Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coronary heart disease (CHD), previously neither diagnosed nor suspected, was strongly suspected in 115 of 2014 men aged 40-59 years during a cardiovascular survey examination. Sixty-nine of 105 men who underwent diagnostic coronary angiography had pathologic angiograms. Twenty-six of these 69 had angina pectoris (AP) with and without pathologic exercise ECGs and 43 had pathologic exercise ECG as the only indicator of CHD. The extent of coronary artery changes was similar in the two groups. The men without AP were in almost all respects similar to 1832 men labelled as normals. The men with AP differed in several respects from their non-AP angiographic counterparts and from their non-AP angiographic counterparts and from the normals: they had more dyspepsia, a higher stress score, higher serum cholesterol and triglycerides, lower antithrombin III levels in the blood and lower blood platelet retention values. These results indicate that coronary artery disease with and without AP may represent somewhat different pathogenetic entities.
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PMID:Coronary artery disease with and without angina--two different entities? 710 61

Beyond peptic ulcer disease, Helicobacter pylori infection is associated with intestinal-type gastric cancer and low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. It is also currently implicated as a possible cause of dyspepsia and extraintestinal disorders such as coronary artery disease, rosacea, chronic urticaria, and delayed growth in children. There are strong epidemiological data from large cohort studies linking H. pylori to gastric adenocarcinoma. Several cofactors, including early childhood acquisition of infection, strain-specific differences, genetic predisposition of the host, and the environment, appear to play a role in the progression of chronic gastritis to gastric cancer. H. pylori infection is seen in over 90% of MALT lymphomas, and about 70% of localized nonbulky tumors will undergo complete histological regression after eradication of the bacterium. Because follow-up data are limited to less than 2 years, those undergoing H. pylori eradication as primary therapy for MALT lymphoma require frequent histological surveillance for tumor recurrence. There are conflicting data from short-term studies regarding the effect of H. pylori eradication on dyspeptic symptoms. The decision to test or not for H. pylori in the dyspeptic patient may become easier when well-controlled studies with longer periods of follow-up become available. Because H. pylori induces a systemic inflammatory response, investigators are beginning to explore possible extraintestinal disease associations with the infection. The global prevalence of both peptic ulcer disease and gastric cancer has led to studies focusing on noninvasive screening for H. pylori in high-risk populations and prevention of primary infection by means of vaccination.
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PMID:Helicobacter pylori: beyond peptic ulcer disease. 953 Nov 10

Helicobacter pylori infection is usually acquired during childhood, and evidence-based guidelines regarding diagnosis and treatment of infected children have been recently published. Diseases associated with H. pylori infection are gastritis, duodenal ulcers, mucosal-associated lymphoid-type (MALT) lymphoma, and gastric adenocarcinoma. The association of specific symptoms with H. pylori infection in children and adults (ie, recurrent abdominal pain and nonulcer dyspepsia) remains controversial. Additionally, the role of H. pylori in gastroesophageal reflux disease or in extra-gastrointestinal diseases (ie, coronary artery disease) lacks sufficient evidence to demonstrate causality. The diagnosis of H. pylori-associated diseases in children can reliably be made through gastroduodenal endoscopy with biopsies. Clinical trials are underway for the validation of noninvasive diagnostic tests for the H. pylori-infected child, and current guidelines recommend eradication therapy for infected children with duodenal and gastric ulcer, gastric lymphoma, and atrophic gastritis with intestinal metaplasia. The natural history of childhood H. pylori infection is poorly described. Moreover, rational approaches to the prevention and control of childhood H. pylori infection are critically needed, requiring characterization of the determinants for acquisition and persistence and the disease outcomes following eradication.
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PMID:New approaches to Helicobacter pylori infection in children. 1135 61

