Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.15.1 (ACE)
 18,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

As infection and malnutrition are steadily overcome in the developing world, cardiovascular disease loom large in the profile of morbidity and mortality in these societies. Hypertension, rheumatic heart disease and the cardiomyopathies are already taking their toll and atherosclerosis is certain to pose public health problems soon unless steps are taken now, through attention to known risk factors, to pre-empt or at least minimize its consequences. There are populations in developing countries among whom blood pressure does not appear to rise with age and in whom the prevalence of hypertension is very low. Studies of these communities and of migrant groups indicate that salt has an important effect on blood pressure. In spite of these observations, however, it is well known that black communities tend, on the whole, to show a higher prevalence of hypertension and more severe target-organ damage than white communities. Other distinguishing features are lower cholesterol, triglyceride and low-density lipoprotein fractions and a delayed response to a sodium load in black populations. Economic constraints limit the effective application of stepped-care therapy in the management of moderate to severe hypertension. Beta-blockers and angiotensin converting enzyme (ACE) inhibitors are not so effective in black communities unless combined with diuretics.
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PMID:Epidemiology of cardiovascular disease in developing countries. 209 92

The adult protein turn-over daily affects 250 grammes, which is equivalent to four times the average daily protein intake. Regulation of synthesis and catabolism appears to occur by independent ways. These systems are altered during the nephrotic syndrome and ultimately lead to a loss of total body nitrogen and a risk for malnutrition. Indeed, during the nephrotic syndrome, muscle protein synthesis is further impaired as the urinary protein losses increase. This may suggest that anabolic compounds are lost in the urine of such patients. A moderate protein restriction (0.8 g/kg BW/day) allows a reduction in proteinuria, as well as pharmacological agents (ACE inhibitors) and should therefore slow the progressive renal insult.
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PMID:[Nephrotic syndrome and protein metabolism]. 892 6

Cardiovascular events are the main cause of death in patients with chronic renal failure who are treated with hemodialysis. Hypertension is frequent among dialysis patients and may be a major cause of mortality, although epidemiological studies are controversial in this regard. This disparity in results may be the consequence of an inadequate definition of hypertension in dialysis patients as well as the interaction with hypertension with other risk factors such as malnutrition or left ventricular hypertrophy (LVH), which are strong predictors of death. Although the goal of blood pressure in dialysis has not been established yet, it seems that predialysis blood pressure levels lower than 150/90 mm Hg must be achieved for patients to avoid complications. LVH is very frequent among dialysis patients and starts early in the progression of chronic renal failure. Hypertension is the main cause for its development, but other potentially reversible factors such as anemia, volume overload, secondary hyperparathyroidism, dose of dialysis or malnutrition may also be implicated. Hence, an adequate management of patients on hemodialysis must include the strict control of blood pressure, preferably with angiotensin converting enzyme (ACE) inhibitors, together with those early measures in order to avoid the development of the other causes of LVH or to treat them when they already exist.
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PMID:Blood pressure, left ventricular hypertrophy and long-term prognosis in hemodialysis patients. 983 91

The capabilities of ICP-MS far exceed the slow, single-element analysis of GFAAS for determination of multiple trace elements. Additionally, its sensitivity is superior to that of DCP, ICP, and FAAS. The analytic procedure for ICP-MS is relatively straightforward and bypasses the need for digestion in many cases. It enables the physician to identify the target trace element(s) in intoxication cases, nutritional deficiency, or disease, thus eliminating the treatment delays experienced with sequential testing methods. This technology has its limitations as well. The ICP-MS cannot be used in the positive ion mode to analyze with sufficient sensitivity highly electronegative elements such as fluorine, because F+ is unstable and forms only by very high ionization energy. The ICP mass spectrometers used in most commercial laboratories utilize the quadrupole mass selector, which is limited by low resolution and, thus, by the various interferences previously discussed. For example, when an argon plasma is used, selenium (m/e 80) and chromium (m/e 52) in serum, plasma, and blood specimens are subject to polyatomic and molecular ion interferences. Low-resolution ICP mass spectrometers can therefore be used to analyze many trace elements, but they are not universal analyzers. High-resolution ICP-MS can resolve these interferences, but with greater expense. With the advent of more research and development of new techniques, some of these difficulties may be overcome, making this technique even more versatile. Contamination during sample collection and analysis causes falsely elevated results. Attention and care must be given to avoid contamination. Proper collection devices containing negligible amounts of trace elements should be used. Labware, preferably plastic and not glass, must be decontaminated prior to use by acid-washing and rinsed with [table: see text] de-ionized water. A complete description of sample collection and contamination has been written by Aitio and Jarvisalo as well as by Chan and Gerson. Lutz et al observed the ranges in blood shown in Table 4. We have adopted the ranges listed in Table 5 in urines of healthy, ambulatory, and community-dwelling individuals through a limited in-house study and review of literature. In conclusion, differentiation of trace element abnormalities (primary intoxication or disease versus secondary underlying disease) can be made only by utilizing results from trace element analyses in clinical specimens, medical history, and careful observation of symptoms. Repeat analysis on a second specimen collection is recommended when contamination is suspected.
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PMID:Technical and clinical aspects of spectrometric analysis of trace elements in clinical samples. 989 2

