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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Action taken by the Food and Drug Administration (FDA) toward the th erapeutic use of estrogens is reported. The FDA has 1st ordered revision of physician-labeling for estrogens, and 2nd has prepared a brochure explaining the advantages and disadvantages of estrogen therapy to patients. Some of the points made in the new labeling and brochure are: 1) the risk of cancer of the uterus increases with duration of use and dosage; 2) users of estrogens should be examined by their physicians at least every 6 months; 3) estrogens should never be given to pregnant women; 4) estrogens should not be given in cases of breast or uterine cancer, undiagnosed abnormal vaginal bleeding, clotting in the legs and lungs, or previous heart disease, angina, or stroke; and 5) estrogens should not be used to treat menopausal nervousness, as they have proved ineffective, or for improving the complexion. There is also no evidence that estrogens are effective in preventing threatened or habitual abortion. It is recommended that estrogens be administered cyclically (3 of 4 weeks), and that the dosage be reduced or discontinued every 3-6 months to assess the need for their continued use.
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PMID:Informing patients about estrogens. 82 30

This study reports the relative risk of death from cancer and from coronary artery disease in 1,811 first-degree relatives of 205 young colorectal cancer probands. The elevation in the risks of death from cancer (eg colon 3.6; rectum 2.0; uterus 1.8; cervix 2.3) is consistent with, though of lower magnitude than previous studies. An unexpected find was a highly significant deficit in coronary deaths. Recently discovered molecular associations between colon cancer and cholesterol metabolism suggest that further family studies of bowel cancer and heart disease in a variety of populations may be worthwhile.
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PMID:Colorectal cancer and ischaemic heart disease: an uncommon inheritance! 146 76

The evidence that estrogen protects against coronary heart disease is biologically plausible, consistent, and strong. These benefits have not been established by a randomized trial, however, so that the degree of protection against heart disease might have been overestimated because estrogen users tend to be healthier than nonusers. A randomized trial to determine whether estrogen alone or in combination with progestin protects against coronary heart disease should be given a high priority. Progestins generally attenuate the effects of estrogen on the concentrations of HDLC. It is not known whether this effect also limits the beneficial effects of estrogen on the risk of coronary heart disease. Recent studies suggest that estrogen may protect against coronary heart disease in other ways besides favorably altering serum concentrations of lipoproteins and that progestins might not have adverse effects on the risk of heart disease. Currently, theoretical concerns that progestins might be harmful seem outweighed by the evidence that they protect against endometrial cancer in women who have a uterus. For these women, some may find the side effects of progestins to be so bothersome that they prefer to take estrogen alone. This approach is reasonable so long as the patient has periodic endometrial biopsies for early detection of pre-malignant or malignant endometrial changes. Women without a uterus should take estrogen alone. Women who take long-term estrogen therapy appear to have about a 30% greater chance of developing breast cancer. On the other hand, breast cancer that develops while taking estrogen therapy might have a slightly better prognosis. Quantitative comparisons of fatal conditions suggest that the benefits of long-term therapy outweigh the risks. But these comparisons assume that all causes of deaths are equally important and do not adequately take account of other psychologic and physical effects of hormone therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluating the benefits and risks of postmenopausal hormone therapy. 175 Apr 10

Recent epidemiologic studies have demonstrated a greater than expected number of pediatric patients with congenital heart disease in areas where drinking water was contaminated by halogenated aliphatic hydrocarbons. Trichloroethylene, trichloroethane and dichlorethylene were the principal contaminants in the groundwater. A previous study of chick embryos demonstrated that when injected into the air sacs of fertilized eggs trichloroethylene produced more than three times the number of cardiac defects that are found in control embryos. This mammalian study demonstrates similar effects of trichloroethylene and dichloroethylene when applied under provocative circumstances (that is, solutions delivered through a catheter into the gravid uterus from an intraperitoneal osmotic pump) to the developing rat fetus in utero during the period of organ differentiation and development. Furthermore, the effect is dose dependent for both agents. Although only a very small number of congenital heart anomalies (3%) were found in the control group, 9% and 12.5% were found in the lower dose trichloroethylene and dichloroethylene groups and 14% and 21% in the higher dose groups, respectively (p less than 0.05). A variety of cardiac defects were found. Dichloroethylene appears to be at least as great a cardiac teratogen as trichloroethylene even though it was administered at a 10-fold lower concentration. These agents appear to be specific cardiac teratogens because only a single noncardiac anomaly was found. This study in a rat model demonstrates a dose-dependent relation between fetal exposure to trichloroethylene and dichloroethylene in utero during the period of organogenesis and the appearance of a variety of congenital cardiac defects.
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PMID:Cardiac teratogenesis of trichloroethylene and dichloroethylene in a mammalian model. 222 79

A comparative study was made on mortality during a 15-year period from 1968 to 1982 between atomic bomb survivors resident in Hiroshima Prefecture and non-exposed controls. The mortality rate for all causes of death was lower in atomic bomb survivors than in the non-exposed, but the rate was higher among those directly exposed within about 1 km than in the non-exposed. The mortality rate for malignant neoplasms was higher in atomic bomb survivors than in the non-exposed, but that for cerebrovascular disease and heart disease was lower. In examining the rate for malignant neoplasms by site, the sites showing a high mortality rate among atomic bomb survivors were almost identical to the results of the Life Span Study. For these sites, the shorter the exposure distance the higher was the mortality rate. The rate for malignant neoplasms of the uterus and stomach, and leukemia was unnaturally high among early entrants whose period after issuance of atomic bomb survivor's health handbook was short. In observing the atomic bomb survivors by the level of family destruction due to the bombing as a socio-economic factor, a tendency was observed for the mortality rate for malignant neoplasms, diseases of blood and blood-forming organs, and peptic ulcer, to be higher among survivors with severe family destruction.
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PMID:Mortality statistics of major causes of death among atomic bomb survivors in Hiroshima Prefecture from 1968 to 1982. 279 17

