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)

Sequential chemotherapeutic regimens, primarily used in the treatment of hematopoietic malignancies, and employing ara-C as a basic antineoplastic agent induce mucosal alterations in the entire gastrointestinal tract. These are characterized by surface and glandular epithelial atypia, immaturity, and necrosis. Glandular regeneration is characteristically delayed leading to a state of intestinal aproliferative cytopenia. Other toxic intestinal changes include telangiectasia of blood vessels and the formation of intramural hematomas. Intestinal infections develop frequently and are complicated by peritonitis, liver abscesses, pneumatosis cystoides in testinalis and sepsis. These intestinal lesions are accompanied by a predictable clinical syndrome which begins concomitantly with ara-C infusions and is characterized by diarrhea, ileus, abdominal pain, hematemesis and melena, severe hypokalemia, hypocalcemia and a protein-losing enteropathy. Additional toxic manifestations induced by ara-C include transient weight gains, fever elevations and severe bone marrow depression. The genesis of the intestinal lesions is linked to the three day dose schedule of ara-C infusions which insures both arrest of the cycling intestinal cells in the S-phase and a high cytotoxic index. The severity of these lesions is markedly augmented by prior treatment with ara-C and cyclophosphamide which causes synchronization and probable recruitment of intestinal stem cells, respectively.
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PMID:Cytosine arabinoside induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols: a clinical-pathologic study of 33 patients. 70 32

Initial examination and therapy, and the avoidance of maltreatment are emphasized. Gastric decompression is of prime importance, after which no compound should be administered via stomach tube. Where large amounts of high starch grains are fed, primary acute gastric dilatation must be differentiated from that secondary to small bowel dilatation, by immediate gastric intubation and irrigation of the cardia with lidocaine. If cessation of pain and improvement of peristalsis and general attitude follow, the former state may be assumed. If pain persists and peristalsis does not improve markedly, one should assume small bowel displacement. Rectal examination is helpful in initial evaluation: impactions, inguinal herniation and ileocaecal intussusception may be diagnosed and small bowel displacement suspected. Palpation of one or more distended loops of bowel in the ventral middle third of the abdomen indicates small bowel displacement or ileus and flaccid distension. Distinction by rectal palpation alone is difficult. Palpation of the gas-distended apex of the caecum in the middle third of the abdomen is virtually pathognomonic for 180 degrees rotation of the large bowel. Abdominal paracentesis yielding true sanguineous effusion indicates a necrotizing segment of the bowel. If negative, such a segment is absent, or there is an infarcted segment, not yet damaged to the point of leaching whole blood, or the necrotizing segment is outside the peritoneal cavity, i.e., in the thorax, intussuscepted into the caecum, or herniated into the inguinal canal. Recurrent colics frequently may be due to verminous arteritis but the relationship to diet should be investigated. Recurrent colics after grain ingestion with occult blood in the faeces may be due to ulcers; such cases respond well to grain withdrawal. The advantages and disadvantages of phenothiazine-derived tranquillizers are discussed. They are contra-indicated if there is any evidence of circulating volume insufficiency but are benefical in many instances through improved peripheral perfusion of organs provided circulating volume is adequate, i.e., early in acute abdominal disease prior to development of circulatory insufficiency. They should not be administered if immediate surgery is contemplated because of hypotensive effects. The administration of oral antibiotics (Neomycin) early in the course of the disease is encouraged. This is contra-indicated if the horse is already toxic, when it should receive parenteral antibiotics, preferably chloromycetin. Tetracyclines may predispose to the later development of salmonella diarrhoea. Absolute analgesia should be provided; our preference is the magnesium sulphate-chloral hydrate solutions. Administration of mineral oil is desirable in initiation of peristalsis, depression of Gram-negative overgrowth and softening of impactioning obstructions but nothing should be administered per os if the stomach has required decompression.
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PMID:Monitoring and evaluating the physiological changes in the horse with acute abdominal disease. 117 34

A four year old Dutch warmblooded mare was born and raised in the province of North-Brabant, the Netherlands. On May 16, 1989, she showed signs of colic, anorexia, depression, ileus, severe dehydration and leukopenia. When the mare collapsed, euthanasia was carried out. Acute colitis and cytoplasmic inclusion bodies in macrophages were observed at autopsy. When an indirect immunofluorescence assay was performed, the Ehrlichia risticii titre of the serum was found to be 1:640.
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PMID:[A horse seropositive for Ehrlichia risticii]. 199 60

