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)

This paper presents three brief case histories from a three year study comparing electroconvulsive therapy (ECT) with acupuncture treatment in functional psychoses. Acupuncture effects were augmented by the simultaneous, non-painful electrical stimulation of eight acupuncture needles. The resulting treatment is called Acupuncture Electric Stimulation Therapy (Acu-EST). Each patient was utilized as her own control, treating exacerbations of depression alternately with ECT and Acu-EST. Acu-EST was not found to be a panacea and did not enable the discontinuation of antidepressant and neuroleptic medication. Individual Acu-EST treatments were often less effective than individual ECT treatments. However, series of Acu-EST did assist in producing significant remissions in depressive symptomatology. Because it did not produce the temporary disabling memory defects which occurred with ECT, Acu-EST was more easily adaptable to outpatient treatment.
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PMID:ECT and Acu-EST in the treatment of depression. 97 Mar 61

The maximal P-wave duration in all time-aligned leads, and the maximal P-wave amplitude in leads V5 and V6 were measured on a 12-lead, signal-averaged electrocardiogram during the recovery period of an exercise stress test (EST). The study group consisted of 75 patients with coronary artery disease (CAD) documented by greater than or equal to 50% diameter stenosis in 1 or more arteries and a control group of 47 subjects, 15 of them young volunteers and 32 with no or minimal coronary atherosclerosis and normal left ventricular function. All subjects underwent a symptom limited EST, with use of the Ellestad protocol. Signal-averaged P waves recorded before exercise, and for the first 6 minutes in recovery were measured using a 5x magnifier. The mean P duration before exercise in the control group was 107 +/- 16 ms (+/- 1 standard deviation) and 111 +/- 15 ms at the third minute of recovery, (p less than 0.001). In patients with CAD it was 112 +/- 12 and 129 +/- 19 ms (+/- 1 standard deviation), p less than 0.001, respectively. Differences in P-wave duration were found to be statistically significant (p less than 0.001) throughout recovery in the group with CAD when compared with control and maximal values at the third minute. The increase in P-wave duration (greater than or equal to 20 ms) was used as an additional parameter to exercise-induced ST-segment depression, ST elevation, or anginal pain for the test interpretation. The sensitivity increased from 57 to 75% and the specificity decreased from 85 to 77%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Significance of signal-averaged P-wave changes during exercise in patients with coronary artery disease and correlation with angiographic findings. 174 63

Early studies suggested that cerebrovascular change may be an etiological factor in the development of late-life depression. With the advent of magnetic resonance imaging (MRI), it has become possible to examine this hypothesis. MRI studies have demonstrated that patients with late-onset depression have more severe and frequent patchy lesions in the frontal deep white matter and basal ganglia than do controls or patients with early-onset depression. Patients with basal ganglia lesions, primarily caudate, are more likely to develop delirium with antidepressants and electroshock treatment (EST). The prognostic significance and the relationship of these lesions to cognitive impairment is unclear.
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PMID:Organic bases of depression in the elderly. 203 71

The feasibility, safety and prognostic importance of high-dose (0.84 mg/kg over 10 minutes) dipyridamole 2D echocardiography test (DET) were evaluated in 78 asymptomatic patients 10 to 14 days after uncomplicated acute myocardial infarction and the results were compared with those of exercise stress test (EST). Criteria of positivity were: for DET a new or worsening asynergy; for EST, ST segment depression greater than or equal to 1 mm (patients were in complete pharmacological wash-out). Patients were followed-up for 9 to 22 months (mean 14 +/- 5) or until one of the following end-points occurred: death, infarction or severe angina. DET was positive in 13/17 patients and EST in 5/17 patients with poor clinical outcome (sensitivity 76% vs 29%; p less than 0.005); for hard events only (death or infarction) sensitivity was respectively 64% vs 9%; (p less than 0.05). Both tests had the same specificity (92%). Cumulative event-free survival curves as a function of DET and EST results were both statistically different (p less than 0.001 and p less than 0.05 respectively). Cumulative survival curves obtained by the combination of DET and EST results showed: 1) an uneventful course in patients with both tests or only DET negative; 2) and a poor clinical outcome in patients with both test or only DET positive (p less than 0.001) DET correctly predicted clinical outcome in 12/16 patients in whom there was disagreement between the two tests. We conclude that DET is more sensitive than EST for identifying patients at increased risk for coronary events and more accurate for predicting clinical outcome after uncomplicated acute myocardial infarction.
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PMID:[Prognostic value of echocardiography with high-dose dipyridamole after recent uncomplicated myocardial infarction]. 205 73

