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Query: UMLS:C0011570 (depression)
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Previous research has demonstrated a number of conditions, such as sleep disturbance, fatigue, depression, spastic colon and mitral valve prolapse, associated with fibromyalgia. The present report describes additional symptoms and medical conditions that appear to be associated with the syndrome based on a survey of 554 individuals with fibromyalgia compared with a group of 169 controls. Individuals with fibromyalgia self report a greater incidence of bursitis, chondromalacia, constipation, diarrhea, temporomandibular joint dysfunction, vertigo, sinus and thyroid problems. Symptomatic complaints found statistically more prevalent in fibromyalgia patients included concentration problems, sensory symptoms, swollen glands and tinnitus. Other associations occurring with significant increased frequency were chronic cough, coccygeal and pelvic pain, tachycardia and weakness. Our previous report on inheritance patterns in fibromyalgia was reaffirmed with 12% reporting symptomatic children and 25% reporting symptomatic parents. Of the respondents, 70% noted that their symptoms were aggravated by noise, lights, stress, posture and weather.
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PMID:Fibromyalgia syndrome. New associations. 146 72

Results of psychometric tests were obtained on 161 male welders and other tradesmen in heavy industry who had recently been made redundant. Anxiety and depression were scored on the Hospital Anxiety and Depression Scale, and negative attitudes and beliefs regarding breathlessness and related aspects of respiratory health on a semantic differential scale. Scores for attitudes and beliefs about health and personal disability were pooled to give a general attitude score. Personality was rated on a standard scale. Subjects completed a questionnaire on respiratory symptoms and underwent routine spirometry, measurement of carbon monoxide transfer factor for the lung, and a progressive exercise test on a cycle ergometer. Scores for anxiety, depression, and negative mental attitudes were significantly intercorrelated; subjects with disordered personality profiles had above average scores for anxiety and depression. The psychometric scores were associated with clinical grade of breathlessness, lung function, and the physiological response to exercise. The general attitude score could be predicted from the anxiety and depression scores and from lung function expressed relative to age and stature, the combination of mood score and FEV1 explaining 38% of the variance in general attitude score. The general attitude score accounted for more than half the explained variance in the clinical grade of breathlessness and contributed more to the variance in maximal oxygen uptake (R2 = 0.11) than FEV1. It was associated with the level of habitual activity but not with smoking category, wheeze, chronic cough or phlegm. Thus attitude to disability reflected the subject's assessment of his exercise capacity and was closely related to the clinical grade of breathlessness.
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PMID:Relation of lung function and exercise capacity to mood and attitudes to health. 276 39

The records of 3920 patients (2068 females, 1852 males) entering a model family practice unit between 1975 and 1978 have been analyzed. Eleven percent of males and 9.5% of females reported an episode of low-back pain during that 3-year interval. The complaint of medically reported low-back pain was significantly related to occupational factors such as truck driving (p < 0.001), lifting, carrying, pulling, pushing, and twisting (P < 0.001 for all variables) as well as nondriving vibrational exposure (P < 0.001). Patients reporting low-back pain also reported more episodes of anxiety (P < 0.001) and depression (P < 0.001) and had more emotionally stressful occupations (P < 0.001). The mean number of pregnancies was greater in women with low-back pain (2.6) than in those without (1.6) (P < 0.001). The low-back pain sufferers were more likely to be cigarette smokers (P < 0.001), particularly when smoking was accompanied by a chronic cough (P < 0.001). This population is currently under prospective study to define the relevance of each of these risk factors to the complaint of low-back pain.
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PMID:Epidemiologic studies of low-back pain. 645 Apr 52

In the UK the prevalence of chronic obstructive pulmonary disease has been estimated at one per cent, rising to five per cent of men aged 65-74 years and 10 per cent of men aged over 75 years. It is thought that only a quarter of COPD cases are diagnosed (Calverley and Bellamy, 2000). The symptoms of breathlessness, chronic cough, and regular sputum production usually develop insidiously. However, COPD not only affects the lungs but has extra pulmonary effects such as muscle wasting and weight loss, pulmonary hypertension, cor pulmonale (enlargement of the right side of the heart), anxiety, and depression.
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PMID:NICE guidelines for chronic obstructive pulmonary disease--a review. 1522 93

This paper reports an audit of clinical outcome in 455 consecutive patients (1100 consultations) presenting for private homeopathic treatment of a chronic illness in which conventional treatment had either: failed, reached a plateau in effect, or was contra-indicated by side effects, age or condition of the patient. Three hundred and four patients (66.8%) derived benefit from homeopathic treatment. One hundred and forty-eight patients (32.5%) were able to stop or maintain a substantial reduction in their conventional drugs. The 10 most frequent clinical conditions treated were eczema, anxiety, depression, osteoarthritis, asthma, back pain, chronic cough, chronic fatigue, headaches and essential hypertension. These 195 patients constitute 43% of the total, 151 of them (77%) were improved. The success rate of treatment is similar between age ranges. There was a difference in outcome between the sexes in adults: 296 females treated, success rate 71.3%; 159 males treated, success rate 58.5%. Two patients (0.4%) had prolonged aggravation of their presenting complaints apparently attributable to homeopathic treatment.
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PMID:Audit of outcome in 455 consecutive patients treated with homeopathic medicines. 1622 98

