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

The aim of this study was to determine the role of endogenous dopamine (DA) and the combined effect of DA and acetylcholine (ACh) on the carotid sinus nerve chemosensory discharge (CSND). CSND was measured in vivo in 6 control cats and 6 cats pre-treated with reserpine and alpha-methyl-paratyrosine [catecholamine depleted group: CAD] during infusions of DA and DA+ACh. In normoxia, CSND was similar between CAD's and controls. DA induced CSND depression was transient in controls but sustained in CAD's. Addition of ACh increased CSND in both groups. In hypoxia (8% O(2) in N(2)), the dynamic CSND response was slowed by DA in CAD's but not controls. Addition of ACh increased this response in both groups. Neither DA nor DA+ACh altered the steady state hypoxic CSND in either group. It is concluded that endogenous DA is important in expressing the dynamic characteristics of both the response to exogenous DA and the response to hypoxia under constant DA infusion. The study also confirms the opposing effects of exogenous DA and ACh on the normoxic CSND.
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PMID:Carotid sinus nerve chemosensory response to dopamine and acetylcholine in catecholamine depleted cats. 1257 76

Elderly patients are significantly less likely to receive statins than younger patients possibly because of doubts regarding compliance or concerns regarding the increased likelihood of adverse events and drug interactions. Poor compliance can be expected especially in patients suffering from dementia or depression as well as those whose stage of cardiovascular disease exhibits few symptoms. On the other hand, the clinical significance of CHD events is high in the elderly, and 80% of coronary deaths occur in patients aged over 65 years. The average statistical life expectancy of elderly and old patients is often underestimated. The HPS and PROSPER studies showed that statins reduce mortality and morbidity even in very elderly individuals with a high global cardiovascular risk and/or CAD. Patients up to the age of 79 years should be treated according to the same guidelines as younger patients. Statin therapy should only be considered for patients aged 80 years and older who are at a very high risk for cardiovascular events.
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PMID:[Recommendations for statin therapy in the elderly]. 1534 Jun 98

The goal of this study was to examine some of the mechanisms underlying emotion regulation in childhood affective disorders by examining the impact of distracting emotional information during performance on a working memory task ("Emotional n-back" or E-n-back). The sample included 75 children (38 girls and 37 boys) between 8 and 16 years of age meeting criteria for: Anxiety disorder (ANX, n = 17), Major depressive disorder (MDD, n = 16), Comorbid anxiety and depression (CAD, n = 24), or Low-risk normal control (LRNC, n = 18). Results showed that the MDD and CAD groups had significantly longer reaction times on negative emotional backgrounds compared to neutral backgrounds, whereas the LRNC group had significantly longer reaction times on positive backgrounds. These results suggest altered processing of emotional information particularly associated with depression. Because the E-n-back task engages higher-order cognitive processes, these results suggest that these alterations in processing emotional information also interfere with the cognitive processes that govern how attentional resources are allocated. Further, research is needed to replicate this study and delineate underlying neural mechanisms.
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PMID:Altered emotional processing in pediatric anxiety, depression, and comorbid anxiety-depression. 1583 95

Numerous applications in mechanical CAD/CAM need robust algorithms for the identification of protrusion and depression features (DP-features) on geometric models with free-form (B-Spline) surfaces. This paper reports a partitioning algorithm that first identifies the boundary edges of DP-features and then creates a surface patch to cover the depressions or isolate the protrusions. The novelty of the method lies in the use of tangent continuity between edge segments to identify DP-feature boundaries that cross multiple faces and geometries.
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PMID:Edge-based identification of DP-features on free-form solids. 1594 18

The aim of the investigation was to study the significance of the functional condition of endothelium for the evaluation of ischemic episodes in patients with type 2 diabetes mellitus (DM2). Ninety-three patients (52 men; 41 women; mean age 58.3+/-4.8 years) were examined. Group 1 consisted of 47 patients with coronary heart disease (CHD) and CD2; group 2 consisted of 46 CAD patients without carbohydrate exchange disorder. Both groups were comparable by gender, age, and the main risk factors. The patients were examined using Holter monitoring, physical load test, EchoCG, reactive hyperemia test (ultrasound evaluation of the endothelium-dependent brachial artery dilation). The number of painless ischemic episodes (PIE), the total duration of ischemia, the maximum degree of ST depression prevailed in group 1 patients. Correlation analysis demonstrated a significant negative correlation between endothelial dysfunction, one the one part, and the number and duration of PIE and the time between the ischemic ST depression and pain syndrome, on the other, in group 1 patients.
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PMID:[Clinicofunctional evaluation of ischemic episodes and vascular endothelium in patients with type 2 diabetes]. 1729 80

Studies in patients recovering from myocardial infarction, episodes of unstable angina, coronary bypass surgery and coronary angioplasty, show that between 12 and 20% of hospitalized cardiac patients meet psychiatric criteria for current major depression. A similar percentage report elevated levels of depressive symptoms on paper and pencil self-report measures. These rates of depression are about three times higher than in the general community. On a practical basis this means that about one in three hospitalized CAD patients has some degree of depression. Despite its high prevalence in patients with CAD, depression is not a normal reaction to cardiac disease. Both major depression and elevated depressive symptoms are associated with at least a doubling in risk of subsequent cardiac events, even when standard cardiac risk factors, including left ventricular ejection fraction and number of blocked coronary arteries, are taken into account. In fact, several large, longitudinal community-based studies show that depression precedes the development of clinically evident CAD by many years. There is substantial evidence that depression is a potentially modifiable cardiac risk factor of as much importance as diabetes or lack of exercise. Although the precise mechanisms explaining the link between depression and CAD remain unknown, there is evidence that changes in autonomic regulation, sub-chronic inflammation, endothelial dysfunction, enhanced platelet responsiveness and reduced omega-3 free fatty acid levels may all be involved. Intriguingly, the mechanisms that have been hypothesized to explain the link between depression and CAD prognosis are the same as those suggested to explain the favorable impact of omega-3 supplements in CAD patients. Additional clinical trials to assess the impact of omega-3 supplements on depression are clearly warranted both in CAD patients and in individuals free of heart disease.
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PMID:Depression and coronary artery disease. 1757 7

