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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite intensive evaluation of acute stroke patients, perhaps only half of the attributable stroke risk is usually identified. In addition to traditional and non-traditional vascular risk factors-including most recently homocysteine, inflammation, and alterations of coagulation-a number of environmental risk factors for stroke have been identified in the last decade. In this update we review the following: lower education and poor socioeconomic status (probable surrogates for exposure to traditional high-risk behaviors such as smoking, poor nutrition, lack of prenatal control, absence of preventive medical and dental care, and non-compliance of treatment of conditions such as hypertension); depression, stress and affective disorders; obstructive sleep apnea; passive smoking and environmental pollution; infections, in particular periodontal diseases that increase C-reactive protein (CRP); raised body mass index (obesity); exercise, and diet. The possible role of high-fructose corn syrup in the epidemic of obesity in the USA is reviewed. Protective diets include higher consumption of fish, olive oil, grains, fruits and vegetables (Mediterranean diet), as well as probiotic bacteria in yogurt and dairy products. Careful attention should be given to the patient's environment looking for modifiable factors. The effects of clean environmental air and water, adequate diet and appropriate nutrition, healthy teeth, exercise, and refreshing sleep in the prevention of stroke and cardiovascular disease appear to be quite compelling. Although some of these modifiable risk factors lack evidence-based information, judicious clinical sense should be used to counteract the potentially damaging effects of adverse environmental vascular risk factors.
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PMID:Environmental vascular risk factors: new perspectives for stroke prevention. 1765 71

The notion that persistence is essential for success and happiness is deeply embedded in popular and scientific writings. However, when people are faced with situations in which they cannot realize a key life goal, the most adaptive response for mental and physical health may be to disengage from that goal. This project followed 90 adolescents over the course of 1 year. Capacities for managing unattainable goals were assessed at baseline, and concentrations of the inflammatory molecule C-reactive protein (CRP) were quantified at that time, as well as 6 and 12 months later. To the extent that subjects had difficulties disengaging from unattainable goals, they displayed increasing concentrations of CRP over the follow-up. This association was independent of potential confounds, including adiposity, smoking, and depression. Because excessive inflammation contributes to a variety of adverse medical outcomes, these findings suggest that in some contexts, persistence may actually undermine well-being and good health.
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PMID:You've gotta know when to fold 'em: goal disengagement and systemic inflammation in adolescence. 1776 Jul 71

Positive affective states are associated with favorable health outcomes, but the underlying mechanisms are poorly understood. The authors assessed associations between positive affect, cortisol sampled over the day, and inflammatory markers (C-reactive protein and interleukin-6) among 2,873 healthy members of the Whitehall II study. Data for this study were collected in 2002-2004 in London, United Kingdom. Saliva free cortisol was assessed on waking, 30 minutes later, and four times over the day and evening. Positive affect was indexed by aggregating ecological momentary assessments of positive mood over the day. Salivary cortisol averaged over the day was inversely associated with positive affect after controlling for age, gender, income, ethnicity, body mass index, waist/hip ratio, smoking, paid employment, time of waking in the morning, and depression (p = 0.003). There was no association with cortisol responses to waking. The adjusted odds of C-reactive protein >/=3.00 mg/liter was 1.89 (95% confidence interval: 1.08, 3.31) in low- compared with high-positive-affect women, and plasma interleukin-6 was also inversely related to positive affect in women (p = 0.016). Neither inflammatory marker was related to positive affect in men. These results confirm findings from smaller studies relating cortisol with positive affect while suggesting that in women, positive affect is associated with reduced levels of inflammatory markers.
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PMID:Neuroendocrine and inflammatory factors associated with positive affect in healthy men and women: the Whitehall II study. 1791 95