Chronic cough (CC) and paradoxical vocal fold movement (PVFM) share several common features; however, there has been no systematic comparison of these two conditions. The aims of this study were to contrast and compare the symptom profiles of CC and PVFM, to clarify the relationship between the two conditions, and to explore how symptom characteristics could be used to design an individualized treatment program. Participants included 55 people with a combination of PVFM and CC that was refractory to medical treatment, 8 people with PVFM alone, 56 people with CC alone, 25 people with voice disorders, and 27 normal controls. Symptoms and descriptive features of CC, PVFM, and voice disorders were assessed via structured case history interview, symptom frequency, and severity ratings, ratings of activity limitation, and anxiety/depression ratings. Results indicated consistent overlap in the symptom profile between people with CC and those presenting with a combination of CC and PVFM. Participants with PVFM without cough and those with voice disorders overlapped with the participants with CC on some dimensions; however, there were still some significant differences between them. These data suggest that CC and PVFM are related and manifestations of a common underlying condition but that voice disorders are a discrete entity. Most participants had normal ratings on screening for anxiety and depression. Results indicated that there were no consistent psychiatric symptoms in any of the groups studied, and they do not support the label of psychogenic cough for CC that is refractory to medical treatment. Characteristics of CC such as nature and timing of the cough provide important information for developing behavioral treatment programs for individual patients who have exhausted medical options. A template has been provided that is a practical method of designing an integrated behavioral treatment program based on those individual patient characteristics.
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PMID:Voice and upper airway symptoms in people with chronic cough and paradoxical vocal fold movement. 1654 40

The nucleus tractus solitarius (NTS) in the caudal medulla is a gateway for a variety of cardiopulmonary afferents important for homeostatic regulation and defense against airway and cardiovascular insults and is a key central target potentially mediating the response habituation to these inputs. Here, whole-cell and field population action potential recordings and infrared imaging in rat brainstem slices in vitro revealed a compartmental pain-pathway-like organization of capsaicin-facilitated vs. nocistatin-facilitated/nociceptin-suppressed neuronal clusters in an NTS region, which receives cardiopulmonary A- and C-fiber afferents with differing capsaicin sensitivities. All capsaicin-sensitive neurons and a fraction of nociceptin-sensitive neurons expressed N-methyl-D: -aspartate (NMDA) receptor-dependent synaptic long-term depression (LTD) following afferent stimulation. All neurons also expressed activity-dependent decrease of excitability (intrinsic LTD), which converted to NMDA receptor-dependent intrinsic long-term potentiation after GABA(A) receptor blockade. Thus, distinct intrinsic and synaptic LTD mechanisms in the NTS specific to the relay of A- or C-fiber afferents may underlie the response habituation to persistent afferents hyperactivity that are associated with varying physiologic challenges and cardiopulmonary derangements-including hypertension, chronic cough, asthmatic bronchoconstriction, sustained elevated lung volume in chronic obstructive pulmonary disease or in continuous positive-airway-pressure therapy for sleep apnea, metabolic acidosis, and prolonged exposure to hypoxia at high altitude.
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PMID:Intrinsic and synaptic long-term depression of NTS relay of nociceptin- and capsaicin-sensitive cardiopulmonary afferents hyperactivity. 1870 88

Twelve distinguished scientists attended the workshop, heard three presentations, and took part in the discussions. Fontana first described his unpublished studies on cough in exercise and during hyperventilation with healthy subjects. Both activities depressed cough induced by inhalation of distilled water aerosol (fog). The possible mechanisms were discussed. Gibson then described the successful use of speech therapy to treat chronic cough, and discussed the possible mechanisms, centering on the role of the larynx and its neural control. A comparison was made with the ability of speech and laughter to precipitate cough. Widdicombe discussed the scanty literature on the effect of singing and playing wind instruments on cough, most of the evidence being anecdotal. In the discussion periods several matters for future study arose. It is usually not clear if the modulation of cough, its depression, enhancement or excitation, arose primarily at peripheral sites (reflexes from the airways), or at a cortical level, or both. Nor is it clear whether the same results would be obtained with provoked cough and with spontaneous cough. But all three aspects of 'behavioual' changes in cough sensitivity (exercise, speech and music) could be further explored, and current techniques should make this possible.
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PMID:Workshop--cough: exercise, speech and music. 1913 43

Chronic obstructive pulmonary disease (COPD) affects approximately 10% of the population aged above 40 years. In advanced COPD (forced expiratory volume in 1 second <50% of the predicted value), patients suffer from severe pulmonary symptoms including dyspnea, chronic cough, poor exercise tolerance, which are commonly associated with systemic disorders, such as osteoporosis, loss of fat-free body mass, fatigue, anxiety, and depression. Moreover, patients with advanced COPD experience annually an average of 2 to 3 episodes of exacerbations requiring hospitalization. We present here a model of integrated care based on the cooperation between medical staff, social workers, volunteers and patients and their families. The essential components of this model are intensive education, treatment supervision, and support in self-management as well as coping with the disease and its consequences. It is expected that these measures will result in a decreased number of exacerbations requiring hospitalization, improved disease course, and better quality of life.
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PMID:Integrated care for patients with advanced chronic obstructive pulmonary disease: a new approach to organization. 2098 Sep 49

Vagus is Latin for wandering, and the vagus nerve fully deserves this name due to its extensive distribution through the body. Indeed, one of the lines of the song that accompanied the 2012 G. L. Brown Prize Lecture exaggerates this diversity, 'My function's almost anythin', and vagus is my name'. Alteration of vagal activity was first investigated in the 1880s as a treatment for epilepsy, and vagus nerve stimulation is now an approved treatment for refractory epilepsy and depression in the USA, despite an incomplete understanding of the mechanisms involved. Vagus nerve stimulation could be beneficial in many other conditions, including heart failure, tinnitus, chronic hiccups, Alzheimer's disease and inflammatory diseases. Inhibition of vagal activity could also be beneficial in some conditions, e.g. reducing activation of vagal respiratory afferents to treat chronic cough. This review discusses evidence underlying some current and potential therapeutic applications of vagal modulation, illustrating the wonders of the Wanderer.
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PMID:The wonders of the Wanderer. 2284 84


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