The aim of our study was to assess if the analysis of precatheterisation initial 12-lead ECG could reliably differentiate between Taco-Tsubo Cardiomyopathy (TTC) and ST-segment elevation myocardial infarction (STEMI), two conditions with a similar clinical presentation. Of the 320 patients with suspected STEMI who underwent angiography over a 2-year period we identified 23 (7.2%) patients without significant coronary artery disease. 6 (26.1%) of whom met the diagnostic criteria for Tako-Tsubo Cardiomyopathy (6 females, median age 70 (65-83) years). TTC patients were compared with the remaining 297 patients with angiographic evidence of CAD. There was no significant difference in regard with heart rate, PR interval, QRS duration, and corrected QT interval, but QT dispersion was less in TTC patients compared to STEMI group (34.1+/-9.7 vs. 43.9+/-16.2 p=0.046). Distribution of ST-segment elevation was similar in both groups, but the sum of the level of ST-segment elevation was significantly smaller (0,6+/-0.14 [0,4-0,8] mV vs. 0.95+/-0.17 [0,8-1,4] mV; p =0.002 ) and concurrent ST-segment depression was rare finding in TTC patients (16.6% vs. 65.7 % p=0.022). Careful analysis of initial ECG in combination with complex analysis of initial cardiac markers and presence of preceding stressful event could be informative tool in differentiating of TTC from STEMI.
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PMID:Assessment of the value of pre-catheterization in diagnosis of st-segment elevation myocardial infarction and tako-tsubo cardiomyopathy. 1999

Objective. We tested the association of specific psychological characteristics in patients having stable coronary disease with the reporting of anginal symptoms during daily activities, and positive exercise testing. Methods. One hundred and ninety-six patients with documented CAD enrolled in the Psychophysiological Investigations of Myocardial Ischemia (PIMI) Study completed an anginal history questionnaire and a battery of psychometric tests. They also underwent standardized exercise treadmill tests. Results. Patients with a recent history of angina were more likely to be female, and had higher Beck Depression (P = .002), State Anxiety (P = .001), Trait Anxiety (P = .03), Harm Avoidance (P = .04) and Muscle Tension (P = .004) scores than patients who had no recent history of angina. Along with several treadmill variables indicating more severe disease state and reduced exercise tolerance, patients who developed angina on a positive treadmill test also displayed higher scores on the Beck Depression Inventory (P = .003) and State Anxiety (P = .004) scales. Conclusions. Several psychological characteristics, and most notably anxiety and depression, are strong correlates of recent angina and angina in the presence of ischemia provoked by treadmill testing.
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PMID:Symptoms of anxiety and depression are correlates of angina pectoris by recent history and an ischemia-positive treadmill test in patients with documented coronary artery disease in the pimi study. 2217

Why do we stay in prison when the door is wide open? - Jalal ad-Din Rumi. Depression is an independent risk factor for the development of CAD. Patients with CAD have a high rate of depression, which worsens their prognosis. Screening CAD patients with the 2-question PHQ-2 to identify those at greatest risk of depression is strongly recommended, as is referring patients for further evaluation and possible treatment when depression has been identified by the PHQ-9. Treating depression is likely to improve cardiovascular outcomes. The PHQs are in the public domain and free to use. To download and for more information, visit www. phqscreeners.com.
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PMID:Identify and treat depression for reduced cardiac risk and improved outcomes. 2274 Jul 39

Exercise electrocardiography (ECG) is one of the most commonly utilized tests in cardiology. Despite the drawbacks, exercise ECG is widely preferred due to low cost, standardization, and strong prognostic information. A prolonged PR interval during recovery has recently been proposed as an indicator of mortality. Herein, we report an interesting case of a patient who presented with the complaint of exertional dyspnea and exhibited PR lengthening during the recovery period on the exercise ECG. The patient had a PR interval of 240 ms before exercise, which decreased to 160 ms at peak stress. However, during recovery, the PR interval prolonged gradually, reaching 320 ms at the second minute and persisting at that length until the end of the recovery period. The patient achieved 87% of the age predicted maximum heart rate, and experienced non-disabling shortness of breath and a pressure sensation in the chest, with no apparent ST segment depression. Recovery parameters, including heart rate recovery and systolic blood pressure recovery, were also within normal limits. The patient underwent coronary angiography with the suspicion of CAD which revealed severe multi-vessel disease. This rare case emphasizes the importance of PR lengthening in the recovery period as a sign of severe ischemia, in addition to other signs, such as prominent ST-segment changes, chronotropic incompetence, impaired hemodynamic response, and poor exercise capacity during stress ECG evaluation.
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PMID:A rare sign of ischemia during exercise ECG: PR interval lengthening in the recovery period. 2351 87


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