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)

Ionic and nonionic contrast materials are similarly efficacious in providing excellent images with minimal risk to the patient. In comparison with ionic media, the nonionic agents produce minor alterations in intracardiac and peripheral pressures as well as in electrocardiographic intervals and morphology. In addition, nonionic media are less often associated with undesirable symptoms, such as flushing and vomiting. At the same time, ionic and nonionic media are accompanied by a similar incidence of nephrotoxicity, serious arrhythmias, and death. Finally, nonionic contrast material is substantially more expensive than ionic media. In light of this marked difference in cost, one could argue that nonionic media should be reserved for "high-risk" patients, that is, those with a history of a serious adverse reaction to ionic contrast media and those in whom contrast-induced hypotension would be particularly deleterious.
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PMID:Contrast agents for cardiac catheterization: conceptions and misconceptions. 192 63

Pheochromocytoma is an unusual but potentially devastating tumor. Although a high index of suspicion is necessary, the likelihood of a pheochromocytoma is lower in the absence of the typical symptoms and findings. Nonetheless, screening must be broadened to include patients with a lower risk of the disease, such as those with resistant or labile hypertension who are minimally symptomatic. Extensive diagnostic evaluations should be reserved for those whose clinical or laboratory findings are more suggestive. Symptoms in a group of patients in whom a pheochromocytoma was seriously considered but excluded overlap symptoms in patients with a pheochromocytoma. Certain symptoms are useful: flushing to suggest a non-pheochromocytoma illness; visual symptoms, flank pain, and pallor to suggest that a pheochromocytoma is more likely. Combinations of symptoms can be of value: 2 or more symptoms from the triad of headache, palpitations, and diaphoresis were present in the majority of pheochromocytoma patients, but in a smaller number of non-pheochromocytoma patients. The presence of the entire triad is more specific, but less sensitive. New hypertension, or hypertension associated with unexplained orthostatic hypotension, are suggestive of an underlying pheochromocytoma. Twenty-four-hour urine studies are consistently abnormal in patients with a pheochromocytoma, but are also elevated in a significant proportion of non-pheochromocytoma patients. Values greater then 1.5-2-fold above the upper limit of normal are very suggestive that a pheochromocytoma is present, and warrant a more intensive subsequent evaluation. Imaging studies are reliable in the diagnosis of pheochromocytoma, and can help to confirm or exclude the disease. Patients with a higher clinical likelihood and any elevated urinary testing, or with a lower clinical likelihood and persistently and/or significantly elevated urinary testing, should have imaging studies performed. This combination of clinical screening, 24-hour urinary testing, and imaging studies is a useful and reliable approach to patients suspected of harboring a pheochromocytoma.
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PMID:A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience. 198 66

Drug therapy should be reserved for patients with marked total cholesterol elevation not amenable to dietary measures. While current guidelines suggest that bile acid sequestrants, such as cholestyramine and colestipol, are first-line drugs for the treatment of hypercholesterolemia, recent studies suggest that lovastatin is a safe, more potent alternative. Gemfibrozil reduces the serum triglyceride level and raises the high-density lipoprotein (HDL) cholesterol level, but has only a moderate effect on the serum cholesterol level. Nicotinic acid lowers serum low-density lipoprotein (LDL) cholesterol and triglyceride levels and raises serum HDL levels, but its use is limited because of troublesome side effects, notably a flushing reaction. Probucol lowers both serum LDL and HDL levels and is a second-line agent for the treatment of hypercholesterolemia.
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PMID:Comparison of cholesterol-lowering regimens. 205 39

