Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cognitive theories of panic disorder suggest that the catastrophic misinterpretation of bodily sensations is the trigger for a panic attack. A challenge to cognitive theories is the suggestion that dyspnea (shortness of breath) is central to the development of panic and that negative cognitions are by-products of panic. To examine these seemingly contradictory theoretical perspectives, the present study investigated panic symptomatology in a sample of patients with chronic shortness of breath (i.e. pulmonary patients). Past studies have shown an increased prevalence of panic in pulmonary patients, a finding that may be useful in elucidating panic etiology. The current sample of pulmonary patients (N = 28) confirmed previous reports of high prevalence rates of panic in this population. Based on self-report of panic symptomatology, a total of nine patients (32%) met DSM-IV criteria that were consistent with panic disorder. Multivariate comparison of participants with and without panic symptomatology revealed that panickers had significantly higher levels of anxiety, depression and agoraphobic cognitions. However, these groups showed no significant differences on physiological measures of pulmonary functioning. The authors conclude that dyspnea alone is inadequate in predicting panic development. High levels of panic symptomatology in pulmonary samples may reflect increased opportunities for these patients to misinterpret bodily sensations and, in particular, their pulmonary symptoms.
 ...
PMID:The catastrophic misinterpretation of physiological distress. 1050 Mar 23

The purpose of this study was to compare patient and proxy (physician and nurse) assessments of symptoms in advanced cancer patients. The sample consisted of 49 patients with advanced cancer admitted to an acute palliative care unit. Three independent assessments were completed for each patient on two occasions within 11 days of admission. On each occasion, symptoms were rated independently by the patient and two proxies (treating physician and nurse), using the Edmonton Symptom Assessment System (ESAS). The ESAS is a nine-item visual analogue scale (VAS) for assessing pain, activity, nausea, depression, anxiety, drowsiness, appetite, well-being and shortness of breath. Symptom ratings were compared using a repeated-measures ANOVA procedure and correlations. Average physician ratings were generally lower than average patient ratings for both occasions. Average nurse ratings agreed more closely with patient ratings, with a trend towards lower ratings on occasion 1 and higher ratings on occasion 2. There was a significant rater (person rating the effects) effect (P < 0.01) for three of the nine symptoms: physicians rated drowsiness, shortness of breath and pain significantly lower than patients. For drowsiness and shortness of breath, these differences were clinically relevant, representing a difference of more than 12 mm on a 100-mm VAS. The accuracy of assessments amongst those rating the symptoms did not improve over time. Proxy assessments of symptom intensity, particularly by physicians, were significantly lower than patient assessments for three of the nine symptoms. Further research regarding the reliability of patient and proxy assessments is needed to assess and manage symptoms in advanced cancer effectively.
 ...
PMID:A comparison of patient and proxy symptom assessments in advanced cancer patients. 1065

Combination drug therapy and enhanced patient management techniques result in increased survival for many AIDS patients. This phenomenon has brought the issue of fatigue, a common and difficult side effect of HIV/AIDS treatment, to the forefront. Three-quarters of the AIDS patients surveyed in a recent study indicated that fatigue negatively affects their quality of life and influences their willingness to continue aggressive treatment. New advances for combating fatigue include the use of nutritional therapy, anti-depressants, anti-infectives, medications that boost the production of red blood cells, hormone replacement, exercise, massage, and acupuncture. The most common source of fatigue in HIV-positive patients is anemia, which also causes shortness of breath and dizziness. Anti-HIV medications may inhibit red blood cell production. An alternative treatment, Epoetin alfa, works by increasing low levels of naturally producing erythropoietin, a protein manufactured in the kidneys. Fatigue resulting from low testosterone levels can be treated with anabolic steroids. Poorly functioning adrenal glands can be the cause of fatigue in patients with advanced disease. Taking hydrocortisone pills is often effective. Depression is the fourth most common cause of fatigue. Antidepressants work well without traditional side effects.
 ...
PMID:More awareness needed in treatment of fatigue. 1136 53

