Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0007222 (cardiovascular disease)
 65,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six highly trained marathon runners developed myocardial infarction. One of the two cases of clinically diagnosed myocardial infarction was fatal, and there were four cases of angiographically-proven infarction. Two athletes had significant arterial disease of two major coronary arteries, a third had stenosis of the anterior descending and the fourth of the right coronary artery. All these athletes had warning symptoms. Three of them completed marathon races despite symptoms, one athlete running more than 20 miles after the onset of exertional discomfort to complete the 56 mile Comrades Marathon. In spite of developing chest pain, another athlete who died had continued training for three weeks, including a 40 mile run. Two other athletes also continued to train with chest pain. We conclude that the marathon runners studied were not immune to coronary heart disease, nor to coronary atherosclerosis and that high levels of physical fitness did not guarantee the absence of significant cardiovascular disease. In addition, the relationship of exercise and myocardial infarction was complex because two athletes developed myocardial infarction during marathon running in the absence of complete coronary artery occlusion. We stress that marathon runners, like other sportsmen, should be warned of the serious significance of the development of exertional symptoms. Our conclusions do not reflect on the possible value of exercise in the prevention of coronary heart disease. Rather we refute exaggerated claims that marathon running provides complete immunity from coronary heart disease.
 ...
PMID:Coronary heart disease in marathon runners. 27 Sep 40

Even though oral contraceptives (OCs) with the new 3 progestins are the most widely prescribed OCs in the world, especially in Europe, they still are not available to US women. Gestodene's, desogestrel's, and norgestimate's effective daily dose are only 75 mcg, 150 mcg, and 250 mcg, respectively, while the daily dose of norethindrone in OCs used in the US ranges from 350-1000 mcg. The older progestins alter lipid metabolism, thus increasing cardiovascular disease risks. Some studies indicate that the new progestins induce fewer lipid metabolic changes than the older progestins. A 1988 study in West Germany suggests, however, that women who use gestodene may be at increased risk of thromboembolism. Yet, similar research in the UK and also in West Germany did not find this association. There has been concern for many years about OCs' ability to change glucose metabolism and insulin resistance. 5 studies show that OCs with desogestrel cause fewer such disturbances than those with levonorgestrel. 1 study also finds that OCs with gestodene do not alter glucose and insulin levels. On the other hand, 1 study suggests, that OCs with gestodene increase glucose and insulin levels over 6 months. European studies of the new progestins demonstrate their low 1-year method failure rates (gestodene, 0.07/100 users; desogestrel, 0.04/100 users; and norgestimate, [pregnancy rate] 0.25/100 users). Further, the 3 progestins result in a smaller proportion of women who have side effects (breakthrough bleeding or spotting, 3-9%, breast discomfort or headaches, 10-13%). Yet, researchers have not directly compared the effectiveness and acceptability of the 3 new progestins. A legal dispute between 2 pharmaceutical companies prevented the marketing of norgestimate in 1990. 1 company claims patent infringement. The US Food and Drug Administration is now evaluating gestodene and desogestrel. It probably will not approve gestodene until the question of apparent excess of thromboembolism is resolved.
 ...
PMID:The new pills: awaiting the next generation of oral contraceptives. 142 86

During the autumn 1989, a material of 1,330 men and 1,561 women aged 20-65 years and resident in the County of Vejle replied to a questionnaire about their smoking habits and knowledge in connection with the prophylaxis of cardiovascular disease. 47% of the men and 39% of the women stated that they smoked. During the past year, 44% of the male and 51% of the female smokers and ex-smokers had altered or considered altering their smoking habits. The main motives for altering smoking habits were health or financial reasons. The main reasons that an attempt to alter smoking habits did not succeed were side effects (restlessness/nervousness), the force of habit or that the desire was too great. The attitude that smoking was of significance for cardiovascular disease was related to non-smokers. In addition, a connection was observed between the knowledge that smoking is a risk factor for cardiovascular disease that the fact that these participants did not smoke. No interactions were observed between knowledge, attitudes and smoking habits i.e. that the attitude that it was important to stop smoking was identical among smokers and non-smokers, regardless of whether smoking was deleterious to health. On the basis of previous attempts to alter smoking habits, the conclusion was drawn that this is a difficult task. One of the reasons is that the cause of smoking are partially unknown and that smoking is probably an important factor in various social situations. In addition, the motivation to alter smoking habits is more than dominated by the discomfort involved.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Smoking habits among adults--attitude and behavior in relation to prevention of cardiovascular diseases]. 153 87