Liver cooling before grafting is usually achieved by aortic plus portal flushing; exclusively aortic flushing is reserved to hemodynamically unstable or non heart-beating donors. We have compared the effects of "aortic plus portal" (8 cases) and "aortic" (8 cases) cold flushing on the early function of pig liver grafts from hemodynamically stable donors. The time for liver removal (mean +/- standard deviation) was 30.4 +/- 7.1 min. in the "aortic plus portal" and 19.7 +/- 3.3 min. in the "aortic" group (p < 0.01). All the recipients survived for at least 72 hrs; only those of the "aortic plus portal" group showed some degree of primary liver dysfunction; recipient serum aspartate transaminase (AST) was significantly higher in the "aortic plus portal" than the "aortic" group. Since aortic flushing allowed for shorter operation times and was better tolerated than and at least as effective as aortic plus portal flushing, it can be proposed for routine liver procurement even from hemodynamically stable donors.
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PMID:Exclusively aortic cold flushing for liver procurement from hemodynamically stable donors. An experimental study in the pig. 867 17

The degradation of municipal solid waste (MSW) under mesophilic conditions can be enhanced by exchanging leachate between fresh waste and stabilised waste. The optimum point in time when leachate from an anaerobically digesting waste bed can be used to initiate degradation of another waste bed might occur when the leachate of the digesting waste bed is highly active with cellulolytic and methanogenic bacteria. In this study, the cellulolytic activity of the leachate was measured using the cellulose-azure assay. As products of hydrolysis are soluble compounds, the rate of generation of these compounds was estimated based on a soluble chemical oxygen demand (SCOD) balance around the fresh waste bed. It was found that once the readily soluble material present in MSW was washed out there was very little generation of SCOD without the production of methane, indicating that flushing leachate from a stabilised waste bed resulted in a balanced inoculation of the fresh waste bed. With the onset of sustained methanogenesis, the rate of SCOD generation equalled the SCOD released from the digester as methane. The experimental findings also showed that cellulolytic activities of the leachate samples closely followed the trend of SCOD generation. reserved.
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PMID:Cellulolytic activity in leachate during leach-bed anaerobic digestion of municipal solid waste. 1160 44

1. The lymph of the thoracic duct furnishes to the blood a larger proportion than is usually supposed of the lymphocytes in circulation. Gross variations in its output of such cells must affect very considerably the blood picture. 2. The quantity of lymphocytes supplied through the thoracic duct of the healthy dog remains practically constant from hour to hour, if the physiological conditions are not notably changed. Transient change in physiological conditions may alter the output of cells, but with the disappearance of this change the output tends to resume its previous rate. These facts indicate that the tissues producing lymphocytes are "set" at a rate of activity definite in the individual. 3. Muscular activity (struggle) produces a prompt increase in the output of lymphocytes through the thoracic duct. (a) This is assured by the presence of an increased number of cells per cubic millimeter of lymph, combined with an increase in the amount of lymph voided. (b) The lymphocyte-output may be tripled or quadrupled during a long-continued struggle. (c) Following prolonged struggle the output of lymphocytes is for a short time less than previous to the exertion. 4. The increased lymph-flow caused by a lymphagogue of the second class (glucose) brings with it increased output of lymphocytes through the thoracic duct. (a) The individual cubic millimeters of lymph are often poor in cells, during the rapid lymph-flow, yet the total number of elements transported is large. (b) The results with glucose support the theory of Ehrlich, that a rapidly appearing lymphocytosis may be produced through the flushing effect of increased lymph-flow. 5. A comparison of the effects of struggle with those of glucose demonstrates that in the former some factor besides increase in lymph-flow per se (Ehrlich) works to cause the large output of lymphocytes. The nature of this factor has not yet been determined. 6. The variations caused by muscular exertion and by increased lymph-flow in the number of lymphocytes coursing through the thoracic duct are so pronounced as to suggest that the total number of lymphocytes in circulation must be considerably influenced by them. Clinical findings by other observers indicate that this is true; and the clinical findings themselves become much simpler of interpretation. 7. The results in general prove the existence, reserved from circulation, of a large fund of lymphocytes, which is quickly yielded to the blood under certain physiological conditions.
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PMID:AN INQUIRY INTO SOME MECHANICAL FACTORS IN THE PRODUCTION OF LYMPHOCYTOSIS. 1986 29