This study was carried out in order to evaluate the efficiency of blood-letting cupping (BLC) therapy as a complementary therapy in management of rheumatoid arthritis (RA) and to investigate its modulatory effects on natural killer cells (NK) and soluble interleukin-2 receptor (SIL-2R). Two groups of RA patients diagnosed according to American Rheumatology Association were included: Group I included 20 patients who received the conventional medicinal therapy of RA, Group II included 30 patients who received combined conventional and BLC therapy. Ten age and sex matched normal controls were also included, as group III. Visual analogue score (VAS), tender joint count (TJC), swollen joint count (SJC), disease activity scores (DAS), laboratory markers of disease activity [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF)] were evaluated on 3 successive months, NK cell (%) measured by flowcytometry and SIL-2R concentrations measured by ELISA were also assessed. After one month of combined therapy there was significant (P < 0.001) reduction in VAS (5.16 +/- 0.28), TJC (11.62 +/- 1.03), SJC (10.13 +/- 1.02) and DAS (5.35 +/- 0.14). Early and marked reductions in laboratory markers of disease activity (26.90 +/- 3.68) for CRP, (51.46 +/- 6.06) for RF and (40.56 +/-3.36) for ESR were also detected as compared to base line, while the effects of conventional therapy appeared late after 3 months of treatment. Conventional therapy induced significant depression in white blood cell (WBC %) (p < 0.001) whereas combined therapy induced marked (p < 0.001) elevation since the first month (8.44 +/- 1.58) compared to base line (6.94 +/- 1.58). There was a significant (P < 0.05) lowering in NK cell (%) with conventional therapy while combined therapy induced significant (P < 0.001) increase (11.33 +/- 0.4.7) compared to base line level (8.50 +/- 0.46). Additionally, combined therapy resulted in marked reduction (P < 0.001) in SIL-2R conc. after 3 months of treatment (1790 +/- 68.11) compared to base line (2023 +/- 92.95), while insignificant reduction was detected with the conventional therapy. The improvement rate (%) of clinical, laboratory cellular & immunological parameters were significantly higher with combined therapy than with conventional therapy. Moreover, strong positive correlations (p < 0.0001) were detected between SIL-R conc. and clinical parameters VAS (r = 0.890), TJC (r = 0.905), SJC (r = 0.872) and DAS (r = 0.923) and also between SIL-R conc. and ESR (r = 0.973), CRP (r = 0.933), RF (r = 0.941), while a strong negative correlation was found with NK count cell % (r = 0.927). In conclusion, BLC therapy combined with conventional therapy may improve the clinical condition of patients with RA. It has modulatory effects on the innate (NK %) and adaptive cellular (SIL-2R conc.) immune responses that could be used as monitoring tools for disease activity and prognosis.
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PMID:Immunomodulatory effects of blood letting cupping therapy in patients with rheumatoid arthritis. 1797 9

Although depression is known to be an independent risk factor for cardiovascular disorders, the mechanisms behind this connection are not well understood. However, the reduction in the number of endothelial progenitor cells (EPCs) in patients with cardiovascular risk factors has led us to hypothesize that depression influences the number of EPCs. EPCs labeled with CD34, CD133 and vascular endothelial growth factor receptor-2 (VEGFR2) antibodies were counted by flow cytometry in the peripheral blood (PB) of 33 patients with a current episode of major depression and of 16 control subjects. Mature (CD34+/VEGFR2+) and immature (CD133+/VEGFR2+) EPC counts were decreased in patients (vs controls; P<0.01 for both comparisons), and there was a significant inverse relationship between EPC levels and the severity of depressive symptoms (P<0.01 for both EPC phenotypes). Additionally, we assayed the plasma levels of VEGF, C-reactive protein (CRP) and tumor necrosis factor (TNF)-alpha and observed significantly elevated TNF-alpha concentrations in patients (vs controls; P<0.05) and, moreover, a significant inverse correlation between TNF-alpha and EPC levels (P<0.05). Moreover, by means of a quantitative RT-PCR approach, we measured CD34, CD133 and VEGFR2 mRNA levels of PB samples and found a net trend toward a decrease in all the investigated EPC-specific mRNA levels in patients as compared with controls. However, statistical significance was reached only for VEGFR2 and CD133 levels (P<0.01 for both markers). This is the first paper that demonstrates evidence of decreased numbers of circulating EPCs in patients with a current episode of major depression.
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PMID:Circulating endothelial progenitor cells and depression: a possible novel link between heart and soul. 1818 Jul 58

