Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Throughout the developed world, populations are growing older. Blood pressure, especially systolic blood pressure, increases with aging, and this increase leads to increased risks of cardiovascular morbidity and mortality. Clinical trials demonstrate that treatment of hypertension in the elderly reduces overall cardiovascular mortality, cardiac mortality, nonfatal cardiovascular events, congestive heart failure, progression to severe hypertension, and strokes. Drug treatment has been well tolerated, but diuretic therapy has been known to increase plasma glucose, uric acid, and creatinine. Therapeutic trials of nonpharmacologic treatment may be indicated in those with mild elevation in blood pressure and no serious end organ disease. However, most people up to age 80 will require drug treatment. Many drugs are effective in the elderly, but, some like beta-blockers, may not be as effective as in younger patients. Controlled clinical trials demonstrate that nitrendipine, a calcium channel blocking drug, significantly reduced mean systolic and diastolic blood pressure in older hypertensive patients, (successfully controlling pressure in a high percentage) and was well tolerated. Drug effects persist for 12 h or more. The drug decreased the exercise-induced rise in the rate-pressure product. Although there is a temporary increase in heart rate, this returns to baseline after a short time. Side effects include headache, flushing, dizziness, edema, and palpitations. Therefore, nitrendipine offers a reasonable and useful alternative to many other drugs in the treatment of combined systolic and diastolic hypertension in the elderly.
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PMID:Epidemiologic aspects of elderly hypertensive patients and the results of treatment with nitrendipine. 248 68

Enteral feedings are safely tolerated by most patients. When complications occur, gastrointestinal disturbances are most frequently encountered, followed by mechanical and metabolic complications. Nurses can prevent many of the problems associated with enteral feeding through careful monitoring. Based on the current literature, the authors make the following recommendations: 1. All patients receiving tube feedings should be placed on a protocol that provides guidelines for (a) confirming correct tube placement; (b) preventing/managing tube obstruction; (c) handling and selecting formulas; (d) administering formulas; and (e) monitoring patients. 2. Fine-bore tubes are easily misplaced or dislodged; ensure correct positioning both before and during feeding. Food coloring should be added to all feedings to help detect aspiration/tube displacement. 3. Multiple factors can cause diarrhea in tube-fed patients and, therefore, require periodic assessment. These factors include concomitant drug therapy; malnutrition/hypoalbuminemia; formula-related factors (for example, lactose content, osmolality); and bacterial contamination. 4. Urine sugar and acetone levels should be checked every 6 hours (until stable). Vital signs and fluid intake and output should be determined every 8 hours, and weight should be measured on a daily basis. Serum electrolytes, blood urea nitrogen, and glucose levels should be determined daily, until serum levels stabilize. Weekly measurements of trace elements should be made to ensure adequate mineral replacement. 5. Use a controller pump to administer continuous feedings at a constant rate or to administer formulas that are viscous. Flush feeding tubes with water every 4 hours during continuous feedings, after giving intermittent feedings, after giving medications, and after checking for gastric residuals. If tube obstruction occurs, attempt to irrigate the tube with either water or cola. 6. Select feedings that contain appropriate nutrient sources, caloric density, and osmolality; handle feedings in a way that minimizes bacterial contamination. 7. Ongoing nutritional assessments are necessary to provide information about the overall adequacy of the enteral feeding in restoring or maintaining nutrition.
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PMID:Enteral nutrition. Potential complications and patient monitoring. 249 46

Although calcium antagonists may impair insulin release in vitro, clinical studies have produced conflicting results. Felodipine is a highly selective dihydropyridine calcium antagonist effective in the treatment of hypertension. The efficacy of felodipine was assessed in a double-blind randomized placebo cross-over study of 21 Type 2 diabetic patients with primary hypertension, 13 men and 8 women, with an age of 61 (range 46-73) years. Thirteen were controlled on oral hypoglycaemic therapy and 8 on diet alone. Mean (SD) blood pressure (mmHg) was 176(20)/102(8) after a 2-4 week placebo run-in period, 169(21)/101(8) during the subsequent placebo period compared with 151(15)/88(9) after 4 weeks felodipine therapy (p less than 0.001). Nineteen patients required 5 mg twice daily and 2 patients 10 mg twice daily to achieve a target diastolic pressure of 95 mmHg. Side-effects seen with felodipine included ankle oedema, facial flushing, headache, and dizziness. During oral glucose tolerance tests performed after the felodipine and placebo phases, mean (SD) fasting blood glucose was 9.5(3.1) and 9.0(3.0) mmol l-1, respectively (NS), and the 90 min (peak) blood glucose was 19.1(4.8) and 18.1(4.8) mmol l-1, respectively (NS). Glycosylated haemoglobin and fructosamine concentrations likewise showed no significant changes.
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PMID:A trial of the calcium antagonist felodipine in hypertensive type 2 diabetic patients. 253 42

