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

Four patients underwent exercise testing because of a history of pain in the chest; all four developed marked elevation of the S-T segment only during recovery after exercise. Three of the four patients showed ST-segment depression during exercise, but ST-segment elevation was absent until two or more minutes after cessation of exercise. ST-segment elevation after exercise was accompanied by hypotension in three patients and by ventricular arrhythmias in one. Subsequent coronary angiographic studies revealed normal or minimally diseased coronary arteries in two patients and significant coronary lesions in the other two. Review of the literature shows that contrary to the prevailing belief, over half of the patients with Prinzmetal's variant angina have electrocardiographic changes diagnostic of ischemia during exercise testing. Over half of the patients with abnormal findings on tests during exercise display ST-segment elevation as a manifestation of ischemia; however, delayed ST-segment elevation of the type seen in these four patients is distinctly uncommon, having previously been described in only three individual case reports. The pathophysiology of this response is uncertain but may relate to rapid alterations in the autonomic balance during recovery after exercise.
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PMID:ST-segment elevation during recovery from exercise. A new manifestation of Prinzmetal's variant angina. 67 40

The term glossodynia refers to all conditions with pain and dysaesthesia of the tongue and entire oral mucosa manifesting themselves in burning, prickling, itching, stinging, and other frequently bizarre sensations as well as subjective xerostomia and bad taste. In most cases psychiatric diseases are the cause of the complex of complaints whereas local and general disorders are of only minor importance. Menopausal women with atypical depression are most often affected. Schizophrenia and abnormal personality development are far less frequent in glossodynia. After exclusion or therapy of organic disorders antidepressants are the treatment of choice in glossodynia. Thereapeutic difficulties may arise in patients suffering from marked xerostomia whose complaints may intensify during therapy because of the anticholinergic effect of most antidepressants, and in neurotic persons.
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PMID:[Psychological aspects of glossodynia (author's transl)]. 67 25

The purpose of this study was to characterize changes in patient behavior associated with a developing depression. The records of 154 depressed patients from a solo family practice were examined for type and number of complaints, number of visits, and amount of hospitalization during two periods of time. In addition, 154 patients were used as controls and matched to the depressive patients by age, sex, and season of year seen. Two similar time periods were examined in the controls. The depressed group in comparisons both with itself and with the control group showed, in the seven months prior to the diagnosis of depression, these changes: (1) increase in number of patient-initiated office and home visits; (2) increased incidence of hospitalization; and (3) increased number of presenting complaints of three types: ill-defined "functional" complaints; pain of undetermined etiology in a wide variety of sites: head, chest, abdomen, and extremities; and "nervous" complaints, mainly increased tension and feelings of anxiety. The study results indicate that increased number of office visits and "functional" somatic complaints or anxiety-tension feelings should suggest depression.
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PMID:Depression in primary care: changes in pattern of patient visits and complaints during a developing depression. 68 97

There is disagreement in the literature as to whether responsivity to painful stimuli possesses psychometric correlates. A series of methodological and statistical factors are specified in this paper which could account for the equivocality of the literature. A series of experiments were performed in which (a) various methodological and statistical issues were first resolved and (b) psychometric correlates of pain perception were then identified by means of a stepwise multiple regression procedure. The criterion variable consisted of the psychophysical judgment of pain during a 2-min. exposure to a 3,000 gm. force on the periosteum of the left fore-finger's second digit. The predictor variables consisted of selected psychological states and traits measured by the State-Trait Anxiety Inventory, Somatic Perception Questionnaire, Depression Adjective Checklist, Profile of Mood States, Eysenck Personality Inventory, and the Embedded Figures Test. The test-retest reliability of the pain test ranged from .64 to .84 across trials separated by a 3-wk. period. In the first experiment significant multiple regressions ranging between .57 and .72 were observed and psychological traits (field dependence, extraversion and trait anxiety) accounted for the variance in these analyses. In the next experiment significant multiple Rs ranging from .62 to .68 were observed. This served as cross-validation for the first experiment. The major difference was that psychological states (depression and vigor) as well as traits entered the multiple regression equations for certain of the analyses. It was concluded that selected psychological states and traits are significantly correlated with the perception of pain.
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PMID:Psychometric correlates of pain perception. 70 52

