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)

Infants are well known to be sensitive to the myocardial depressant effects of halothane. In this study of more than 300 infants, 0 to 24 weeks of age, who received halothane anesthesia, preoperative risk factors were correlated with intraoperative outcome and postoperative recovery. Possible risk factors considered were age, history of respiratory distress syndrome (RDS), preoperative fasting time, and anemia. Intraoperative morbidity was evaluated by occurrence of significant hypotension, slow heart rates, or serious bradycardias. Parameters of postoperative recovery included postanesthetic recovery room admission score, duration of recovery room stay, and time to first feeding. Arterial hypotension occurred with an unexpectedly high frequency of 49.2%. Infants younger than 8 weeks of age (particularly newborns), infants 9-16 weeks of age (fasting eight or more hours), and RDS survivors 0-16 weeks of age were found to be most susceptible to hypotension. Only age and history of RDS, however, proved to be statistically significant risk factors in predicting the probability of intraoperative circulatory depression. Though circulatory depression during halothane inhalation was common, it was not associated with significant intraoperative or postoperative morbidity in terms of cardiorespiratory arrests, serious dysrhythmias, prolonged postanesthetic recovery, or delayed feeding times.
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PMID:Halothane anesthesia in infancy: identification and correlation of preoperative risk factors with intraoperative arterial hypotension and postoperative recovery. 405 16

The authors report twenty two cases of post-operative gas gangrene. In the series studied mortality was 40.9 p. 100, independent of age and sex. Rapidly progressive forms were the most severe. The delay before effective treatment was prescribed influenced prognosis. In clinical terms, shock and associated renal insufficiency were grave, as well as a picture of respiratory distress which led, in certain cases, to contra-indication of one of the therapeutic possibilities, i.e. that of hyperbaric oxygen. Responsible organisms could be isolated in nineteen cases from local samples. There was a marked predominance (15 cases) of clostridium perfringens. Contamination with aerobic flora was common. Examination to assess favourizing circumstances led essentially to a conclusion of the role of microbial contamination, ischemia, broad spectrum antibiotics, absence of appropriate antibiotics and underlying immuno-depression. Treatment was based in the majority of cases on the triple combination of antibiotics, surgery and hyperbaric oxygen, as well as the correction of any general systemic disorders. Mortality was markedly reduced (31 p. 100) in patients receiving complete and early treatment. The gravity and recrudescence of disorders due to anaerobic organisms lead the authors to review current therapeutic possibilities. Appropriate treatment should be prescribed in all situations where an infection due to anaerobic organisms is feared, and should cover the risk of clostridial infection (penicillin 200,000 mu/kg/24 h) as well as the risk of bacteroides (metronidazole 25 mg/kg/24 h). Curative treatment should be prescribed, even in the absence of bacteriological proof, on the basis of presumptive clinical evidence, this being a true emergency which should not be delayed under any circumstances.
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PMID:[Postoperative gas gangrene. Apropos of 22 cases]. 611 45

Hypertension in pregnancy has implications for both maternal and fetal welfare. Extrapolation from concepts of mechanisms operating in hypertension in general to pregnancy-related hypertension is not justified. In the latter, the major features are a hyper-adrenergic state, plasma volume reduction and an increased systemic resistance. A reduction in uteroplacental perfusion may result from or may activate the mechanisms that elevate blood pressure. Humoral factors (e.g. hormonal attenuation of vascular reactivity) and prostacyclin deficiency may be central to the disordered physiology. Treatment of hypertension in pregnancy should aim at avoiding the vascular damage due to blood pressure elevation but not cause a reduction in uteroplacental perfusion. Unlike earlier antihypertensive regimens using centrally acting sympatholytics, adrenergic neuron blockers or diuretics, regimens using beta-blockers or combinations of beta-blockers with alpha-blockers or vasodilating agents such as hydralazine permit effective blood pressure control, even in severe hypertension, and pregnancy can often proceed until term or until fetal maturity is secured. Adverse effects on the fetus (growth retardation, cardiorespiratory depression, hypoglycaemia, hyperbilirubinaemia) formerly attributed to beta-blockers are more likely related to poorly controlled hypertension. Specific benefits of maternal beta-adrenoceptor blockade are suggested by evidence for prevention of proteinuric deterioration and a decrease in the incidence and severity of respiratory distress in premature infants. Hypertension in pregnancy still presents a formidable therapeutic challenge and requires comprehensive management with close monitoring of fetal welfare. The presence or development of proteinuria in a hypertensive pregnant woman implies a major increase in risk to the fetus and warrants immediate admission to hospital for specialist management.
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PMID:Hypertension in pregnancy. Pathophysiology and management. 614 40

