UMLS:C0011570 - FACTA Search

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)

THE response of hippocampal CA3 neurones to commissural stimulation, as expressed by the orthodromic population spike (PS2) recorded in anaesthetized rats, was increased when the recording micropipette contained the nitric oxide (NO) synthase inhibitor N omega-nitro-L-arginine methyl ester (20 mM). The increase was stable upon repeated stimulation. When the recording micropipette contained the NO donor sodium nitroprusside (SNP; 10 mM) the amplitude of PS2 elicited by low and middle stimulus strength (Istim) rapidly decreased, while remaining unchanged at higher Istim. When the SNP-containing microelectrode was maintained in place for longer, the depression of PS2 observed at low and medium Istim disappeared and PS2 increased at high Istim. This long-term SNP-induced increase in PS2 at high Istim was reduced by pretreatment with cycloheximide (5 mg kg-1, i.p.). These data, which provide the first demonstration that in situ manipulation of NO produces dual effects on neuronal responsiveness in a highly seizure-prone brain region, suggest that tonic levels of endogenous NO reduce the excitability of CA3 pyramidal neurones, whereas long-term overexposure to NO causes hyperexcitability possibly via genomic mechanisms.
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PMID:Effects of in situ manipulation of nitric oxide on rat hippocampal CA3 neurone excitability. 898 58

CONCLUSION OF THE ICU: Preliminary results from this stage of our study demonstrate a significant decrease of the duration of oedema, probably due to the effects of the inhibition of vascular hyperpermeability. This means that patients under Citalopram therapy can undergo surgical procedures such as necrectomies and autografts sooner because they are stabilized as early as the beginning of their treatment. Particularly the patients with burned faces and deep dermal burns have a better prognoses in respect to cosmetics. CONCLUSION OF THE PSYCHOLOGIST: From the beginning of the study to the present time, no patient experienced PTSD. The compared group of out-patients had been treated on average of 3 months when the first signs of a reduction in the clinical symptoms of PTSD was registered. The clinical onset of the therapeutical effect--on average in the third week--is comparable with references from anxiety or inhibitory depression treatment by using Citalopram. We suggest, at present, that the above-mentioned, preliminary results of our study have shown that Citalopram treatment has a beneficial effect on emotional disturbances in severely burned patients. CONCLUSION OF THE SCAR SPECIALIST: Seropram is a very useful preparation in burn praxis. When we apply it as a bolus 40 mg i.v. immediately after admission to the ICU, the scarring process is very good and hypertrophic scars are not seen. When we apply Seropram in the form of a continual infusion, using the injectomat during a 24-hour period, scarring is better than in the control group, but hypertrophic scarring is not out of the question.
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PMID:Therapeutical aspects of using citalopram in burns. 1039 77

PHYSICAL ACTIVITY AND AGING: Physical activity prevents some age-related impairment. Physical activity reduces the decline of physical capacity which remains limited by maximal heart rate, and reduces the incidence of cardiovascular diseases by decreasing and preventing associated risk factors. Physical activity reduces age-related bone loss, its effect being potentialized by hormonal replacement therapy, and improves balance function, leading to a lower incidence of falls and fractures in older subjects. Physical activity helps to preserve nutritional balance and lean mass/fat mass ratio and reduces age-related insulin resistance. Moreover, physical activity has a beneficial influence on psychological function by improving cognitive performances and decreasing incidence of depression. Lastly, physical activity seems to reduce the incidence of several cancers, colic and mammary cancers particularly. PHYSICAL ACTIVITY, QUANTITY AND QUALITY OF LIFE: These multiple actions explain that physical activity, if it's adapted to subject's specificities increases longevity, delay entry in dependence and improves quality of life in older subjects. WHAT ARE THE RECOMMENDED ACTIVITIES: There is a superiority of individualized programs giving greater place to warm-up and associated endurance and resistive exercises intended to improve simultaneously cardiovascular and muscular functions. SPECIAL INTERESTS OF PHYSICAL ACTIVITY IN FRAIL AND VERY OLD SUBJECTS: Throughout its beneficial effects on aerobic capacity, muscular function, social integration, cognitive function and autonomy, physical activity may have a particular interest in frail subjects, when programs are adapted to physical capacities of these subjects and associated with nutritional supplements.
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PMID:[The preventive effects of physical activity in the elderly]. 1091 38