This was a double-blind, placebo-controlled, flexible-dose study of the efficacy and safety of sildenafil in men with erectile dysfunction (ED) and clinically stable coronary artery disease (CAD). Patients were randomized to receive sildenafil or placebo for 12 weeks. Primary outcomes were questions 3 and 4 of the International Index of Erectile Function (IIEF). Secondary outcomes included the other IIEF questions and functional domains, the Life Satisfaction Checklist, the Erectile Dysfunction Inventory of Treatment Satisfaction, 2 global efficacy assessment questions, and intercourse success rate. By week 12, sildenafil-treated patients (n = 70) showed significant improvements on questions 3 and 4 compared with placebo-treated patients (n = 72; p <0.01). Larger percentages of sildenafil-treated patients reported improved erections (64%) and improved intercourse (65%) compared with placebo-treated patients (21% and 19%, respectively). Sildenafil-treated patients were highly satisfied with treatment and their sexual life compared with placebo-treated patients. Forty-seven percent of sildenafil- and 32% of placebo-treated patients experienced adverse events, including transient headache, hypertension, flushing, and dyspepsia. There were no serious drug-related cardiovascular effects. Thus, sildenafil is an effective and well-tolerated treatment for ED in men with CAD. Sildenafil was not associated with additional safety risks in this patient population.
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PMID:Efficacy and safety of sildenafil citrate in men with erectile dysfunction and stable coronary artery disease. 1471 38

Nonsteroidal antiinflammatory drugs (NSAIDs) are widely used to treat arthritis but are associated with adverse gastrointestinal events. While the selective COX-2 inhibitors show fewer gastrointestinal complications than NSAIDs, they may not be suitable for all patients and one of them has been associated with serious thrombotic cardiovascular events. Furthermore, many arthritis patients are at high risk of coronary artery disease and take low-dose aspirin, which is also associated with adverse gastrointestinal events. Proton pump inhibitor (PPI) therapy has been shown to be effective in reducing the risk of gastrointestinal complications in this patient population. Recent randomized clinical trials have also shown that pantoprazole therapy is effective in the healing of NSAID-induced gastrointestinal damage. Several studies have also demonstrated that pantoprazole is effective in preventing the development of gastrointestinal lesions in patients with continuous NSAID intake. The use of PPIs in combination with nonselective NSAIDs has also been found to be beneficial in patients at high risk for rebleeding and reduces the incidence of dyspepsia. Finally, the combination of a COX-2 inhibitor with a PPI has shown promise in patients with previous NSAID-related gastrointestinal complications who are at high risk for reinjury.
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PMID:Understanding NSAID-PPI-COX-2 interrelationships. 1519 Mar 84

This cross-sectional psychiatric and cardiological study compared patients with and without coronary artery disease (CAD) with respect to psychiatric morbidity, psychological factors, pain characteristics, medical morbidity and the prevalence of coronary risk factors. The 199 participants had been referred to cardiological outpatient clinics for the investigation of chest pain and had no history of heart disease. Current panic disorder occurred significantly more often in non-CAD patients (41% vs. 22%). No significant differences were found for other psychiatric disorders and psychological variables. Non-CAD patients reported significantly longer histories of pain and a higher prevalence of atypical chest pain. In other respects, there were surprisingly few differences between the groups. High morbidity of both psychiatric disease (pain disorder, 19%; any current psychiatric disorder, 72%) and somatic conditions (musculoskeletal disease, 33%; dyspepsia, 23%) was found with no significant differences between the groups. In these patients, multifactorial complaints may explain chest pain in both patient groups. The physicians should attend to psychiatric disorders in non-CAD as well as in CAD patients.
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PMID:Psychological factors, pain attribution and medical morbidity in chest-pain patients with and without coronary artery disease. 1556 12

Erectile dysfunction (ED) affects up to 50% of men, between 40 and 70 years of age. In the first major trial of sildenafil in ED, at 24 weeks, improved erections were reported by 77 and 84% of men taking sildenafil 50 and 100mg, respectively. Subsequently, sildenafil has been reported to be effective in men with ED associated with diabetes and prostate cancer, and in psychogenic ED. Sildenafil is safe in men with coronary artery disease, provided it is not used with the nitrates (a contraindication). The most commonly reported adverse effects with sildenafil are headache, flushing and dyspepsia. Vardenafil is more potent and more selective than sildenafil at inhibiting phosphodiesterase-5. Vardenafil is similarly effective to sildenafil in the treatment of ED. The only advantage that vardenafil has over sildenafil is that it does not inhibit phosphodiesterase-6 to alter colour perception, a rare side effect which sometimes occurs with sildenafil. Tadalafil has a longer duration of action than sildenafil and vardenafil. Tadalafil is similarly effective as sildenafil in the treatment of ED. In comparison studies, tadalafil is preferred to sildenafil (50/100mg) by men with ED, possibly because of its longer duration of action. Of the phosphodiesterase inhibitors, tadalafil may displace sildenafil as the drug of choice among men with ED.
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PMID:Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction. 1570 77