Exercise stress testing (EST) after myocardial infarction helps to define the clinical subsets of patients at high and low risk. It should be performed before hospital discharge, unless a contraindication exists. In order to exclude false positives, EST must be repeated 4-6 weeks later. EST helps to recognize the presence of residual ischaemia. Significant ST segment depression during exercise, associated or not with angina, is the most important indicator of ischemia. These patients with ischaemia at distance i.e., those with ST segment changes in ECG leads without W waves, are at high risk. Some continuous exercise variables (degree of ST deviation, time of recovery and exercise duration) are related to cardiac mortality. Exercise induced complex ventricular arrhythmias seem to be related to left main or three vessels disease, and a greater likelihood of sudden death, particularly when coexist a low ejection fraction, important segmentar disturbances of contractility and ST segment depression. EST after myocardial infarction has great value to assess the results of medical therapy and/or coronary angioplasty or bypass grafting. EST also constitutes a valuable clinical tool to support a comprehensive rehabilitation programme.
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PMID:[Value of the ergometric test after myocardial infarction]. 225 61

Twenty-four patients with a history of effort angina, a positive exercise stress test (EST) and coronary artery disease were enrolled in the study; 12 patients had a positive dipyridamole-echocardiography test (DET) and 12 had a negative DET. Each patient performed a total of 4 ESTs in the absence of therapy on two successive days; for each test the rate-pressure product (RPP), an established index of myocardial oxygen demand, was measured at the onset of ischaemia (ST depression greater than 0.15 mV) or at the peak of maximal exercise (if a repeated EST was negative). Taking into account the lowest of the 4 RPP values (X 1/100) in each patient, there was no significant difference between DET-negatives and DET-positives (185.2 +/- 49.3 vs 157.4 +/- 32.4). Conversely, when considering the highest of the 4 RPP values in each patient, there was a significant difference between DET-negatives and DET-positives (280.3 +/- 63.9 vs 183.3 +/- 37.0; p less than 0.01). Thus, DET may provide a clinically useful tool for assessing in the individual the organic 'ceiling' of coronary reserve, by eliminating the variability in coronary tone, which may affect EST reproducibility and the correct evaluation of the impairment of organic coronary reserve.
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PMID:Dipyridamole-echocardiography test as a clue for assessing the organic 'ceiling' of individual coronary reserve. 381 37

This study assesses the clinical feasibility and usefulness of dipyridamole infusion for the detection of coronary artery disease (CAD) by using 2-dimensional echocardiography (2-D echo) and 12-lead electrocardiographic monitoring. Dipyridamole infusion (0.14 mg/kg/min for 4 minutes) was performed in 66 consecutive patients with effort chest pain and in 9 control subjects. Among the 28 patients with positive dipyridamole-echocardiography test responses, 18 had diagnostic electrocardiographic changes (ST-segment depression on anterolateral leads), but these changes were unrelated to the site of asynergy. The dipyridamole-echocardiography test had an overall sensitivity of 56% and specificity of 100% for the presence of CAD. Exercise stress testing (EST) had an overall sensitivity of 62% and a specificity of 80%. Thus, the dipyridamole-echocardiography test, which is feasible in essentially all patients with good basal echocardiograms, has a lower overall sensitivity in detecting CAD than EST but a higher specificity, detects the site of apparent ischemia as identified by regional asynergy more precisely than EST, and can unmask electrocardiographically silent effort ischemia.
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PMID:Dipyridamole-echocardiography test in effort angina pectoris. 403 26

