300.25, respectively, p < .001).
 ...
PMID:Anxiety and depression in cataract surgery: a pilot study in the elderly. 1703 77


<< Previous 1 2 3 4 5 6 7 8 9 Next >>