UMLS:C0011570 - FACTA Search

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Query: UMLS:C0011570 (depression)
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As an important neurotoxin, aluminium can cause cognitive dysfunctions and mental diseases. Previous studies have reported that aluminium impaired long-term potentiation (LTP) in vivo and in vitro. Here, we utilise two models of synaptic plasticity, LTP and long-term depression (LTD) to study the effects of aluminium on synaptic plasticity in vivo. Neonatal Wistar rats were chronically exposed to aluminium from birth to weaning via the milk of dams fed with 0.3% aluminium chloride solution. Excitatory postsynaptic potential (EPSP) and population spikes (PS) were recorded from the dentate gyrus (DG) of adult rats by electrically stimulating the perforant path. THE FOLLOWING RESULTS WERE OBTAINED: (1) The input/output function indicated that, as compared to controls, aluminium increased the baseline amplitude of the PS, but decreased the baseline slope of EPSP. (2) Aluminium significantly prevented LTD in PS (controls: 77.36+/-6.7%, n=7; aluminium-exposed: 102.01+/-9.1%, n=7; P<0.05) and decreased the LTD amplitude in EPSP (controls: 76.61+/-4.1%, n=7; aluminium-exposed: 94.31+/-7.9% n=7, P<0.05). (3) Aluminium reduced the amplitude of LTP in both PS (controls: 190+/-16.1%, n=7; aluminium-exposed: 135+/-9.7%, n=7; P<0.05) and EPSP (control: 132+/-9.3%, n=7; aluminium-exposed: 115+/-10.6%, n=7; P<0.05). As for LTD and LTP, PS was impaired more seriously than EPSP in aluminium-exposed rats. (4) Aluminium exposure decreased the paired-pulse facilitation (PPF) of PS at 30-150 ms interpulse interval (IPI), and reduced 93.5% of PPF at 80 ms IPI in PS (controls: 243.4+/-39.8%, n=7; aluminium-exposed: 149.9+/-12.3%, n=7). There was no significant difference in EPSP of PPF. From these results we conclude that aluminium exposure in neonatal rats thus reduces the amplitude of LTP and PPF and blocks the induction of LTD in the DG. We suggest that aluminium affects both presynaptic and postsynaptic mechanisms of synaptic transmission.
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PMID:Early chronic aluminium exposure impairs long-term potentiation and depression to the rat dentate gyrus in vivo. 1208 47

BACKGROUND: Depression represents one of the most common behavioral health problems among the workforce in the United States, with about 1 in every 20 employees experiencing this condition. A recent study estimated that in 1990 the economic costs of depressive disorders in the American workplace amounted to as much as $43 billion, with absenteeism alone accounting for $12 billion. Recently, economists have been focusing attention on the relationship between mental health and labor supply, but a lack of quality data sets containing detailed information on mental health and labor market variables represents a significant barrier to rigorous research. AIMS OF THE STUDY: The primary aims of the present study were to (i) examine the relationship between depression and employment, (ii) conditional on being employed, estimate the effect of depression on annual weeks worked, and (iii) examine the stability of the model estimates to the co-morbid effects of substance use (illicit drugs and alcohol), which has been consistently found to be a correlate of depression. DATA: The study used a unique set of survey data collected between 1996 and 1997 in crime-ridden and low-income neighborhoods of Miami-Dade County, Florida. A targeted sampling strategy was used to recruit chronic drug users (including injection drug users) and non-drug users to examine local health care delivery system characteristics in relation to the population of substance users. The final analysis sample for the present study included 1,274 adults, aged 18 to 65. Depression status was measured from the 20-item Zung Self-Rating Depression Scale (SDS) that classified 384 individuals as depressed and 890 as non-depressed. According to the definition developed by the U.S. Office of National Drug Control Policy for chronic drug use (CDU), about 46 percent of the depressed individuals were found to be CDUs compared to 30 percent of the non-depressed sample. The survey instrument collected information on alcohol use and problem drinking as defined by the 10-item Michigan Alcoholism Screening Test (MAST-10). Based on criteria defined in the MAST-10, 26 percent of the depressed individuals were problematic alcohol users (PAUs) compared to about 16 percent of the non-depressed sample.METHODS: The labor supply measures included employment in the past 30 days and number of weeks worked in the past 12 months. The analysis estimated a univariate probit model of employment as well as a bivariate probit model of depression and employment, which accounted for the possible correlation between the unobserved determinants of depression and employment. The annual weeks worked specification was estimated by a standard Tobit model as well as an instrumental variable (IV) Tobit model, which, in addition to the censoring of the observations, accounted for the possible endogeneity of depression. The stability of the estimated effects of depression to comorbid illicit drug and alcohol use was assessed, by controlling for CDU and PAU in these models. RESULTS: Results from both the univariate probit and the bivariate probit models indicate that depression significantly decreased the probability of being employed. Specifically, depression reduced the probability of employment by an average of 19 percentage points in both models, from a sample average of 43 percent for the non- depressed to 24 percent for the depressed. Estimates from the Tobit models revealed that depression also significantly reduced the number of weeks worked. Conditional on being employed, depressed individuals worked an average of 7 fewer annual weeks than the non-depressed sample in the univariate Tobit model and 8 fewer weeks in the IV Tobit. The findings also showed that the effects of depression on employment and annual weeks worked may be over-estimated if the analysis does not account for the comorbid influence of substance use. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The results suggest that prevention and/or treatment of mental health problems such as depression may yield economic benefits by promoting employment and enhancing labor supply. While expansion of public mental health services may not lead to overall increases in employment, it may be justified on social grounds given the high unemployment rate in low-income and crime-ridden neighborhoods. Further insights can be gained by estimating these models with national and international data if one applies appropriate econometric tools to account for complex sample designs.
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PMID:Labor Supply of Poor Residents in Metropolitan Miami, Florida: The Role of Depression and the Co-Morbid Effects of Substance Use. 1211 26

