Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although it is well established that coronary revascularization can reverse exercise-induced ischemic dysfunction, the effects on resting ventricular performance are controversial. From a group of 183 patients receiving surgical therapy for ischemic heart disease, 166 underwent bypass graft arteriography at an average of 7 to 14 days postoperatively. In 149 patients, satisfactory preoperative and postoperative biplane left ventriculograms were obtained. Regional wall motion was assessed by the 100 segment method of Sheehan and Dodge, and a perioperative change in shortening greater than 2 standard deviations of normal variability over 20 or more adjacent segments was considered significant. Ninety-five patients had stable or progressive angina, 88 had medically refractory unstable angina, 155 were in New York Heart Association Class IV, and 37 had a preoperative left ventricular ejection fraction of less than 0.4. Myocardial integrity was preserved with crystalloid cardioplegia and topical hypothermia. Seven hundred ninety-eight bypass grafts were performed (522 vein grafts and 276 mammary artery grafts), and 13 patients had concomitant left ventricular aneurysmectomy. Hospital mortality was 2.2%. The overall early graft patency rate was 95.9% (93.7% for vein grafts and 100% for mammary arteries). Only one patient had a decrement in regional wall motion, and 51 (37%) had significant postoperative improvement (27 in the unstable angina group and 24 in the stable angina group); in the patients with improved regional wall motion, ejection fraction increased by an average of 0.18 (p less than 0.01). Ejection fraction also improved after aneurysmectomy, and the increment seemed to result from both a reduction in end-diastolic volume and improved regional wall motion. Thus, reversible ischemic myocardial dysfunction appears to be common in the general population of patients undergoing coronary artery bypass grafting; 40% of patients with unstable angina and 34% of those with stable angina can be expected to have improved regional wall motion after successful revascularization. Finally, ventricular aneurysm resection significantly enhances left ventricular performance as assessed by ventriculographic ejection fraction.
 ...
PMID:The effects of coronary revascularization on left ventricular function in ischemic heart disease. 406 32

Pituitary coma is a rare case of emergency and primarily due to ACTH and TSH deficiency. Pituitary coma occurs more often in patients with well-known pituitary deficiency than in patients with intrasellar tumor. Clinical manifestations are hypotonia, bradycardia, decreased skin and nipple pigmentation, muscle weakness, vomitus, nausea, obstipation, hypothermia, and hypoventilation. A postpartal agalactia is often the first sign of Sheehan's syndrome. Unlike primary adrenal insufficiency (Addison's disease) ACTH deficiency does not cause hyperpigmentation, hyperkalemia, or salt loss. The suspicion of pituitary coma requires replacement with 100 mg hydrocortisone iv, 200 mg hydrocortisone iv/24 h, 500 micro g levothyroxine iv and fluid substitution. Since thyroxine accelerates the degradation of cortisol and can precipitate adrenal crisis in patients with limited pituitary reserve, hydrocortisone replacement should always precede levothyroxine therapy. ACTH stimulation test, CRH stimulation test and insulin tolerance test (optional) should be performed after therapeutic compensation to determine pituitary function.
 ...
PMID:[Hypophyseal coma]. 1468 87

Sheehan's syndrome is described as panhypopituitarism secondary to a pituitary hypoperfusion during or just after obstetric hemorrhage. Advances in obstetric care make this syndrome quite unusual, but some cases are reported in underdeveloped countries. Clinical presentation may change depending on the severity of the hormone deficiencies. The diagnosis is clinical, but abnormalities are observed in the magnetic resonance in up to 70% of patients. We present a case of a woman with hypotension, hypothermia and edemas in relation to a previous massive postpartum hemorrhage. Failure in lactation was the clue to the diagnosis. A review of its main features, its diagnosis and treatment in the current literature is also presented.
...
PMID:[Sheehan's syndrome after obstetric hemorrhage]. 2463 98