Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recombinant gamma interferon (r-GIFN) demonstrates in vitro and in vivo characteristics that contrast with those of alpha and beta interferons. It has relatively weak antiviral properties, yet relatively potent immunomodulatory effects. A phase I trial was performed with r-GIFN (specific activity 2.6 X 10(6) IU/mg protein), administered as a continuous intravenous (IV) infusion over 24 hours for five days (Cl X 5) and repeated every 28 days. This schedule was chosen based on the short half-life of r-GIFN in animal systems and the in vitro augmentation of biologic effects with continuous exposure to interferons. Twenty-one patients with refractory solid tumors received 46 evaluable courses of therapy. The dose-limiting toxicities included fever, flu-like symptoms, cardiovascular toxicity, and neurotoxicity. The cardiovascular toxicity included hypotension and one episode of cardiac ischemia with chest pain. Neurotoxicity consisted of lethargy and confusion. These toxicities were reversible, and although dose-limiting, occurred sporadically throughout all dosage levels. Mild to moderately severe non-dose-limiting toxicities included nausea and vomiting, leukopenia, and liver function abnormalities. Other infrequent toxicities included hypocalcemia, diarrhea, constipation, and alopecia. The maximally tolerated dose of r-GIFN on this schedule is 0.5 X 10(6) IU/m2/d. Partial responses were seen in one patient with metastatic melanoma and in one patient with renal cell carcinoma. Toxicity and antitumor activity were seen at doses where interferon serum levels could not be detected by radioimmunoassay. In addition, the toxicity and antitumor activity seen were at much lower doses than previously described for shorter infusion schedules of other recombinant gamma interferon preparations. Differences in biologic activity of interferon preparations and/or differences in scheduling may account for this variability. Although this study defines a recommended phase II dose of r-GIFN based on the maximally tolerated dose, the optimal therapeutic index may exist at a lower dosage level.
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PMID:A phase I clinical trial of recombinant DNA gamma interferon. 310 84

Neonatal necrotizing enterocolitis is the most common serious gastrointestinal disorder encountered in neonatal intensive care units. It is a major cause of morbidity and mortality in the newborn, particularly in premature infants. Consistent risk factors are birth weight and prematurity. Polycythemia and hyperviscosity altering blood flow and infectious agents are also implicated. Clinical findings include abdominal distention and diarrhea, and systemic symptoms such as apnea, acidosis, and lethargy. Pneumatosis intestinalis can be demonstrated radiographically. Mucosal ulcerations, hemorrhage, and thrombosis occur early, followed by inflammatory changes. Later still necrosis develops. Ischemia, infection, and enteral feedings are suspected to be involved in the pathophysiology. Eicosanoids, especially thromboxane, platelet-activating factor, and leukotrienes are likely mediators.
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PMID:Neonatal necrotizing enterocolitis. Inflammatory bowel disease of the newborn. 312 29

Although chronic mesenteric ischemia is an infrequent, even rare, condition and a busy vascular surgeon may encounter only one such patient in a year, the associated morbidity and mortality are high, especially if the condition is not recognized. General and vascular surgeons must bear in mind the triad of postprandial pain, weight loss and diarrhea. Patients with mesenteric ischemia are at high risk and generally have diffuse peripheral vascular disease. Although surgery is hazardous, successful repair can result in long-term survival without morbidity. The author favours antegrade supraceliac bypass grafting over infrarenal grafting which is technically more difficult.
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PMID:Chronic mesenteric ischemia. 336 11

Anemia in runners is common but its origin is unknown. The present study reports on frequency and origin of gastrointestinal blood loss in cross-country skiers and runners. 41 participants in the Engadin Ski Marathon were checked by questionnaire and occult blood test. 8 (19%) had diarrhea or abdominal pain during or immediately after skiing and 3 (7%) had hemoccult-positive stools. In addition, the blood flow of the superior mesenteric artery was measured by duplex scanning in two trained runners after standardized exercise. While the mesenteric blood flow in the asymptomatic runner changed only insignificantly there was an impressive decrease in the second runner, who had been treated for anemia, down to 20% and 40% (30 and 90 min respectively) after exercise. It is concluded that the occurrence of gastrointestinal blood loss in cross-country skiing, and the significant decrease in mesenteric blood flow in a symptomatic runner, indicate a close and possible causal relationship between mesenteric ischemia and "jogging anemia".
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PMID:[Mesenterial anemia as a cause of jogging anemia?]. 376 81