The male patient for aesthetic plastic surgery should expect to have a good experience, with few, if any complications from anesthesia. Proper planning is essential to the process, from setting up the surgical facility to selection and preparation of patients. Anesthetic techniques should be adapted to the needs of each patient, with his safety and comfort the most important consideration. Anesthesia for plastic surgery has progressed from simple injection of local anesthetics to sophisticated sedation and general endotracheal techniques. Better anesthetic drugs, monitors, and procedures for dealing with complications have made anesthesia a major factor in the advances of the plastic surgery specialty. Male patients frequently have different medical problems than their female counterparts have, including cardiovascular disease, hypertension, and smoking history. Other problems include back discomfort and prostate enlargement, both factors that must be taken into consideration with local sedation anesthesia techniques. The use of basic monitoring equipment has made ambulatory surgery safer for patients and has been instrumental in reduction of medication-related complications. Monitoring standards changed in anesthesia in the late 1980s to include electrocardiogram (EKG), precordial or pretracheal continuous monitoring, blood pressure, and pulse oximetry. In addition, if general anesthesia is used, end-tidal carbon dioxide and temperature monitoring and oxygen analysis of the anesthesia gases are also recommended. General anesthesia is being utilized more frequently in cosmetic surgery procedures and offers many advantages over local and conscious sedation techniques. The modern agents and techniques permit the patient to recover quickly, with minimum postoperative sequelae, and provide obvious comfort during the operative procedure. The traditional anesthesia technique for facial plastic surgery has been local anesthesia supplemented by sedation. This technique requires a combination of skillful local administration, selection of appropriate sedation drugs in proper doses, and a cooperative patient. Ideally, the selection and administration of drugs and monitoring of the patient should be by an anesthetist, who understands drug interactions and synergistic and additive effects of sedation drugs. Facility set-up, professional personnel, and recovery and discharge criteria are essential to good anesthesia care for the male aesthetic patient.
 ...
PMID:Anesthesia for male aesthetic surgery. 193 98

The estradiol transdermal therapeutic system is a cutaneous delivery device which delivers estradiol into the systemic circulation via the stratum corneum at a constant rate for up to 4 days. Physiological levels of estradiol (the major estrogen secreted by the ovaries in premenopausal women) can therefore be maintained in postmenopausal women with low daily doses because first-pass hepatic metabolism is avoided. In short term clinical studies, the beneficial effects of transdermal estradiol on plasma gonadotrophins, maturation of the vaginal epithelium, metabolic parameters of bone resorption and menopausal symptoms (hot flushes, sleep disturbance, genitourinary discomfort and mood alteration) appear to be comparable to those of oral and subcutaneous estrogens, while the undesirable effects of oral estrogens on hepatic metabolism are avoided. As with oral or injectable estrogen replacement therapy, concomitant sequential progestagen is recommended for patients with an intact uterus during transdermal estradiol administration, in order to reduce endometrial stimulation. Transdermal estradiol has been well tolerated in clinical trials, with local irritation at the site of application being the most common adverse effect. The incidence of systemic estrogenic effects appears to be comparable to that observed with oral therapy. Thus, transdermal estradiol offers near-physiological estrogen replacement in postmenopausal women in a convenient low-dose form which may avoid some of the complications of higher dose oral therapy. Long term epidemiological studies are warranted to determine whether transdermal estradiol therapy provides protection against osteoporosis and fractures and cardiovascular disease equivalent to that offered by oral and injectable estrogens. However, despite the importance of such data, it seems reasonable to conclude at this stage of its development that transdermal estradiol represents an important advance in hormone replacement therapy.
 ...
PMID:Transdermal estradiol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in the treatment of menopausal complaints. 208 14

