Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this cross-sectional study was to investigate how different types of prescriptions using different illness labels may influence lay views about the use of generic or brand medicines. The participants were 882 Portuguese (both sexes) recruited from the general population, who completed a self-administered questionnaire. A vignette methodology was used in which different prescriptions (generic versus brand) were given for the same label (flu, hypertension, asthma and angina pectoris). The dependent variables were for each illness label: (a) the level of agreement with the prescription, (b) beliefs about the efficacy of a medicine and (c) beliefs about the relief of symptoms. There were main effects of the label and the type of prescription upon beliefs about the use of medicines. There were interactions between illness label and type of medicines. Labels which were perceived as more serious were associated with a lower belief in generic medicines. These results raise important questions concerning the need to consider illness perceptions of lay people (including perceived severity) and its relationship with perceptions of treatment for different conditions. Furthermore, these results may have implications for health-related behaviour in general, and in particular for communication between lay people and health professionals, prescribing behaviour, health costs and adherence to treatment.
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PMID:Lay views about medicines: the influence of the illness label for the use of generic versus brand. 2030 76

The interferons are a complex group of virally induced proteins produced by activated macrophages and lymphocytes, which have become the mainstay of therapy for hepatitis C infection. Sustained viral response (SVR) rates in noncirrhotic patients vary from 40-80% with interferon-based therapy. This, along with transplantation, has drastically changed the course of hepatitis C virus (HCV) infection over the last two decades. Numerous side effects associated with interferon therapy have been reported. These range from transient flu-like symptoms to serious effects such as cardiac arrhythmias, cardiomyopathy, renal and liver failure, polyneuropathy, and myelosuppression. Pulmonary side effects including pneumonitis, pulmonary fibrosis, and reversible pulmonary hypertension have been reported. Herein, we present four cases in which irreversible pulmonary hypertension was diagnosed after prolonged treatment with interferon alpha. In each case, other causes of pulmonary hypertension were systematically eliminated. Pulmonary artery hypertension, which may be irreversible, should be considered in patients being treated with interferon alpha who present with exertional dyspnea and do not have a readily identifiable inflammatory or thromboembolic cause.
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PMID:Irreversible pulmonary hypertension associated with the use of interferon alpha for chronic hepatitis C. 2041 21

Lentinus edodes is the first medicinal macrofungus to enter the realm of modern biotechnology. It is the second most popular edible mushroom in the global market which is attributed not only to its nutritional value but also to possible potential for therapeutic applications. Lentinus edodes is used medicinally for diseases involving depressed immune function (including AIDS), cancer, environmental allergies, fungal infection, frequent flu and colds, bronchial inflammation, heart disease, hyperlipidemia (including high blood cholesterol), hypertension, infectious disease, diabetes, hepatitis and regulating urinary inconsistencies. It is the source of several well-studied preparations with proven pharmacological properties, especially the polysaccharide lentinan, eritadenine, shiitake mushroom mycelium, and culture media extracts (LEM, LAP and KS-2). Antibiotic, anti-carcinogenic and antiviral compounds have been isolated intracellularly (fruiting body and mycelia) and extracellularly (culture media). Some of these substances were lentinan, lectins and eritadenine. The aim of this review is to discuss the therapeutic applications of this macrofungus. The potential of this macrofungus is unquestionable in the most important areas of applied biotechnology.
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PMID:Lentinus edodes: a macrofungus with pharmacological activities. 2049 36