Carcinoid tumors are neuroendocrine tumors with a very unpredictable clinical behavior. In the setting of hepatic metastases, the tumor's release of bioactive substances into the systemic circulation results in carcinoid syndrome: a constellation of symptoms among which cutaneous flushing, gastrointestinal hypermotility, and cardiac involvement are the most prominent. Cardiac manifestations, also known as carcinoid heart disease, are secondary to a severe fibrotic reaction which frequently involves the right-sided valves and may extend towards the subvalvular apparatus leading to valve thickening and retraction. Left-sided involvement is rare and mostly observed in the presence of an interatrial shunt, endobronchial tumor localization, and high tumor activity. Echocardiographic techniques often reveal noncoaptation of the valves, which are fixed in a semiopen position. In patients with advanced lesions and severe valvular dysfunction, surgery is currently the only definitive treatment to potentially improve quality of life and provide survival benefit. Although cardiac surgery has been traditionally reserved for those patients with symptomatic right ventricular failure, a significant trend towards improved surgical outcomes has triggered a more liberal referral for valve replacement. Carcinoid heart disease poses two distinct challenges for the anesthesiologist: carcinoid crisis and low cardiac output syndrome secondary to right ventricular failure. Carcinoid crisis, characterized by flushing, hypotension, and bronchospasm, may be precipitated by catecholamines and histamine releasing drugs used routinely in patients undergoing valve surgery. Although a broader utilization of octreotide have significantly simplified the anesthetic and perioperative management of these patients, a very balanced anesthetic technique is required to identify and manage low cardiac output syndrome.
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PMID:Current concepts in diagnosis and perioperative management of carcinoid heart disease. 2317 18

Carcinoid tumors are neuroendocrine tumors with an unpredictable clinical behavior. In the setting of hepatic metastases, the release of bioactive amines from the tumor into the systemic circulation results in carcinoid syndrome: a constellation of clinical symptoms, among which cutaneous flushing, gastrointestinal hypermotility, and cardiac involvement are the most frequent. Cardiac manifestations, also known as carcinoid heart disease, are secondary to a severe endocardial fibrotic reaction that leads to progressive valve thickening and retraction. Imaging studies commonly reveal severe right-sided valve disease, with fixed leaflets or cusps in a semiopen position. The replacement of the right-sided valves, including the patch enlargement of the right ventricular outflow tract, is currently the only definitive treatment to potentially improve quality of life and provide survival benefit. Although cardiac surgery has been traditionally reserved for those patients with symptomatic right ventricular failure, a significant trend toward improved surgical outcomes has triggered a more liberal referral for valve replacement during the past decade.
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PMID:Surgical management of carcinoid heart valve disease. 2346 73

The term red face is reserved for lesions located exclusively or very predominantly on the face that result from changes in cutaneous blood flow triggered by multiple different conditions. Facial erythema may not only present clinically as a distinct entity, but can also be a sign of other diseases. Patients with a red face challenge clinicians to consider a broad differential diagnosis. Diagnosis is based on date and mode of appearance, characteristics of the erythema, functional signs, and associated systemic manifestations. In most cases, the cause is a benign disease such as rosacea, contact dermatitis, photodermatosis, and climacterium, and a thorough history and physical examination is enough to make a diagnosis; facial erythema may also present as a symptom of drug allergies, cardiac disease, carcinoid syndrome, pheochromocytoma, mastocytosis, and anaphylaxis, as well as some rare causes such as medullary carcinoma of the thyroid, pancreatic cell tumor, and renal carcinoma where further laboratory, radiologic, or histopathologic studies are required. In this review, the mechanisms of flushing, its clinical differential diagnosis, and management of various conditions that cause flushing are discussed.
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PMID:Red face revisited: Flushing. 2544 73