FORMATION OF THE QUIC: The Quality Interagency Coordination Task Force (QuIC) was established in 1998 to enable the participating federal agencies to coordinate their activities to study, measure, and improve the quality of care delivered by federal health programs; provide people with information to help them in making more informed choices about their care; and develop the research base and infrastructure needed to improve the health care system, including knowledgeable and empowered workers, well-designed systems of care, and useful information systems. STUDY, MEASURE, AND IMPROVE CARE: The QuIC's initial efforts to improve the care delivered in federal health care programs have focused on diabetes, depression, and the effect of working conditions on quality of care. More recently, patient safety efforts are under way to establish a coordinating center that will enable those who are testing methods of reducing errors to share information across their projects and with experts in error reduction. DEVELOP A RESEARCH BASE AND INFRASTRUCTURE: The QuIC has coordinated efforts in credentialing, information on measures of quality, a taxonomy of quality improvement methods, and errors data collection. PROVIDE INFORMATION TO AMERICANS ABOUT HEALTH CARE QUALITY: The QuIC agencies are developing products that will enhance their ability to communicate with the American people about their health care choices: improved gateways for consumer information available from federal agencies, a glossary of commonly used terms, and guidance for producing report cards on quality of care. MOVING THE QUALITY IMPROVEMENT AGENDA FORWARD: Federal efforts to improve quality of care are moving forward in a more integrated fashion on a wide number of fronts.
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PMID:Federal efforts to improve quality of care: the Quality Interagency Coordination Task Force (QuIC). 1122 Oct 14

DIFFICULT DIAGNOSIS: Depression in the elderly can take on many often misleading aspects. Sadness may be considered legitimate or "normal" for an elderly person. Depression may masquerade as an organic disorder where somatic complaints, pain and anxiety predominate. All these different clinical forms may mislead the clinician. THE MASK OF HYPOCHONDRIA: A tendency to hypochondria, found in more than one-half of all depressed elderly subjects, may be reinforced by bouts of complementary examinations. The patient is convinced of having an unrecognized organic disease. The mask of hypochondria must be considered with special care because it is a major risk factor for attempted and successful suicide. THE MASK OF DELUSIONS: Elderly patients often develop a state of melancolia-like depression with delusions. Delusions may be congruent with the predominant depressed mood, for example a guilt feeling for an act never committed, or inversely, non-congruent with the thymic state (persecution, negation delusin), for example Cotard syndrome where the patient is persuaded that his/her organs are malfunctioning or have disappeared. Despite these impressive mood disorders that often incite prescription of a neuroleptic, these elderly patients respond favorably to antidepressor treatment.
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PMID:[Depression in the elderly. Clinical aspects]. 1126 11

THE ADVENT OF DRUG THERAPY: In 1957, the advent of two compounds caught the attention of clinicians and psychopharmacologist: G 22355 or Tofranil, the leading drug in the tricyclic family, and iproniazid or Marsilid, a non-sedative monoamine oxidase inhibitor. WHAT IS AN ANTIDEPRESSOR DRUG?: Antidepressor drugs are not effective in all domains simultaneously: it takes 7 to 10 days before an effective equilibrium of mood is reached. Adverse effects often occur earlier, but generally fade out or are well tolerated when the antidepressor effect becomes patent. CASE-BY-CASE PRESCRIPTION: Twenty-four different antidepressor drugs are available in France, classed among imipramines, non-imipramines and non IMAO, serotonine and noradrenaline reuptake inhibitors, and specific serotonin reuptake inhibitors. Each class has its own contraindications, adverse effects and precautions for use. Normothymic drugs and mood' regulators are a separate category that constitute considerable progress for the treatment of relapse and recurrent depression.
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PMID:[Depression in the elderly. Medical treatment]. 1126 13