A request for euthanasia (RFE) in the terminally ill raises concerns that physical and/or mental suffering remain unaddressed and thus mandates a critical appraisal of the physical and psychosocial aspects of the individual concerned. An alert datasheet (AD) is completed at the weekly Palliative Care Service (PCS) meeting as a measure of self-audit and deals with issues considered to be of importance in ensuring high-quality patient care, one of which is a RFE. The ADs for the year 2000 were examined, and where a RFE was made, the contributing factors as documented on the forms together with demographic data, the case synopsis and patient-rated main three problems/issues were appraised. Among 490 patients referred to the service, there were 6 RFE (1.6%) recorded. These were made by 1 female (age 44) and 5 male (age range 58-78 years) patients. Four of these patients had a cancer diagnosis (all had metastatic disease). Median survival from first contact with the PCS was 13 days (range 4-29). The contributing factors identified were: uncontrolled symptoms (2/6 - severe constipation in both), depression (1/6), issues of burden/dependency (6/6), lack of autonomy/control (4/6), sense of hopelessness (3/6) and social isolation (4/6). The patient-rated main three problems were: (i) physical symptoms (5/6), specifically pain (2/6), shortness of breath (2/6), fatigue (1/6) and nausea (1/6), and (ii) psychosocial issues (4/6). A RFE was seen to be a multifactorial entity (issues of burden/dependency being universal) and merits a focused appraisal in order to adequately address potentially unrecognised issues that contribute to suffering. The short median survival from the time of referral to the service suggests that (i) RFEs are made late in the trajectory of the illness and (ii) these patients are being referred late in the course of their illness - thus limiting the window in which these issues can be addressed.
 ...
PMID:Requests for euthanasia made to a tertiary referral teaching hospital in Sydney, Australia in the year 2000. 1202 30

First-term attrition, defined as failing to complete the contracted first enlistment term, is one of the most serious and costly problems faced by the U.S. Navy. This study was an investigation of 1-year Navy attrition in relation to demographic factors and variables assessed by the Sailors' Health Inventory Program (SHIP) questionnaire, a medical and psychosocial history questionnaire completed by all Navy recruits. Overall attrition, as well as specific categories of attrition (e.g., medical, behavioral, and administrative), were studied. The sample consisted of 66,690 Navy recruits whose status (retention vs. attrition) could be tracked to the 1-year mark. The strongest predictors of overall attrition were educational level, self-reported history of shortness of breath, ever being suspended or expelled from school, history of depression/excessive worry, fainting or dizziness, and recurrent back pain. Many other medical and psychosocial items from SHIP were also predictive of attrition. Similar factors were associated with different categories of attrition (e.g., medical, behavioral). The implications of these findings for attrition reduction strategies are discussed.
 ...
PMID:Predictors of Navy attrition. I. Analysis of 1-year attrition. 1236 69

In order to investigate symptom burden in the last week of life, we conducted after-death interviews with close relatives of deceased older persons from a population-based sample of older people in The Netherlands (n=270). Results show that fatigue, pain, and shortness of breath were common (83%, 48% and 50%, respectively). Other symptoms were confusion (36%), anxiety (31%), depression (28%), and nausea and/or vomiting (25%). Cancer patients and patients with chronic obstructive pulmonary disease were clearly at a disadvantage with respect to pain and shortness of breath, respectively. Furthermore, cognitive decline turned out to be predictive of specific symptom burden. Persons with cognitive decline in the last three months had a higher symptom burden and different symptoms compared to patients with no cognitive decline. It is suggested that older persons with cognitive decline require specific attention.
 ...
PMID:Symptom burden in the last week of life. 1471 64

Symptoms serve as intervention foci for patients and health care providers. Research has established a relationship between symptoms and quality of life for persons living with HIV/AIDS. This article reports symptom prevalence and intensity data that include gynecological and cognitive symptoms self-reported by HIV-infected women (N = 118). Using a cross-sectional, descriptive design, data were obtained using the Center for Epidemiological Studies-Depression Scale (CES-D), Medical Outcomes Study Short Form-36 (MOS SF-36), and the revised Sign and Symptom Check-List for Persons Living with HIV/AIDS (SSC-HIV). Prevalent symptoms were depression (83%), muscle aches (84%), weakness (80%), and painful joints (71%). Symptoms with the highest mean intensity, however, were headaches, rash, insomnia, vaginal itching, and shortness of breath at rest. Symptoms also significantly predicted role functioning. This study contributes to our understanding the nature of symptoms and the influence of symptoms on role and physical functioning among HIV-infected women.
 ...
PMID:The influence of symptoms on quality of life among HIV-infected women. 1498 39

