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)

The most common cause of drop-out from continuous ambulatory peritoneal dialysis (CAPD) therapy is an insufficient dose of dialysis. Several reports and the Dialysis Outcomes Quality Initiative (DOQI) guidelines recommend maintaining a weekly creatinine clearance (CCr) of at least 60 L/1.73 m2. Previously, at our center, we found that many patients switched from CAPD to hemodialysis (HD) owing to insufficient solute clearance (less than 50 L/1.73 m2). We attempted to determine whether once-weekly HD would improve solute clearance. We treated 7 cases (6 men, 1 woman; average age: 54.3 +/- 4.5 years; mean duration of CAPD: 4.3 +/- 1.1 years) with once-weekly HD therapy (3.5 hours; 200 mL/hour). The average CCr was 45 +/- 2 L/1.73 m2. No ultrafiltration failure was found. Addition of once-weekly HD therapy improved CCr to 66 +/- 7 L/1.73 m2. That improvement was attributable to not only to the addition of HD therapy but also to an increase in peritoneal CCr for 3 consecutive days after completion of once-weekly HD therapy. Creatinine clearance and ultrafiltration were both significantly increased. Other clinical parameters such as blood pressure control, weight control, and dose of erythropoietin were significantly improved after introduction of once-weekly HD therapy. Moreover, uremic symptoms such as pruritus and depression were markedly improved. In conclusion, once-weekly HD therapy in conjunction with regular CAPD therapy improves solute clearance and symptoms related to uremia in CAPD patients with an insufficient dialysis dose.
 ...
PMID:Once-weekly hemodialysis helps continuous ambulatory peritoneal dialysis patients who have insufficient solute removal. 1476 51

Androgenic-anabolic steroids (AAS) are synthetic derivatives of the male hormone testosterone. They can exert strong effects on the human body that may be beneficial for athletic performance. A review of the literature revealed that most laboratory studies did not investigate the actual doses of AAS currently abused in the field. Therefore, those studies may not reflect the actual (adverse) effects of steroids. The available scientific literature describes that short-term administration of these drugs by athletes can increase strength and bodyweight. Strength gains of about 5-20% of the initial strength and increments of 2-5 kg bodyweight, that may be attributed to an increase of the lean body mass, have been observed. A reduction of fat mass does not seem to occur. Although AAS administration may affect erythropoiesis and blood haemoglobin concentrations, no effect on endurance performance was observed. Little data about the effects of AAS on metabolic responses during exercise training and recovery are available and, therefore, do not allow firm conclusions. The main untoward effects of short- and long-term AAS abuse that male athletes most often self-report are an increase in sexual drive, the occurrence of acne vulgaris, increased body hair and increment of aggressive behaviour. AAS administration will disturb the regular endogenous production of testosterone and gonadotrophins that may persist for months after drug withdrawal. Cardiovascular risk factors may undergo deleterious alterations, including elevation of blood pressure and depression of serum high-density lipoprotein (HDL)-, HDL2- and HDL3-cholesterol levels. In echocardiographic studies in male athletes, AAS did not seem to affect cardiac structure and function, although in animal studies these drugs have been observed to exert hazardous effects on heart structure and function. In studies of athletes, AAS were not found to damage the liver. Psyche and behaviour seem to be strongly affected by AAS. Generally, AAS seem to induce increments of aggression and hostility. Mood disturbances (e.g. depression, [hypo-]mania, psychotic features) are likely to be dose and drug dependent. AAS dependence or withdrawal effects (such as depression) seem to occur only in a small number of AAS users. Dissatisfaction with the body and low self-esteem may lead to the so-called 'reverse anorexia syndrome' that predisposes to the start of AAS use. Many other adverse effects have been associated with AAS misuse, including disturbance of endocrine and immune function, alterations of sebaceous system and skin, changes of haemostatic system and urogenital tract. One has to keep in mind that the scientific data may underestimate the actual untoward effects because of the relatively low doses administered in those studies, since they do not approximate doses used by illicit steroid users. The mechanism of action of AAS may differ between compounds because of variations in the steroid molecule and affinity to androgen receptors. Several pathways of action have been recognised. The enzyme 5-alpha-reductase seems to play an important role by converting AAS into dihydrotestosterone (androstanolone) that acts in the cell nucleus of target organs, such as male accessory glands, skin and prostate. Other mechanisms comprises mediation by the enzyme aromatase that converts AAS in female sex hormones (estradiol and estrone), antagonistic action to estrogens and a competitive antagonism to the glucocorticoid receptors. Furthermore, AAS stimulate erythropoietin synthesis and red cell production as well as bone formation but counteract bone breakdown. The effects on the cardiovascular system are proposed to be mediated by the occurrence of AAS-induced atherosclerosis (due to unfavourable influence on serum lipids and lipoproteins), thrombosis, vasospasm or direct injury to vessel walls, or may be ascribed to a combination of the different mechanisms. AAS-induced increment of muscle tissue can be attributed to hypertrophy and the formation of new muscle fibres, in which key roles are played by satellite cell number and ultrastructure, androgen receptors and myonuclei.
 ...
PMID:Effects of androgenic-anabolic steroids in athletes. 1524 88

