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

Karl Evang (1902-1981) was one of the leading figures in public health in the post-World War II era. His first contributions were in social epidemiology in the 1920s-30s, and his studies on sexually transmitted diseases, nutrition and health, and occupation and health, were seminal. He was instrumental in framing the constitutions of two key U.N. agencies, the Food and Agricultural Organization and the World Health Organization, and he helped shape the WHO definition of health. Following the war, as Norway's Director General of Health, he helped create one of the preeminent humanitarian democracies and its welfare state. He and his generation of public health workers were so effective because of ties to the dominant labor parties, the need for government intervention as a result of the Great Depression and the Second World War, and the humanistic reaction to the Nazi horrors. At the same time, their excessive emphasis on medical care, and the role of the physician in health policy, resulted in the great medical costs of today. Those who believe in activist government and the goal of equality in health status owe an enormous debt to Evang and his generation.
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PMID:Karl Evang: a giant in public health. 222 18

This paper is addressed to patients' need for help with punitive self-critical attitudes. Such help has not always been sufficiently provided by psychoanalysts, owing to an unrecognized failure of neutrality. Historically, a gradual overemphasis on the concept of an unconscious sense of guilt has acted as a barrier to the appreciation of shame. An alternative concept, punitive unconscious self-criticism, which stands in contrast to constructive self-criticism and is common to the painful affects of guilt, shame, humiliation, and depression, can facilitate helpful analytic treatment. Heinz Kohut's contributions are examined. His analytic stance is differentiated from his theories of development. In the former, characterized by an affirmative attitude, he takes a position of functional neutrality toward shame and pays consistent though unstated attention to the effects of punitive unconscious self-criticism. The affirmative attitude can be employed without adoption of Kohut's self psychology, i.e., without abandoning the basic psychoanalytic approach to mental conflict and development. The concept of punitive unconscious self-criticism and the concept of divergent conflict, provide sufficient explanatory power. Clinical examples are used to illustrate these ideas.
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PMID:Helping patients by analyzing self-criticism. 222 78

A patient referred to the authors for evaluation and treatment of depression, behavioral dyscontrol syndrome, and polydipsia is described. The authors reviewed his medical status and, finding damage to his right temporal lobe, conceptualized his symptom constellation as representing interictal syndrome and treated him with carbamazepine. His affective symptoms, but not the polydipsia, improved following treatment with carbamazepine.
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PMID:Depression, episodic behavioral dyscontrol, and polydipsia following right temporal lobe damage. 234 49

The mechanisms responsible for slowing cardiac impulse conduction through the atrioventricular (AV) node are not well understood but include anatomical architecture, presence of cells with diverse electrophysiological characteristics, and modulation by autonomic nervous system. The present study was designed to determine the site of vagally induced slowing of conduction through the AV node. We attempted to correlate the electrophysiological response of AV nodal cells to postganglionic vagal stimulation applied in different regions of the node with the morphological findings and patterns of acetylcholinesterase-positive staining of nodal tissue. This multifaceted approach revealed that vagal stimulation produced localized hyperpolarization of the cells from the N region of the AV node, which correlated with the strong acetylcholinesterase positive staining of the central nodal area. In contrast, the density of the acetylcholinesterase staining decreased toward both the AN and His bundle regions, whereas vagal stimulation had a negligible effect on the cells from these regions. These results suggest that vagal-induced depression of AV nodal conduction is produced by release of acetylcholine predominantly around the midnodal region and the depressive action of acetylcholine is concentrated on the cells occupying the same region (i.e., the N cells). Thus, there appears to be a close juxtaposition of nerve elements and effector cells in the midnodal region of the AV node. This unique combination of available neuromediator and responding cells with hyperpolarization and depressed action potential determines the midnodal region as the focus of vagal effect on AV nodal conduction.
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PMID:Morphological and electrophysiological correlates of atrioventricular nodal response to increased vagal activity. 239 13

A few cases of sinus node dysfunction (SND) and AV block (AVB) were described with clonidine therapy. The aim of this study is to evaluate the electrophysiologic properties of clonidine in volunteers with normal electrophysiologic data. Twenty-eight subjects were investigated by endocavitary techniques. The following parameters were measured before and 20 min after intravenous administration of clonidine: systolic and diastolic blood pressure (BP); sinus cycle (SC); PA, AH, and HV intervals; effective (ERP) and functional (FRP) refractory period of right atria (RA); AV node (AVN); His Purkinje system (HP); right ventricle (RV); corrected sinus node recovery time (SNRT); and sinoatrial conduction time (SACT). Blood pressure was reduced from 149/89 to 115/74 mm Hg. Sinus cycle was prolonged by 71 ms (p less than 0.01), corrected SNRT by 81 ms (p less than 0.05), and FRP of AVN by 16 ms (p less than 0.05). SND was more marked when initial SC was longer. Atrioventricular node depression was more marked when the PR interval was longer and when subject was older. Electrophysiologic effects of clonidine are similar to those of beta-blockers. The tensional effects are more marked than electrophysiologic effects. Clonidine in the high risk subject (age, bradycardia, long PR) may be cautiously dosed. Drug association with digitalis antiarrhythmic drugs, beta-blockers, and calcium antagonists may be avoided.
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PMID:Study of the electrophysiologic properties of clonidine administered intravenously. 242 9