Few advancements in postoperative pain control in children have been made despite longstanding inadequacies in conventional intramuscular analgesic regimens. While overestimating narcotic complication rates, physicians often underestimate efficacious doses, nurses are reluctant to give injections, and many children in pain shy away from shots. This study prospectively focuses on the safety, efficacy, and complication rate of intermittent intramuscular (IM) versus continuous intravenous infusion (IV) of morphine sulfate (MS) in 46 nonventilated children following major chest, abdominal, or orthopedic surgical procedures. Twenty patients assigned to the IM group had a mean age of 6.17 years and a mean weight of 23.0 kg. Twenty-six patients assigned to the IV group had a mean age of 8.74 years and a mean weight of 27.4 kg. The mean IM MS dose was 12.3 micrograms/kg/h while the mean IV dose was 19.8 micrograms/kg/h (P less than .001). Postoperative pain was assessed with a linear analogue scale from 1 to 10 (1, "doesn't hurt"; 10, "worst hurt possible") for 3 days following operation. Using the analysis of covariance (ANACOVA), nurse, parent, and patient mean pain scores in the IV group were significantly lower than those of the IM group when controlled for age, MS dose, and complications (P less than .007). Nurse assessment of pain correlated well with the patient and parent assessments (Pearson correlation coefficients greater than 0.6). Not only did IV infusion give better pain relief than IM injections, but there were no major complications such as respiratory depression. Minor complications in this study (nausea, urinary retention, drowsiness, vomiting, hallucinations, lightheadedness, and prolonged ileus) were not significantly different between IM and IV groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postoperative analgesia in children: a prospective study in intermittent intramuscular injection versus continuous intravenous infusion of morphine. 230 87

The principal mechanisms forming the basis of detoxication abnormalities have been analysed using the data of research into the status of the hepatic monooxygenase enzyme system, which is responsible for the liver detoxication potential, and the literature reports. Irrespective of the pathology, a similar depression of the monooxygenase enzyme system of hepatocytes was revealed in acute stercoraceous peritonitis, acute ileus, burn disease, acute renal failure, and pyo-inflammatory conditions in the maxillofacial region. A pathogenetic model is proposed, which explains the mechanism of hepatic detoxication dysfunction in endogenous intoxications of different etiology. New approaches to the therapy of detoxication abnormalities in the conditions attended with endotoxemic syndrome are discussed proceeding from the pathogenetic mechanisms.
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PMID:[Development of immunologic deficiency conditions and sensitization in industrial workers and methodologic approach to their detection and evaluation]. 262 80

A 15-year review of children's hospital patients with cystic fibrosis (CF) who underwent surgery yielded 578 cases in 210 patients (mean 2.7 per patient). The median age was 16 years (range newborn to 43 years). Four hundred procedures were done under general anesthesia and 176 under local. There was one anesthetic complication, respiratory depression in a patient whose MediPort (Cormed, Inc, Medina, NY) was inserted using local anesthesia and sedation. The most frequent procedure was nasal polypectomy, with 165 procedures in 50 patients. The second most common procedures were vascular access procedures: 75 central lines and 29 MediPorts were implanted in 57 patients, complicated by two pneumothoraces. Thoracic procedures included 32 bronchoscopies, 8 lobectomies, 2 pneumonectomies, and 30 pleural strippings. There were three reoperations for bleeding in the pulmonary resection patients. Thirteen newborns underwent a total of 26 procedures for meconium ileus and its complications, with two deaths secondary to respiratory failure and sepsis. These, and one death postlobectomy were the only operative deaths in the entire series of 578 cases (0.5% mortality rate). There were four slings for rectal prolapse; two required removal secondary to infection. Eight patients underwent central splenorenal shunts for portal hypertension, 15 underwent cholecystectomy, 5 underwent Nissen fundoplication, 16 underwent inguinal herniorrhaphy, 2 underwent umbilical herniorrhaphy, 3 underwent orchidopexies, and 4 underwent miscellaneous pediatric surgical procedures. Eleven patients underwent appendectomy for appendicitis; four were ruptured at the time of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgery in patients with cystic fibrosis. 361 55

