Gene/Protein Disease Symptom Drug Enzyme Compound
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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A normal constituent of the human upper respiratory flora, Streptococcus pneumoniae also produces respiratory tract infections that progress to invasive disease at high rates in specific risk groups. The individual factors that contribute to the development of invasive pneumococcal disease in this distinct minority of persons, include immune (both specific and innate), genetic, and environmental elements. Specific defects in host responses may involve age, deficiencies in levels of antibodies and complement factors, and splenic dysfunction. Combinations of these immune defects contribute to the increased rates of invasive pneumococcal disease in patients with sickle cell disease, nephrotic syndrome, neoplasms, and underlying medical conditions such as diabetes and alcoholic liver disease. The number of risk factors are greatest and the rates of invasive disease are highest in patients with HIV-1 infection, which has emerged as a major risk factor for serious S. pneumoniae infection worldwide.
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PMID:Invasive pneumococcal disease in the immunocompromised host. 927 Sep 91

Reactive oxygen species (ROS) are believed to cause vascular injury in the pathophysiology of atherosclerosis, diabetes, and vasoocclusion in sickle cell disease. Studies have shown that ROS causes increased adhesion of monocytes and neutrophils to the endothelium. We investigated the effects of tert-butylhydroperoxide (t-BuOOH), an inducer of oxidant stress, to determine the cellular signaling pathway leading to the transendothelial migration of polymorphonuclear leukocytes. Our studies revealed that signaling by t-BuOOH in human umbilical vein endothelial cells (HUVECs) causes a twofold increase in the transendothelial migration of monocyte-like HL-60 cells and a fivefold increase in platelet endothelial cell adhesion molecule-1 (PECAM-1) phosphorylation. The transmigration induced by t-BuOOH was inhibited by an antibody to PECAM-1. These events were inhibited by antioxidants and inhibitors of protein kinase C, p21ras and glutathione synthesis. However, treatment of HUVECs with the phosphatase inhibitor calyculin A augmented the t-BuOOH-mediated transendothelial migration of monocytes and PECAM-1 phosphorylation. Our results suggest that oxidative stress can induce the transendothelial migration of monocytes as a result of phosphorylation of PECAM-1, a crucial event in the diapedesis of leukocytes during pathophysiology of vascular diseases.
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PMID:Oxidant stress-induced transendothelial migration of monocytes is linked to phosphorylation of PECAM-1. 931 33

Anemia with a relatively low erythropoietin level has been described in several medical conditions associated with chronic inflammatory diseases such as rheumatoid arthritis, cancer, sickle cell disease, chronic renal failure, acquired immunodeficiency syndrome, and severe autonomic nervous system failure. This case report describes the development of anemia with a relatively low erythropoietin level in a 65-year-old man with non-insulin-dependent diabetes mellitus, normal renal function, and negative hematologic, thyroid, and autoimmune disease work-ups. The serum erythropoietin level was 14 mU/mL (N: 10-20 mU/mL). The hemoglobin was 7.5 g/dL and the hematocrit was 24%. The patient was treated with recombinant erythropoietin at 50 U/kg subcutaneously three times weekly. The hemoglobin level increased over a 4-week period. When erythropoietin was stopped, the anemia recurred in 2 months. We conclude that the patient's anemia was caused by a relative lack of endogenous erythropoietin release. The exact mechanism of this anemia is unknown. We recommend including a test for erythropoietin level in the evaluation of any unexplained anemia.
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PMID:Anemia secondary to low erythropoietin in a patient with normal renal function. 936 36