Following His bundle ablation and implantation of a rate adaptive pacemaker (Vitatron TX 911) a 52-year-old gentleman experienced several presyncopal attacks while driving a car. On examination pectoralis muscle contraction caused temporary pacemaker inhibition. Incremental overdrive stimulation demonstrated progressive depression idioventricular automaticity and was associated with similar symptoms following overdrive at high pacing rates. Following appropriate pacemaker programming the patient remained symptom free.
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PMID:Rate dependent depression of subsidiary ventricular impulse formation--cause of Stokes-Adams attacks in a patient with rate modulated pacing. 245 89

The synthesis of carnosine (beta-Ala-His) by astroglia-rich primary cultures was much higher if the cells were cultivated in Ham's nutrient mixture F-12 than if they were grown in Dulbecco's modified Eagle's medium. Carnosine synthesis was not affected by the presence of insulin, transferrin, phorbol myristate acetate, or dexamethasone. However, dibutyryl cyclic AMP and other agents that can, directly or indirectly, activate cyclic AMP-dependent protein kinases strongly lower the rate of carnosine synthesis. The depression of carnosine synthesis was dependent on the concentration of dibutyryl cyclic AMP. The effect was maximal (approximately 80% inhibition) in cultures preincubated with 1 mM dibutyryl cyclic AMP for 4 days. The adenylate cyclase activator forskolin, the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine, and 8-bromo-cyclic AMP caused the same depression as dibutyryl cyclic AMP, whereas neither butyrate nor dibutyryl cyclic GMP elicited any effect.
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PMID:Regulation by dibutyryl cyclic AMP of carnosine synthesis in astroglia-rich primary cultures kept in serum-free medium. 246 17

The effect of maternal diabetes (induced by i.p. injections of 40-50 mg/kg BW Streptozotocin on the day of mating) on TRH in the pancreas of newborn rats was studied. Determination of peptide alpha amidation activity and TRH precursor level on the day of birth revealed decreased biosynthesis of TRH resulting in profoundly (10 times) lower pancreatic TRH and TRH-OH concentrations in pups of diabetic rats. Pancreatic His-Pro-diketopiperazine (His-Pro-DKP) remained unaffected by maternal diabetes. The depression of pancreatic TRH was less profound 24 h later, and even elevated TRH was measured in the pancreas of pups of diabetic mothers on postnatal day 5. Short term postnatal starvation or nursing of intact pups by the diabetic foster mother did not affect pancreatic TRH. It could be postulated that postnatal TRH development in the rat pancreas is retarded by maternal diabetes, while His-Pro-DKP remains unaltered.
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PMID:Thyrotropin releasing hormone in the pancreas of newborn rats from streptozotocin-treated mothers. 249 94

High-frequency currents constitute an attractive form of energy for transcutaneous myocardial destruction, but their potential for creating lesions varies with the nature of contact between electrode and skin. The adequacy of a suction catheter for electrocoagulation of the AV node-His bundle junction was assessed in 7 dogs. The high-frequency current (1.2 MHz) was delivered as bursts of 6 watts lasting 30 seconds, between the distal electrode of a bipolar catheter containing a central lumen (USCI 8F) and a wide skin electrode. During firing, an 80 kPa depression was applied to the lumen. Electrophysiological testing was performed before and immediately after firing. Continuous 24-hour Holter recording was carried out before, immediately after, then between the 2nd and 20th days post-firing. Following another electrophysiological study, the animals were killed on the 15th or 21st day for anatomical study. Complete atrioventricular block was obtained in all dogs during the first (n = 4) or second (n = 3) firing and persisted in 6 dogs up to the time of anatomical study. The atrial and right ventricular electrophysiological parameters remained unmodified after firing, and no severe ventricular arrhythmia was recorded during the study. The histological lesions were 4.7 +/- 0.7 mm in mean diameter and 3.1 +/- 0.6 mm in mean depth. It is concluded that electrocoagulation of the AV node-His bundle junction performed with high-frequency currents is a safe and selective technique. Using suction catheters makes this technique well reproducible with moderate amounts of energy. The development of preformed catheters should reduce the duration of the procedure.
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PMID:[Electrocoagulation of the His bundle node junction in dogs by a high-frequency current delivered by suction catheter]. 250 69

A British court awarded a patient damages after she had been rendered a quadriplegic as a result of surgery to drain a cyst on her spine. Her physician had failed to inform her that there was a substantial risk of total paralysis from the surgery, or that total paralysis would result within a few months if her condition was untreated. His argument for withholding the information was to avoid excessively frightening the patient, but three neurosurgeons testified that the plaintiff should have been informed of both the risks and the benefits involved in undertaking a difficult procedure. The court determined that the patient would have agreed to the surgery if fully informed of its risks, but awarded damages for shock and depression consequent to her being rendered quadriplegic without warning.
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PMID:Informed consent and 25% risk of paralysis. 256 37


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