Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nine cases have been presented in detail to illustrate some of the varied causes of sudden neurological deficit in childhood: arteriovenous malformation, cryptic hamartoma, berry aneurysm, mycotic aneurysm, intraspinal arteriovenous malformation, brain tumor, migraine, arteritis, and multiple sclerosis. The Boston Children's Hospital experience with aneurysms and intracranial arteriovenous malformation has been summarized. It is noteworthy that a cutaneous hemangioma overlay one cranial and one intraspinal arteriovenous malformation. One small but deep cerebral arteriovenous malformation apparently destroyed itself after its second hemorrhage. Not only have multiple sclerosis and a brain tumor mimicked a vascular lesion, but a series of vascular accidents was misdiagnosed first as multiple sclerosis then as a thalamic tumor. The many possible causes of childhood strokes has been thoroughly cataloged in the Report of the Joint Committee for Stroke Facilities in 1973 (11). Children may be more susceptible to strokes because of congenital abnormalities such as congenital heart disease, hemophilia, and sickle cell anemia, or by diseases which more commonly occur in this age group, such as leukemia. The likelihood of brain abscess in cyanotic congenital heart disease is stressed. Arteriographic studies in our series have been safe; however, there have been reports of probable worsening of symptoms in children with multiple cerebral occlusive lesions in the presence of homocystinuria.
 ...
PMID:Strokes in children. 98 45

A 42-year-old black man, a physician, presented with a three week history of intermittent right arm and leg numbness and weakness, lasting about five minutes. This was not associated with headache, visual changes, seizures, aphasia or loss of consciousness. There was no history of head trauma, migraines, or previous attacks. Positive findings on physical examination were confined to a blood pressure of 182/80; evidence of hypertensive retinopathy; normal carotid pulses without bruits; and a Grade II/VI systolic ejection murmur with normal sinus rhythm. Initial hematocrit was 25.7%; white blood cell count 14,000 cu/mm with a normal differential; platelet count 532,000 cu/mm. An electrocardiogram showed left ventricular hypertrophy. Duplex scan demonstrated normal carotid bifurcations bilaterally, and arteriogram revealed no carotid or intracranial pathology. Hemoglobin electrophoresis revealed sickle cell disease of the SS type. He was treated with transfusion therapy and has remained asymptomatic at 40 months. Approximately 20% of children with the SS type sickle cell disease will have cerebrovascular symptoms caused by small intracranial artery occlusion due to sludging of the abnormal hemoglobin. This unusual cause of transient ischemic attacks can occur in older patients of African-American ancestry and must be recognized to enable early and effective therapy with exchange transfusion.
 ...
PMID:An unusual cause of transient ischemic attacks: case report. 187

Oral contraceptives are clearly contraindicated in patients with a history of thromboembolic disease, ischemic heart attack, or cerebral stroke. Patients requiring long-term anticoagulant treatment can be treated with gonadotropin-releasing hormone analogs to prevent ovulation, because ruptured follicles can cause massive intraperitoneal bleeding. Patients with essential hypertension and severe liver diseases should also discontinue treatment 4 weeks before major elective surgery. Migraine and diabetes mellitus are regarded as relative contraindications, depending on the individual situation. Long-term diseases, such as Crohn's disease, epilepsy, and sickle cell anemia, also require individualized consultation.
 ...
PMID:Oral contraception in disease states. 225 29

An updated review on oral contraception opens with history and mechanism of action and concentrates on clinical management of users, especially adolescents. Other types of hormonal contraception are mentioned in passing. Since the introduction of Enovid in 1960, the steroid dose of pills has fallen about 10-fold, reducing side effects and especially complications to the minimum. Despite this, the public is more suspicious than ever of the danger of pills. Orals work by preventing the estrogen surge, usually blocking ovulation, and reducing endometrial development. Currently the latest low dose pills are the triphasics, which offer the lowest total dose of both estrogen and progestin to date. Some of them have such low progestin content that estrogen side effects become a problem. Guidelines for patient selection, and patient management are listed and tabulated. The ideal pill user has a mature menstrual cycle, frequent sexual activity, poor compliance with other methods, a need for maximal protection and no contraindications such as history of risk of factors for thromboembolism, cancer, migraine, sickle cell disease, or depression. Lab tests, history, and a physical exam are recommended. Instructions and danger signals are listed. Estrogenic versus androgenic pills, how to deal with breakthrough bleeding, weight gain, breast pain, and other side effects are discussed. All complaints of headache should be seriously evaluated. Use of minipills, medicated IUDs, implants, vaginal rings and injectables are briefly noted.
 ...
PMID:Hormonal contraception. 266 92

The cause of stroke in a young adult can usually be ascertained with proper workup. One of the most common causes is atherosclerotic cerebrovascular disease, and cigarette smoking is an important risk factor in young adults. Several types of nonatherosclerotic cerebral vasculopathy can also result in premature cerebral infarction; these include cervicocephalic arterial dissection, nonpenetrating traumatic arterial disease, moyamoya disease, fibromuscular dysplasia, vasculitis, and migraine. Cardiac embolism may play a more important role than was previously thought, and hematologic disorders (eg, sickle cell disease, polycythemia rubra vera, coagulation problems) are known to predispose patients to stroke. A careful history of risk factors and a thorough neurologic and cardiovascular examination followed by adequate testing, including angiography, are essential to diagnosis.
 ...
PMID:Diagnosis of stroke in young adults. 356 68