Pituitary glands of proestrous (PRO) rats display enhanced LH secretory response to LHRH when compared to pituitary glands of estrous (EST) rats. In addition proestrous pituitary glands display a self-potentiating (priming) response to LHRH, whereas estrous pituitary glands do not. This study addresses the role of the proestrous surge of progesterone in converting the proestrous-like LH secretory responses of the pituitary gland to those of estrus. Anterior pituitary glands were obtained from PRO and EST rats. In addition, Pro rats were treated with pentobarbital alone (PRO/PB) or with pentobarbital plus progesterone (PRO/PB-P4). Pentobarbital was given to prevent proestrous surges of LH and progesterone. Pentobarbital-treated animals were killed the day after treatment, estrus. Pituitary glands from each group were tested for LH secretory response in a superfusion chamber with exposure of two 15-min pulses of 10 nM LHRH separated by 90 min, or assayed for LHRH receptor content using iodinated D-Ala6-LHRH. Anterior pituitary glands from PRO rats secreted higher levels of LH than EST rats in response to an LHRH pulse. Only PRO anterior pituitary glands secreted priming responses to LHRH. Though anterior pituitary glands obtained from pentobarbital-treated rats showed LH responses of similar magnitude to anterior pituitary glands of PRO rats after initial LHRH challenge, they did not display priming responses. Progesterone replacement (PRO/PB-P4) led to depressed secretory responses when compared to PRO pituitary glands similar to EST rats. LHRH receptor concentrations in pituitary glands of EST rats was lower than those in pituitary glands of PRO rats. Depression of pituitary LHRH receptor concentration from proestrus to estrus was prevented by pentobarbital-treatment on proestrus. Estrus-like depression of receptor concentration was restored after progesterone treatment (PRO/PB-P4). These data suggest the LHRH receptor depression on estrus is a consequence of the secretion of progesterone on proestrus. Further, the declining magnitude of the in vitro LH-secretory response to LHRH follows a declining LHRH receptor concentration; however no correlation exists between receptor number and ability to prime.
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PMID:Secretion of luteinizing hormone (LH) and pituitary receptors for LH-releasing hormone as modified by the proestrous surge of progesterone. 609 51

This study was undertaken to assess the diagnostic and prognostic value of ST depression equal to or more than 3 mm during exercise stress testing (EST). Out of 4050 EST performed over an 8 year period, 128 patients (3,2%) had this degree of ST depression. These changes were observed in leads V4 V6 in 92% of cases. Coronary angiography was performed in 56 patients: all had significant coronary artery disease (greater than 50% stenoses) with 50% three vessel, 30% two vessel and only 20% single vessel disease; all patients had at least one severe stenosis (greater than 75%) of a main coronary artery. The predictive value of EST was therefore 100% in the 56 patients undergoing coronary angiography. Angina or ventricular extrasystoles during EST or greater than 5 mm ST depression were predictive of multiple vessel disease. The following correlations were observed between EST and the extent of coronary artery disease: maximal heart rate and systolic pressure were lower, ischemic changes appeared sooner (less than 2 min) and lasted longer during the recovery phase (greater than 7 min) in patients with multiple vessel disease. The 5 year prognosis was studied in 58 patients; it was poor (death or infarction) in 31 cases (53%). The following factors were associated with a poor prognosis: low maximal heart rate and systolic blood pressure, early ischemic changes and frequent ventricular extrasystoles on EST; on the other hand, the development of anginal pain during EST was not of significant prognostic value in this series. ST depression greater than 3 mm on EST is rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnostic and prognostic value of ST segment depression greater than or equal to 3 mm during exercise testing]. 642 95

To further elucidate the value of the R wave criteria during the exercise stress test (EST), we studied the direction and magnitude of the changes of the QRS amplitude (delta R) as well as the extent of ST segment depression in 75 patients with coronary artery disease (CAD) and 26 normal subjects (NLS). Results were analyzed in relation to severity of the disease (number of vessels involved) and left ventricular EF. In NLS, there was an average decrease of the QRS amplitude of --1.9 +/- 0.6 mm (mean +/- SE) compared to an average increase of 0.6 +/- 0.35 mm for CAD patients. Mean delta R for 1VD was --0.28 +/- 0.75 mm; for 2VD, it was 0.27 +/- 0.54 mm, and for 3VD, it was 1.37 +/- 0.55 mm. Mean delta R for NLS was significantly different (Duncan's multiple range test, p less than 0.05) from 2VD and 3VD but not from 1VD. Although there was no statistically significant difference of mean delta R among CAD groups, a significant linear trend was observed (p less than 0.008). Resting EF did not correlate either with extent of ST segment depression or with the direction or magnitude of delta R induced by exercise. We conclude that the direction of changes in delta R during exercise is related to the presence or absence of CAD. The magnitude of delta R appears to correlate with the severity of coronary arterial involvement. We did not detect any relationship between R wave changes and left ventricular function. The use of R wave criteria may slightly improve the sensitivity of EST but detracts from specificity.
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PMID:Relationship of resting ejection fraction and extent of coronary arterial disease with changes of QRS amplitude during exercise stress testing. 732 12


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