Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy and safety of oral ciprofloxacin (750 mg every 12 hours) in the treatment of infections was evaluated in 84 geriatric patients. Duration of treatment ranged from three to 42 days (for a mean of 10.45 days). Satisfactory responses (cured or improved) were noted in 33 of 34 cases of urinary tract infections (97%); in 11 of 13 cases of lower respiratory tract infections (85%); in four of nine cases of skin and skin structure infections (44%); and in both cases of bone infection and bacteremia. Bacteriological cure rates were 91% of 33 urinary tract infections; 83% of 12 lower respiratory tract infections; 62% of eight skin and skin structure infections; and in both cases of bone infection and bacteremia. Three patients evaluable for clinical purposes were bacteriologically unevaluable. Overall clinical efficacy and bacteriological cure rates were 86% and 85%, respectively. Of the 78 evaluable pathogens isolated, 70 (90%) were eradicated. Adverse reactions occurred in 24 patients (29%) and included candida colonization in eight, gastrointestinal upset in six, dermatologic symptoms in five, and vaginal candidiasis, chest pain, renal failure, tremors, monocytosis, thrombocytosis, and increased serum theophylline level in one patient each. Ciprofloxacin appears to be a safe and effective treatment for infections in geriatric patients. Advantages of the oral form include cost effectiveness and decreased length of hospitalization.
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PMID:Oral ciprofloxacin treatment of infections in geriatric patients. 277 66

Malignant mesothelioma of the pleura most commonly occurs in persons with a heavy occupational exposure to asbestos. Some patients, however, have no such history of exposure. Clinical features include initial complaints of nonpleuritic chest pain and dyspnea. The most frequent roentgenographic finding is a unilateral pleural effusion. Thrombocytosis and elevated erythrocyte sedimentation rates are common. Pleural effusions are typically exudates, are often hemorrhagic, and are usually insufficient for diagnosing mesothelioma based on cytology alone. Even pleural biopsy may not produce enough tissue to enable the pathologist to make a firm diagnosis. Thoracotomy and open biopsy will confirm the diagnosis in most cases. Pathologic distinction from metastatic adenocarcinoma may be difficult even after the use of special stains and electron microscopy. Clinical deterioration is primarily attributable to local spread of tumor. Several factors seem to predict prolonged survival: (1) epithelial histologic subtype, (2) performance score, (3) age of the patient at the time of diagnosis, and (4) absence of chest pain. Surgical treatment, chemotherapy, and irradiation, alone or in combination, have been used for malignant mesothelioma. Except for the palliative effect of irradiation, most treatment protocols have not altered the dismal median survival of approximately 11 months seen in untreated patients with malignant mesothelioma.
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PMID:Malignant mesothelioma of the pleura. 305 81

Malignant primary cardiac tumors have uniformly been associated with poor long-term survival. We reviewed data on 11 patients with such tumors seen between 1956 and 1986. There were five men and six women, with a mean age at presentation of 44 years. Nine (82 percent) of 11 patients presented initially with respiratory symptoms, and 45 percent (five) presented with chest pain. No patient was asymptomatic on initial presentation. Forty-five percent (five) of the patients had elevated jugular venous pressure or a systolic murmur. Cardiomegaly was present in eight (73 percent) of 11 patients. Nine of ten patients had a hemoglobin level less than 12 g/100 ml, and 30 percent (3/10) presented with thrombocytosis. Seventy percent (eight) of the patients underwent surgical biopsy, and in 30 percent (three), surgical excision of the tumor was attempted. Angiosarcoma was the most frequent type of tumor (four patients), followed by malignant fibrous histiocytoma (three patients), mesothelioma (two patients), rhabdomyosarcoma (one patient), and primary lymphoma (one patient). Long-term follow-up data reveals that ten (91 percent) of 11 patients had died, with a mean duration from diagnosis until death of 9.7 months. Newer pathologic techniques for identification of sarcomas, aggressive surgical resection, and advanced chemotherapy for certain subgroups may contribute to better survival for patients with these tumors in the future. In addition, cardiac transplantation may play an important role in the future for those patients with localized disease.
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PMID:Malignant primary cardiac tumors. The Cleveland Clinic experience, 1956 to 1986. 366 1

Serial determinations of peripheral venous platelet counts were performed in 43 consecutive patients with acute chest pain. On admission, patients with acute myocardial infarction (AMI) had a significantly lower mean platelet count (p less than 0.05). Thereafter a further reduction was seen with steadily reduced platelet counts by about 20%, both in comparison with healthy controls (p less than 0.001) (n = 113) and patients with peripheral artery disease (PAD) without heart symptoms (p less than 0.005) (n = 54). The platelet number increased one week after admission and even thrombocytosis was observed. The changes in platelet number during AMI seem to parallel the changes in platelet function. Patients with PAD had normal mean platelet counts. Female patients as well as healthy subjects had significantly higher values than men (p less than 0.01).
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PMID:Platelet counts in myocardial infarction, angina pectoris and peripheral artery disease. 397 30