PURPOSES OF THE PAPER: The theory of acculturation was specifically explored as a possible cause for the increased suicide rate among Japanese and Chinese elderly women as documented by Liu and Yu. SUMMARY OF METHODS UTILIZED: Cultural factors surrounding suicide among Asian and white elderly living in Los Angeles County during the period of 19841989 were examined. Differences in factors contributing to suicide were also compared within specific Asian subgroups, i.e. Japanese, Chinese, Filipino, and Vietnamese. The authors reviewed L.A. County Corloner's investigative reports of 48 Asians and Whites age 65 years and above. PRINCIPAL FINDINGS: Significant differences (p<.05) were found between Asians and Whites in citizenship, number of years in the United States, occupation, living situation, and method of suicide. No significant differences (p>.05) were found for marital status, medical history, reason, previous attempt, or depression. CONCLUSIONS: The majority Asian elderly (50%) were living with their children as compared to White elderly suicide victims (2%), which showed that the Asian tradition of filial piety, as a measure of acculturaltion, was still being obeyed and thus, does not support the theory that acculturation factors cause a higher suicide rate in the Asian elderly population in L.A. County. Suicide is highly prevalent among some elderly Asian Americans and this fact is relevant for health professionals working with them. KEY WORDS: Elderly, Suicide, Asians, Whites, Culture, Male, Female.
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PMID:Suicide in the Elderly: Profiles of Asians and Whites. 1156 60

PURPOSE OF THE PAPER. The purpose of this paper is to study the relationship between religiosity and psychosocial adjustment in a group of Asian refugees from Laos. SUMMARY OF METHODS UTILIZED. Subjects consisted of 100 adult Hmong refugees from Laos who had relocated one decade earlier to Minnesota. At the time of the interview, about 80% remained in Minnesota; the remainder were interviewed in their respective communities. Five measures of religiosity were operationalized: Religious Belief (animism versus monotheism); recent Religious Practice (present/absent in previous monthrpar;; Religious Conversion lpar;present/absent in the U.S.rpar;; having a Home Altar (present/absent today); and having a shamanistic Trance Ritual (present/absent in the last five years). These five indices of religiosity were then compared against four general areas of psychosocial adaptation as follows: demographic characteristics lpar;5 itemsrpar;; sociocultural indices of adaptation lpar;5 items, including 2 scales) health care seeking over the previous five years (6 items); and psychiatric signs and symptoms (4 psychiatric scales). SUMMARY OF METHODS UTILIZED. Methods of data collection were as follows: (1) questionnaire-based interviewing by Hmong research assistants to provide data on religion affiliation, belief and practice; demographic information; psychosocial function; cultural affiliations and behaviors; and health care seeking; (2rpar; a psychiatric interview by the senior author followed by completion of two psychosocial scales (Axis 4 Psychosocial Stressors and Axis 5 Psychosocial Function using DSM-III criteriarpar; and several psychiatric rating scales lpar;Hamilton Anxiety Scale, Hamilton Depression Scale, Brief Psychiatric Rating Scale, and Global Assessment Scalerpar;. PRINCIPAL FINDINGS. Religious Pracitice in the last month was highly associated with several measures of psychosocial adaptation. Conversely, any Trance Ritual in the last five years was associated with increased anxiety and health care seeking. Religious Belief (animism versus monotheism) and having a Home Altar were associated with the other cultural factors, but not with psychosocial, heatlh and mental health measures. CONCLUSIONS. Aspects of religiosity among Hmong refugees were related to psychosocial adaptation in diverse ways, with some factors associated with better adaptation, some factors associated with maladaptation, and some factors related to other cultural dimensions but not psychosocial adaptation. KEY WORDS. Hmong; psychosocial adjustment.
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PMID:Religiosity and Psychosocial Adjustment Among 100 Homng Refugees. 1156 65

