Gene/Protein Disease Symptom Drug Enzyme Compound
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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With the availability of a wide selection of antihypertensive drugs acting by different mechanisms, it should be possible to match the requirement of individual patients with the pharmacological and clinical properties of an appropriate agent. Although the concept of stepped-care therapy is now largely outdated, therapy must be initiated with one agent. Diuretics remain a first-choice option in the elderly and in Black patients, as do calcium antagonists. In patients with ischaemic heart disease or enhanced adrenergic drive, beta-blockers are preferred. Calcium antagonists or ACE inhibitors are finding increasing use as initial therapy when quality of life is important and metabolic neutrality is required. The choice of antihypertensive agent may be limited by adverse effects, e.g. pedal oedema with nifedipine, constipation with verapamil, and cough with ACE inhibitors. Certain advantages are evident for both calcium antagonists and ACE inhibitors. Calcium antagonists are more likely to be effective first-line therapy than ACE inhibitors in Black patients, in those with a high salt intake, in patients with Raynaud's disease, and when angina pectoris is present. ACE inhibitors are preferred for use in combination with diuretic agents, and in the presence of congestive heart failure or low salt intake. Combination therapy between these 2 drug classes is finding increasing acceptance because of its many theoretical advantages, and may provide a means of maximising benefit.
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PMID:Choosing the correct drug for the individual hypertensive patient. 128 79

A 52-year-old woman was admitted to our hospital because of anemia and abnormal lung shadow. She had Raynaud's symptom for 6 months, and recently developed cough and easy fatigability. She had thrombocytopenia, restrictive pulmonary dysfunction, and swollen fingers. ANF was positive (X1280), and anti-RNP antibody was also positive. Mixed connective tissue disease was diagnosed. Chest X-ray showed a diffuse alveolar pattern, and BAL revealed many hemosiderin-laden macrophages. Alveolar hemorrhage was suspected. The pulmonary shadow resolved spontaneously, and no recurrence occurred after steroid and immunosuppressant therapy.
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PMID:[A case of alveolar hemorrhage associated with mixed connective tissue disease]. 203 1

Due to the large group of patients with advanced testicular cancer now being cured, it is important to identify the men who are at risk of deteriorated health. The purposes of this study were: (1) to delineate and compare frequency of self-perceived physical, psychologic, and general symptoms in men treated for testicular cancer with those of a general population sample and (2) to compare self-perceived physical, psychologic, and general symptoms in relation to secondary Raynaud phenomena, sexual dysfunction, infertility, and self-perceived attractiveness in different treatment modalities. The subjects were 277 survivors of testicular cancer (M = 42.2 years) who had completed a self-reported questionnaire (75.5% response rate). A population survey comprising 392 men was used as a comparison group (M = 45 years). The result demonstrated that although survivors of testicular cancer as a group reported significantly less frequency of backache, leg pain, cough, and eye problems than did the general population sample, they described that they significantly more often felt cold. Men reporting secondary Raynaud phenomena, infertility, and/or feeling less attractive had experienced significantly more self-perceived symptoms. Oncologist nurses could play an important role in psychologic counseling for those men.
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PMID:Self-perceived physical, psychologic, and general symptoms in survivors of testicular cancer 3 to 13 years after treatment. 1204 Feb 27

A woman with scleroderma and classic polyarteritis nodosa (PAN) who developed idiopathic myelofibrosis (IM) is reported. The patient presented with a one-year history of weakness, polyarthritis, Raynaud phenomenon, dry cough, and epigastralgia. The diagnosis of scleroderma with visceral involvement was made and treatment with prednisone subsequently started, with good clinical response. Six years later, fever, weight loss, livedo reticularis, and dysesthesias developed. Electromyographic studies were consistent with sensory neuropathy and a sural nerve biopsy yielded the diagnosis of PAN. The patient received cyclophosphamide plus prednisone with a favorable response, but 11 years later she was admitted because of weakness, constitutional symptoms, and abdominal pain due to spleen infarcts. Marked anemia, with aniso-poikilocytosis, tear-drop cells, immature myeloid precursors in the peripheral blood, and an increased serum LDH, was observed and the diagnosis of IM established by bone marrow biopsy. This case represents a new association between IM and an autoimmune disease and supports the hypothesis of an immune basis of IM in some patients.
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PMID:Idiopathic myelofibrosis associated with classic polyarteritis nodosa. 1268 29

