Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cardiac complications of radiotherapy have been reviewed in the light of 46 case histories collected from 16 treatment centres in France. They are usually found after radiotherapy for Hodgkin's disease and carcinoma of the breast. Although histologically there may be diffuse fibrosis involving the endocardium, myocardium and pericardium, it is pericarditis which is the usual clinical feature. It often occurs late, and takes many forms. The dry constrictive fibrous type of pericarditis is the most severe because of the amount of myocardial fibrosis usually associated with it. It is rare for there to be clinical features of myocardial fibrosis, and if present they are variable: isolated disorders of repolarisation or of conduction, or true cardiomyopathies. Lesions of the coronary arteries are exceptionally rare after radiotherapy, and involve fibrosis of the intima or atherosclerosis.
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PMID:[Cardiac complications of thoracic radiotherapy]. 9 62

The metabolic effects of sex steroids pertinent to cardiovascular risk are described. These effects are discussed for estrogen inducible proteins, coagulation and fibrinolysis, blood pressure and hypertension, carbohydrate metabolism, lipids and lipoproteins, and vessel walls and local prostaglandins. Also described is the cardioprotection from estrogens and estrogen/progesterone treatment and cardiovascular risk. Oral contraceptive (OC) and cardiovascular risk are also discussed with the following effects identified: the influence on many of the multiple risk factors involved in the development of cardiovascular diseases (i.e., lipids, carbohydrate metabolism, and hemostasis), an association between OC use and thromboembolic accidents, a state of hypercoagulability counterbalanced by increased fibrinolytic activity, venous thrombosis, a relationship with the dosage of androgenic progestogens. no atherogenic origin, no age limit for prescribed, healthy, nonsmoking women, and an increased peripheral insulin resistance. It is concluded that it is rarely inadvisable to prescribe low dose natural estrogens in postmenopausal hormone replacement therapy. Factors contraindicating such use are undiagnosed genital bleeding, an active thrombolic or cardiovascular process, carcinoma of the breast or endometrium, and acute liver failure. Estrogen replacement therapy may exert some cardioprotective effect. When progestogens are added to prevent endometrial carcinoma development, the benefits might be reduced. Low estrogen and low progesterone OC use among healthy, nonsmoking women even in middle age poses no risk of death from cardiovascular disease. Premenopausal women may even be protected from coronary atherosclerosis with estrogen-containing OCs. However, it is advisable that OCs be used with the least possible impact on lipid and carbohydrate metabolism, as well as on hemostasis. For those with some prior cardiovascular risk, there are theoretical advantages at present for use of the new, less, or nonandrogenic progestins in OCs; however, caution is urged and informed consent must be obtained until epidemiological studies support this position.
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PMID:Sex hormones and cardiovascular risk. 192 64

Coronary artery stenosis is one of the possible complications of radiotherapy to the mediastinum. Although less frequent than pericardial disease, anatomopathological studies have shown it not to be uncommon. Five cases with different clinical presentations are reported and the 30 previously described cases are reviewed. Radiotherapy was performed for Hodgkin's disease in 70% of cases and for carcinoma of the breast in 10% of cases. The average delay before onset of the symptoms was 4 years but in some cases delays of up to 10 years were observed. The most common presentation was an inaugural myocardial infarction (50 to 60% of cases). In other cases, angina of effort or typical spastic angina was observed. The coronary lesions were mainly proximal single artery stenosis affecting especially the left anterior descending artery. The typical histological appearances of the stenosis were intimal and sometimes adventicial fibrosis, occasionally associated with medial hyaline sclerosis. However, atherosclerotic lesions were also commonly present. This observation raises the question of the role of irradiation in the development of precocious atherosclerosis by coronary endothelial damage. This hypothesis is supported by the results of experimental studies and by the fact that several autopsy reports showed that the atheroma only developed in the irradiated zone. In addition, although the most demonstrative cases are those of young patients of 30 to 35 years of age, the responsibility of radiotherapy in the development or coronary pathology of older patients cannot be excluded, especially when none of the classical coronary risk factors are present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Coronary stenosis after radiotherapy. Clinical study of 5 cases and review of the literature]. 310 71

The clinical features of all 150 Jewish patients with squamous cell carcinoma of the vulva diagnosed in Israel during a 13-year period (1961-73) are presented. As in other studies, the frequencies of diabetes, hypertension, atherosclerosis and early onset of menopause were relatively high, and there was a long time lag from onset of symptoms to diagnosis. The most common complaint was pruritus vulvae, and the labia were the most common site of the primary lesion. The predictive value of clinical lymph node examination was reasonably good; lymph node involvement adversely affected survival. In contrast to other studies, the frequency of nulliparity and venereal diseases was low and the most common second primary malignancy was carcinoma of the breast. During the period reviewed, the surgical approach was mainly conservative and the postoperative mortality high, yielding a low 5-year survival rate. We attribute this to the lack of trained gynecologic oncologists during the period reviewed. Preliminary data indicate that in recent years a more aggressive surgical approach is being used and an improved 5-year survival rate achieved.
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PMID:Clinical features of Jewish Israeli patients with squamous cell carcinoma of the vulva. 646 62