Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Quality-of-life (QOL) assessment is becoming increasingly important in the evaluation of the impact of disease and the effect of therapy. This is particularly so forirritable bowel syndrome (IBS) where there is often a tendency for a chronic clinical course, but with no associated mortality. Instruments used to study quality of life may be generic or disease specific, and care needs to be taken to ensure that the instrument used has been adequately validated for the purpose intended. Several disease-specific instruments [Irritable Bowel Syndrome Quality of Life (IBS-QOL, IBSQOL) and Functional Digestive Disorders Quality of Life (FDDQL)], in addition to generic measures, are now available for use in IBS. Quality of life in patients with IBS is surprisingly poor, particularly in the population seeking healthcare, where it can be compared with conditions which carry a high mortality, such as ischaemic heart disease, heart failure and diabetes mellitus. Pain severity appears to be an important factor in determining quality of life in IBS, although bowel disturbance and psychological difficulties are also likely to be important. There is limited data on the effect of treatment of IBS on quality of life. Improvement has been reported with dietry modification, drug treatments and hypnotherapy. It is likely that, in the future, QOL measures will become increasingly used as secondary end-points in therapeutic trials in IBS.
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PMID:Quality of life in irritable bowel syndrome. 1145 12

Doxorubicin (DXR) is one of the most effective antineoplastic agents, but its use is limited by its myocardial toxicity. Myocardial injury reduces the cyclic variation of integrated backscatter (CV-IBS) and so the present study was designed to investigate whether CV-IBS can be used to detect the early phase of myocardial damage in patients receiving DXR. Thirty-four subjects constituted the study population, none of whom showed clinically evident heart failure. CV-IBS was obtained for both the interventricular septum and the left ventricular posterior wall in the parasternal short-axis view. Standard echographic measures of left ventricular function were also made. Subjects without DXR exposure or evident cardiac diseases served as controls. The total dose of DXR administered per patient was 339+/-164 mg/m2 (range: 95-680 mg/m2). Conventional echographic parameters, including left ventricular wall thickness, dimensions, fractional shortening, and ejection fraction, showed no significant differences between the 2 groups. In contrast, CV-IBS was significantly decreased in the DXR group compared with the control group (septum: 4.7+/-1.7 vs 7.2+/-1.9 dB, p<0.0001; posterior wall: 6.7 +/-2.2 vs 8.0+/-1.6 dB, p<0.05). CV-IBS can be used as an early indicator of DXR-induced myocardial damage in patients demonstrating normal left ventricular systolic function.
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PMID:Early detection of doxorubicin-induced myocardial damage by ultrasound tissue characterization with integrated backscatter. 1457 99

Myocardial involvement is a common finding in certain myopathies, while it has not been extensively investigated in facioscapulohumeral muscular dystrophy (FSHD1A). Aim of this study was to assess in FSHD1A patients the electrical and functional properties of the myocardium. Twenty-four patients with FSHD1A (mean age 41.2+/-14.5 years) and 24 matched healthy subjects were studied. Standard- and signal-averaged electrocardiography were recorded to determine QT dispersion and the presence of ventricular late potentials (VLPs). Standard echocardiography with systo-diastolic variations of integrated backscatter signal (CV-IBS) were performed to assess functional properties of the myocardium. Compared with control subjects, patients with FSHD1A had significantly lower CV-IBS and higher QT dispersion. Nine patients had positive VLPs. QT and QTc dispersion were inversely related to CV-IBS at both septum and posterior wall levels. Moreover, septal CV-IBS was inversely related to the Kpnl-BinI4q fragment size. These results suggest a subclinical cardiac involvement in FSHD1A patients, which can represent a substrate for ventricular arrhythmias and heart failure.
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PMID:Subclinical cardiac involvement in patients with facioscapulohumeral muscular dystrophy. 1636 38

