Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adverse reactions following very rapid (ten seconds) and slow (two minutes) i.v. bolus injection of meglumine ioxitalamate (380 mg I/ml, 1.5 ml/kg bodyweight) for urography were compared. Except for warmth and a mild transient headache, rapid injection caused no higher incidence of adverse reactions. The rapid injection provides a high quality nephrogram. It may be hazardous in patients with pre-existing heart disease.
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PMID:Adverse reactions to urographic contrast medium. Rapid versus slow injection rate. 742 87

We report two patients with solitary thalamic abscesses, occurring among 91 consecutive patients (2.2%) with computed tomography (CT)-diagnosed and surgically-verified brain abscess experienced in our college during 1975 to 1991. A 9-year-old girl with congenital heart disease experienced frequent vomiting followed by left hemiparesis and deterioration of consciousness. CT demonstrated a right thalamic ring-enhanced lesion. Purulent material was aspirated via a burr hole. She died of heart failure on the 5th postoperative day. Autopsy disclosed diffuse brain swelling and an encapsulated abscess in the right thalamus, which had ruptured into the third ventricle. A 30-year-old female experienced headache, nausea, and vomiting, which progressed to somnolence and right hemiparesis. CT demonstrated a left thalamic ring-enhanced lesion. Purulent material was aspirated by stereotactic procedures. All symptoms had resolved by the end of the 2nd postoperative week.
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PMID:Solitary pyogenic thalamic abscess--two case reports. 750 3

This paper analyzes the available literature on intracranial arteriovenous malformations (AVM) in Taiwan. The incidence and symptoms of the disease are studied with a view to assisting practitioners in its recognition. The incidence of intracranial AVM in patients who have suffered hemorrhagic stroke in Taiwan is 2.5% to 4.8%, with the male to female ratio being 1.5:1. The peak age at which bleeding from intracranial AVM occurred ranged from 10 to 40 years; bleeding showed no seasonal variation. Sudden headaches, vomiting, and disturbance of consciousness were the commonest presenting symptoms of AVM, similar to the rupture of intracranial aneurysms. However, the possibility of focal neurological deficit among patients with intracranial AVM was higher than in patients with intracranial aneurysms. Risk factors, such as hypertension, diabetes mellitus, heart disease, smoking and alcohol intake showed no close relationship to bleeding in intracranial AVM. Pregnancy is not a risk factor in female patients with intracranial AVM with no history of hemorrhage. Small intracranial AVM are more likely to bleed. Since 1961 the majority of Taiwan's intracranial AVM patients have been treated surgically, while before that date general medicine was the treatment of choice. In recent years, several developments such as operation microscope, microsurgical instruments and microsurgical techniques have enhanced the efficacy of surgical intervention in the treatment of AVM. When the mortality and morbidity rates resulting from the two forms of treatment are compared, surgical treatment shows a better prognosis for the treatment of intracranial AVM.
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PMID:[Intracranial arteriovenous malformations in Taiwan]. 791 74

The US Food and Drug Administration has not yet approved combined estrogen/progesterone compounds for postcoital contraception (PCC), yet administering them has been an accepted practice for at least 10 years. The health service at the University of Rochester in New York has a formal protocol to dispense PCC to female students who have had unprotected intercourse and wish to prevent pregnancy. The women must have experienced unprotected intercourse within 72 hours prior to presenting at the clinic. The clinicians screen the women for absolute contraindications to oral contraceptives (OCs), which include blood clotting disorders, stroke, heart disease, cancer of the breast or reproductive tract, and liver tumors. They also determine whether conception has occurred. If indeed it has occurred, and the patient has given written consent, the clinicians administers 2 times the dosage of 1 OC to the patient and a repeat dose 12 hours later. She is seen at the clinic 3 weeks later. Clinic workers review their protocol every 6-12 months as part of the quality assurance program. Providers who do not approve of PCC are asked not to see students requesting PCC. Between March, 1985, and February, 1991, the service's staff administered PCC 209 times. 18.7% of PCC patients took PCC more than once. Date rape was responsible for 3 episodes of unprotected intercourse. Pregnancy occurred in 4 of the 209 PCC episodes (1.9%). 3 of these pregnancies were not midcycle exposures. All 4 cases had received PCC within 24 hours of unprotected intercourse. They all underwent an abortion. The expected pregnancy rate for unprotected intercourse without PCC would be 11-14%. Side effects were nausea (19%), vomiting (13%), and other symptoms (8%), including headache, cramps, menstrual irregularities, or abdominal pain. Another possible PCC is mifepristone, which was 100% effective in a study in Scotland. It probably will not be available soon in the US because of the controversy surrounding its use as an abortifacient.
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PMID:Six years of clinical experience using postcoital contraception in college women. 824 18

