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Secondary depression is a depression in an individual who has one or more preexisting, nonaffective psychiatric disorders or an incapacitating or life-threatening medical illness which precedes and parallels the symptoms of depression. Secondary depression is commonly seen in patients presenting to psychiatric facilities. For every 5 patients who are seen with a diagnosis of depression, approximately 2 should be classified as secondary. A patient with secondary depression is more likely to be younger, male, and to have a family history of alcoholism. His first diagnosis is most likely to be alcoholism; however, the preceding diagnosis varies depending on the setting in which the patient is seen. Hysteria, sociopathy, drug abuse and anxiety neurosis are also common. The symptom picture of secondary depression is almost indistinguishable from primary depression. One important reason a patient enters psychiatric treatment is that he develops a coexistent depression. 相似文献
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C. Dendle R.L. Stuart W.R. Mulley K.R. Polkinghorne P.Y. Gan J. Kanellis J. Ngui K. Laurie K. Thursky V.K. Leung S.R. Holdsworth 《Transplantation proceedings》2018,50(10):3367-3370
Purpose
The aim of this study was to determine if measurement of B cell protective immunity was associated with susceptibility to sinopulmonary infection in kidney transplant recipients.Methods and Materials
A prospective cohort of 168 patients with stable graft function (median 4.1 years) underwent assessment of B-lymphocyte antigen CD19 (CD19+) cell number, immunoglobulin G concentration, and seroresponses to influenza vaccination upon study entry. Patients received a single dose of a trivalent, seasonal influenza vaccine.Results
After 2 years follow-up, 31 patients (18%) developed sinopulmonary infection. CD19+ cell number was strongly associated with future sinopulmonary infection. A higher proportion of patients with CD19+ cell counts below the fifth percentile for controls developed sinopulmonary infections than those above the fifth percentile, 30% (23 of 77 patients) compared with 9% (7 of 79 patients; P = .001). There was a trend toward a higher proportion of patients with reduced immunoglobulin G concentrations developing infections than in the normal range for controls, 29% (14 of 48 patients) compared with 15% (16 of 108 patients; P = .060). Influenza vaccination seroresponses were poor in patients and controls such that they could not be used to identify a subgroup of patients at high risk for the development of severe pulmonary infection.Conclusions
Monitoring B-cell numbers represents a simple, inexpensive means of stratifying transplant recipients' risk of sinopulmonary infection. 相似文献58.
Because of dismal results after pancreaticoduodenectomy for adenocarcinoma of the head of the pancreas, a review was made of patients treated by total pancreatectomy for this condition. Although the early experience with total pancreatic resection was disappointing, the results during the past decade have been encouraging. Among the forty-two patients reported on with sufficient detail for analysis the operative mortality has been 17 per cent, and the morbidity has been 21 per cent. Sixty-five per cent of these patients (20 of 30) have survived at least one year and 53 per cent (16 of 30) have lived at least two years after surgery. The management of the diabetes and pancreatic insufficiency has not been difficult. Total pancreatectomy appears to be preferable to pancreaticoduodenectomy in the treatment of ductal carcinoma of the head of the pancreas. 相似文献
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Paula J. Clayton 《Comprehensive psychiatry》1981,22(1):31-43
There are three reasons why a review of the existing data on the epidemiology of bipolar affective disorder may be indicated: (1) to summarize the general differences between unipolar and bipolar affective disorder; (2) to illustrate the similarities and differences in biopolar disease (especially mania) and chronic schizophrenia, and (3) to look more closely at the depression of bipolar and unipolar disease. 相似文献
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