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

Unstable angina pectoris and feelings of fatigue and general malaise are often mentioned as premonitory symptoms of myocardial infarction. From a psychological point of view these feelings of fatigue and malaise reflect a syndrome of vital exhaustion and depression (VED). A questionnaire which measures this syndrome was given to 3,571 males who participated in a voluntary health check up. It was found that the prevalence of "imminent myocardial infarction," defined as unstable angina pectoris plus electrocardiographic signs of ischaemia, was more than four times higher among exhausted and depressive persons, than among persons not so affected.
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PMID:Imminent myocardial infarction: a psychological study. 652 Mar 93

The exercise tests performed by 197 patients aged 65 years or more (mean age 68.8) have been reviewed, including 43 healthy subjects, 20 with high blood pressure, 10 with mitral valve disease and 125 with demonstrated coronary artery disease. All tests were done on an electrical cycloergometer, with load increases of 30 W every 3 min. Eighty-four (42.6%) achieved at least 85% of their maximal predicted heart rate. The reasons for non-achievement of this heart rate were limitation by symptoms (30.2%), betablocker therapy (25.8), exhaustion (20.2%), pain in lower extremities (14%) and non-adaptation to cycloergometer (10%). The maximum load achieved and the duration of exercise were significantly lower in mitral and coronary patients. Functional aerobic capacity was decreased in coronary and mitral patients. The VO2 max was directly determined in 45 patients. Mean values (ml kg-1 min-1) were 33.3 +/- 3.5 in normals, 15.4 +/- 6.2 in coronary and 15.8 +/- 4.1 in mitral patients. The incidence of arrhythmias during exercise was higher in hypertensive (55%) than in mitral (40%), normal (33.3%) and coronary patients (32.8%). In 5 patients the test had to be interrupted because of ventricular tachycardia. The yield of ST depression (greater than 0.1 mV) or elevation (greater than 0.2 mV) in the diagnosis of coronary artery disease was 0.62 sensitivity and 0.93 specificity. We conclude that stress test is a useful tool in cardiovascular diagnosis among older patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnostic value of stress testing in the elderly. 652 42

To examine the antianginal effects of felodipine, a new calcium antagonist, 8 patients with coronary artery disease and exertional angina pectoris were studied. Hemodynamic measurements were made at rest, during submaximal exercise and during angina-limited exercise before and 30 minutes after oral administration of 0.1 mg/kg of felodipine. Angina pectoris was always prevented after the drug was given and the exercise intensity was increased until recurrence of angina (5 patients) or exhaustion (3 patients). Hemodynamic data were also recorded at this higher exercise capacity. At rest and during submaximal exercise, felodipine increased heart rate and decreased arterial blood pressure and systemic vascular resistance. The prevention of angina pectoris was accompanied by lower mean pulmonary capillary wedge pressure, systemic vascular resistance and ST-segment depression; the pressure-rate product was unchanged. The 20% greater exercise capacity after felodipine was attended by a 20% increase in maximal cardiac output, a 17% increase in maximal heart rate and a 13% increase in maximal pressure-rate product; the maximal arterial blood pressure and ST-segment abnormalities were unchanged and the systemic vascular resistance was lower. The relation between ST-segment depression and the pressure-rate product during exercise was favorably influenced by felodipine. Thus, felodipine is an active antianginal drug; its major mechanism of action is to lower the systemic vascular resistance. The data also suggest that it improves coronary blood flow during exercise.
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PMID:Hemodynamic effects of felodipine at rest and during exercise in exertional angina pectoris. 661 67