Heart rate variability (HRV) indices based on 24-hr electrocardiograph recordings have been used in clinical research studies to assess the aggregate activity of the autonomic nervous system. Although 24-hr HRV is generally considered noninvasive, use in research protocols typically involves considerable data collection and processing expenses and substantial participant burden. The purposes of this research methods evaluation were to describe the relationships between 24-hr minimum heart rate (HR) and several 24-hr time domain HRV indices (Ln SDNN, Ln SDANN, Ln SDNNIDX, Ln RMSSD, and Logit50) across several research data sets (normal women, normal men, children enrolled in a study of recurrent abdominal pain, women with irritable bowel syndrome, sudden cardiac arrest survivors, and heart failure patients) and to explore the possibility that 24-hr minimum HR might serve as a simpler alternative or adjunct to HRV measures in some situations. The correlations of global HRV measures (e.g., Ln SDNN, Ln SDANN) with 24-hr minimum HR were consistently larger (typical r approximately -.80) than with average HR (typical r approximately -.50). In repeated measurements, change in minimum HR was also correlated with change in general HRV (typical r approximately -.60). However, modest differentiation of minimum HR and HRV measures was noted in patients taking certain classes of cardiac medications (e.g., anti-arrhythmics, beta blockers). Twenty-four-hour minimum HR is correlated with general time domain HRV measures and might be useful as a simpler proxy, surrogate, or auxiliary variable in some clinical research applications, especially those in which participants are not receiving cardiac medications.
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PMID:Heart rate variability and 24-hour minimum heart rate. 1658 96

Monitoring intrathoracic impedance has become an integral part of follow-up of patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy/defibrillator due to heart failure. However, several noncardiac factors may influence intrathoracic impedance. We report on an unusual cause of decrease in intrathoracic impedance in a 54-year-old male patient following successful implantation of biventricular ICD for heart failure symptoms due to nonischemic dilated cardiomyopathy and severely impaired left ventricular systolic function. During the follow-up period, the patient presented several times with the OptiVol alarm due to an increase in the OptiVol fluid index, in the absence of symptoms or signs of heart failure. Further inquiry into the possible causes of decreased intrathoracic impedance revealed that the patient had frequent episodes of irritable bowel syndrome, which increased intra-abdominal pressure, leading to elevation of diaphragm and subsequent compression of intrathoracic organs, and thus to a decrease in intrathoracic impedance.
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PMID:An unusual cause of OptiVol alarm: increased intra-abdominal pressure associated with irritable bowel syndrome. 2001 54

The introduction of biologic therapy for the treatment of IBD has substantially changed its management. The safety concerns associated with biologic therapies include the increased risk of infection, autoimmunity, development of lymphoma and demyelinating disease, and the risk of worsening heart failure. There are several strategies for minimizing the risks associated with biologic therapies. Pretreatment strategies include taking a proper history from the patient, physical examination of the patient, screening for latent tuberculosis and ruling out sepsis. Vaccination of patients against vaccine preventable diseases is also recommended. During treatment, patients should be closely monitored and any symptoms that develop should be dealt with early. Education of physicians and patients is also important to allow the early detection of any adverse events.
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PMID:Optimizing the safety of biologic therapy for IBD. 2013 91

5-HT4 receptor antagonists have been suggested to have clinical potential in treatment of atrial fibrillation, diarrhea-prone irritable bowel syndrome and urinary incontinence. Recently, the use of 5-HT4 antagonists has been suggested to have a therapeutic benefit in heart failure. Affinity for the hERG potassium ion channel and increased risk for prolonged QT intervals and arrhythmias has been observed for several 5-HT4 ligands. Serotonin may also have beneficial effects in the central nervous system (CNS) through stimulation of the 5-HT4 receptor, and reduced distribution of 5-HT4 antagonists to the CNS may therefore be an advantage. Replacing the amide and N-butyl side chain of the 5-HT4 receptor antagonist SB207266 with an ester and a benzyl dimethyl acetic acid group led to compound 9; a hydrophilic 5-HT4 antagonist with excellent receptor binding and low affinity for the hERG potassium ion channel. To increase oral bioavailability of carboxylic acid 9, two different prodrug approaches were applied. The tert-butyl prodrug 11 did not improve bioavailability, and LC-MS analysis revealed unmetabolized prodrug in the systemic circulation. The medoxomil ester prodrug 10 showed complete conversion and sufficient bioavailability of 9 to advance into further preclinical testing for treatment of heart failure.
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PMID:Synthesis and pharmacological properties of a new hydrophilic and orally bioavailable 5-HT4 antagonist. 2371 70

