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)

Patients are presenting in increasing numbers with multiorgan symptoms allegedly resulting from exposure to environmental chemicals. Among the symptoms expressed by patients with alleged multiple chemical sensitivities (MCS) are profound fatigue, mental confusion, myalgia, depression, anxiety, dizziness, headache, insomnia, loss of appetite, and numbness of the extremities, all in the absence of objective physical signs. Diagnostic criteria to assess the effects of environmental agents on organ systems are sorely needed because patients with MCS often have no tissue pathology or physiological abnormalities, but often do have diagnosable psychiatric illnesses. In treating patients with MCS, the physician should first perform a complete history and physical examination, including a comprehensive evaluation of chemical exposure. If the findings strongly suggest the presence of disease related to particular organ systems, further diagnostic evaluation should be undertaken. If abnormal findings are absent, psychiatric advice may be useful. The physician should keep an open mind about MCS but must also remember that a cause-effect relationship between exposure to multiple chemicals and symptoms has not been established.
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PMID:Multiple chemical sensitivity multiorgan dysesthesia, multiple symptom complex, and multiple confusion: problems in diagnosing the patient presenting with unexplained multisystemic symptoms. 895 67

A visual analog pain scale and scalar responses to 13 pain/symptom indicator Symptom Checklist-90-Revised (SCL-90-R) questions were used to assess symptom prevalence and pain severity in 43 chronic orofacial muscle pain patients and 40 control subjects. The orofacial muscle pain group reported pain in an axial skeletal distribution; neurocognitive, gastrogenitourinary, and musculoskeletal symptoms; infectious events at or preceding onset; similar symptoms in sexual partners; and low prevalence of trauma. Sudden onset was reported by 30.2% of pain patients. Strong associations were found between chronic orofacial muscle pain and (1) onset-related infectious-like events (67.4%); (2) a higher prevalence of history of respiratory and gastrogenitourinary infectious events; and (3) high prevalences of similar pain symptoms in long-term sexual partners. The SCL-90-R somatization scores (> 62) had a higher prevalence in the chronic pain group. No prevalence differences or associations with pain/symptom indicators were found for depression or anxiety dimension scores. These data suggest that patients with recurrent systemic infectious events have a higher prevalence of reporting of chronic orofacial muscle pain compared with control subjects, and these infectious events are associated with the onset of chronic orofacial muscle pain in 67% of patients.
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PMID:Assessment of pain (distribution and onset), Symptoms, SCL-90-R Inventory responses, and the association with infectious events in patients with chronic orofacial pain. 916 Dec 39

Fifty-eight outpatients with panic disorder (PD) were examined to determine their clinical features in comparison with a cohort of 52 patients with generalised anxiety disorder (GAD). Both groups were of comparable age, sex, educational level, marital status and ethnicity. PD patients were more likely to complain of palpitations, breathlessness, chest pain, numbness, choking sensations and especially fear of dying. GAD patients tended to complain of feeling tense, insomnia, headaches, weakness, restlessness and muscle aches. PD patients had greater comorbidity especially with agoraphobia and depression. Contrary to other reports, there were more males than females in both groups but alcohol dependence and suicide attempts were relatively rare. PD symptoms seemed more distressing, caused more social and occupational disruption, led to more requests for medical investigations and earlier psychiatric consultations. These factors seemed to suggest that panic disorder is a more severe illness than generalised anxiety disorder.
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PMID:Panic disorder in Singapore: clinical features and comparisons with generalised anxiety disorder. 920 72

To minimize the symptoms of antidepressant discontinuation, gradual tapering is necessary for all serotonin reuptake inhibitors (SRIs) except fluoxetine, which has an extended half-life. Agents with shorter half-lives such as venlafaxine, fluvoxamine, and paroxetine should be tapered gradually. Discontinuation symptoms, which frequently emerge after abrupt discontinuation or intermittent non-compliance and, less frequently, during dose reduction, are generally mild, short-lived, and self-limiting but can be distressing and may lead to missed work days and decreased productivity. The symptoms may be somatic (e.g., dizziness and light-headedness; nausea and vomiting; fatigue, lethargy, myalgia, chills, and other flu-like symptoms; sensory and sleep disturbances) or psychological (anxiety and/or agitation, crying spells, irritability). Mild symptoms can often be treated by simply reassuring the patient that they are usually transient, but for more severe symptoms, it may be necessary to reinstitute the dosage of the original antidepressant and slow the rate of taper. Symptoms of discontinuation may be mistaken for physical illness or relapse into depression; misdiagnosing the symptoms may lead to unnecessary, costly tests and treatment. Thus, health care professionals need to be educated about the potential adverse effects of SRI discontinuation.
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PMID:Clinical management of antidepressant discontinuation. 981 35

The efficacy and safety of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) administered as a 3-hour infusion was investigated in a phase II study involving 21 patients with stage III/IV non-small cell lung cancer. The study included two quality of life assessments (the Hospital Anxiety and Depression Scale and the Rotterdam Symptom Checklist) to test their suitability for use in a future randomized phase III trial of paclitaxel and best supportive care versus best supportive care alone. Four (19%) of the 21 patients (95% confidence interval, 8% to 38%) achieved a partial response. The median time to disease progression for all patients entered was 19 weeks. Paclitaxel was well tolerated, with dose reduction required in only one patient because of arthralgia/myalgia. No dose reductions, delays, or discontinuations were required for hematologic toxicity. Completion and compliance with quality of life questionnaires was high, and these research tools proved to be acceptable for future use in phase III studies with paclitaxel.
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PMID:Single-agent paclitaxel in advanced non-small cell lung cancer: single-center phase II study using a 3-hour administration schedule. 933 Nov 11