In addition to its well-known erythropoetic effect, erythropoietin (EPO) has also been shown to be neuroprotective in various animal models. In contrast to EPO, carbamylated EPO (CEPO) does not bind to the EPO receptor on UT7 cells or have any haematopoietic/proliferative activity on these cells. In vivo studies in mice and rats showed that even high doses of CEPO for long periods are not erythropoietic. However, in common with EPO, CEPO does inhibit the apoptosis associated with glutamate toxicity in hippocampal cells. Like EPO, CEPO is neuroprotective in a wide range of animal models of neurotoxicity: middle cerebral artery occlusion model of ischaemic stroke, sciatic nerve compression, spinal cord depression, experimental autoimmune encephalomyelitis and peripheral diabetic neuropathy. To date, EPO and CEPO have been exciting developments in the quest for the treatment of various types of neurotoxicity. The development of CEPO should continue.
 ...
PMID:A neuroprotective derivative of erythropoietin that is not erythropoietic. 1550 Mar 99

While advances in treatment strategies and pharmacotherapy have produced a dramatic reduction in the mortality of patients with heart failure during the past 15 years, there is still a major challenge to improve patient well being, reduce hospitalizations and reduce mortality further. The prevalence of heart failure is not decreasing, and heart failure is currently a cause for hospitalization in >25% of admissions to internal medicine and cardiology departments. It has recently become apparent that anaemia is present in 20-30% of patients with heart failure, and the severity of anaemia has important implications regarding outcome and prognosis. Anaemia may be due to a number of causes, including iron and vitamin deficiency, insidious blood loss, haemodilution, renal impairment and bone marrow depression with resistance to erythropoietin. In the presence of a damaged heart and often coronary artery disease, anaemia may worsen contractile ability and systolic function, while the necessary volume load and ventricular hypertrophy which accompany anaemia contribute to diastolic dysfunction. Preliminary data show that appropriate treatment of anaemia, based on correction of the underlying cause, with, in most patients, the addition of exogenous erythropoietin and iron therapy, improves ventricular function and clinical status. Treatment of anaemia has opened a new frontier in the management of heart failure. We await the results of ongoing clinical trials for more detailed information regarding appropriate haemoglobin targets, choice of medication and dosing and the degree of improvement that may be expected when the issue of anaemia is properly addressed.
 ...
PMID:Anaemia and heart failure: statement of the problem. 1602 30