Toxicology and carcinogenesis studies of d-limonene, a naturally occurring monoterpene found in many volatile oils, especially in citrus oils, were conducted because of its widespread use as a flavor and fragrance additive for food and household cleaning products and its increasing use as an industrial solvent. The d-limonene used in these studies was more than 99% pure and was administered in corn oil by gavage. Short-term studies were conducted in F344/N rats and B6C3F1 mice to identify toxic effects and affected sites and to help establish doses for the 2-year studies. Genetic toxicology studies were conducted in Salmonella typhimurium, mouse L5178Y cells, and Chinese hamster ovary (CHO) cells. The doses selected for the 16-day studies ranged from 413 to 6,600 mg/kg for both rats and mice; deaths and reduction in body weight gain occurred at the two highest doses. No compound-related clinical signs or histopathologic lesions were observed in any of the surviving dose groups. In the 13-week studies, doses of d-limonene ranged from 150 to 2,400 mg/kg for rats and from 125 to 2,000 mg/kg for mice. Deaths occurred in the high dose group of each species and sex. Greater than 10% reductions in body weight gain were observed in the two highest dose groups of male rats and male mice and the high dose female rats. Rough hair coats and decreased activity were observed at the two highest doses in both rats and mice. There were no chemical-related histopathologic lesions in female rats or in mice of either sex. A compound-related increased severity of nephropathy was observed in the kidney of male rats. This lesion was characterized by degeneration of epithelial cells in the convoluted tubules, granular casts in the outer stripe of the outer medulla, and epithelial regeneration. These lesions have been described as reasonably characteristic of the hyaline droplet nephropathy that is associated with an accumulation of liver-generated a2u-globulin in the cytoplasm of tubular epithelial cells. Two-year studies of d-limonene were conducted by administering 0, 75, or 150 mg/kg d-limonene in corn oil by gavage to groups of 50 F344/N male rats, 5 days per week for 103 weeks; groups of 50 female F344/N rats were administered 0, 300, or 600 mg/kg. These doses were selected based on compound-related, potentially life-threatening kidney lesions observed in males at 300 mg/kg and higher and on the large number of deaths of female rats at 2,400 mg/kg. Groups of 50 male B6C3F1 mice were administered 0, 250, or 500 mg/kg according to the same schedule; groups of 50 female B6C3F1 mice were administered 0, 500, or 1,000 mg/kg. These doses were selected based on the deaths observed for both male and female mice at 2,000 mg/kg during the 13-week studies and the body weight depression in male mice at 1,000 mg/kg and higher. Mean body weights of rats dosed with d-limonene were similar to those of vehicle controls throughout the studies. Survival of the high dose female rats after week 39 and of the vehicle control male rats after week 81 was significantly reduced (survival at week 104-- male: vehicle control, 29/50; low dose, 33/50; high dose, 40/50; female: 42/50; 40/50; 26/50). Mean body weights of dosed and vehicle control male mice were similar throughout the studies. Mean body weights of high dose female mice were notably lower than those of the vehicle controls after week 28. Survival of the low dose group of male mice was significantly lower than that of vehicle controls at the end of the study (33/50; 24/50; 39/50). No difference