Widespread muscle pain and tender points are the most common complaints of fibromyalgia patients, and the underlying mechanisms responsible for these symptoms have been studied intensively during the past decade. It has been suggested that fatigue and pain may lead to decreased levels of physical activity in many patients. The resulting deconditioned state may itself contribute to muscle abnormalities. Associated symptoms such as disturbed sleep, anxiety, depression, or irritable bowel also may have a negative impact on muscle function and level of daily activities. The important interactions between the central nervous and musculoskeletal systems may involve another element, the neuroendocrine stress-response system. This review will consider both the current state of knowledge and also future studies which might be designed to answer more effectively the outstanding questions regarding the underlying pathogenesis of fibromyalgia.
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PMID:Skeletal muscle abnormalities in patients with fibromyalgia. 963 91

Vincristine, referred to as a vinka alkaloid, has been used as a component of the various chemotherapeutic regimens. The major side effects of the usual dosage of vincristine are bone marrow suppression, gastrointestinal disorder, and neurotoxicity. A 53-year-old cervical cancer patient received 14 mg (4 mg/m2/day for 2 days) of vincristine instead of vinblastine because of the similarity between the two names. Then life threatening toxicities including paresthesias, bone marrow depression, severe oral mucositis, paralytic ileus, bladder atony, myalgia, muscle weakness, high fever, derangements of various organs (liver, heart), hypertension, and insomnia were encountered. But hypotension and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) were not observed. Other than paresthesias in the extremities, the patient recovered completely from toxic impairments with intensive symptomatic and supportive care. In order to prevent the administration of the overdosed drug, it would be advisable for chemotherapy to be administered only by an experienced physician who is able to check the dose and concentration.
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PMID:Overdose of vincristine: experience with a patient. 968 18

Phosphate depletion is associated with neuromuscular dysfunction due to changes in mitochondrial respiration that result in a defect of intracellular oxidative metabolism. Phosphate diabetes causes phosphate depletion due to abnormal renal re-absorption of phosphate be the proximal renal tubule. Most of the symptoms presented by patients with phosphate diabetes such as myalgia, fatigue and mild depression, are also common in patients with chronic fatigue syndrome, but this differential diagnosis has not been considered. We investigated the possible association between chronic fatigue syndrome and phosphate diabetes in 87 patients who fulfilled the criteria for chronic fatigue syndrome. Control subjects were 37 volunteers, who explicitly denied fatigue and chronic illness on a screening questionnaire. Re-absorption of phosphate by the proximal renal tubule, phosphate clearance and renal threshold phosphate concentration were the main outcome measures in both groups. Of the 87 patients with chronic fatigue syndrome, nine also fulfilled the diagnostic criteria for phosphate diabetes. In conclusion, we report a previously undefined relationship between chronic fatigue syndrome and phosphate diabetes. Phosphate diabetes should be considered in differential diagnosis with chronic fatigue syndrome; further studies are needed to investigate the incidence of phosphate diabetes in patients with chronic fatigue syndrome and the possible beneficial effect of vitamin D and oral phosphate supplements.
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PMID:Phosphate diabetes in patients with chronic fatigue syndrome. 1019 6

Cognitive problems are frequently reported in patients with eosinophilia-myalgia syndrome (EMS). This is the first study to explore, in EMS, the relationship between specific neuropsychological deficits and fatigue and pain. Relationships among depression, sleep disturbance, and neuropsychological deficits in EMS were also examined. Neither fatigue nor pain was correlated with memory impairment. Sleep disturbance was significantly correlated with verbal memory impairment, but not with deficits in visuospatial memory. These results suggest that cognitive loss in EMS cannot be attributed to pain or fatigue. Although some aspects of memory impairment may be associated with disturbed sleep, visual memory deficits are clearly independent of sleep deficits and may result from direct effects of the disease on the central nervous system.
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PMID:Pain, fatigue, and sleep in eosinophilia-myalgia syndrome: relationship to neuropsychological performance. 970 42

It is generally recognized that psychological factors play an important role in chronic orofacial pain patients. This study analysed psychological profiles of chronic pain patients affected with temporomandibular disorders (TMD), by means of the Minnesota Multiphasic Personality Inventory (MMPI) test. Fifty consecutive TMD patients were examined and were then divided into two subgroups: 1. myofascial pain and 2. temporomandibular joint articular disorders. Sixty-two percent of the whole sample presented pathological MMPI scores. Both subgroups presented similar profiles with alteration of the neurotic triad (hypochondriasis, depression, hysteria), and pathological values of hypochondriasis and hysteria ("V" configuration). Since the personality profile did not differ between the two subgroups investigated, it was not dependent on the dysfunctional origin of the pathology (myalgia or primary TMJ pathology). Chronic TMD patients presented personality characteristics similar to those of other chronic pain patients according to the MMPI.
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PMID:Personality characteristics of temporomandibular disorder patients using M.M.P.I. 970 66


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