The primary aim of the present study was to examine the relationship of changes in hemoglobin levels following recombinant human erythropoietin (rHuEPO) treatment to changes in cognitive functioning studied by Mini Mental State Examination (MMSE) in elderly cancer patients undergoing chemotherapy treatment. The secondary aim was that to assess the relationship of changes in hemoglobin levels following rHuEPO treatment to changes in functions studied by Comprehensive Geriatic Assessment (CGA), such as Activity of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Geriatric Depression Scale (GDS) and the Mini Nutritional Assessment (MNA). To this end, hemoglobin levels and cognitive functioning were evaluated in a sample of cancer patients prior to the start of chemotherapy treatment and again after 4, 8 and 12 weeks of treatment with chemotherapy plus rHuEPO. Ten elderly patients (mean age 71.4 years) were enrolled. At baseline, enrolled patients had a mean Hb value of 10.3g/dl. After 4 weeks of rHuEPO treatment, Hb values increased significantly (p<0.0001), with a mean increase of 1.2g/dl (range: 0.2-2.1). Remarkably, 8 out of 10 (80%) showed an increase of Hb levels >or=1g/dl in comparison to baseline and therefore were considered responders. At baseline, four patients (40%) showed a moderate cognitive impairment, whilst six patients (60%) showed a normal cognitive function. After 4 weeks of rHuEPO treatment nine patients (90%) showed a significant improvement of cognitive functions in comparison to baseline (p<0.005): eight of them were responders also to rHuEPO in terms of correction of anemia. The Spearman's rank correlation test showed a statistical significant correlation between Hb increase and increase in cognitive functioning assessed by MMSE after 4 weeks (p=0.049), 8 weeks (p=0.044) and 12 weeks (p=0.031) of rHuEPO treatment. Therefore, the findings of this study provide support for the hypothesis that significant increases in hemoglobin over the course of chemotherapy supplemented with rHuEPO administration would be accompanied by significant improvement in cognitive performance over the same interval.
 ...
PMID:Evaluation of the effectiveness of treatment with erythropoietin on anemia, cognitive functioning and functions studied by comprehensive geriatric assessment in elderly cancer patients with anemia related to cancer chemotherapy. 1621 40

The time-response curve for RBC-59Fe uptake following i.p. injection of 5 mg of dexamethasone into normal, non-polycythemic mice, shows a maximal depression (50% of normal) at 3 days after dexamethasone with return to almost normal values by 5 days. The effect is dose-related showing a plateau with doses of dexamethasone above 3 mg. The shape of the time-response curve indicates that the more mature cells in the erythron are not affected by dexamethasone and that the major effect of the steroid must be on earlier erythroid cells. Intravenous injection of dexamethasone 33 and 48 h after i.v. injection of erythropoietin in post-hypoxic polycythemic mice has no effect on the response to erythropoietin, suggesting that the early and late erythroblasts develop normally into erythrocytes. Injection of dexamethasone 13 h after erythropoietin is also ineffective, suggesting that the final steps of differentiation from erythropoietin responsive cells (ERC) to proerythroblasts are not affected. On the contrary, injection of dexamethasone 1 h after erythropoietin reduces by 60% the effective erythropoiesis, which can be attributed to a decrease in differentiation of ERC into proerythroblasts. These results indicate that the inhibitory action of dexamethasone on erythropoiesis is exerted on cells of the erythroid line before the stage of proerythroblast is reached.
 ...
PMID:Mechanism underlying the inhibitory effect of dexamethasone on in vivo erythropoiesis. 1639 23