in survival was observed between vehicle control and dosed female mice (43/50; 44/50; 43/50). In the 2-year studies, the kidney was confirmed as the primary target organ for chemically related lesions. No lesions were observed in female rats. For males, the nonneoplastic lesions included exacerbation of the age-related nephropathy, linear deposits of mineral in the renal medulla and papilla, and focal hyperplasia of the transitional epithelium overlying the renal papilla. Uncommon tubular cell adenomas and adenocarc and adenocarcinomas of the kidney also occurred in dosed male rats, and this effect was supported by a dose-related increased incidence of tubular cell hyperplasia, as shown in the table below. INCIDENCES OF MALE RATS WITH RENAL LESIONS IN THE TWO-YEAR GAVAGE STUDY OF d-LIMONENE Site/Lesion Vehicle Control 75 mg/kg 150 mg/kg Renal papilla Mineralization 7/50 43/50 48/50 Epithelial hyperplasia 0/50 35/50 43/50 Kidney Tubular cell hyperplasia 0/50 4/50 7/50 Tubular cell adenoma 0/50 4/50 8/50 Tubular cell adenocarcinoma 0/50 4/50 3/50 In subsequent 21-day studies, male and female F344/N rats were administered d-limonene at doses ranging from 75 to 1,200 mg/kg. Microscopic examination of the kidney sections from these rats indicated a compound-related increase in intracytoplasmic granules in the proximal convoluted tubules of dosed male rats but not of female rats. The granules were shown to contain a2u-globulin by an immunohistochemical strain. a2u-Globulin was shown to be increased in kidney homogenates from dosed male rats by an ELISA test. In mice, no chemically related increases in neoplasms were observed. The incidence of neoplasms of the anterior pituitary gland in high dose female mice was lower than that in vehicle controls (adenomas or carcinomas, combined:vehicle control, 12/49; high dose, 2/48). Cells with an abnormal number of nuclei (8/49; 32/50) and cytomegaly (23/49; 38/50) were observed in the liver of high dose male mice. Genetic Toxicology: d-Limonene was not mutagenic in four strains of S. typhimurium (TA98, TA100, TA1535, or TA1537), did not significantly increase the number of trifluorothymidine (Tft)-resistant cells in the mouse L5178Y/TK± assay, and did not induce chromosomal aberrations or sister chromatid exchanges (SCEs) in cultured CHO cells. All assays were conducted in the presence and absence of exogenous metabolic activation. Conclusions: Under the conditions of these 2-year gavage studies, there was clear evidence of carcinogenic activity of d-limonene for male F344/N rats, as shown by increased incidences of tubular cell hyperplasia, adenomas, and adenocarcinomas of the kidney. There was no evidence of carcinogenic activity of d-limonene for female F344/N rats that received 300 or 600 mg/kg. There was no evidence of carcinogenic activity of d-limonene for male B6C3F1 mice that received 250 or 500 mg/kg. There was no evidence of carcinogenic activity of d-limonene for female B6C3F1 mice that received 500 or 1,000 mg/kg. An increased severity of spontaneous nephropathy, increased incidences of linear mineralization of the renal medulla and papilla, and hyperplasia of the transitional epithelium of the renal papilla were present in dosed male rats. Synonyms: cyclohexene; 4-isopropenyl-1-methyl; 1-methyl-4-(1-methylethenyl)cyclohexene; p-mentha-1,8-diene; carvene; cinene; cajeputene
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PMID:NTP Toxicology and Carcinogenesis Studies of d-Limonene (CAS No. 5989-27-5) in F344/N Rats and B6C3F1 Mice (Gavage Studies). 1270 37