Understanding the particular pharmacology of different antidepressant drugs can help explain their adverse effects when they are discontinued. For all antidepressant drugs, abruptly stopping them can sometimes result in "rebound" hypomania or mania. Antidepressant drugs having anticholinergic effects often are associated with a discontinuation syndrome characterized by cholinergic rebound, with symptoms of nausea, vomiting, abdominal cramping, sweating, headache, and muscle spasms. Discontinuation of monoamine oxidase inhibitor drugs sometimes results in flu-like symptoms, dysphoria, restlessness, tachycardia, hypertension, and a delirium-like state. Serotonergic antidepressant drugs are sometimes associated with a distinct discontinuation syndrome characterized by dizziness, weakness, nausea, headache, lethargy, insomnia, anxiety, poor concentration, and paresthesias. Adverse discontinuation effects can occur with all types of antidepressant drugs, but only rarely would they be considered serious. To minimize adverse discontinuation effects and to reduce the risk of relapse or recurrence of the underlying treated condition, tapering antidepressant medication is prudent for all patients.
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PMID:Potential adverse effects of discontinuing psychotropic drugs: part 2: antidepressant drugs. 2060 81

The H1N1 pandemic flu is a significant risk factor for both patients with chronic disease who need organ transplantation and transplant recipients. This population needs special care regarding comorbidities and related complications. MB, a 38-year-old Italian cystic fibrosis male patient with lung and pancreatic involvement, was referred to our division in July 2009 for fever-associated arthromyalgia, headache, and rhinitis. Lung transplantation had been performed in September 2005, and he was subsequently treated with immunosuppressive therapy: tacrolimus, everolimus, and prednisolone. In the past, chronic respiratory colonization with Pseudomonas aeruginosa and intermittent infection with Aspergillus flavus, chronic renal failure, hypertension, and diabetes mellitus complicated his clinical history. He started antiviral treatment with oseltamivir despite no travel history and no respiratory symptoms. H1N1 swab was positive. Three days later, the patient was admitted to the hospital for the persistence of fever and the onset of cough. Chest x-ray showed a left lower pneumonia, which was confirmed by computerized tomography. Broad-spectrum antibiotic therapy led to an improvement of the clinical condition. The patient was discharged 8 days later; a control swab was negative. This case report suggests some general considerations regarding solid organ recipients: 1) Flu-related complications require early treatment (both antiviral and antibiotic); 2) active microbiologic surveillance is important to prevent lethal infections (ie, invasive aspergillosis); 3) evaluation of immunosuppressant blood levels is necessary for drug-drug interactions. Active prevention is the best option for decreasing morbidity and mortality in the transplanted patient.
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PMID:Case report: cystic fibrosis, lung transplantation, and the novel H1N1 flu. 2069 61

Even though quality indicators are becoming more common in clinical medicine, there are very few of them in the area of stroke rehabilitation. This article proposes quality indicators for stroke rehabilitation based upon the Donabedian triad of structure, process, and outcomes. The quality indicators are in 3 categories: service delivery; system care coordination; and stroke prevention, health promotion, and medical management. Specific areas of focus include organized care, intensity of service, transitions of care, secondary stroke prevention, hypertension, diabetes mellitus, coronary artery disease, hyperlipidemia, deep venous thrombosis prophylaxis, pneumonia and influenza vaccines, and patient and professional education. By highlighting both the presence and absence of evidence in various aspects of stroke rehabilitation, clinicians and researchers can focus on quality improvement in areas that already are known while providing opportunities for research into areas that evidence does not yet support.
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PMID:Stroke rehabilitation quality indicators: raising the bar in the inpatient rehabilitation facility. 2082 17

A 15-year-old male patient developed atypical hemolytic uremic syndrome (aHUS) at 16 months of age leading to end-stage renal disease. The family history was suggestive of autosomal dominant aHUS, and he was more recently found to have a C3 heterozygous gene mutation (1835C>T mutation in exon 14, which determines the amino-acidic substitution R570W) with no other complement abnormalities. He had two renal transplants, the first at 2.5 years, and the second at 8 years of age, but allograft dysfunction developed in both transplants leading to graft failure due to recurrent HUS at 5 years and 18 months post-transplantation respectively. At 15 years of age he received a third transplant from a deceased donor with pre-emptive plasmapheresis. He had immediate graft function and nadir serum creatinine was 1.3-1.4 mg/dl. Severe allograft dysfunction and hypertension developed 2 months after transplantation following influenza infection. Renal allograft biopsy showed thrombotic microangiopathy. He received plasmapheresis followed by eculizumab therapy. Allograft function returned to baseline 3 weeks after starting therapy, and post-treatment allograft biopsies showed improvement in thrombotic microangiopathy. He continues to receive eculizumab every 2 weeks with stable graft function 13 months after transplantation.
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PMID:Eculizumab induces long-term remission in recurrent post-transplant HUS associated with C3 gene mutation. 2112 5