The effects of subchronic trypanosomiasis upon immune responses were examined in Trypanosoma gambiense infection and in subcurative treatment of T. brucei- and T- equiperdum-infected mice. About 60% of the mice infected with T. gambiense developed a subchronic infection similar to human trypanosomiasis, characterized by the absence of circulating trypanosomes. The animals died between 1 and 12 months after infection with elevated serum immunoglobulin M (IgM) levels (16 times the normal level). After 1 month of infection, the mice showed a normal primary antibody response against sheep erythrocytes, as tested by hemagglutination, despite their high serum IgM levels. After more than 1 month of infection, about 20% of the mice showed depressed hemagglutination titers (25% of control), whereas all relapsed mice that contained circulating parasites showed a pronounced suppression. Elimination of the blood parasites with Berenil treatment restored immune competence, which persisted until the relapse of the animals. Identical results were obtained in T. brucei-infected mice. Berenil treatment abolished the immune depression against sheep erythrocytes, but did not cure the animals, which relapsed with the development of a new state of immune depression. T. gambiense and T. brucei infections were always followed by a marked increase of serum IgM levels. Hypergammaglobulinemia was also induced in relapsing T. equiperdum-infected mice treated with Berenil. No immune depression against sheep erythrocytes could be detected. It appeared that immune depression was not the result of clonal exhaustion (measured by the serum IgM level) but seemed to be closely associated with the presence of living trypanosomes.
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PMID:Immune depression and macroglobulinemia in experimental subchronic trypanosomiasis. 678 8

230 patients with therapy-resistant depression were given intravenous drip infusion treatment with clomipramine (a predominantly serotonin-uptake inhibitor) and maprotiline (a predominantly noradrenaline-uptake inhibitor), preceded by a five-day tranquilizing regimen with a neuroleptic drug. During the treatment period of 10-20 days the patients were given one infusion daily, while later both antidepressants were taken orally. The neuroleptic drug was given at night from the start of the infusion phase to the end of hospitalization. After four weeks' treatment 68% of the endogenous depressives and 54% of the exhaustion depressives had completely remitted. In patients who fail to respond the infusion regimen can be repeated after carefully rechecking the patient's diagnosis. After discharge and resumption of work the antidepressants should be reduced stepwise. A prerequisite for success in the management of refractory depression is the combination of drug administration with adequate psychotherapeutic and physiotherapeutic measures. The infusion regimen is relatively easy to administer, can be given on an outpatient basis and could be the treatment of choice in the future not only for treatment-resistant depression but also for patients whose depressive state requires rapidly effective antidepressive measures. In view of the encouraging experience obtained to date with this treatment, the World Health Organization is conducting an international collaborative research project involving 12 psychiatric centres to elucidate the effectiveness of intravenous infusion therapy in different races with different dietary habits and varying climatic conditions.
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PMID:[Treatment of therapy-resistant depressions. Results of combined infusion treatment]. 713 34

The influence of exhaustive exercise on the capacity of liver and muscle of rats to oxidize fatty acids was investigated in vitro. The rate of oxidation of fatty acids by liver preparations was significantly elevated as a result of exhaustion. Concurrently, the concentrations of beta-hydroxybutyrate were elevated in the plasma of the exhausted rats, suggesting that oxidation of fatty acids was also elevated in vivo. These findings are analogous to the findings of increased oxidation of fatty acids that results from training. In muscle, oxidation of palmitate, palmitoylcarnitine and beta-hydroxybutyrate by homogenates and isolated mitochondria was depressed with exercise. Despite the decrease in the oxidative capacity of the muscle preparations, the activities of several enzymes of beta-oxidation were either increased or unchanged as a result of exercise, suggesting that the depression in fatty acid oxidation may not be related to alterations in the process of beta-oxidation. Further studies showed that oxidation of [2-(14)C]pyruvate by muscle was depressed, whereas oxidation of [1-(14)C]pyruvate was not changed as a result of exercise. These results suggest that the decrease in fatty acid oxidation may be related to aberrations in the oxidation of acetyl-CoA. The changes in fatty acid oxidation that were observed, which are at variance with what is reported to occur with training, may have resulted from increased fragility of muscle mitochondria as a result of exercise. This increased fragility may render the mitochondria more susceptible to experimental manipulations in vitro and a subsequent loss of normal function.
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PMID:Fatty acid oxidation by liver and muscle preparations of exhaustively exercised rats. 715 10