Equine ehrlichial colitis (Potomac horse fever), a newly identified colitis of the horse, was first recognized in Maryland. In this report, we document occurrence of the disease in Pennsylvania, New Jersey, New York, Ohio, Idaho, and Connecticut. Enzootic areas were recognized by a characteristic pattern. Frequently there was a seasonal pattern and high prevalence of sporadic colitis in unstressed horses. The attack rate per farm generally was low. Horses on pasture, as well as those stabled, were affected. Clinical signs varied from fever and depression to severe diarrhea and laminitis. Occasionally horses developed profound ileus and severe colic. Diagnosis was based on detection of an increase or decrease in serum antibody titers to Ehrlichia risticii, using an indirect fluorescent antibody technique.
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PMID:Equine ehrlichial colitis (Potomac horse fever): recognition of the disease in Pennsylvania, New Jersey, New York, Ohio, Idaho, and Connecticut. 374 78

The epidural instillation of morphine for pain control has been utilized for some time, although primarily intraoperatively or for patients with chronic severe pain, as in terminal cancer. Long term indwelling catheter or subarachnoid administration of epidural morphine are both potentially hazardous. However, in relatively brief applications, up to a few days, the epidural administration of morphine sulfate Is effective, safe, and well tolerated when used according to a carefully controlled plan. We report the use of this method as an improved means for the control of post-lumbar surgery pain in 25 cases. These patients were compared with 25 others receiving standard doses of parenteral and oral narcotics. The two groups were quite similar preoperatively. However, patients receiving epidural morphine were more comfortable, had fewer side effects such as nausea and lassitude, and exhibited no respiratory depression. Further, they ambulated sooner, showed no definitive orthostatic hypotension and less ileus, and remained much more alert and cooperative during the initial 48 hours after operation. Hospitalizations were usually shorter by 1 or 2 days. The administration of very small doses (1.0 to 2.5 mg) of morphine every 12 to 24 hours was usually adequate for good to excellent postoperative pain control. Hydroxyzine was sometimes used to potentiate the analgesia between doses. The epidural catheters were routinely removed within about 72 hours. The technique for the intraoperative placement of the epidural catheter and drug administration are detailed. Precautions for catheter placement were carefully followed to prevent dural penetration or intrathecal injection.
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PMID:Indwelling epidural morphine for control of post-lumbar spinal surgery pain. 663 31

Three consecutive cases of myxedema coma treated successfully with either nasogastric or intravenous route of administration of I-triiodothyronine, followed by oral thyroxine, are described. All were hypothermic, had biochemical evidence of advanced hypothyroidism (T4 less than 1.0 micrograms/dl, T3 less than 20 ng/dl and TSH greater than 150 microU/ml), severe hypoxemia, respiratory acidosis, hypercarbia and temporary depression of respiratory center responsiveness. In only one patient it was found significant hyponatremia (Na = 127 mEq/l). Two patients were successfully treated with the nasogastric route of administration of T3 (12.5 micrograms/6h) but in a female patient with intestinal atony (ileus) there was no absorption of the orally administered T3. Intravenously administered T3 promptly corrected the hypometabolic state in this patient. It was confirmed that T4 therapy, although promptly correcting low serum T4 concentration, failed to rise serum T3 levels due to lack of peripheral T4 5'-monodeiodination to T3 in these critically ill patients.
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PMID:Management of myxedema coma: report on three successfully treated cases with nasogastric or intravenous administration of triiodothyronine. 715 77

35--40% of psychosomatic disturbances among depressive patients present as abdominal troubles. These are difficult to interpret in the case of larvate depression which manifests itself mainly in the somatic sphere. For the last twenty years, we have noticed an increased incidence of larvate depressions. As a result, patients are often inadequately treated or submitted to surgery. This report is about a 37-year-old female patient who was referred to us with the diagnosis of an acute abdomen. After extensive investigations we were able to rule out as well a mechanical as a reflectory ileus. Nevertheless, the rapid deterioration of her general condition, increasing peritonism and radiological evidence of ileus made us suspect a perforated ulcer with accompanying paralytic ileus and perform an exploratory laparotomy 24 h later. We were very surprised not to discover any abnormal findings at operation. The consultant psychiatrist eventually diagnosed a depression. Up to this date, we have not been able to discover any information about similar patients presenting with such an acute history, even in specialised psychiatric literature. Should one refer such patients with acute abdomen to the psychiatrist before operating?
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PMID:[Laparotomy for acute abdomen in larvate depression]. 739 45


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