THE FIRST ROUTES OF RESEARCH: The first antidepressants were developed after the discovery of the existence during depression of a perturbation in the synaptic transmission of the principle monoamines: noradrenalin, serotonin and dopamine. The pharmacological effect of the various molecules developed is mainly on the metabolisation routes of neurotransmitters, but may also concern the different receptors present on synaptic level. THE AWARENESS OF NEW MEDIATORS: The progress in research on antidepressants has widened the scope of the development of such medicinal products to the domain of endocrinology (hypothalamo-pituitary-adrenal axis, progestogen hormones, thyreotropic axis) and studies on neuropeptides (substance P, neuropeptide Y). The complexity of the physiopathological mechanisms of depression hence appears enhanced.
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PMID:[Development of antidepressant drugs. Experience and prospects]. 1273 93

DEPRESSION IN THE PATIENT: Signs of depression in patients with Alzheimer's disease are difficult to detect because they change over time and vary in intensity and duration. Estimated frequency depends greatly on the evaluation scale (Cornell scale, Geriatric Depression Scale, Behave-Alzheimer disease scale, Cohen-Mansfield scale, Neuropsychiatric Inventory (NPI)). Several risk factors have been identified including early age of disease onset, female gender, etc). The anatomic basis of depression is essentially related to the noradrenergic and serotoninergic systems. DEPRESSION IN THE CAREGIVER: Caregivers bear a heavy burden, psychologically (30-50% of all cases of depression), physically, and financially. Depression in the caregiver favors depression in the patient, and vice versa. Episodes may develop at any time during the disease course. Decompensation depends on both patient-related and caregiver-related factors. IMPORTANCE OF DETECTING DEPRESSION: Depression is frequent, both in the patient and in the caregiver and must be detected and treated early. It has been demonstrated that 50% of the caregivers may be affected, but only 10-20% are treated.
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PMID:[Epidemiology of depression in patients with Alzheimer's disease and in their caregivers]. 1294 1

DEPRESSION IN THE ELDERLY SUBJECT: Depression is diagnosed to a varying extent in the elderly. In subjects with Alzheimer's disease, the most specific signs involve mood disorders, loss of energy, a feeling of hopelessness, and sometimes body discomfort or pain. DEFINITION OF APATHY: Apathy is defined as a loss of motivation, expressed by a loss of interest in activities, lack of productivity, loss of will and initiative, as well as limited affective response to positive or negative elements. TWO DIFFERENT SYNDROMES: The differential diagnosis is difficult, but studies have demonstrated that depression and apathy are two relatively different syndromes, which may be intertwined. Lack of volition and initiative are suggestive of apathy. Neuropsychology, particularly the capacity to divide attention, may be useful. FUNCTIONAL CONSEQUENCES: Apathy and depression both have functional effects which may accelerate institutionalization (altered capacity for initiative, adaptation to the environment). FUNCTIONAL ANATOMY AND NEUROCHEMICAL CONSEQUENCES: Apathy and to a lesser degree depression, involve prefrontal cortical areas. Involvement of the prefrontal pathways is a common feature of apathy and depression, but the other pathways are affected specifically. Cholinesterase inhibitors and selective serotonine reuptake inhibitors as well as serotoninergic antidepressants have been found to be effective for certain components of apathy.
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PMID:[Depression and apathy in Alzheimer's disease]. 1294 3

THE DECISION FOR SPLENECTOMY MUST BE BASED ON A KNOWLEDGE OF THE THREE FUNCTIONS OF THE SPLEEN: Hematopoiesis (usually ceasing during fetal life but sometimes resuming when bone marrow function fails); filtration of abnormal and senescent cells and control of bone marrow activity, most probably humoral. When bone marrow function fails, splenectomy is contraindicated since splenic hematopoiesis becomes a vital function. On the other hand, when a large proportion of erythrocytes are abnormally shaped (spherocytes), although otherwise adequate, the spleen may trap these cells in its filter and destroy large numbers. Splenectomy is beneficial in almost every case of congenital spherocytosis, but in only half the cases of the acquired defect. In panhematocytopenia, thrombocytopenia and neutropenia, all apparently due to depression of hematopoiesis by endocrine or other action of the spleen, splenectomy may be beneficial if medical therapy fails.A SURGEON UNDERTAKING SPLENECTOMY SHOULD RECOGNIZE TWO SPECIAL PROBLEMS: (1) The presence of accessory spleens, which if not removed may negate the effects of the operation, and (2) the apparently high rate of infection in infants and children who have undergone splenectomy.
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PMID:Splenectomy in blood dyscrasia. 1352