Sustained virologic response rates are significantly higher in patients who have relapsed after a previous course of therapy compared with patients who did not respond. A meta-analysis of combination therapy in patients who failed IFN monotherapy reported SVR rates of 52% in relapsers to prior therapy and 16% in nonresponders. Similarly, relapsers after combination standard IFN and RBV therapy have higher SVR rates than combination of therapy nonresponders when treated with pegylated interferon and ribavirin. For this reason, patients who relapse after a previous course of therapy should be considered potential candidates for retreatment. Factors that have been associated with SVR in these patients include genotype non-I, low viral loads, and lesser degrees of fibrosis. The course of treatment in all patients who have relapsed after prior therapy should be reviewed to identify possible reasons for failure to achieve an SVR. In particular, optimal dosing of PEG IFN and RBV and the occurrence and timing of treatment dose reductions during prior therapy should be reviewed. The reasons for dose reduction should be addressed before initiating another course of therapy in an effort to optimize the chance for a SVR. Patients who had dose reduction for depression, anemia, or neutropenia, should be considered for antidepressants, erythropoietin, or, if neutropenia is severe, granulocyte colony stimulating factor therapy, respectively, during retreatment. Prolongation of therapy beyond 48 weeks in patients with relapse after a standard course of PEG IFN and RBV may offer a chance of SVR. Novel agents currently in development, including protease and polymerase inhibitors, may prove to be therapeutic options for these patients in the future.
 ...
PMID:Treatment of relapsers after combination therapy for chronic hepatitis C. 1532 41

Anaemia has a high prevalence and incidence in patients with cancer receiving chemotherapy and is associated with a range of symptoms, including fatigue, drowsiness, depression, dyspnoea, tachycardia and dizziness. Fatigue, in particular, exerts a considerable impact on patient quality of life, affecting 80-100% of patients receiving chemotherapy and, potentially, delaying treatment. Until recently, red blood cell transfusions were the mainstay of treatment for cancer-related anaemia. While effective in ameliorating symptoms, transfusions are associated with short-lived benefits and a risk of infections and disease transmission. The development of the erythropoiesis-stimulating agent (ESA), recombinant human erythropoietin (rHuEPO), resulted in a 50% reduction in the number of transfusions required in anaemic cancer patients receiving chemotherapy. The subsequently introduced rHuEPO analogue, darbepoetin alfa, stimulates erythropoiesis by the same mechanism as rHuEPO but is associated with a prolonged serum half-life, allowing extended dosing intervals and less frequent administration. With the introduction of a number of ESAs and a growing wealth of data concerning their indications, dosing regimens and safety, European cancer organizations have recently developed guidelines for their effective use in clinical practice.
 ...
PMID:Cancer-related anaemia management in the 21st century. 1672 69

Cancer-related fatigue (CRF) is either a symptom or a syndrome depending on criteria for diagnosis. CRF is present in 20% to 30% of long-term cancer survivors and 80% to 90% during treatment and at the end of life. Assessment requires determining the presence, severity, and interference with daily activities. Different descriptors for fatigue (eg, tiredness, lack of vigor) measure different patient experiences. Associated factors such as depression, pain, insomnia, dyspnea, anemia, and deconditioning worsen CRF and should be treated if present. Associated factors that contribute to the severity of fatigue differ depending on the stage of cancer. Pharmacologic interventions include recombinant erythropoietin, psychostimulants, corticosteroid, anti-inflammatory drugs other than steroids, and L-carnitine. Advances in the management of CRF will require an understanding of the underlying mechanism before target-specific therapies can be developed.
 ...
PMID:Management of fatigue in cancer patients. 1683 40

Endocrine abnormalities are common in patients with chronic kidney disease (CKD) and lead to sexual dysfunction, anemia, hyperparathyroidism, and altered mineral metabolism. Common clinical problems include disturbances in menstruation in women, erectile dysfunction in men, and decreased libido and infertility in both sexes. Organic factors tend to be prominent and are related to uremia and other comorbid illnesses. Psychological factors and depression may exacerbate the primary problem. Alterations in the hypothalamic-pituitary axis are seen early in CKD and tend to worsen after patients start dialysis. Hypogonadism plays a dominant role in male sexual function, whereas changes in hypothalamic-pituitary function predominate in female sexual dysfunction. In patients on dialysis, treatment strategies include optimizing dose of dialysis, correction of anemia with erythropoietin, and correction of hyperparathyroidism. Successful kidney transplantation may restore normal sexual function, especially in younger patients.
 ...
PMID:Sexual function in chronic kidney disease. 1739 14


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