Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study seeks to assist in setting priorities for assessing medical practices and technologies when assessment resources are scarce. It develops an objective index of expected gain from technology assessment, using modified DRG-level data on hospitalizations in NY State. The index uses standard economic concepts to combine measures of resource use, the coefficient of variation in use rates across regions, and the rate at which the incremental value of a medical intervention changes as its rate of use changes, providing a dollar-valued welfare loss from variations. For the entire US in 1987, the highest index occurred for coronary artery bypass graft ($0.95 billion per year), but most of the high-index interventions were nonsurgical, including hospitalizations for psychosis ($0.74 billion per year), cardiac catheterization ($0.62 billion per year), chronic obstructive lung disease ($0.55 billion per year), angina pectoris ($0.46 billion per year), adult gastroenteritis ($0.38 billion per year), adult pneumonia ($0.32 billion per year) and medical back problems ($0.28 billion per year). The top 25 interventions create an annual welfare loss of exceeding $7 billion. The present value of convincingly assessing the correct way to use these interventions sums many years of annual gains from eliminating these welfare losses. The gains from eliminating unexplained variation in medical practices appear greatly larger than costs of necessary studies.
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PMID:Priority setting in medical technology and medical practice assessment. 164 Jul 69

Amphetamine, methamphetamine, pemoline, sydnocarb and other psychomotor stimulants derived from phenylethylamine are referred as the most effective agents for an urgent increase of performance. Their positive effect is however reduced or even transformed in a nonbeneficial one if the work is of the complex nature or is performed under emotional stress, overfatigue, hypoxia, overheating. The psychomotor stimulants, in particular amphetamine and methamphetamine, can cause attacks of angina pectoris, arrhythmias, an elevation of arterial blood pressure, drug addiction, anxiety or aggressive behavior, psychotic reactions.
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PMID:[Psychomotor stimulants as agents for enhancing work capacity]. 222 69

In Japan, the age-adjusted death rate from ischemic heart disease has decreased for both male and female since 1970, although the rate appears to be slightly affected by mortality from senility without mention of psychosis, "cardiac insufficiency", and sudden death in elderly persons. On the other hand, consultation rate has shown an increase, suggesting an increase in the number of recovered patients and a lengthening in the duration of ischemic heart disease from onset to termination by CCU treatment. A 7.5-year prospective study of ischemic heart disease (myocardial infarction + angina pectoris on effort + sudden death) among residents 40 years and older was conducted at a rural community, Akadani-Ijimino district in Niigata Prefecture. Statistically significant risk factors appeared to be age, hypertension, ECG abnormalities and fuduscopic changes. Even in 1977-1984 when Japanese dietary habits were westernized, neither hyperlipidemia nor obesity was related to the development of ischemic heart disease in this agricultural district. Statistically significant risk ratios were not observed for any nutrient or food, although the ratio for animal fat, calcium, salted vegetables and caloric percent of animal protein was more than one respectively.
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PMID:Trends in death and consultation rates of ischemic heart disease in Japan and the risk factors in a rural community. 359 72

A 84-year-old man was given nifedipine for control of angina pectoris. Acute psychosis with paranoid ideation developed soon after he began receiving the medication. All symptoms resolved with discontinuation of nifedipine. This is the second reported case of nifedipine-associated acute psychosis. Alternations in calcium-mediated neurotransmitter release, particularly dopamine, may be responsible. Clinicians should consider nifedipine when presented with a patient with acute psychosis.
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PMID:Nifedipine-associated acute psychosis. 376

Mortality and morbidity from ischaemic heart disease (IHD) was studied in 5404 Finnish males aged 35-64 years who had been hospitalised for alcohol-related disease in 1972 without any admissions for IHD during that same period. By record-linkage, morbidity and mortality were followed up to the end of 1975. The mortality of patients with alcohol-related diseases was compared to 1120 patients with acute appendicitis by calculating indirectly age-standardised mortality ratios (SMR). The mortality and morbidity of 5963 patients with acute myocardial infarction or angina pectoris was also studied. The following SMRs for IHD mortality, non-fatal-IHD-hospitalisation and for mortality from all causes respectively, were found: acute myocardial infarction 11.6, 7.2 and 7.2; alcohol intoxication 6.0, 4.5 and 4.5; angina pectoris 5.2, 10.5 and 3.4; liver cirrhosis 2.2, 2.5 and 11.8; alcoholism 1.9, 1.9 and 3.6; pancreatitis 1.8, 1.2 and 4.4; alcohol psychosis 1.7, 2.5 and 4.2. IHD mortality and morbidity appeared to be more prevalent in patients hospitalised with alcohol intoxication than in patients with other alcohol-related diseases. This suggests that rapid drinking predisposes both to serious intoxication and to fatal disturbances of cardiac rhythm.
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PMID:Alcohol-related diseases associated with ischaemic heart disease: a three-year follow-up of middle-aged male hospital patients. 376 98