Familial infantile myasthenia is a rare type of myasthenia that usually occurs in connection with respiratory depression. The condition is characterized by (1) absence of myasthenia in the mother, (2) occurrence of a similar disorder among siblings, (3) respiratory depression at birth, (4) episodic weakness and apnea during the first two years of life, and (5) improvement with age. Since the condition responds to anticholinesterase medication, early diagnosis is important. Familial infantile myasthenia is a potential cause of sudden infant death and should be considered in infants with unexplained respiratory distress.
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PMID:Familial infantile myasthenia. 624 29

Effects of a modified live vaccine (MLV) strain of bovine viral diarrhea virus (BVD) on lymphocyte and neutrophil function were determined in cattle with and without increased plasma cortisol (hydrocortisone) concentrations. Cattle were given MLV-BVD vaccine IM and intranasally. Cattle given ACTH received 200 IU every 12 hours for 10 doses. The MLV-BVD virus when administered alone caused no apparent clinical signs or body temperature response. Of 4 MLV-BVD-treated calves that were also given ACTH, 2 developed increased body temperature and respiratory distress. The MLV-BVD virus caused a decrease in circulating lymphocytes and neutrophils, whereas administration of ACTH and MLV-BVD induced a neutrophilia and lymphopenia. The MLV-BVD virus and ACTH when administered separately or in combination caused a depression of lymphocyte blastogenesis in response to selected mitogens. Neutrophils were separated from the peripheral blood and their function was evaluated, using the following procedures: (i) random migration under agarose, (ii) ingestion of 125I-labeled Staphylococcus aureus, (iii) quantitative nitroblue tetrazolium reduction, (iv) iodination, and (v) antibody-dependent cell-mediated cytotoxicity (ADCC). The MLV-BVD virus produced a significant (P less than 0.05) suppression of neutrophil iodination and ADCC. Neutrophils from cattle given MLV-BVD virus and ACTH had enhanced random migration, enhanced S aureus ingestion, suppressed iodination, and suppressed ADCC activity.
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PMID:Suppression of neutrophil and lymphocyte function induced by a vaccinal strain of bovine viral diarrhea virus with and without the administration of ACTH. 631 14

The nonstress test (NST) and the contraction stress test (CST) have had wide application to term pregnancies, but little has been reported of use in the management of preterm fetuses. Seventy-two of 438 high-risk gravidas, receiving both tests between 25 and 34 weeks' gestation, delivered singleton infants before completion of their 34th week. On the basis of the last NST and CST preceding delivery, the 72 fetuses could be divided into reactive-negative and nonreactive-positive groups. Nonreactive-positive fetuses experienced greater perinatal mortality and significantly higher rates of intrapartum fetal distress, neonatal depression, respiratory distress syndrome (RDS), intrauterine growth retardation, and cesarean section. Pulmonary complications in nonreactive-positive fetuses, regardless of the lecithin: sphingomyelin ratio, were significantly increased if intrapartum fetal distress had preceded delivery. Most neonatal deaths stemmed from RDS-related complications, 86% preceding the 31st week of gestation; however, nearly half of the perinatal deaths before the 30th week followed reactive NSTs. The data suggest that for clinical management of preterm pregnancy, fetal heart rate testing should be initiated after the 29th week; earlier, test significance is less clear and infant survival less likely. Maternal estriol determinations aid little in the management of nonreactive-positive fetuses. Rather, the care of these selected pregnancies should be temporized through the 30th week; when delivery is then elected, intrapartum fetal distress should be avoided through liberal use of cesarean section in the nonreactive-positive group.
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PMID:Antepartum fetal heart rate testing in preterm pregnancy. 712 29