This study was conducted to assess the validity and the reliability of simple tools to screen the protein-energy malnutrition (PEM) risk among the elderly population in healthcare facilities. An initial screening tool, made up of nine PEM risk factors, was previously developed to be validated. This tool was quite complex and showed low validity results. A stepwise regression analysis determined significant risk factors (P < or = 0.05) among those included in the initial tool. These were the foundation to develop two simplified screening tools. One included Body Mass Index (BMI) and % weight loss over time. The second included BMI and albumin. Both tools classified subjects in low or high PEM risk levels. In the present study, the simple tools were assessed in a sample of 142 elderly subjects divided into two categories: acute care elderly (ACE, n=72) and long-term care elderly (LTCE, n=70). The simple tools were administered by a dietetic technician and a nurse with the purpose of assessing inter-rater and test-retest reliabilities. The criterion validity of the simple tools were assessed in comparison to in-depth nutritional assessments carried out by a dietitian. The validity results were ranked between 60.5% and 91.7%. The reliability scores showed levels of agreement of 70.8% to 93.1% and kappa coefficients ranking between 0.59(+/-0.07) and 0.79(+/-0.05). Simple tools are now available for efficiently screening the PEM risk among the elderly population on a healthcare facility-wide basis.
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PMID:Validity and reliability of simple nutrition screening tools adapted to the elderly population in healthcare facilities. 1175 98

In recent years several multicentric prospective studies have demonstrated the efficacy of some therapeutic measures to slow the progression of renal diseases. Inhibition of renin-angiotensin system (RAS) both by ACE inhibitors (ACEI) and angiotensin II receptor antagonists (ARA) is probably the strongest therapeutic alternative: The antiproteinuric effect of these drugs is an excellent surrogate marker and a predictor of the beneficial influences on the progression of renal failure. The type of renal disease, an inadequate control of blood pressure, and the presence of obesity may counteract the beneficial influences of RAS inhibition, whereas early treatment of all patients with significant proteinuria before the appearance of renal insufficiency and combined therapy with an ACEI and an ARA may augment it. Dietary protein restriction is a classic treatment of chronic renal insufficiency whose effectiveness has been validated by multicentric studies. However, a poor compliance of the patient and the risk of malnutrition with very strict protein restriction could limit the benefits of this treatment. Treatment of hyperlipidemia, prevention of obesity, avoidance of smoking, and regular physical exercise are interventions whose therapeutic potential is progressively recognized, particularly in type 2 diabetic nephropathy. Early correction of anemia may contribute to the slowing of renal disease progression. Although further studies are required, the accumulated evidence and the likelihood of additive beneficial effect of these therapeutic measures advise their combined implementation in patients with chronic renal diseases.
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PMID:Slowing the progression of renal failure. 1198 7