Pain control is recognised as perhaps the most important single objective in the patient with terminal disease. Cancer, cardiovascular disease and obstructive airways disease are foremost among many causes of pain requiring control in the terminal phase. Spiritual, emotional, religious and socio-economic factors are important in raising or lowering the pain threshold. Analgesic strategies include use of drugs, neurosurgery, radiotherapy and supportive measures which may be brought to bear singly or in combination as required. Pain is clinically classified as being acute or chronic, by the type of patient, and by a series of common pain syndromes and their pathological mechanisms. General concepts of control of pain and discomfort in disease are discussed, together with a brief comment on epidemiology, in the first part of the article. Rationale is then discussed under the following headings: (i) principles of pain control; (ii) causes of pain; and (iii) analgesic modalities and factors impinging on their efficacy.
 ...
PMID:Pain control in terminal disease. 244 40

Clinical profiles were analysed of 18 children with congenital ventricular aneurysm (CVA) and diverticulum (CVD) (nine with CVA and nine with CVD). Of 18 children, only six had any symptoms, consisting of chest discomfort, palpitation, or convulsion. Heart murmurs were heard in nine of the 18 children, and a nonspecific systolic ejection murmur in one. A systolic click was heard in only four children. Dyskinesia of an abnormal protrusion of the cardiac silhouette on the chest x-ray film was detected in only three. The ECG revealed abnormal findings in all children. In those with CVA, signs of myocardial damage or left axis deviation (LAD) and left bundle branch block (LBBB) were the main findings. Among those with CVD, multiple premature ventricular contractions (PVCs) were present in four; some signs of myocardial damage were present in three. None of those with CVD had LAD or LBBB. Among the four children with right ventricular diverticulum, multiple PVCs were present in three. The lesions were detected by two-dimensional echocardiography (2DE) before angiography in 13 (72%) of 18 children. The wall kinetics of the lesions, as seen on 2DE, were in agreement with the subsequent angiographic findings.
 ...
PMID:Congenital ventricular aneurysm and diverticulum in children. 312 83

For at least the last 200 years it has been suspected that somatic manifestations of psychological distress play a role in the medical recognition and treatment of coronary artery disease (CAD). The cardiovascular system is intricately linked to the experience of emotion, and these links may explain how and when neuroticism can cloud the diagnosis of cardiovascular disease. A possible source of anginal symptoms in the absence of angiographically documented CAD is high standing on the personality dimension of neuroticism, which is a broad dimension of individual differences in the tendency to experience negative, distressing emotions and to possess associated behavioral and cognitive traits. A brief review of the clinical cardiologic literature on chest pain is presented, with special attention to distinguishing true angina pectoris from pseudoangina and related syndromes. After a brief description of the major dimensions of normal personality, especially the domain of neuroticism, empirical evidence is reviewed on 1,191 adult men and women who 10 years earlier had made chest pain or discomfort reports part of the National Health and Nutrition Examination Survey. The findings illustrate neuroticism's links to illness and disease. When the mean initial neuroticism levels of the chest pain groups were compared, significantly higher initial levels of neuroticism were found for those who reported any pain or discomfort. As hypothesized, logistic regression results on myocardial infarction death indicated no increased risk due to neuroticism. Neuroticism was related to increased somatic complaints, including chest pain or angina-like complaints, but was not causally or etiologically related to objective signs or pathophysiologic evidence of disease, especially CAD.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Influence of the normal personality dimension of neuroticism on chest pain symptoms and coronary artery disease. 332 65

