Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085632 (apathy)
 4,089 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Loss of excretory function in acute renal failure results in the retention of catabolites and fluid. In the absence of available carbohydrate, endogenous fat and protein become the main caloric sources. This results in the rapid accumulation of keto acids and nitrogenous wastes. By providing readily available non-nitrogenous calories, protein catabolism is reduced, complete oxidation of fat is obtained and energy is provided to drive potassium into the intracellular compartment. The patient should be encouraged to eat despite his apathy, fear of vomiting and characteristically paranoid mood. Tube or parenteral feeding is complicated by the need to restrict fluid. Numerous small feedings are more successful than large meals. Hard candy and alcohol are often acceptable sources of calories, fat emulsions seldom. Oral hygiene aids feeding, and tranquilizers and anticholinergics are useful. If the patient does not take food by mouth, tube feeding may be carried out. Because of the bleeding tendency so often occurring in uremia, tube feeding may be contraindicated if it causes erosion of the pharynx or esophagus. Intravenous infusion of invert sugar, glucose and alcohol may be necessary if nutrition cannot be accomplished by other means.
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PMID:Importance of caloric intake during renal failure. 1358 43

The function and dysfunction of the central noradrenergic system were reviewed together with the implications for the pathophysiological understanding of functional psychosis. Like the peripheral noradrenergic system, the central noradrenergic system plays a pivotal role in fight/flight reactions and stress. Overactivity of the system induces not only a sympathotonic state but also hyperarousal accompanied by insomnia, anxiety, irritability, emotional instability, paranoia, and excitation. On the other hand, its underactivity lowers the sympathetic tone and arousal level, resulting in hypersomnia, blunted responsiveness, or apathy. It has been confirmed in animal experiments that excess stress causes dysfunctions of the central noradrenergic system as a result of compensation, such as the overutilization-induced oversynthesis of noradrenaline. Dysfunction of the system, particularly its overactivity, plays an important role in various functional psychoses such as anxiety disorder, schizophrenia, and mood disorder, as well as behavioral and psychological symptoms of dementia (BPSD). Pharmacologically, the sedative effect of minor and major tranquilizers on hyperarousal is mediated by their action as noradrenaline antagonists. Some antidepressants potentiate noradrenergic activity, and should be used carefully in hyperaroused depressive patients. Thus, clinical evaluation of the central noradrenergic pathophysiology will provide us with information related to arousal to advance our understanding and treatment of functional psychoses.
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PMID:[Central noradrenergic system in psychiatry]. 1982 61

Psoriasis is a chronic, inflammatory scaling dermatosis. The marked visible appearance of the lesions have a negative impact on body image that leads to decreased self-esteem, hence seriously compromising the patient's quality of life. The clinical picture critically affects the social well-being of the patient since the disease is commonly misunderstood and feared by the social environment as being contagious. The patient feels stigmatized and this further intensifies their lack of self-confidence and self-esteem. Feelings of shame and guilt increase the tendency toward suicidal ideation. The poor quality of life of psoriatic patients has been associated with excessive alcohol consumption, increased smoking and greater use of tranquilizers, sedatives and antidepressants. As far as mental impairment is concerned, a correlation has been found between psychological stress and the clinical severity of symptoms: the more mentally affected the patient, the more severe the dermatologic lesions. Similarly, stressful life events constitute a major risk for the occurrence and recurrence, exacerbating the severity and duration of the symptoms. Depression and anxiety can worsen the disease or cause resistance to treatment or patient's indifference, which in turn can lead to expensive and prolonged treatment. Not least, the disease itself contributes to anxiety, depression and psychological stress, thus creating a "vicious circle" that is difficult to manage. Given that women seem to invest more in their personal appearance than men, it is hardly surprising that female psoriatic patients report higher levels of depression. Similarly, the risk of mental disorders is also higher in younger patients for whom body image plays an equally significant role. The severity of the disease, side effects of therapy and mental disorders are among the causes that have been attributed to sexual dysfunction reported by some psoriatic patients. At the social level, stigma, social rejection, feelings of shame, embarrassment and lack of confidence provoked by the disease often lead to the discontinuation of daily activities and social withdrawal. This review attempts to describe the prevalence of psychological stress and its negative social impact on patients with psoriasis. The recognition and treatment of these psychosocial problems may contribute to improving the quality of life for patients and reduce treatment costs. The collaboration between the psychiatrist and the dermatologist is a fundamental prerequisite toward addressing these issues.
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PMID:Psychological parameters of psoriasis. 2854 Dec 39