Atenolol, a cardio selective beta-adrenergic blocker, frequently prescribed in various cardiac ailments, has not been thoroughly investigated for its adverse reaction profile in Indian patient. The present ADR monitoring study which was open, prospective and collaborative was therefore planned. A total of 440 patients with various heart disease were enrolled after a strict inclusion and exclusion criteria from Maulana Azad Medical College, New Delhi and J.N. Medical College, Aligarh. fifteen patients dropped out leaving 435 for final analysis. Cold extremities occurred in 1.18% headache and dizziness in 1.41% breathlessness in 0.94% oedema in 0.70% and bradycardia in 0.47%. Adverse drug reaction in our study were less than those reported from Western countries. Better patient selection, optimal dose could have reduced the frequency of ADR in the present study. Racial factor and season might be operating to bring down ADR to atenolol in Indian patients.
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PMID:Monitoring the adverse profile of atenolol--a collaborative study. 827 98

A 27-year-old patient with pulmonary atresia, ventricular septal defect, and multifocal lung-perfusion suddenly developed headache and left facial sensory disturbances. Using computed tomography and magnetic resonance imaging a temporo-parietal brain abscess was diagnosed. After abscess aspiration and antibiotical therapy neurological signs disappeared immediately and the patient could leave hospital without any neurological deficit. Adult patients with congenital cyanotic heart disease are at risk to develop a brain abscess which should therefore be ruled out if headache, fever of unknown origin or focal neurologic signs occur.
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PMID:[Brain abscess in congenital cyanotic heart defect in adulthood]. 829 Dec 92

Patients with supraventricular arrhythmias have been safely and effectively treated with flecainide. We conducted an open-label, 20-center trial to define further the safety and efficacy profile of oral flecainide in patients with supraventricular arrhythmias, including atrial tachycardias (ectopic or multifocal), atrial-ventricular tachycardias (reentrant), paroxysmal atrial fibrillation/flutter (PAF), and chronic atrial fibrillation (CAF). Our study population of 151 patients with documented supraventricular arrhythmias requiring treatment included 67 with paroxysmal supraventricular tachycardia (PSVT), 67 with PAF (symptoms < 15 days), and 17 with CAF (symptoms > of = 15 days)> The initial flecainide dose of 100 mg twice daily could be increased by 50 mg bid every 4 days to a maximum of 200 mg twice daily. Patients who were effectively treated could receive flecainide for 1 year. The study was terminated April 26, 1989, in response to interim results reported by the Cardiac Arrhythmia Suppression Trial (CAST). All patients were removed from the study by August 1989. At study termination 87% of PSVT, 73% of PAF, and 56% of CAF patients had improved symptomatically while on flecainide therapy. Eleven patients experienced cardiac adverse experiences: proarrhythmic events (3 patients), new or worsened congestive heart failure (7 patients), sinus pauses (1 patient). Cardiac side effects appeared to be more frequent in patients in the CAF group (5/17 patients), all of whom had structural heart disease. Overall, 45 (67%) PSVT, 43 (64%) PAF, and 9 (56%) CAF patients reported at least 1 noncardiac adverse experience; the most common were abnormal vision, dizziness, and headaches. One patient from the CAF group died; the death was considered to be unrelated to flecainide. Flecainide appears to be safe and effective treatment for patients with supraventricular arrhythmias of a variety of mechanisms and appears particularly effective for patients with PSVT. The efficacy is lowest and side effects most frequent in patients with CAF, as seen with other trials of antiarrhythmic medication in these patients. In the context of the CAST experience and other trials of antiarrhythmic drugs in patients with CAF, the balance of risk and benefit of therapy should be considered carefully before initiating treatment.
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PMID:Safety and utility of flecainide acetate in the routine care of patients with supraventricular tachyarrhythmias: results of a multicenter trial. The Flecainide Supraventricular Tachycardia Study Group. 860 95