The UW solution developed for cold storage of the liver, pancreas, and kidney was used in a modified form in this study and tested in the orthotopic transplantation of dog livers, kidneys, and pancreases preserved for 48 hr. The modification was the alteration of the concentrations of potassium and sodium. The original UW solution contained 120 mM K+ and 30 mM Na+. In this study the Na+ was 140 mM and the K+ only 9 mM, all other agents were identical to the original UW solution. Six of 11 dogs survived with livers preserved for 48 hr. The five deaths were due to technical complications and unrelated to preservation failure. Postoperative AST and partial thromboplastin time (PTT) values were lower (statistically significant on days 1, 3, and 4) in livers preserved in the high Na+ UW solution than as previously shown in the high-k+ UW solution. Other measures of liver function (bilirubin and fibrinogen) were similar between the high-Na+ and high-K+ groups. Six dogs survived with kidneys preserved for 48 hr in the high-Na+ UW solution. The results were comparable to those obtained with the high K+ solution. Four of six dogs survived for up to 28 days with pancreases preserved for 48 hr. The two deaths were due to technical complications unrelated to preservation failure. Three of the four dogs had normal blood glucose values for one month, and intravenous glucose tolerances test on day 7 and 28 were identical to those obtained in pancreases preserved with the high-K+ UW solution. The high-Na+ version of the UW solution appears equally or slightly more effective for 48-hr organ preservation than the original high-K+ UW solution. The use of a high-Na+ UW solution reduces the problems of hyperkalemic cardiac arrest in in situ flushing of the donor for multiple organ harvesting and in transplantation of the liver. Thus, with this solution livers do not need to be flushed with a low K+-containing solution prior to transplantation.
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PMID:Preservation of dog liver, kidney, and pancreas using the Belzer-UW solution with a high-sodium and low-potassium content. 266 Mar 54

The aim of this phase IV study was to assess the tolerability and efficacy of acipimox, a lipid-lowering drug, in 3009 type II diabetic out-patients with types II and IV hyperlipoproteinaemia. The study was carried out by 150 Italian diabetes centres. Acipimox was given at the dosage of one capsule (250 mg), two or three times daily for at least 2 months. Acipimox produced a mean fall of 43% in serum triglycerides and of 18% in total serum cholesterol levels compared with baseline. The lipid-lowering effect was present throughout treatment, but was most pronounced at the end of treatment. An increase in the serum concentration of high density lipoprotein cholesterol (15%) was also observed at the end of the trial. Fasting blood glucose and glycosylated haemoglobin levels showed a slight reduction during the study. Adverse events were reported in 263 (8.8%) cases and 165 (5.4%) patients discontinued the treatment. The female trial population showed a nearly two-fold greater incidence of adverse events than the males. In the majority of cases the adverse events experienced by patients were transient episodes of flushing and mild gastro-intestinal disturbances (e.g. gastric pain and pyrexia).
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PMID:Results of a phase IV study carried out with acipimox in type II diabetic patients with concomitant hyperlipoproteinaemia. 267 53

Strain PA-1 (S. Barik, W.J. Brulla, and M.P. Bryant, Appl. Environ. Microbiol. 50:304-310, 1985) is an anaerobic, gram-negative rod that in pure culture decarboxylates succinate to propionate and that grows syntrophically as an acetogen with the H2 utilizer Methanospirillum hungatei if glucose, pyruvate, aspartate, or fumarate is provided. In pure culture, strain PA-1 grows optimally in a medium containing 5% ruminal fluid, 0.1% yeast extract, a 4:1 N2-CO2 gas phase, and 20 mM succinate. With the PA-1 plus M. hungatei coculture, good growth was obtained with 7.5 mM glucose and tryptophan could replace the yeast extract. Strain PA-1 in pure culture grew quite well in glucose medium if the large headspace was flushed intermittently with N2. Flushing with H2 inhibited this growth.
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PMID:Growth of the syntrophic anaerobic acetogen, strain PA-1, with glucose or succinate as energy source. 275 84

Estimates of the volume of fluid and the concentration of cations in the uterus were made by flushing the uterine cavity of mice mated to vasectomized males and measuring the concentrations of sodium and potassium cations in the recovered fluid. On day 1 following mating, large volumes of fluid (greater than 90 microL) were found in the uterus but, from days 2 to 5, only 2-5 microL of fluid were present. The ratio of sodium to potassium fell from 4.5:1 on day 1 to 1.8:1 on days 2 to 5 of pseudopregnancy, indicating that uterine fluid in the mouse has a high K+ content ranging from 35 mEq L-1 on day 1 to 75 mEq L-1 on day 5. Glucose, lactate and pyruvate in uterine flushings were also assayed and their concentration in uterine fluid calculated using the volumes found above. The level of all substrates was low on day 1 after mating. From day 2 onwards approximately 1 mM glucose was present in the fluids. The concentration of lactate was more variable, and peaked at 4 mM on day 2 of pseudopregnancy. In general, the concentration of pyruvate was 10% of the lactate value.
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PMID:Volume of fluid and concentration of cations and energy substrates in the uteri of mice during early pseudopregnancy. 279 44