Oral immunization with vaccines has proven its worth by eradicating several diseases worldwide, yet only few oral vaccines exist in practice. This is because the oral route is plagued with various challenges for successful delivery of vaccines, such as limited absorption and high degradation in the gastrointestinal tract. Tremendous research in the last decade has made bilosomes a potential carrier system for oral immunization. Bilosomes with its name derived from bile salts (which is one of its major constituent), is a 'niosome-like' colloidal carrier. The collective information addressed through this review, convincingly points out that factors such as size, composition (type of bile salt, and lipid), charge, ligand attached, etc., which show significant influence on the type, and amount of immunity developed following the oral administration of bilosomes. These bile salts containing vesicular carriers have been employed to treat various serious conditions. Some of these methods have been successfully established into patents. Bilosomes loaded with antigens, peptides and other biological materials for the treatment of influenza, heart failure, diuresis, Irritable Bowel Syndrome (IBS) and other gastrointestinal disorders have been discussed in the present article.
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PMID:Bilosomes: A Novel Approach to Meet the Challenges in Oral Immunization. 2607 57

The incidence and prevalence of neuroendocrine tumors (NETs) are continually increasing. While it is known that NET symptoms often predate diagnosis, their prevalence and impact on resource utilization and costs are largely unknown. We identified 9,319 elderly patients diagnosed with NETs between 1/2003 and 12/2011 from the Surveillance, Epidemiology and End Results (SEER)-Medicare. We examined the patients' conditions potentially associated with NET, resource utilization and costs during the year before diagnosis. We found that NET patients were more likely to have diagnoses of hypertension (63.8% vs. 53.3%), abdominal pain (22.2% vs. 7.6%), heart failure (11.7% vs. 8.0%), diarrhea (5.8% vs. 1.8%), peripheral edema (5.4% vs. 3.8%) and irritable bowel syndrome (1.2% vs. 0.5%) compared to the non-cancer control group. They also had much higher resource utilization including number of outpatient visits (mean: 22.1 vs. 17.2), percentage with ER visits (20.9% vs. 11.6%), and hospitalizations (28.4% vs. 17.0%). Similarly, NET patients incurred significantly higher total (mean: $14602 vs. $9464), outpatient (mean: $5987 vs. $4253), and inpatient costs (mean: $8615 vs. $5211). This first population-based study on the pre-diagnosis symptoms and healthcare utilization found that NET patients were more likely to have certain conditions and incur higher resource utilizations and costs.
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PMID:Pre-existing Symptoms and Healthcare Utilization Prior to Diagnosis of Neuroendocrine Tumors: A SEER-Medicare Database Study. 3044 2

Iron deficiency anaemia is a common problem. The majority of patients are treated with oral iron supplements. The current recommended dosage for oral supplementation of 200 mg ferrous fumarate 3x per day however, is based on a single small study of poor quality. There is no consensus concerning parenteral dosing. In recent years, new insights have been gained regarding both the dosage of oral supplementation and the indication for parenteral supplementation. Oral therapy is preferred. In principle, 100 mg ferrous fumarate once a day is sufficient for the treatment of symptom-free patients with anaemia. In cases of severe anaemia, or in patients with symptoms, 200 mg/day should be prescribed. If side effects appear, it can be dosed every other day. Where oral therapy does not show effectiveness, the anaemia is severe, or rapid increase of haemoglobin is indicated, parenteral supplementation should be chosen. Parenteral supplementation is more effective than oral supplementation in specific conditions, such as dialysis-dependent renal insufficiency, heart failure or active IBD.
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PMID:[Iron supplementation in iron deficiency anaemia]. 3158 37


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