The non-healing leg ulcer is examined by discussing three disease processes: peripheral vascular occlusive disease (PVOD), chronic venous insufficiency (CVI), and vasculitis. For PVOD, management decisions are based on risk factors and disease history. Comprehensive management includes the discontinuation of smoking, exercise conditioning and regulation of diabetes, hyperlipidemia, hypertension, and the appropriate application of anticoagulant/antiplatelet drugs. Methods of surgical management include bypass with autogenous or synthetic material in addition to reconstructive surgery with patch angioplasty or extra-anatomic bypass, amputation, percutaneous transluminal angioplasty/stents, thrombolytic infusion, atherectomy, intraluminal ultrasound, and angioscopy. The optimal healing environment for all ulcers prevents contamination, pain, and fluid loss. In CVI, higher venous pressure in the veins of the lower limb during exercise results in ambulatory venous hypertension and ulceration. Various theories are associated with the disease and ulceration process; the classic treatment of elevation, ambulation, and compression for venous disease remains unchallenged. Diagnosis is based on history, physical examination, invasive venography, and/or non-invasive studies. Two groups of vasculitic disorders that share varying degrees of vascular inflammation and necrosis are arteritis (lupus, erythematosus, periarteritis nodosa, dermatomyositis) and blood dyscrasias (sickle cell disease, thalassemia). Leg ulcers associated with vasculitis are due to inadequate tissue oxygenation at the local level, are typically chronic, slow to heal, and commonly recur.
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PMID:The non-healing leg ulcer: peripheral vascular disease, chronic venous insufficiency, and ischemic vasculitis. 939 80

Protein energy malnutrition (PEM) is common in underprivileged populations in many parts of the world and results from diets deficient in protein (kwashiorkor) or protein and calories (marasmus). The literature documents renal tubular abnormalities in children with PEM. In PEM the reabsorption of amino acids and phosphate is defective. In many kidney disorders in which renal tubular function is impaired (e.g., diabetes, preeclampsia, nephrotic syndrome, sickle cell anemia), lysosomal enzymuria ensues. We compared the urinary excretion of the following five lysosomal enzymes in 31 Nigerian children with marasmus, kwashiorkor, or marasmic-kwashiorkor: beta-hexosaminidase, alpha-galactosidase, beta-galactosidase, beta-glucuronidase, and alpha-mannosidase. All of the protein energy malnourished children and the 18 age- and gender-matched controls were from the city of Jos, located in central Nigeria. In the severely malnourished children, the urine levels of all five lysosomal enzymes (expressed as units of enzyme activity per mg creatinine) were markedly increased. The greatest increases were seen with beta-hexosaminidase (16-fold) and beta-glucuronidase (14-fold). Routine clinical analyses also revealed that, relative to the control population, the sera of the 14 most severely malnourished patients contained 2- to 5-fold more vitamin B12 and markedly reduced levels (15%, p < 0.00001) of calcium. These data are significant in that they document lysosomal enzymuria in Nigerian children with severe PEM and point to the potential diagnostic utility of the urinary beta-galactosidase determination for assessing renal function in children with this disorder.
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PMID:Lysosomal enzymuria in protein energy malnutrition. 948 33

Cancer has the potential to provoke worries which should be assessed in order to adequately respond to patients' problems. We highlight in this paper the problems that concerned 30 women with cervical cancer (mean age 51.2) and 76 with breast cancer (mean age 44.9), how these concerns affected their emotional lives, and the factors associated with these worries. They were interviewed with the 33-item modified version of a German questionnaire rating psychosocial concerns (FBS) by Sullwold, and Goldberg's General Health Questionnaire (GHQ-12) for psychopathological symptoms. Cervical cancer patients had significantly higher FBS and GHQ-12 scores than breast cancer. Breast cancer cases had FBS scores similar to those of women with sickle cell disease and insulin-dependent diabetes mellitus. The commonest recurrent worries in both groups were depression about their condition (45%), thoughts of death (37%), insomnia (33.3%), bodily odour (30%), impairment of work efficiency (30%) terrifying dreams (27%) and fear of illness being life-long (25%). Over 90% denied experience of worries indicating social stigma. FBS scores were significantly correlated with GHQ scores and both were negatively associated with adequacy of social contacts. These data suggest the need for psychosocial intervention in such cases in Nigeria.
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PMID:Psychosocial concerns of Nigerian women with breast and cervical cancer. 988 90

Social support plays a positive role in compliance and other health behaviors. The purpose of this study was to investigate the role of social support in compliance and other health behaviors for patients with sickle cell disease and diabetes. Subjects consisted of 49 patients with sickle cell disease and 78 patients with diabetes attending outpatient clinics at an urban hospital. Subjects were given questionnaires which assessed their appointment-keeping behavior, adherence to health activities, and social support. The results indicated that social support was significantly associated with appointment-keeping behavior and adherence to health activities in both the sickle cell and the diabetic sample. Implications of the study findings for improving compliance by increasing social support are discussed.
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PMID:The role of social support in compliance and other health behaviors for African Americans with chronic illnesses. 1013 63