This case focuses on a general medical patient who resides in a local senior community-housing center and who has multiple comorbid diseases that are commonly seen in practice. The patient's past medical history includes coronary artery disease, peptic ulcer disease, hypertension, and type 2 diabetes mellitus. The patient was recently hospitalized and treated with an intravenous antibiotic for an influenza-related pneumonia infection, then discharged with a prescription for a course of oral fluoroquinolone antibiotics. This case discusses and addresses each of the patient's conditions, various drug interactions, and issues pertaining to the patient. An interdisciplinary-team approach is important for the medical management of a patient with multiple comorbid diseases along with the contribution of a consultant pharmacist as pharmacotherapy expert.
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PMID:The consultant pharmacist provides consultation and recommendations for a medical patient. 2131 Jul 9

The knowledge derived from the three-dimensional structure of a macromolecular receptor either in the native form or in complex with different ligands has given new insights to the development of improved drug candidates contributing to the drug development pipeline. The structure-based drug design approach has been tested on a number of macromolecular targets implicated in various diseases such as hypertension, glaucoma, HIV and influenza. This approach has also been employed for the development of new antidiabetic agents targeting glycogen phosphorylase (GP), an enzyme that modulates glucose levels in blood circulation. The key role of x-ray protein crystallography in the structure-based inhibitor design process is presented by the case of rabbit muscle GP (RMGPb) that shares increased homology with the liver isoenzyme. The properties of the allosteric binding sites of RMGPb are revealed by filing the interactions formed upon binding of characteristic functional groups and documenting the changes induced in the residues lining the site of interest.
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PMID:From structure--based to knowledge--based drug design through x-ray protein crystallography: sketching glycogen phosphorylase binding sites. 2156 87

Since several characteristics of pandemic influenza A (H1N1) virus infection remain to be determined, this study aimed to describe clinical features and complications of patients infected with H1N1. Subjects affected by influenza-like illnesses and a control group of asymptomatic patients were enrolled prospectively at an Emergency Department from October 2009 to April 2010. At enrollment, clinical data and nasopharyngeal swabs for virological analyses were obtained. Ill subjects were followed until recovery and swabs were collected weekly in patients infected with H1N1. Of 318 patients enrolled, 92 (28.9%) were positive to H1N1. Patients infected with H1N1 were mainly young adults and complained classic influenza-like symptoms. Fever was observed for a median time of 5 (IQR 3-7) days. Hospitalization occurred in 27.7% with 2% requiring intensive care unit admission: median length of hospitalization was 6 days (IQR 5-9). Pneumonia was diagnosed in 19.6% of patients. A similar proportion of lower airways involvement and of clinical complications was observed in subjects testing positive or negative for H1N1. However, patients infected with H1N1 were younger and hospitalized for a shorter period as compared to the control group (P = 0.002 and P = 0.045, respectively). Older age, asthma/chronic obstructive pulmonary disease and hypertension were associated with an increased risk of pneumonia. Viral shedding was observed for at least 1 week in 21.3% of patients. Asymptomatic infection was uncommon (1.1%). Respiratory syndromes caused by H1N1 and factors associated with disease severity were investigated and compared to influenza-like illnesses of other origin. Such findings might contribute to improve clinical and epidemiological management of the disease.
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PMID:Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy. 2201 11


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