Acute fibrinous and organizing pneumonia (AFOP), recently described, is a histologic pattern characterized by the presence of fibrin "balls" within alveolar spaces. The term undifferentiated connective tissue disease (UCTD) is used to identify autoimmune systemic diseases that do not fulfill the criteria to be classified as a definitive connective tissue disease. The AFOP has never been reported in association with UCTD. The present reported case is a 39-year-old Caucasian, female with dry cough and progressive dyspnea. Eight months later, she was diagnosed with "organizing pneumonia" based on clinical history and radiologic images. She manifested Raynaud's Phenomenon, sicca syndrome, boot and gloves neuropathic pain, and previous hypothyroidism. Antinuclear antibody, rheumatoid factor, and specific autoantibodies were negative. Salivary gland biopsy and electroneuromyiography were normal. The capillaroscopy showed a "scleroderma" pattern with capillary deletion and ectasia. She experienced clinical and radiologic worsening. Despite being submitted to cyclophosphamide pulse, she developed hemorrhage and then died. Thoracotomy pulmonary specimen showed histological pattern of AFOP. This paper shows a rare association of AFOP with UCTD.
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PMID:Acute fibrinous and organizing pneumonia and undifferentiated connective tissue disease: a case report. 2295 92

The pulmonary histopathologic manifestations of the antisynthetase syndromes is poorly understood and reported. Eight cases of interstitial lung disease related to the presence of antitheonyl (PL7) transfer RNA synthetase autoantibodies along with a review of biopsy changes reported in the English literature are described. Most patients presented with dyspnea and cough, with myositis, skin changes including "mechanic's hands," and Raynaud phenomenon. Biopsy patterns of injury included usual interstitial pneumonia (n = 4), organizing pneumonia (n = 2), nonspecific interstitial pneumonia, and lymphoid interstitial pneumonia (n = 1 each), which, in a minority of instances, contrasted with predictions by thoracic radiologists based on high-resolution computed tomographic scans. This study emphasizes the integrated clinical, radiologic, and pathologic approach to interstitial lung disease, especially in connective tissue disorders, and points out the occurrence of usual interstitial pneumonia and organizing pneumonia in this patient group where nonspecific interstitial pneumonia has been the dominant pattern of clinical interest.
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PMID:The pulmonary histopathologic manifestations of the anti-PL7/antithreonyl transfer RNA synthetase syndrome. 2476 52

PATIENT PRESENTATION AND CLINICAL HISTORY: The patient is a 43-year-old male non-smoker who works as a farmer and cheese-maker. He complained of a dry cough for 6-12 months without fever or other clinical signs. His medical history was unremarkable with no use of drugs or alcohol and no signs of Raynaud's syndrome. In his family history he had two first-degree relatives with pulmonary fibrosis, one of whom also had rheumatoid arthritis.
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PMID:Challenges in the classification of fibrotic ILD: Patient case 1. 2623 37

Introduction The antisynthetase syndrome is a rare autoimmune disease described by the presence of inflammatory myositis, interstitial lung disease and antibodies against aminoacyl-transfer RNA synthetases. Interstitial lung disease can be the only manifestation in the absence of an inflammatory myositis. Other clinical signs are Raynaud phenomenon, hyperkeratotic skin lesions, fever and inflammatory polyarthritis. Case presentation We report the case of a 64-year old woman who complained of a dry cough, progressive dyspnea and arthralgia since 2 years, with no other systemic symptoms. High resolution computed tomography (HRCT) of the thorax showed the presence of bilateral ground glass opacities, reticular opacities and some traction bronchiectasis. Further biochemical testing revealed the presence of anti-PL12 antibodies. Management The diagnosis of antisynthetase syndrome was made and the patient was treated with steroids and azathioprine with a good response. Conclusion The search for antisynthetase antibodies should always be considered in patients with an interstitial lung disease without any other clinical symptoms or signs of an underlying connective tissue disease.
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PMID:A 64-year-old woman with interstitial lung disease and positive antibodies against aminoacyl-transfer RNA synthetases in the absence of myositis: presentation of an anti-PL-12 positive antisynthetase syndrome. 2917 35