This 50-year-old male was admitted to the hospital on April 1983 with complaints of severe chest pain attacks 2 weeks previously. Laboratory data: On admission the blood findings were Hb 14.3 Gm/dl of blood, RBC 4.70 million/mm3, WBC 11,600/mm3 and a platelet count of 1.1 million/mm3. ECG showed elevation of ST-T in V1 to V4. Serum LDH and CPK levels were high. He was diagnosed as acute myocardial infarction with thrombocythemia. Three days after admission he abruptly fell into a semicomatose state and left hemiplesia. Head computed tomography showed a large, low-density lesion in the right mid-cerebral artery area, and we also diagnosed cerebral infarction. He was given nimustine (ACNU) 100 mg/week three times as remission induction therapy. For maintenance chemotherapy, at first we administered mitobronitol (DBM) 150 mg/day then changed to intermittent administration of ACNU 100 mg. On September 1991, the patient was admitted to the hospital with progressive anemia and uncontrollable thrombocythemia. Bone marrow chromosome analysis revealed aneuploidy. The patient received interferon alpha 3 million unit/day. The thrombocythemia could be controlled but his general condition deteriorated. On April 1992, he died of interstitial pneumonia.
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PMID:[A case of essential thrombocythemia with clonal evolution in the terminal phase]. 812 97

Essential thrombocythemia (ET) can cause systemic vascular thrombosis, but involvement of coronary arteries in the setting of ET is rare. This report describes a case of acute myocardial infarction (MI) in a patient with ET. A 67-year-old man with ET complained of severe acute chest pain. Emergent coronary angiography revealed subtotal thrombotic occlusion of the left main trunk (LMT) coronary artery. Coronary angioplasty and stenting were performed successfully. Coronary angiography 4 weeks later revealed no significant restenosis. The patient has done well after primary coronary stenting with the use of only an antiplatelet agent to treat the thrombocythemia.
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PMID:Acute myocardial infarction in a patient with essential thrombocythemia who underwent successful stenting--a case report. 1632 55

A 75-year-old woman with thrombocythemia underwent distal gastrectomy. Preoperative platelet count was 103 x 10(4) x mm(-1). General anesthesia was given and heparin 20 units x kg(-1) was administered intravenously for prevention of deep vein thrombosis. Operation was finished uneventfully. On the next day, she complained chest pain and was diagnosed as pulmonary thromboembolism. Later, she was diagnosed as essential thrombocythemia.
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PMID:[Postoperative pulmonary thromboembolism in a patient with essential thrombocythemia]. 2056 Mar 78

Essential thrombocythemia (ET) can cause systemic vascular thrombosis but rarely cause obstruction of coronary arteries or acute myocardial infarction (MI). Treatment of acute MI in patients with ET may be a problem due to the important role of platelets in the pathogenesis of infarction. In this report, a 63-year-old man presented with acute chest pain and a greatly increased platelet count. The patient was successfully treated with intravenous tirofiban, a glycoprotein IIb/IIIa receptor blocker. Essential thrombocythemia was diagnosed based on bone marrow findings, clinical presentation, and laboratory analysis. Thrombocythemia had been controlled with hydroxyurea.
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PMID:Non-ST-segment elevation myocardial infarction in a patient with essential thrombocythemia treated with glycoprotein IIb/IIIa inhibitor: a case report. 2072 3

We report a case of essential thrombocythemia (ET) in a 30-year-old female who exhibited inferior wall ST-elevation acute myocardial infarction (AMI) without significant obstructive coronary artery disease. Right coronary vasospasm was observed after intra-coronary methylergonovine administration and she received verapamil 120 mg/dthereafter and hydroxyurea 1500 mg/d for thrombocythemia. After discontinuation of the hydroxyurea for 9 mo based on the impression of coronary spasm-related instead of coronary thrombosis-related AMI, her platelet count rose but no chest pain was observed. It is suggested that coronary spasm potentially plays a role in patients with ET, AMI and no significant coronary artery stenosis.
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PMID:Coronary spasm-related acute myocardial infarction in a patient with essential thrombocythemia. 2187 78

Platelet size correlates with platelet activity and can be assessed by platelet volume indices (PVI). The PVI, mean platelet volume (MPV), is universally available with routine blood counts by automated hemograms and therefore is an attractive index to study in clinical scenarios. PVI are useful in assessing the etiology of thrombocytopenia. In addition, a normal platelet distribution width in the setting of thrombocytosis is highly suggestive of a reactive etiology. Higher MPV is also associated with the presence of cardiovascular risk factors, chest pain due to acute coronary syndrome, and adverse outcome after acute coronary syndrome. Results from studies evaluating MPV in patients with peripheral artery disease, unprovoked deep vein thrombosis, and pulmonary embolism further advocate a potential role for MPV in identifying patients at high risk of thrombosis. Nevertheless, most of these data come from retrospective studies some of which have small study populations and confounding factors influencing platelet volume. Moreover, the cut-off values derived from these retrospective studies have not been validated prospectively. Despite the potential for clinical utility evident from these studies, the above-mentioned flaws together with technical problems in measuring MPV currently limit its clinical usefulness. Our review provides a perspective on PVI's potential clinical use.
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PMID:Are platelet volume indices of clinical use? A multidisciplinary review. 2241 13


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