Thirteen pregnant women were treated with 4 mg dexamethasone intramuscularly, three times daily, for seven days during the last trimester of pregnancy, in order to prevent the respiratory distress syndrome (RDS) in the neonate. Determination of human placental lactogen (HPL) was made daily during the treatment and at intervals of 2--3 days afterwards. No changes in HPL were seen during the treatment. One week after the treatment had been stopped, a statistically significant decrease in HPL was observed (p less than 0.01). The levels returned to normal during the following week. It is presumed, that the observed decrease in HPL may be regarded as a result of a direct depression of placental function caused by the dexamethasone therapy. The implications of this finding for the fetus are not clear, but in cases of placental insufficiency, glucocorticoid treatment should not be employed.
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PMID:Serum levels of human placental lactogen during and after prenatal dexamethasone therapy. 740 47

The ability of macrophages of phagocytize particulate matter is largely dependent on fibronectin, a nonspecific opsonin found in plasma. Fibronectin depletion, resulting in reticuloendothelial system (RES) depression, occurs following a variety of physical insults. RES depression may contribute to postinjury sequelae such as respiratory distress syndrome and septicemia. Fibronectin concentration was measured in the plasma of sheep with chronic lung lymph fistulas subjected to controlled thermal injury. Fibronectin levels were significantly (p < 0.05) decreased at 4, 24, 48, and 72 hours following burning. Fibronectin concentration decreased in parallel with serum albumin concentration; serum globulin concentrations did not decrease. Fibronectin concentration had an inverse relationship to lung lymph flow, a reflection of pulmonary transvascular fluid filtration rate. The role of fibronectin in the pathogenesis of postinjury respiratory distress syndrome deserves further exploration.
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PMID:Response of plasma fibronectin to major body burn. 743 53

The objective of the study was to evaluate the relation between every-night (habitual) snoring, sleep apnoea and cognitive complaints (concentration and memory complaints) in an adult population-based sample. In the DAN-MONICA (MONItoring trends in CArdiovascular iseases) 1504 males and females aged 30, 40, 50 and 60 years were classified according to their snoring habits. Nocturnal respiration was measured in 748 participants. The following measures were regarded as potential confounders: age, gender, unintended sleepiness, insomnia, depression, hypnotic use, alcohol consumption by questionnaire, body mass index (BMI) and blood pressure. Concentration and memory problems were both related to depression, insomnia and unintended sleepiness. Snoring and sleep apnoea (defined as a respiratory distress index-RDI > or = 5) were associated with concentration problems and unintended sleepiness. The odds ratios (95% confidence intervals) between snoring, concentration and memory problems, calculated by logistic regression analysis after adjustments for the above confounders, were 1.90 (1.23-2.91, p < 0.01) and 1.38 (0.97-1.99, NS). For those with sleep apnoea, the odds ratios were 3.53 (1.42-8.73. p < 0.001) and 1.51 (0.81-2.14, NS) for concentration and memory problems, respectively. The main conclusion drawn from this study is that cognitive complaints show a high correlation to mood, insomnia and hypersomnia. Habitual snoring and sleep apnoea show a correlation to concentration problems, but not to memory problems. This suggests that part of the association between snoring, sleep apnoea and cognitive dysfunction is related to the presence of sleep disturbances and daytime sleepiness.
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PMID:[Cognitive symptoms in persons with snoring and sleep apnea. An epidemiologic study of 1.504 women and men aged 30-60 years. The Dan-MONICA II study]. 860 12

Respiratory patients require psychotropic drug administration to treat pain, cough and respiratory distress or to treat insomnia, anxiety, depression or psychosis. Terminal patients require thoughtful and compassionate use of these drugs, even when there is an expectation that such therapy may lead to an earlier death. Most psychotropic agents can be used safely in patients with respiratory disease, and careful use of selected drugs should always be employed if indicated for treating distressful conditions that may be benefitted. Guidelines to appropriate choices and doses are provided.
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PMID:Psychotropic drugs in terminal care. 753 7


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