Progestogens should be added to estrogen replacement therapy, not only to prevent endometrial cancer in women with a uterus, but also to reduce the risk of breast cancer in some women. Smoking should be discouraged to reduce the risk for both lung cancer and heart disease. Recommendations should be made to increase fiber intake to lessen the risk for carcinoma of the colon. Reducing fat intake also decreases risk for colon cancer, as well as carcinoma of the breast. Postmenopausal bleeding must be investigated for early diagnosis of endometrial cancer and, when endometrial hyperplasia is the finding, it should be treated with progestogens to prevent adenocarcinoma. The progestogen challenge test is recommended for all women with a uterus, and if bleeding occurs, the progestogen should be continued for 13 days each month. Use of mammograms and other diagnostic modalities should be increased to make the earliest possible diagnosis of breast cancer.
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PMID:Cancer in the older woman: diagnosis and prevention. 304 28

An estrogen-progestogen regimen of hormone replacement therapy has become widely used in recent years, primarily as a means to protect the endometrium from the carcinogenic effects of unopposed estrogen therapy (ERT). In this article, we evaluate the probable effects of this regimen on mortality from endometrial cancer as well as mortality from other chronic diseases. We conclude from this analysis that ERT is to be preferred to combination therapy for postmenopausal women without a uterus, primarily because it is predicted that ERT confers a significantly greater benefit on heart disease risk. In women with a uterus, if progestogens are to be prescribed, they should be given in the lowest possible dose needed to achieve the desired histologic changes in the endometrium, since the predicted loss in heart disease benefit from adding the progestogen is substantial.
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PMID:Re-evaluating the role of progestogen therapy after the menopause. 336 Jan 88

Inhalational general anesthetics can contribute to postoperative morbidity (Table II). Postoperative effects of inhalational anesthetics on the central nervous system are speculative. The "toxic" effects of these agents during the postoperative period are most often an extension of their pharmacologic and physiochemical properties. Inhalational anesthetics may produce a number of varied changes in mental status after surgery such as headache, emergence excitement, and delirium. It is very important for health professionals to be aware of the risk of perioperative myocardial infarction in patients with preexisting heart disease if early detection and treatment are to occur. Relative to the common postoperative problems of atelectasis, pneumonia, and aspiration, inhalational agents may have a contributory role especially in patients with preexisting pulmonary disease. Postoperative nausea and vomiting are other common problems in which inhalational agents may have a role in their development. Although extensively investigated, suspected halothane hepatoxicity is a very rare complication if it exists at all. The renal effects of inhalational anesthetics are usually mild and transitory, although the use of methoxyflurane can produce direct nephrotoxicity. The evidence to support a clinically significant direct immunosuppressant effect of inhalational anesthetics after surgery is inconclusive. A concensus exists that any minor, short-lived effects are in all probability overshadowed by the nonspecific stress of surgery itself. By reducing this stress, anesthetics undoubtedly have a protective effect. There are probably no major mutagenic or carcinogenic effects of inhalational anesthetics under normal conditions. Inhalational anesthetics should be avoided during pregnancy because of their teratogenic potential and their effects on the uterus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The postoperative adverse effects of inhalational anesthetics. 351 Oct 14

Double vulva is an extremely rare congenital malformation; there are only 17 previously reported cases in the world literature. The syndrome usually consists of complete or partial duplication of the vulva, vagina, uterus, urethra, bladder and colon, with normal ovaries and kidneys and associated congenital malformations, especially of the lumbar spine. The etiology is uncertain. Mortality in the 18 cases reviewed was 35%. Diagnostic evaluation should include a careful newborn physical examination for associated congenital malformations, especially congenital heart disease, along with a radiologic survey of the lumbar spine, gastrointestinal tract and urinary system. No gynecologic surgical treatment is needed except for cosmetic reasons.
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PMID:Double vulva. A case report. 358 76

A 23-year-old phenotypic female with congenital heart disease, mental retardation and mild virilization was referred for evaluation of short stature and delayed sexual development. Endocrine studies revealed a markedly elevated serum testosterone, which was within the adult range. At laparotomy, a small uterus, normal fallopian tubes and bilateral gonadal tumors, consisting of a left gonadoblastoma and right dysgerminoma were found. Trypsin G banding of peripheral blood revealed a 45,XO, 18p+ karyotype. Q banding demonstrated intense fluorescence of the distal portion of the extra material on chromosome 18, consistent with fluorescence of Y chromosomal heterochromatin. A combination of banding techniques enabled us to determine a 45,X,t(Y;18) (p11;p11) karyotype in peripheral blood. Cultures of gonadal tissue revealed 45,X,t(Y;18)/46,XY mosaicism.
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PMID:Cytogenetic and endocrine findings in a female with 45,X,t(y;18) (p11;p11). 719 97


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