In order to provide information for the appropriate package insert labeling of progestin-only oral contraceptives (POC) in the US, a comprehensive review was made of norgestrel (0.075 mg) and norethindrone (0.35 mg), with the clinical differences indicated where applicable. The goal of this review was to cite primary sources for virtually all research specific to POPs since 1975. Conclusions and the types of studies which support these conclusions are given for each major section. The introductory chapter discusses the advantages and disadvantages of POCs and the magnitude and prevalence of their use. Future trends are also predicted. Chapter 2 considers the mode of action, including ovulation prevention; suppression of midcycle gonadotropin peaks; changes in cervical mucus, the endometrium, and the fallopian tubes; and clinical implications. Chapter 3 covers pharmacology (pharmacokinetics, pharmacodynamics and potency, and clinical implications). The next chapter presents information on efficacy and pregnancy outcomes in terms of pregnancy rates, compliance and efficacy, ectopic pregnancies, the outcome of pregnancies conceived while using POCs, and fertility following discontinuation. Chapter 5 focuses on metabolic effects, specifically lipid metabolism, carbohydrate metabolism and diabetes, coagulation factors, and blood pressure. Cardiovascular disease is considered in the next chapter, and chapter 7 presents findings on endometrial, ovarian, cervical, breast, and other cancers. A host of other medical considerations are discussed in chapter 8, including persistent ovarian follicles; reproductive tract infections; abnormal vaginal bleeding; uterine fibroids; gestational trophoblastic disease; benign breast disease; diseases of the liver, gallbladder, and bowel; endocrine dysfunction; epilepsy; bone density; sickle cell disease; ocular effects; surgery; and overdose. The last 4 chapters cover interactions with drugs and laboratory tests, common side effects, breast feeding, and effective use of POCs. Information on precautions and contraindications, indications, use instructions, and instructions for appropriate actions after missing a pill is appended.
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PMID:Progestin-only oral contraception: a comprehensive review. 1022 77

We identified maternal demographic, behavioral, and medical history factors that predict bacteriuria (that is, symptomatic and asymptomatic urinary tract infection) at prenatal care initiation. We applied logistic regression modeling to data from all prenatal care recipients who delivered during 1990-1993 and resided in selected North Carolina counties (N = 8037), omitting those with diabetes mellitus, human immunodeficiency virus, or structural urologic abnormalities. The two strongest predictors of bacteriuria at prenatal care initiation were an antepartum urinary tract infection prior to prenatal care initiation (for whites, adjusted prevalence odds ratio (POR) = 2.5, 95% CI 0.6-9.8; for blacks, POR = 8.8, 95% CI 3.8-20.3) and a pre-pregnancy history of urinary tract infection (POR = 2.1, 95% CI 1.4-3.2). For white women only, education beyond high school and age > or =30 years were inversely associated (POR < or = 0.6). Sickle cell hemoglobin nearly doubled the prevalence odds for bacteriuria among African-Americans (POR = 1.9, 95% CI 1.0-3.5), whereas African-Americans with normal hemoglobin had reduced prevalence odds compared with whites (POR = 0.6, 95% CI 0.4-0.9). This study suggests predictors not considered before, including race controlling for sickle cell disease or trait and antepartum urinary tract infections prior to prenatal care.
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PMID:Predictors of urinary tract infection at the first prenatal visit. 1023 Aug 39

Leukemia, aplastic anemia, sickle cell anemia, hemophilia, lymphoma, neuroblastoma, rhabdomyosarcoma, renal failure, cystic fibrosis, scoliosis, diabetes, and asthma. These are only a few of the many chronic diseases or handicapping conditions confronting children today. Little attention has been paid to children's emotional reactions to illness and hospitalization, important facets of the healing process. In the first part of this paper, children's characteristic emotional reactions to hospitalization are discussed within a developmental framework. Next, some of the emotional reactions elicited in hospital staff and parents by seriously ill children are discussed. It is hoped that an elucidation of the types of feelings hospitalized children experience, and the kinds of emotional responses they elicit in adult caretakers, can lead to more sensitive and effective child care-giving in hospital settings.
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PMID:Coping with feelings: seriously ill children, their families, and hospital staff. 1026 27


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