Considerable evidence exists for the place of mind body medicine in the treatment of anxiety disorders. Excessive anxiety is maladaptive. It is often considered to be the major component of unhealthy lifestyle that contributes significantly to the pathogenesis of not only psychiatric but also many other systemic disorders. Among the approaches to reduce the level of anxiety has been the search for healthy lifestyles. The aim of the study was to study the short-term impact of a comprehensive but brief lifestyle intervention, based on yoga, on anxiety levels in normal and diseased subjects. The study was the result of operational research carried out in the Integral Health Clinic (IHC) at the Department of Physiology of All India Institute of Medical Sciences. The subjects had history of hypertension, coronary artery disease, diabetes mellitus, obesity, psychiatric disorders (depression, anxiety, 'stress'), gastrointestinal problems (non ulcer dyspepsia, duodenal ulcers, irritable bowel disease, Crohn's disease, chronic constipation) and thyroid disorders (hyperthyroidism and hypothyroidism). The intervention consisted of asanas, pranayama, relaxation techniques, group support, individualized advice, and lectures and films on philosophy of yoga, the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The outcome measures were anxiety scores, taken on the first and last day of the course. Anxiety scores, both state and trait anxiety were significantly reduced. Among the diseased subjects significant improvement was seen in the anxiety levels of patients of hypertension, coronary artery disease, obesity, cervical spondylitis and those with psychiatric disorders. The observations suggest that a short educational programme for lifestyle modification and stress management leads to remarkable reduction in the anxiety scores within a period of 10 days.
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PMID:Effect of yoga based lifestyle intervention on state and trait anxiety. 1685 Sep 2

The aim of the study was to determine the frequency of functional and organic dyspepsia and possible predictors for organic dyspepsia in coronary artery disease (CAD) patients. The 150 patients (109 men; mean age 62.61 +/- 10.23 yr) undergoing coronary artery by-pass grafting because of stable pectoral angina due to significant CAD were enrolled in the study. Dyspepsia was determined by the existence of epigastralgy, heartburn, nausea and vomiting. Dyspepsia with endoscopic lesions was defined as organic, and dyspepsia with normal endoscopy was defined as functional. Multivariate analysis (logistic regression) was used to estimate predictive values of some independent clinical and demographic variables in relation to organic dyspepsia (dependent variable). One hundred thirty-five (90%) patients had at least one symptom of dyspepsia. Eighty five patients (63%) had organic dyspepsia, and 50 (37%) patients had functional dyspepsia (P < 0.001). Patients with organic dyspepsia had more dyspeptic symptoms than patients with functional dyspepsia (1.92 +/- 0.88 vs. 1.38 +/- 0.87, P < 0.001). More dyspeptic symptoms correlated with heavy GD lesions (r = 0.267; P < 0.0001). Multivariate analysis revealed independent correlation of consuming low-dose aspirin (standardized coefficient beta = 11.701, P = 0.004), diabetes (beta = 2.921, P = 0.027), cigarette smoking (beta = 2.910, P = 0.037) and nausea (beta = 3.620, P = 0.015) with organic dyspepsia. The study showed high frequency of dyspepsia, especially organic dyspepsia, in CAD patients. Three or more dyspeptic symptoms, low-dose aspirin, cigarette smoking, diabetes and nausea, increased the probability of organic dyspepsia. Therefore, for patients with combination of dyspeptic symptoms and present risk factors the endoscopic examination should be considered.
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PMID:[Frequency and characteristics of dyspepsia in coronary artery disease patients]. 2085 6

Chronic myocardial ischemia often presents with a fairly typical history, but patients can present with atypical chest pain or pain referred to a less-typical location like the jaw, stomach, or back. Sometimes patients describe symptoms usually not attributed to heart disease, like indigestion or feeling cold and clammy, in the presence or absence of chest pain. One important clue to underlying coronary artery disease is the appearance of symptoms that are induced by effort and relieved by rest. This paper describes two unusual presentations of myocardial ischemia in patients whose main symptom was hiccups, the first intractable hiccups over months and the second effort-induced hiccups. Both also described atypical chest pain.
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PMID:Hiccups as a sign of chronic myocardial ischemia. 2085 49


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