For about three decades glomerular diseases have been the most intensively investigated research area in nephrology. The increasing proportion of patients with end-stage renal disease (ESRD) secondary to hypertension has now revived interest in hypertension. Prospective studies have firmly established that high blood pressure is associated with an increased risk of renal failure independent of other risk factors. Hypertension-related renal injury might be interpreted in a general context taking into account genes, intrauterine growth and environmental factors. Disturbed intrauterine growth (due to malnutrition or other factors) has a negative influence on the development of the cardiovascular system and favours the occurrence of hypertension, insulin resistance, hypercholesterolaemia and hyperuricaemia in adult life (Barker's hypothesis). Altered intrauterine growth has also been associated with a reduced number of nephrons at birth. Damage attributable to glomerular hyperperfusion in kidneys with a reduced number of nephrons is aggravated by vascular lesions in middle and small arterial vessels (secondary to hypertension, hyperlipidaemia and environmental risk factors such as smoking). The observation that subjects homozygous for the D allele of the ACE gene are predisposed to both cardiovascular complications and nephrosclerosis, suggests that genetic factors may interact with altered intrauterine growth in determining the risk of cardiovascular and renal diseases.
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PMID:[Nephropathy associated with arterial hypertension: genes and Barker's hypothesis]. 1243 39

Anemia (Hemoglobin of < 12 to 13 g/dl) is frequently encountered in patients with congestive heart failure (CHF). This anemia may be partly due to hemodilution, partly to the associated reduction in renal function, and partly to the use of ACE inhibitors and aspirin. However, there is evidence that CHF alone--through excessive cytokine production may also reduce the bone marrow and cause anemia. In several recent studies anemia has been found to be associated with a more severe degree of CHF, a higher rate of death, renal failure, hospitalization and evidence of malnutrition. In both uncontrolled and controlled studies correction of anemia with erythropoietin with or without the addition of i.v. iron has been attempted. The correction of anemia has been associated with a marked improvement in New York Heart Association (NYHA) functional cardiac class and Left Ventricular Ejection Fraction, a marked reduction in the need for hospitalization and high dose oral and i.v. diuretics, and an improvement in exercise capacity, peak exercise oxygen utilization and quality of life. The serum creatinine, which had been increasing steadily before treatment, stabilized with the correction of anemia. All this suggests that control of anemia in CHF could become a valuable addition to the therapeutic armamentarium of CHF and might also play a major role in the prevention of progressive renal failure.
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PMID:The cardio renal anemia syndrome: correcting anemia in patients with resistant congestive heart failure can improve both cardiac and renal function and reduce hospitalizations. 1294 May 39

The aim of this study was to systematically identify the type and severity of all comorbid conditions in a cohort of 180 patients with laryngeal squamous cancer. The authors retrospectively surveyed the notes using the Adult Comorbidity Evaluation -- 27 index (ACE-27) and applying a systematic process of data abstraction that had previously been shown to be accurate and reliable. The results provided insight into the distribution, site and extent of decompensation caused by comorbidity. It was found that 116 (64.4 per cent) of 180 patients in the study population had some form of comorbid illness, with the cardiovascular and respiratory systems being the top two body systems affected in 43.9 per cent and 24.1 per cent respectively. One-quarter (25.8 per cent) of these 116 patients had comorbid illnesses in more than one body system. Concurrent neurological disease is associated with high mortality. The ACE-27 is a comprehensive instrument that codes all forms of comorbid diseases in the head and neck cancer setting excepting malnutrition. This study suggests that routine collection of comorbidity will be important in future outcomes analysis and in comparing treatment results between centres. Apparent improvements in treatment outcome following newer therapeutic modalities will have to take into account any changes in the comorbidity type and burden over time.
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PMID:Descriptive study of the type and severity of decompensation caused by comorbidity in a population of patients with laryngeal squamous cancer. 1531 57

This study retrospectively evaluated the charts of 56 patients who had been referred to an oral medicine clinic between 1995 and 2004 with oral burning and limited clinical findings. Of the 56 patients, 35 had a final diagnosis of essential burning mouth disorder (EBMD). Five patients with EBMD had a family history of diabetes and two had been diagnosed with late-onset diabetes. Other oral burning diagnoses included sialoadenitis (burning lips syndrome), irritation or allergic reactions to triclosan, diabetic neuropathy, subclinical oral candidiasis, nutritional deficiency/neuropathy, and a drug reaction to an ACE inhibitor (scalded mouth syndrome) that resulted in oral burning.
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PMID:A retrospective evaluation of 56 patients with oral burning and limited clinical findings. 1690 1


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