Characteristics, and the occurrence of other diseases, and complications related to diabetes mellitus of 91 consecutive diabetic patients who underwent vitreous surgery in 1979-1985 were examined. The mean age of the patients was 40 years (median 37, range 19-74), and the mean duration of diabetes 23 years (range 5-44). All, but one, had insulin therapy. Abnormalities in the cardiovascular and/or renal function were found in 89 of the 91 patients (98%). Signs of cardiovascular disease were observed in 58 patients (64%): 42% had elevated blood pressure (greater than or equal to 150/100 mmHg), 46% were on antihypertensive therapy, 14% had a history or signs of ischaemic heart disease, 12% had been digitalized, 7% had a history of cerebral ischaemia, and 8% had had surgery for gangrene of the lower limb. Signs of nephropathy were recorded in 64 patients (70%); 6 of them were on dialysis therapy, and two had received a kidney transplant. Symptoms possibly related to autonomic neuropathy e.g. postural hypotension, urinary tract symptoms, and gastric discomfort were found in 27%. Nine patients (10%) had some kind of thyroid disease, and two of them signs of multiple autoimmune endocrinopathy. The percentage surviving decreased from 96% at one year to 80% after 5 years of follow-up.
 ...
PMID:Characteristics and survival of diabetic patients undergoing vitreous surgery. 360 10

Low dose estrogen tablets, containing less than 50 mcg of ethinyl estradiol, were formulated because of the recognized dose response relationship with the steroid content of the tablet and side effects. These new oral contraceptives (OCs) are as effective as the older high-dose OCs, and available evidence reports fewer side effects. This discussion reviews pharmacology of these new OCs, the mechanism of action, contraindications, side effects, and problems with the low-dose estrogen OC. Ethinyl estradiol is the only estrogen used in the low-dose combination OC. There are several synthetic progestins: norethindrone, norethindrone acetate, norgestrel, levonorgestrel, and ethynodiol diacetate. These progestins have different potencies so the pharmacologic activity cannot be accurately predicted based on the amount present in the tablet. The synthetic steroids in OCs are absorbed in the small intestine, metabolized in the liver, excreted in the bile and feces with a half-life of 24 hours. The low-dose estrogen combination preparation is taken 3 out of every 4 weeks. Its contraceptive effect is primarily a result of hypothalamic mediated gonadotropin suppression with subsequent inhibition of ovulation. Contraindications to taking the low-dose OC are the same as for the higher dose OC: thromboembolic or cardiovascular disease, estrogen dependent neoplasia, markedly impaired liver function, undiagnosed genital bleeding, congenital hyperlipidemia, pregnancy, and women over age 30 who smoke. Relative contraindications include hypertension, diabetes mellitus, migraine headaches, uterine myomas, and epilepsy. The often quoted 2-5-fold increased incidence of thromboembolic disease, myocardial infarction, and stroke is based on large epidemiologic studies involving patients taking the older higher dose OCs. Current data from patients taking the newer low-dose medication demonstrate minimal if any increased incidence of these problems in young women who do not smoke. The low-dose estrogen OCs have minimal effect on lipid levels. Early reports of patients using the low-dose OC have shown little if any increased incidence of hypertension. The low-dose contraceptives have little effect on glucose tolerance, and there is no evidence to show an increased incidence of overt diabetes in OC users. There is no evidence that use of the combination OC causes an increase in cancer of the cervix, uterus, or ovaries. Clinical complaints of nausea, breast discomfort, chloasma, weight changes, and depression are reduced with the low-dose estrogen preparation. Hypomenorrhea while taking the OC occasionally occurs because the lower dose of estrogen is insufficient to stimulate the endometrial growth in face of the predominant progestin-atrophy effect.
 ...
PMID:Oral contraceptives in 1984. 649 Mar 38


1 2 3 4 5 6 7 Next >>