Heart failure is a chronic disabling problem afflicting a growing number of adults. These individuals experience episodes of exacerbation demonstrated by increasing shortness of breath, fatigue, and fluid retention. The symptoms often develop in a slow and insidious manner making perception of worsening difficult to determine. Theoretically, an increase in body awareness may help individuals recognize symptoms of worsening heart failure earlier, but it is not known whether increased body awareness leads to somatization, an abnormal dwelling on body symptoms. This study was conducted to describe body awareness in 90 persons with heart failure or after transplant. We found that the Body Awareness Quesionnaire was a reliable measure of this concept in this sample. When body awareness was examined for age, gender, and treatment (HF or transplant) group were examined, no significant differences were found. Furthermore, there were no significant relationships between body awarenss and negative moods such as anxiety, depression, or anger. Interventions to enhance body awareness may be a fruitful new direction that will improve symptom recognition without increasing somatization in persons with heart failure.
 ...
PMID:An exploratory study of body awareness in persons with heart failure treated medically or with transplantation. 1499 80

Severe acute respiratory syndrome (SARS) is associated with considerable morbidity and mortality in the acute phase. Worldwide case fatality rate is 11% (range 7 to 27%) for the most severely affected regions. Several adverse prognostic factors have been identified, including advanced age, presence of comorbidity, higher lactose dehydrogenase levels and initial neutrophil count, but the impact of viral and other host factors on outcome is unknown. Published data on sequelae of SARS are limited. Clinical follow-up of patients who recovered from SARS has demonstrated radiological, functional and psychological abnormalities of varying degrees. In the early rehabilitation phase, many complained of limitations in physical function from general weakness and/or shortness of breath. In a small series of subjects who underwent CT scan of the chest, over half showed some patchy changes consistent with pulmonary fibrosis. Lung function testing at 6-8 weeks after hospital discharge showed mild or moderate restrictive pattern consistent with muscle weakness in 6-20% of subjects. Mild decrease in carbon monoxide diffusing capacity was detected in a minority of subjects. Preliminary evidence suggests that these lung function abnormalities will improve over time. Psychobehavioural problems of anxiety and/or depression were not uncommon in the early recovery phase, and improved over time in the majority of patients. Avascular necrosis of the hip has been reported as another complication. The long-term sequelae of SARS are still largely unknown. It is important to follow up these patients to detect and appropriately manage any persistent or emerging long-term sequelae in the physical, psychological and social domains.
 ...
PMID:SARS: prognosis, outcome and sequelae. 3307 3

Although efforts have been made to define optimal terminal care in palliative care units (PCUs), comprehensive longitudinal evaluations of care outcomes in PCUs at the end of life are scarce. In this study, changes in functional status (assistance needed for walking, and toilet use) and symptoms (pain, nausea, shortness of breath, depression, and anxiety) were assessed in all patients (n=355) admitted to 10 PCUs in Dutch nursing homes. Outcomes were measured at 24 hours, 48 hours, one week, and two weeks before death, and at PCU admission. Results show that functional status deteriorated from admission to one week before death, but most symptoms did not worsen in the last three weeks before death. Decreases in pain, anxiety, and nausea were observed. The results suggest that the care provided in the PCUs stabilized the symptom levels. Patients who die between two and four weeks appeared to have more favorable symptom change patterns than patients who die within two weeks, which supports the recommendation to admit eligible patients in earlier phases of their disease. Limitations include the use of proxy measures and some forms of selection bias, which may lead to underestimation of symptom levels.
 ...
PMID:Palliative care units in The Netherlands: changes in patients' functional status and symptoms. 1533 35


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>