There are contraceptive methods available to the adolescent, and a knowledgeable clinician can help the patient choose the best method available for the individual. In this discussion of alternatives to adolescent pregnancy, attention is directed to the following: a historical overview of pregnancy prevention and management of sexually transmitted diseases; oral contraceptives; contraindications of oral contraceptive (OC) use (cardiovascular/cardiopulmonary conditions, migraine headaches, epilepsy, oligomenorrhea, sickle cell disease, the liver, cancer, and miscellaneous side-effects); the low-estrogen OC, the mini-pill; IUDs; barrier methods; postcoital contraceptives; injectable contraceptives; abstinence; periodic abstinence; and miscellaneous methods. Although the OC continues to be the most popular method among teenagers who use an effective method, the clinican needs to emphasize the safety and efficacy of barrier methods for the motivated teenager. The clinical also needs to remember that understanding of these issues of adolescent contraception and pregnancy is rooted in the very process of adolescence itself. The health care professional should remember that he/she is providing information for the teenage patient for only part of her reproductive years. A method selected by the patient at a particular time in her life may be replaced later by other methods as she matures. The health care professional provides the information and counsel; the patient chooses for herself.
 ...
PMID:Alternatives to adolescent pregnancy: a discussion of the contraceptive literature from 1960 to 1980. 701 Jun 13

Forty-eight children, aged 5 to 15 years, were tested for their ability to raise and lower their index finger temperature with self-hypnosis and/or biofeedback. Group A (self-hypnosis only) and group B (self-hypnosis with biofeedback) were children who had previous successful experience with self-hypnosis (eg, for the treatment of enuresis, pain, asthma, or obesity). Group C (biofeedback only) were children with no experience with hypnosis. All three groups showed significant success with warming and cooling. The range of warming for the three groups was 0 to 3.7 F, and for cooling, 0 to 7.3 F or 0 to 8.8 F for attempts exceeding the ten-minute trial period. No significant difference in ability to warm or cool was noted when the children were compared by group, age, or sex. Some of the children in group A who had little or no success with hypnosis only were very successful with the addition of biofeedback monitoring, suggesting a synergistic effect between biofeedback and hypnosis. A significant temperature rise was also noted in groups A and B accompanying a neutral hypnotic induction relaxation-imagery exercise in which no mention of temperature change was made. This rise varied from 0 to 6 F, averaging 1.7 F. Possible therapeutic implications include the treatment of migraine headaches, Raynaud's syndrome, sickle cell anemia, and the use of temperature monitoring as a diagnostic and therapeutic adjunct to clinical hypnosis.
 ...
PMID:Self-hypnosis, biofeedback, and voluntary peripheral temperature control in children. 742 23

The selection of a contraceptive method for women with intercurrent disease necessitates complex balancing of the medical risks inherent in pregnancy and effects of the method on the underlying disease process. Presented in this review are contraceptive options for women with psychiatric, coagulation, cardiovascular, endocrine, and neurologic disorders as well as sickle cell disease and acquired immunodeficiency syndrome (AIDS). In women who are taking antidepressants or anti-anxiety medications, drug interactions can lower the efficacy of estrogen. Those with cardiovascular disorders face the potential adverse effects of exogenous steroids contained in oral contraceptives (OCs); at the same time, the need for effective methods is great given the increased cardiovascular demands of pregnancy. Current OC preparations can be safely prescribed to women with chronic nonvascular headaches, while the relationship between OC use and migraine remains inconclusive. In all cases, thorough counseling is essential to ensure informed consent and compliance.
 ...
PMID:Contraception in women with intercurrent disease. 789 62

Unusual causes of stroke account for a minority of all strokes, but they have specific diagnostic and therapeutic implications which must be considered early in the clinical course. This article focuses on arteriopathies such as arterial dissection, vasospasm-induced stroke, and vasculitis; hematological disorders such as hypercoagulable states, disseminated intravascular coagulation, and sickle cell disease; migraine-induced stroke, and cerebral venous thrombosis.
 ...
PMID:Stroke treatment-specific considerations. 1075 33

Vasospasm can have many different causes and can occur in a variety of diseases, including infectious, autoimmune, and ophthalmic diseases, as well as in otherwise healthy subjects. We distinguish between the primary vasospastic syndrome and secondary vasospasm. The term "vasospastic syndrome" summarizes the symptoms of patients having such a diathesis as responding with spasm to stimuli like cold or emotional stress. Secondary vasospasm can occur in a number of autoimmune diseases, such as multiple sclerosis, lupus erythematosus, antiphospholipid syndrome, rheumatoid polyarthritis, giant cell arteritis, Behcet's disease, Buerger's disease and preeclampsia, and also in infectious diseases such as AIDS. Other potential causes for vasospasm are hemorrhages, homocysteinemia, head injury, acute intermittent porphyria, sickle cell disease, anorexia nervosa, Susac syndrome, mitochondriopathies, tumors, colitis ulcerosa, Crohn's disease, arteriosclerosis and drugs. Patients with primary vasospastic syndrome tend to suffer from cold hands, low blood pressure, and even migraine and silent myocardial ischemia. Valuable diagnostic tools for vasospastic diathesis are nailfold capillary microscopy and angiography, but probably the best indicator is an increased plasma level of endothelin-1. The eye is frequently involved in the vasospastic syndrome, and ocular manifestations of vasospasm include alteration of conjunctival vessels, corneal edema, retinal arterial and venous occlusions, choroidal ischemia, amaurosis fugax, AION, and glaucoma. Since the clinical impact of vascular dysregulation has only really been appreciated in the last few years, there has been little research in the according therapeutic field. The role of calcium channel blockers, magnesium, endothelin and glutamate antagonists, and gene therapy are discussed.
 ...
PMID:Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. 1128 96


1 2 3 Next >>