In 101 patients with ischemic heart disease (unstable angina class I and II-III) with hypercholesterolemia at the background of standard therapy (51 patients) and after administration of atorvastatin (50 persons) prescribed from first day of hospitalization in mean dose 10.8 +/- 0.1 mg/day immune status was studied in accordance with 3 stage scheme of examination. In dynamics (before onset of treatment and after 6 months of therapy) a concentrations of a row of cytokines was studied: alpha-factor of tumor necrosis (TNFalpha) and C-reactive protein (CRP). At correlation analysis of parameters of plasma lipid composition and immune profile it has been established that in patients with unstable angina (in the presence of hypercholesterolemia) together with elevation of CRP level substantial signs of dysbalance in immune system are observed. These signs appear as elevation of levels of TNFalpha, interleukin-4, and especially interferon gamma with simultaneous depression of cells of immune defense. In has been demonstrated that atorvastatin not only exerts good hypolipidemic effect, but is capable to diminish immunoinflammatory shifts in patients with acute coronary pathology.
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PMID:[Immunoinflammatory factors in unstable angina. Possibility of influence of atorvastatin]. 1826 Aug 69

Among the factors influencing weight loss and maintenance, psychobehavioral, nutritional, metabolic, hormonal and hereditary predictors play an important role. Psychobehavioral factors influence adherence to lifestyle changes and thus weight loss maintenance. The outcome of short-term weight reduction treatment is mainly affected by changes in energy and nutrient intake and physical activity and thus the impact of hormones can possibly be obscured. In order to reveal hormonal determinants of weight loss, a 4-week in-patient comprehensive weight reduction program was introduced in which food intake and physical activity were under the strict control. Women (n = 67, BMI: 32.4+/-4.4 kg; age: 48.7+/-12.2 years) who exhibited stable weight on a 7 MJ/day diet during the first week of weight management were given a hypocaloric diet yielding daily energy deficit 2.5 MJ over the subsequent 3-week period. This treatment resulted in a mean weight loss of 3.80+/-1.64 kg. Correlation analysis revealed that baseline concentrations of several hormones were significantly associated either with a higher (free triiodothyronine, C-peptide, growth hormone, pancreatic polypeptide) or with a lower (insulin-like growth factor-I, cortisol, adiponectin, neuropeptide Y) reduction of anthropometric parameters in response to weight management. In a backward stepwise regression model age, initial BMI together with baseline levels of growth hormone, peptide YY, neuropetide Y and C-reactive protein predicted 49.8 % of the variability in weight loss. Psychobehavioral factors (items of the Eating Inventory, Beck Depression score) did not contribute to weight change induced by a well-controlled short-term weight reduction program.
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PMID:Hormonal and psychobehavioral predictors of weight loss in response to a short-term weight reduction program in obese women. 1827 95

Rimonabant (Acomplia) is the first selective CB1 receptor blocker of the endocannabinoid system. Clinical trials showed that, compared to placebo, rimonabant 20 mg/ day consistently increases weight loss, reduces waist circumference, improves atherogenic dyslipidaemia (low HDL cholesterol, high triglycerides, high small dense LDL), diminishes insulin resistance, reduces HbA1c levels, and contributes to lower blood pressure and C-reactive protein levels. Almost half of the most important metabolic effects occur beyond weight loss, suggesting direct peripheral effects of rimonabant, especially in visceral adipose tissue as suggested by the increase in adiponectin levels. Rimonabant at a daily dose of 20 mg is indicated as an adjunct to diet and exercise for the treatment of obese patients, or overweight patients with associated risk factor(s) such as type 2 diabetes or dyslipidaemia. Adverse effects concern digestive tract (nausea, mostly transient) and psychological disorders (depressed mood, anxiety), in relation to the mechanism of action of the drug. Therefore, rimonabant is contra-indicated in case of depression and/or in patients receiving antidepressants.
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PMID:[Medication of the month. Rimonabant (Acomplia): first CB1 receptor antagonist of the endocannabinoid system]. 1830 86