An unusual case of colitis in a 37-year-old cocaine addict is described. The patient presented with right-sided abdominal pain and diarrhea exacerbated by his use of cocaine. Significant antibiotic ingestion was denied. At laparotomy, an edematous cecum and ascending colon were found, the cut surface of which revealed diffuse superficial ulcerations and yellowish fibrinous material. Microscopic examination demonstrated findings consistent with pseudomembranous colitis with an ischemic component. A mechanism involving catecholamine-induced mucosal ischemia is postulated to explain the findings seen in this patient.
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PMID:Cocaine colitis. Is this a new syndrome? 397 30

A case of mesenteric vascular occlusion is detailed. The 30-year-old female had abdominal pain, bloody diarrhea, and small bowel changes seen on x-ray. She had begun taking the oral contraceptive Ovral (.5 mg norgestrel, .05 mg ethinyl estradiol) 3 years prior to hospital admission. Symptoms began to disappear when her oral contraception was discontinued on the ninth hospital day. Over the next 5 days abdominal signs and symptons subsided progressively. A follow-up small bowel series showed complete disappearance of previous abnormalities. In the differential diagnosis of acute abdominal pain progressing to bloody diarrhea, especially in young women or oral therapy, acute vascular insult with small bowel ischemia must be considered.
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PMID:Reversible mesenteric vascular occlusion associated with oral contraceptives. 470 Oct 37

An 11 year old boy was admitted to the Department of Pediatrics Medical School of Vienna with 2nd and 3rd degree burns covering 30% of his body. He presented with complications--high fever, vomiting, diarrhea and dehydration--which had led to acute renal failure. After 6 hemodialyses renal function recovered after two weeks and the patient entered a polyuric phase. In connection with a transient dehydration the patient showed a sudden bilateral cortical blindness. The computerized tomogram (CT) showed vague evidence of an occipital cortical ischemia. We assume that several factors have played a role in this sudden occurrence. As a result of hypovolemia and coincident anemia and electrolyte inbalance, cerebral edema and cortical tissue hypoxia with emphasis in the occipital cortical region developed in the brain possibly already damaged by burn injury. A complete reversal of the clinical state was achieved. The patient was discharged with normal vision and normalized renal function.
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PMID:[Acute cortical blindness: a reversible complication of acute kidney failure in a child with burns]. 683 79

Acute mesenterial ischemia resulting from thrombosis of atherosclerotic mesenterial arteries still carries a very high mortality, even when revascularization is undertaken early. Four patients are presented in whom acute revascularization of the superior mesenteric artery with minor intestinal resections were performed. Three of the patients had previous histories of abdominal angina; one of these died postoperatively. Of the surviving three patients, two were free of gastrointestinal symptoms 13 and 19 months after the operation respectively, while the last was still hospitalized three months postoperatively with frequent bouts of diarrhea and feeding problems. Since approximately 50 per cent of patients with acute intestinal ischemia develop abdominal angina prior to the acute exacerbation, it is of utmost importance to diagnose this condition before onset of the acute episode, as an elective operation has a low mortality and a good long-term prognosis. A dramatic improvement in the operative results of the acute episode are not to be expected, but revascularization as soon as possible after the onset of the acute episode combined with localized intestinal resection as required can improve the prognosis, especially in younger patients free from complicating cardiac disease.
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PMID:Emergency revascularization of the superior mesenteric artery in acute intestinal ischemia caused by thrombosis. 694 87

Intestinal ischemia should be suspected in any patient following aortic surgery who has pain out of keeping with the operation, postoperative diarrhea (with or without bleeding) or an unexplained metabolic acidosis. Ten such cases of intestinal ischemia were identified during a 10-year period at the Toronto General and Toronto Western hospitals. Six occurred following repair of a ruptured abdominal aneurysm, one followed elective aneurysmectomy and three followed elective bypass for occlusive disease. The overall mortality was 70%. Transmural bowel infarction was found in six patients (all died), while four patients had partial-thickness injury (one died, three had late strictures). Potentially preventable factors in each patient, either single or multiple, were identified and are discussed. Emphasis on early diagnosis is stressed, because once transmural necrosis has occurred the prognosis is poor.
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PMID:Incentive breathing devices and chest physiopathy: a controlled therapy. 697 22

A 48-yr-old woman with chronic intestinal ischemia and a long history of oral contraceptive use is reported. She presented with a 6-month history of severe diarrhea, abdominal pain, and weight loss. Abdominal arteriography revealed occlusion of the celiac axis at its origin and 90% stenosis of the superior mesenteric artery. This chronic arterial lesion has not been previously noted in association with the use of oral contraceptive agents in otherwise healthy women. The patient's isolated arterial lesions proved amenable to successful surgical bypass. Postoperatively she became completely asymptomatic and has remained so on long-term follow-up.
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PMID:Chronic intestinal ischemia associated with oral contraceptive use. 706 61


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