A patient with severe variant angina that was refractory to conventional treatment became symptom free when she was treated with benzhexol (trihexyphenidyl hydrochloride), a cholinergic blocking agent used in the management of Parkinson's disease. There was a brief psychotic reaction when a large dose was taken and some memory impairment on the maintenance dose. Benzhexol should be used with caution but may prove to be an additional therapeutic agent in the management of severe variant angina.
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PMID:Management of a case of refractory variant angina with benzhexol hydrochloride (trihexyphenidyl hydrochloride). 405 85

Diltiazem, a calcium-channel blocker, is an effective antianginal agent, particularly in treating the vasospastic type of angina pectoris. This drug has recently been released for use in the United States. Noncardiac untoward effects of diltiazem are few. We describe a case of mania with psychotic features that occurred while a patient was on diltiazem.
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PMID:Secondary mania associated with diltiazem. 649 91

Coronary artery bypass grafting was performed on 3 patients for refractory angina pectoris 48, 5, and 40 months after orthotopic liver transplantation. At the time of the cardiac operation, all 3 patients had drug-induced moderate renal dysfunction, and 1 of the 3 exhibited mild chronic rejection of the graft. Maintenance immunosuppressive therapy was continued during the cardiac operation and the perioperative period. Stress-dose steroids and standard prophylactic antibiotics were also employed. All 3 patients tolerated the cardiac surgical procedure without hepatic decompensation, excessive bleeding, infection, impaired wound healing, and other complications related to the transplanted organ or to the immunosuppressive therapy. Early postoperative liver function test results showed mild transient deterioration. One patient experienced a brief psychotic episode and massive upper gastrointestinal bleeding. Both complications were attributed to the steroids used in immunosuppressive therapy. Follow-up ranging from 2 to 24 months after coronary artery bypass grafting revealed that the patients were active and had no cardiac symptoms or manifestations of hepatic decompensation. It appears from this limited experience that cardiac operations can be performed safely in patients who have previously undergone liver transplantation.
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PMID:Coronary artery bypass grafting in patients with transplanted livers. 794 49

There has been an increasing interest in developing clinical practice guidelines for general practitioners as a means of improving health outcomes. We conducted a survey of a national random sample of Australian general practitioners in May 1995 to determine their needs, preferred formats and dissemination strategies and to identify potential lead agencies for guidelines development. Of 373 eligible general practitioners, 286 (77 per cent) returned completed questionnaires. At least 50 per cent of respondents considered guidelines in angina, psychotic illness, skin cancer and attention deficit disorder as 'extremely' or 'very' useful. However, three other topics identified as areas for future guidelines development in Better health outcomes for Australians were so rated by less than half of the general practitioners surveyed. The Australian Cancer Society and the Australian Medical Association outranked nine other organisations in terms of credibility in guidelines development. Innovative formats, including computerised medical records or text, were not highly rated, consistent with our finding that only 27 respondents (9 per cent) had Internet access. Strategies nominated as likely to increase the adoption of a guideline included a personal visit by a trained nurse, a lecture about its content or a Medicare rebate being available when a patient was managed in accordance with the guideline. Public health practitioners and nominated lead agencies are encouraged to respond to these findings and recognise potential strategies to enhance the effective dissemination of guidelines. Interventional studies are required to demonstrate and allow understanding of changes in clinical practice attributable to guidelines.
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PMID:Future directions for clinical practice guidelines: needs, lead agencies and potential dissemination strategies identified by Australian general practitioners. 934 94

A multi-employer database that links medical, prescription drug, absence, and short term disability data at the patient level was analyzed to uncover the most costly physical and mental health conditions affecting American businesses. A unique methodology was developed involving the creation of patient episodes of care that incorporated employee productivity measures of absence and disability. Data for 374,799 employees from six large employers were analyzed. Absence and disability losses constituted 29% of the total health and productivity related expenditures for physical health conditions, and 47% for all of the mental health conditions examined. The top-10 most costly physical health conditions were: angina pectoris; essential hypertension; diabetes mellitus; mechanical low back pain; acute myocardial infarction; chronic obstructive pulmonary disease; back disorders not specified as low back; trauma to spine and spinal cord; sinusitis; and diseases of the ear, nose and throat or mastoid process. The most costly mental health disorders were: bipolar disorder, chronic maintenance; depression; depressive episode in bipolar disease; neurotic, personality and non-psychotic disorders; alcoholism;, anxiety disorders; schizophrenia, acute phase; bipolar disorders, severe mania; nonspecific neurotic, personality and non-psychotic disorders; and psychoses. Implications for employers and health plans in examining the health and productivity consequences of common health conditions are discussed.
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PMID:The health and productivity cost burden of the "top 10" physical and mental health conditions affecting six large U.S. employers in 1999. 1255 74


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