BACKGROUND: Evaluating treatments for depression is of great importance given that estimates of lifetime prevalence range up to 20 per cent. The class of antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs) has been a major innovation in this area, but has also raised questions about their cost-effectiveness as a first-line treatment, due to their high price compared to other drugs. AIMS OF THE STUDY: The study aimed to contribute to this debate, from within the context of European health care systems. These systems share a common set of pressures to contain costs, many of which, in Europe, are funded from public finances, unlike the US system, with its greater private sector involvement. METHODS: A range of published papers were reviewed. They all covered the general area of costs and SSRIs and were evaluated in a European context. RESULTS: Some studies have considered the possible use of SSRIs purely as a matter of accounting costs. Not surprisingly, they have argued against switching, on the grounds of high acquisition costs. However, studies based alongside clinical trials have incorporated efficacy into the analysis. They have produced cost-effectiveness or cost utility based arguments in favour of the SSRIs or other innovative, high-price antidepressants. Another approach has used retrospective analysis of real patients'experience of treatment. This has shown that, if the full costs of treatment are considered, there is an argument for switching from Tricyclic Antidepressants (TCAs) to first-line use of SSRIs. Most economic evaluations have used decision analysis techniques and thus are subject to all the qualifications that apply to such modelling exercises. With only one exception, all the studies in this category were in favour of switching to newer antidepressants. While efficacy was generally accepted as roughly equal, the newer products were seen as less toxic and better tolerated. The consequence was savings in health care costs that outweighed the increase in drug acquisition costs. DISCUSSION: The economic evaluation papers in this review have almost all challenged the view that health care providers should regard SSRIs as 'too expensive' for widespread use. Instead, if one integrates clinical outcomes with a full range of health care costs the high-price products may be more cost-effective. Certainly that is the message from this review, although the observations must be qualified, as most of the studies considered were UK based. CONCLUSIONS: In all health care systems there are now incentives to control costs, which may act as a disincentive to the use of SSRIs, but if those responsible for drug budgets also have financial responsibilities outside the drug budget they will also have an incentive to control those areas. In this case, there is a body of evidence to suggest they would gain by switching to SSRIs. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Decisions on favoured classes of antidepressant for first-line treatment should not be made purely on the basis of drug costs. The implications for all aspects of health spending should be included in the deliberations. IMPLICATIONS FOR HEALTH POLICY FORMULATION: The impact of spending across all budgets should be considered when drawing up policy on the use of new health care technologies, such as the SSRIs. IMPLICATIONS FOR FURTHER RESEARCH: Most studies in this area have used modelling techniques, which are subject to a number of limitations. They have also used results taken from the artificial environment of clinical trials. Future research should aim to generate economic evaluations based on effectiveness amongst real patients in clinical practice.
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PMID:Cost-effectiveness of SSRIs: a European perspective. 1196 90

BACKGROUND: Two important policy levers to affect health care delivery are financing and informational interventions. Unfortunately, these two approaches have not been considered simultaneously and little is known about how their effects compare. AIMS OF THE STUDY: This paper estimates the relative role of financial incentives (prepaid versus fee for service) and provider information (perceived knowledge of antidepressant medications and skill in counseling for depression) on quality of care for less and more severely depressed patients and their health and cost outcomes. METHODS: We develop a theoretical model of provider behavior and estimate a reduced form using a multinomial probit model with heteroskedastic covariances. The likely effects of changing provider knowledge about depression treatment in primary care are then simulated and contrasted with the effects of a shift toward prepaid managed care as opposed to fee-for-service care. The empirical model is estimated using data from the Medical Outcomes Study. RESULTS: We conclude that financing and information have different effects and that their combination can achieve the conflicting goals of improved health outcomes and reduced direct treatment goals. Moreover, including family income as one important dimension of social cost suggests that the combination of informational interventions and a shift to prepaid care may dominate either one intervention in isolation from a social cost perspective. Specifically regarding information, we found that increasing provider knowledge could have the highly desirable effect of greater targeting of treatments to sicker patients while not raising overall treatment rates much - a treatment pattern that many hoped managed care could achieve, but for which there has been little evidence. CONCLUSIONS: Our analysis illustrates the value of considering these widely different policy goals simultaneously. We learned that variation in physician knowledge generally had stronger associations with clinically relevant practice patterns for depression than did a complete change in financing strategy. The moderate change in perceived knowledge we simulated (not near the extremes of observed values of perceived knowledge) was associated with enough improvement in appropriateness of care to more than offset the reduction in appropriateness with a complete shift from fee-for-service to prepaid managed care. IMPLICATIONS FOR HEALTH POLICY: The paper demonstrates the importance of considering different interventions simultaneously. Combining informational and financial interventions simultaneously can achieve better quality of care and reduce health care costs, something neither intervention can in isolation.
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PMID:Physician knowledge, financial incentives and treatment decisions for depression. 1196 95

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