THREE THERAPEUTIC MODALITIES HAVE PROVED EFFECTIVE IN THE TREATMENT OF DEPRESSIVE SYNDROMES: electroconvulsive therapy (ECT), pharmacotherapy and psychotherapy. ECT gives the most reliable and most rapid results but may be contraindicated in certain cases. Psychotherapy is limited in its application to the reactive aspects of a depression. Pharmacotherapy is currently the most widely applied treatment of depression. Two classes of drugs are available which are effective in about 60% of depressed patients: the monoamine oxidase inhibitors and tricyclic compounds. Their mechanism of action is probably related to the regulation of the biogenic amine balance in the brain. The distinction between antipsychotic and antidepressant drugs is not as sharp as was formerly assumed. Maintenance pharmacotherapy has been shown to have prophylactic value in preventing relapses.
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PMID:THE PHARMACOTHERAPY OF THE DEPRESSIVE SYNDROME. 1427 1

SLAVES TO THEIR WORK: The Anglo-Saxons were the first to evoke the "burn out syndrome" although the Canadians prefer to use "burning" in order to emphasize these situations in which the person is as it were literally "consumed by his/her work". The burn-out syndrome more specifically involves all those who have chosen to devote their lives to others. This is the case notably with health care workers because they are in direct contact with suffering, poverty, hardship, disease and death. THE ENHANCING FACTORS: There is no particular pre-morbid personality. Nevertheless, various factors can be at the origin of a burn out syndrome: subconscious motivations in the choice of the profession, capacity to adapt to hardship at work, excessive idealization of the profession, lack of recognition and the absence of any possibility of promotion. INSTALLATION IN 4 STAGES: The onset of an occupational burn out syndrome is usually insidious. Schematically, the first stage is idealistic enthusiasm. Then a helpless stagnation period follows with progressive disinterest, followed by a phase of frustration, before the onset of an apathetic disenchantment with search for a form of security. VARIOUS POINTS IN COMMON WITH DEPRESSION: A range of effects exist: sleep and digestive disorders, reduced performance, progressive feeling of exhaustion with impact on friends and relatives, irritability towards others, absence of dialogue, and a feeling of "emptiness". THREE ELEMENTS TO THERAPEUTIC POSSIBILITIES: The first consists in improving work conditions by changing the environment; the second consists in improving communications and enhancing the end to isolation and the third consists in changing the employee's private life. Such as reorganizing the person's life so that they can disconnect and develop other interest than through their work.
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PMID:[The burnout syndrome of the caregiver]. 1510 85

PHYSICIANS RESPOND TO THE FDA PUBLIC HEALTH ADVISORY ON WORSENING DEPRESSION AND SUICIDALITY IN PATIENTS BEING TREATED WITH ANTIDEPRESSANTS: On March 22, 2004, the U.S. Food and Drug Administration (FDA) issued a health advisory informing the public that manufacturers of several popular antidepressants have been asked to include a warning statement on product labeling. This warning statement recommends that antidepressant-treated patients-both children and adults-should be closely monitored for worsening of depression or emergence of suicidal behavior. The full text of the advisory, along with supporting information and presentations from the February 2004 meeting on which this advisory was based, can be found on the FDA's Web site at http://www.fda.gov/cder/drug/antidepressants/default.htm. Recently, the CME Institute, as a service to its members-you, the readers of this journal-and Larry Culpepper, M.D., Editor in Chief of the Primary Care Companion, assembled a group of psychiatrists and primary care physicians to discuss the FDA advisory and advise clinicians how it will affect their treatment of depressed patients. Their discussion and recommendations appear here. Faculty affiliations and disclosures appear at the end of this Commentary.
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PMID:Suicidality as a Possible Side Effect of Antidepressant Treatment. 1525 1

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