Endothelin-1 (ET-1) exerts powerful vasoconstrictive and blood pressure elevating properties through endothelial cells. However, no systematic examination of ET-1 in migraine has ever been attempted. The present investigation was focused on evaluating the level of ET-1 in patients with migraine with aura. Studies on ET-1 were made in 17 patients with migraine with aura (age, 23.4 +/- 9.1 years old, mean +/- SD) according to the Classification of Headache of the Ad Hoc Committee. All patients had been free of migraine attacks for at least 7 days prior to the examination. Twenty-eight age-matched healthy volunteers (age, 23.0 +/- 12.3 years old) were similarly used as a control group. None of them revealed evidence of any other disease, such as hypertension, obesity, or heart disease. Informed consent was obtained from each subject. We measured the immunoreactive ET-1 in plasma by radioimmunoassay. The plasma level of ET-1 in migraine was 2.53 +/- 1.06 pg/ml. On the other hand, the level of ET-1 in the controls was 4.24 +/- 0.80 pg/ml. The ET-1 level in migraine was significantly lower than that in the controls (p < 0.002). We also measured the level of ET-1 in the cerebrospinal fluid (CSF). There was no significant difference between migraine (23.2 +/- 3.10 pg/ml) and the control group (20.85 +/- 3.20 pg/ml). In conclusion, the lower plasma level of ET-1 observed in the patients with migraine is consistent with the pathogenesis of migraine, further supporting the hypothesis that a lower ET-1 may be closely related to marked vasodilatation following constriction partly due to a deficiency of ET-1 for maintaining vasoconstriction.
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PMID:[Lower level of endothelin-1 in migraine with aura]. 872 Mar 38

Patients with severe hypertension with retinoscopic bilateral papilloedema only are not classically regarded as having malignant hypertension (MHT). We have encountered 23 such patients between 1965-1993, whilst over a similar period we have seen 315 patients who fulfilled the conventional criteria for MHT with bilateral retinal haemorrhages, exudates with or without papilloedema. We hypothesised that patients with "lone" papilloedema and severe hypertension were suffering from a disease which was identical in aetiology and outcome to conventional MHT. There were no significant differences in age, mean blood pressure, proteinuria or renal function at presentation, ethnic composition, smoking status and followup blood pressure control between the papilloedema group and those presenting with conventional MHT. Clinical features at presentation in the papilloedema only group included strokes in 4, visual disturbance in 2, headaches in 3 and heart failure in 1 patient. Many patients however had no complications at presentation. After a mean followup of 59.8 months, of the "lone" papilloedema group, 7 patients (30.4%) were still alive, 1 patient was on renal dialysis therapy, 13 were dead (56.5%) and 2 (8.7%) were lost to followup. The commonest causes of death were stroke in 4 patients, renal failure in 4 and heart disease in 2. This was a similar pattern of mortality to those patients with "conventional" MHT. Lifetable analyses showed a median survival of 35.9 months for the papilloedema group which was significantly worse than the 108.7 months for the conventional MHT group (Lee-Desu statistic 4.04, p = 0.045). We suggest that patients with high blood pressure and lone bilateral papilloedema may comprise a hitherto unrecognised subgroup of patients with MHT. Once intracerebral pathology has been excluded, these patients need to be treated as aggressively as those with MHT.
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PMID:Severe hypertension with lone bilateral papilloedema: a variant of malignant hypertension. 874

Intravenous immune globulin (IVIg) is advocated as a safe treatment for immune-mediated neurologic disease. We reviewed the medical records of 88 patients who were given IVIg for a neurologic illness. Major complications in four patients (4.5%) included congestive heart failure in a patient with polymyositis, hypotension after a recent myocardial infarction, deep venous thrombosis in a bed-bound patient, and acute renal failure with diabetic nephropathy. Other adverse effects included vasomotor symptoms 26, headache 23, rash 5, leukopenia 4, fever 3, neutropenia 1, proteinuria (1.9 g/day) 1, viral syndrome 1, dyspnea 1, and pruritus 1. Fifty-two patients (59%) had some adverse effect of IVIg infusion, most commonly vasomotor symptoms, headaches, fever, or shortness of breath in 40 (45%), which improved with reduced infusion rate or symptomatic medications. Five (6%) had asymptomatic laboratory abnormalities and seven (8%) had other minor adverse effects. Adverse effects led to discontinuation of therapy in 16% and permanent termination of therapy in 10% of patients. There was no mortality or long-term morbidity. Although adverse effects were frequent, serious complications were rare except in patients with heart disease, renal insufficiency, and bed-bound state.
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PMID:Complications of intravenous immune globulin treatment in neurologic disease. 930 72


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