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Biomedical subjects

Richard M Sobel

Publications and source records attributed to Richard M Sobel.

4 recordsLinked to original sources
PubMed2005

Update on depression in neurologic illness: stroke, epilepsy, and multiple sclerosis.

The risk of depression is increased in chronic neurologic illness and can adversely affect the course of disease. Recent literature is reviewed for depression in stroke, epilepsy, and multiple sclerosis. Depression can share pathophysiologic aspects of the comorbid illness, such as neurotransmitter pathway disturbances, hypothalamus-pituitary-adrenal pathway disturbances, and changes in immunologic function. Depression also can be a psychologic reaction to the burden of the neurologic condition. Risk factors for development of depression are reviewed. Depression and other medical conditions can have shared symptoms (eg, fatigue, psychomotor retardation) that can complicate the diagnosis of depression in neurologic illness. Proper selection of antidepressant treatment is necessary to avoid worsening the neurologic disorder.

Depression↗
PubMed2005

The impact of anxiety and mood disorders on physical disease: the worried not-so-well.

Depression and anxiety can adversely affect the course of chronic physical illnesses, increasing morbidity and mortality. The literature during the past year is reviewed for gastrointestinal disorders, cancer, pain, heart disease, diabetes, and pulmonary disease. Causes for this relationship are behavioral and biological. Behavioral factors in patients with depressive and anxiety disorders include unhealthy lifestyle choices, disrupted sleep, and poor adherence to medical regimens. Biological mechanisms include increased inflammatory response and disruption of the hypothalamic-pituitary-adrenal axis.

Anxiety Disorders↗
PubMed2002

Pacemaker-mediated tachycardia: management by pacemaker interrogation/reprogramming in the ED.

We report a case of a patient with symptomatic pacemaker-mediated tachycardia (PMT). PMT should be suspected when asynchronous pacing induced by magnet application causes temporary resolution of an unknown tachycardia in a patient with a pacemaker. The underlying mechanism of PMT is either reentrant tachycardia or atrial triggering. PMT is better discerned with an intracardiac electrocardiogram (ECG) obtained through pacemaker interrogation (PI) than the standard 12-lead ECG. In the case reported, the interrogator was used to demonstrate that the initiating dysrhythmia was atrial flutter. Next, the programmer was used to overdrive the atrium restoring normal sinus rhythm. After pacemaker reprogramming, the patient was discharged from the emergency department (ED) in improved condition. We believe this to be the first reported case of a patient with PMT diagnosed, treated, and discharged effectively after PI, overdrive pacing and reprogramming from the ED. The pacemaker interrogator/programmer is a rapid noninvasive device that has practical applications in the ED.

Aged↗