Synthetic analogs of growth hormone-releasing hormone, GHRH(1-29)-NH2 and D-Ala2 GHRH(1-29)-NH2 were administered as a bolus intravenous injection to five normal men in a dose range of 0.015 to 0.5 micrograms/kg body weight. Vehicle only was administered in a control study. Peak responses to GHRH analogs occurred at 15 or 30 min. An increase in the integrated plasma growth hormone (GH) response was observed at each dose. The dose-response curve of GHRH(1-29)-NH2 indicated that it has a similar molar potency to GHRH(1-40) and GHRH(1-44). The potency of D-Ala2 GHRH(1-29)-NH2 was approximately twice that of GHRH(1-29)-NH2. Neither analog affected blood levels of PRL, TSH, LH, FSH, ACTH, insulin, glucagon, glucose, cortisol, free thyroxine, and free triiodothyronine. No side effects were noted other than transient flushing with the highest dose administered. The findings demonstrate GHRH(1-29)-NH2 and its D-Ala2 analog are potent stimulators of GH release and have potential application in clinical medicine.
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PMID:Growth hormone responses to growth hormone-releasing hormone (1-29)-NH2 and a D-Ala2 analog in normal men. 286 96

SMS 201-995 (Sandostatin) was studied using low doses (50 to 100 micrograms) administered subcutaneously every 12 hours. A single 50-micrograms dose of SMS 201-995 effectively controlled gastric acid and blood gastrin levels for 12 hours in three patients with benign gastrinomas and was useful in their perioperative management. Higher doses of the agent (500 to 800 micrograms per day) had no effect on metastases in one of two patients with metastatic gastrinoma. In the other patient, one tumor shrank but the other continued to grow after three months of treatment while serum gastrin levels did not change. Cultured metastatic tumor tissue from this patient released different forms of gastrin; growth rates varied, independent of uptake of SMS 201-995, and gastrin release increased. A neonate with nesidioblastosis maintained normal blood glucose levels while receiving SMS 201-995 therapy following a 95 percent pancreatic resection. In two elderly patients with organic hypoglycemia--one with a single benign adenoma and one with multiple adenomatosis--the somatostatin analogue did not prolong the hypoglycemia-free interval. In nine patients with carcinoid syndrome, flushing was uniformly controlled with 50 micrograms of SMS 201-995 administered every eight to 12 hours. One of the nine required exocrine pancreatic replacement. After six months of treatment, three of the nine had no change in tumor size and one had remission of symptoms and stopped treatment. In two patients with vipoma, SMS 201-995 controlled diarrhea and reduced levels of vasoactive intestinal peptide; tumor necrosis occurred in one patient. In a patient with diabetic diarrhea unresponsive to all treatments, SMS 201-995 therapy controlled the diarrhea but did not interfere with control of the diabetes.
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PMID:Somatostatin analogue (SMS 201-995) in the management of gastroenteropancreatic tumors and diarrhea syndromes. 287 47

We describe a 63-yr-old man with disseminated medullary carcinoma of the thyroid and pancreatic nesidioblastosis and microadenosis with pancreatic polypeptide (PP) hypersecretion. His major symptoms were watery diarrhea, flushing, and abdominal bloating; these and the elevated plasma PP levels did not change after resection of the distal two thirds of the pancreas, which contained a 2-cm mass of nesidioblastotic tissue. Postoperatively, a long-acting somatostatin analog, SMS 201-995 (100 micrograms/day), normalized PP secretion acutely and chronically (7 months) and ameliorated his symptoms. The analog had no side-effects and did not alter glucose tolerance, calcitonin hypersecretion, or growth of the medullary carcinoma, but it did inhibit GH secretion. After withdrawal from therapy for 1 month, PP hypersecretion and all symptoms except diarrhea recurred. The coexistence of medullary carcinoma of the thyroid and PP cell nesidioblastosis represents a new variant of the overlap syndromes between multiple endocrine neoplasia types I and II. Patients with medullary carcinoma and unexplained watery diarrhea should have fasting gastroenteropancreatic hormone assays done to screen for a potential gastrointestinal or pancreatic origin for the diarrhea.
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PMID:Medullary carcinoma of the thyroid, pancreatic nesidioblastosis and microadenosis, and pancreatic polypeptide hypersecretion: a new association and clinical and hormonal responses to long-acting somatostatin analog SMS 201-995. 288 96


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