Studies have suggested that subjective social status (SSS) is an important predictor of health. This study examined the link between SSS and health in old age and investigated whether SSS mediated the associations between objective indicators of socioeconomic status and health. It used cross-sectional data from the second wave (2004-2005) of the English Longitudinal Study of Ageing, which were collected through personal interviews and nurse visits. The study population consisted of 3368 men and 4065 women aged 52 years or older. The outcome measures included: self-rated health, long-standing illness, depression, hypertension, diabetes, central obesity, high-density lipoprotein cholesterol, triglycerides, fibrinogen, and C-reactive protein. The main independent variable was SSS measured using a scale representing a 10-rung ladder. Wealth, education, and occupational class were employed as covariates along with age and marital status and also, in additional analyses, as the main independent variables. Gender-specific logistic and linear regression analyses were performed. In age-adjusted analyses SSS was related positively to almost all health outcomes. Many of these relationships remained significant after adjustment for covariates. In men, SSS was significantly (p<or=0.05) related to self-rated health, depression, and long-standing illness after adjustment for all covariates, while its association with fibrinogen became non-significant. In women, after adjusting for all covariates, SSS was significantly associated with self-rated health, depression, long-standing illness, diabetes, and high-density lipoprotein cholesterol, but its associations with central obesity and C-reactive protein became non-significant. Further analysis suggested that SSS mediated fully or partially the associations between education, occupational class and self-reported and clinical health measures. On the contrary, SSS did not mediate wealth's associations with the outcome measures, except those with self-reported health measures. Our results suggest that SSS is an important correlate of health in old age, possibly because of its ability to epitomize life-time achievement and socioeconomic status.
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PMID:Socioeconomic status and health: the role of subjective social status. 1844 Jan 11

Although the role of inflammation has been studied in specific diseases or in community living elderly, data in hospitalized acute care elderly patients are scarce. The present study was designed to determine the predictive value of sociodemographic, clinical and biological factors for mortality in acute care geriatric wards. Retrospective study was conducted in two acute care wards in a university-based geriatric hospital with elderly patients (n=224) consecutively admitted to acute care wards with available medical files. Sociodemographic variables, primary medical diagnosis and number of associated conditions, dementia, depression, pressure sores, functional status (measure by the activities of daily living=ADL scale), weight, and plasma levels of albumin, transthyretin, C-reactive protein (CRP) and orosomucoid were recorded at admission. Patients who died in the acute care wards were compared to those who survived. The mean length of stay was 16+/-13 days; mortality was 12%. Univariate analysis revealed that disability, no anti-depressant drug, pressure ulcers, a higher number of associated conditions, living with another person, and biological markers of malnutrition (albumin <35g/l, transthyretin <200mg/l) and inflammation (CRP < or =30mg/l, orosomucoid > or =1.25g/l) were significantly associated with an increase in the risk of death. The logistic regression model retained CRP > or =30mg/l (odds ratio (OR)=3.72, 95% confidence interval (CI)=1.34-10.31; p=0.009) and disability for at least one ADL item (OR=2.16, 95% CI=1.55-2.99; p<0.001) as independent risk factors for death. We conclude that CRP and disability are strong independent risk factors for death in this population, and special attention should be paid to these patients in an integrated therapeutic approach to geriatric care.
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PMID:Inflammation and disability as risk factors for mortality in elderly acute care patients. 1845 52


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