3 patients with different clinical and electrocardiographic manifestations of coronary artery spasm are discussed. All 3 patients had anginal attacks at rest. In addition, 2 of these patients, who did not have significant preexisting narrowing of their coronary arteries, also had anginal pain related to exercise. During pain, 1 patient showed ST-segment elevation, the other ST-segment depression, while the third showed ST-segment depression shortly followed by ST-elevation on the electrocardiogram. At coronary angiography, spontaneous or induced spasm of one of the major coronary arteries could be demonstrated in all 3 patients. In 2 cases, sublingual nitroglycerin failed to completely relieve the spasm. This raises the question whether a residual stenosis after NTG conclusively proves a fixed organic narrowing. It is concluded that the clinical spectrum of spasm of the coronary arteries is wider than was originally reported by Prinzmetal and coworkers. Clinical and electrocardiographic manifestations are probably dependent on the site and severity of the spasm, which may cause different degrees of myocardial ischemia.
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PMID:Variant forms of angina pectoris. 71 Apr 90

The expression of cold pressor pain was measured by recording simultaneously verbal magnitude estimates, heart rates, and facial displays of 16 recently hospitalized depressed patients, and 16 nondepressed adults. Independence of the two groups for the depression factor was verified using the Hamilton Scale for Depression and the 100-mm line self-rating scale. Verbal responses and amount of time the ice bath was tolerated, as well as heart-rate measures, indicated that depressed individuals were significantly more sensitive to the pain stimulus. However, this elevated intolerance to pain was not reflected by marked changes of facial display. Reasons for this discrepancy are discussed. Nondepressed subjects, although clearly able to verbalize intensity of pain, were much less reactive to the pain along all dimensions.
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PMID:A multidisciplinary approach to the expression of pain in psychic depression. 72 76

CBF was studied in 15 cases of vascular headache by the 135Xe intra-arterial injection method. The mean CBF was found to be increased during the headache phase of the migraine attacks in half the cases, mainly due to an increase in the rapid component (CBFg). After the attack there could be an increase or a decrease of the slow component (CBFw). Reactivity to anaesthetic depression was studied in 8 migraine cases and on the whole it was found not to be much altered in most cases. Finally, no modifications of CBF were found in any of 3 cases of cluster headache who were studied during attacks of severe pain.
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PMID:Cerebral blood flow in migraine and cluster headache. Compartmental analysis and reactivity to anaesthetic depression. 72 60

Suicidal patients are common in family practice. Risk factors can alert the family physician to persons at unusual risk. Demographic factors, especially those revealing changing social status, recent loss, intentionality, lethality, past history, and high-risk groups, can be rapidly assessed. Viewing suicide as a final common pathway of system dysfunction at any or all major levels-biologic, psychologic, sociocultural-leads to an appreciation of the ubiquitous nature of passive or active "self murder" impulses. Persons depressed for any significant length of time for whatever reasons are potentially suicidal. Thus, the "typical" depression is suicidal but so are persons whose depression is related to drug side effects, primary illness effects, to living in a dysfunctional family system, or to normal grief. Diagnosis requires inquiry about the depth of the patient's depression pain. Treatment takes into account the aforementioned risk factors, plus interventions appropriate to the malfunctioning system.
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PMID:Problems in family practice: the suicidal patient. 74 93

Forty patients with chronic pain below the waist level were evaluated in a multidisciplinary pain clinic using a refined differential spinal block (DSB) technique. The refinements consisted of verbal instructions to prevent biasing the patients, coupled with a thorough evaluation of verbal and physiologic responses to the block. When demographic and psychologic data were assessed according to pain mechanisms, a pattern of patient groups emerged along a chronic pain continuum. Stress, anxiety, depression, and hysteria, as well as the neurophysiologic and demographic factors, modified the responses to the block. Long-term follow-up of these patients, including repeat DSB procedures and confirmatory anatomic blocks of sympathetic and somatic nerves, validated these impressions. The findings indicate a link between pain mechanisms and psychosocial factors that may directly influence responses to DSB.
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PMID:Towards an understanding of chronic pain mechanisms: the use of psychologic tests and a refined differential spinal block. 76 May 99

The analgesic effects of R & S 218-M, administered in doses of 0.56 mg/70 kg and 0.35 mg/70 kg, were compared with those of morphine sulphate 10.5 mg/70 kg for the relief of abdominal pain following surgery in healthy adults. The drugs were given as the first potent analgesic after operation and the subjects were interviewed at 30-min intervals until the pain became severe again. All the interviews were conducted by the one observer. R & S 218-M 0.56 mg/70 kg was as effective as morphine sulfate 10.5 mg/70 kg, while R & S 218-M 0.35 mg/70 kg was inferior. No evidence was found to support the claim that R & S 218-M causes less respiratory depression when compared with morphine sulphate.
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PMID:A double-blind clinical trial of the analgesic effects of R & S 218-M, a new potent analgesic for the relief or pain following abdominal surgery: comparison with morphine sulphate. 76 98


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