In a population sample of 'healthy' males (N = 136; age 39-41) the classifications on the Jenkins Activity Survey (JAS) for assessing the Type A/B coronary-prone behavior pattern, and on the Maastricht Questionnaire (MQ), measuring emotional drain and subsequent depression, were investigated in relation to retrospective reporting of life changes on a newly developed Middle Adulthood Life Changes Questionnaire (MALC). In ANOVA, Type A subjects (N = 70) did report significantly more life changes in their work environment and family situation over the last two years than their Type B counterparts (N = 66). For subjects reporting clearcut manifestations of vital exhaustion and depression (N = 32) the same statistical associations do hold. Also, these latter subjects did evaluate their life changes as significantly 'more distressing' or as 'requiring more adjustment'. A group of male myocardial infarction (MI) patients (N = 35; average age 52) was compared with this control group on the MQ and the MALC. The MI-group showed a significantly lower average MQ-score than the section of the control group with clearcut manifestations of emotional drain and depression. Mean 'adjustment' scores, however, were significantly higher in the MI-group. In the discussion, the requirements for a dynamic life-span developmental model for explaining the assumedly different life-courses of MI-cases and controls are enunciated.
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PMID:[Life styles of myocardial infarct patients and of control groups: various similarities and differences]. 720 68

In this prospective study a psychological test (the "Maastricht Questionnaire') was constructed which measures feelings of vital exhaustion and depression. It is shown that those subjects who have elevated scores on this test have more chance to get a new coronary event within a period of 10 months than those who have low scores on this test.
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PMID:Psychological prodromata of myocardial infarction and sudden death. 722 Jul 70

In epidemiological surveys about neurotic and psychosomatic disturbances there is the question of how relevant the reported syndromes are. An important criterion to evaluate the relevance of a syndrome is its individual and social consequences. In a general population sample of 600 young adults in the Canton of Zurich (Switzerland), subjects answered a structured interview (SPIKE) about 25 different neurotic and psychosomatic syndromes and their consequences: personal suffering, imparied role performance, tendency to become chronic, and medical treatment. A number of neurotic syndromes (especially depression, anxiety, and exhaustion) ranked highest with regard to individual suffering and impaired role performance, but they rarely led to medical treatment. Psychosomatic syndromes, on the other hand, while treated more often, only caused minor personal suffering and did not impair role performance very much.
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PMID:[Social consequences of psychic disturbances in the population: a field study on young adults (author's transl)]. 722 34

Swimming is frequently recommended for cardiac rehabilitation, but little is known of its physiologic consequences in ischemic heart disease. Eight males who had had a myocardial infarction 8-17 months before the study were exercised to exhaustion or angina with 10 W/min-1 ramp on a cycle ergometer in sitting and supine positions. Oxygen uptake (VO2) was continuously measured to monitor the physiologic power requirement. All eight patients were taking beta blockers and four were taking digoxin. During sitting cycling, angina occurred in four and ST depression in five; during supine cycling, angina occurred in five and ST depression in six. VO2 was then measured while they swam at their own comfortable speed (mean 0.43 m/sec-1) in a swimming flume at water temperatures of 25.5 degrees C and 18 degrees C. In six, the water speed was gradually increased until they were limited by symptoms. Comfortable swimming at 25.5 degrees C was 87% (1.28 1/min-1) and at 18 degrees C 89% (1.30 1/min-1) of sitting peak VO2, while heart rates were 92% and 91% respectively. The mean peak VO2 and heart rate did not differ significantly between bicycle and swim tests (peak VO2 sitting 1.49 +/- 0.23, supine 1.42 +/- 0.24, 25.5 degrees C 1.60 +/- 0.17, 18 degrees C 1.52 +/- 0.19 1/min-1). Only two patients reported angina while swimming in warm water and one in cold water, although ST depression occurred in six in both swims. The subjective comfort and large muscle groups involved make swimming a good exercise, but the high relative energy cost and failure to identify ischemic symptoms indicate caution in cardiac patients, especially if their swimming skills are poor.
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PMID:The effect of swimming on patients with ischemic heart disease. 747 81


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