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)

A case report of subacute, reversible ischemic colitis associated with use of oral contraceptives (OCs) is reported. A 19-year-old woman was admitted to the hospital with chief complaints of abdominal cramps, nausea, vomiting, diarrhea, and rectal bleeding of 2 days' duration. Past medical history and family history were noncontributory. The patient was receiving no medication other than Norinyl 2 (2 mg of norethindrone and .1 mg of mestranol), which she had been taking for 6 months. 2 days before admission the patient had taken 100 mg of dimenhydrinate and 2 ExLax tablets (90 mg of phenolphthalein) for constipation. Colonic roentgenograms revealed impaired mesenteric circulation and bowel ischemia; OC-induced ischemic bowel disease was diagnosed. Patient symptoms subsided within 96 hours of discontinuing the OC and initiating supportive therapy (including intravenous fluid infusion, nasogastric suction, analgesics, and antiemetics). When a repeat barium enema was performed, it showed resolution of the ischemia. In a short review following the case report, these drugs were indicted in causation of colitis-like syndrome: amoxicillin, ampicillin, cephazolin, chloramphenicol, chlorpropamide, clindamycin, cloxacillin, cotrimoxasole, cyclophosphamide, digitalis, ergotamine tartrate, flucytosine, fluorouracil, gold salts, laxative and cathartic abuse, mercurous chloride, methyldopa, penicillin V, and tetracycline. Ischemic bowel disease secondary to OC use is a rare but important complication because of its significant morbidity and potential mortality, and because of the widespread use of the drugs. The case report emphasizes the need to consider the differential diagnosis of acute vascular insult with bowel ischemia when acute abdominal pain progressing to bloody diarrhea occurs in young women taking OCs.
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PMID:Oral contraceptive-induced ischemic bowel disease. 48 72

The authors report a case of acute cardiac failure linked to 5 fluoro-uracil. The toxicity seen most commonly involves ischemia. The pathophysiological mechanisms are discussed as well as the role played by pharmacokinetic characteristics in the occurrence of adverse reactions. 5 fluoro-uracil (5 FU) is a compound widely used in the treatment of ENT, breast and gastrointestinal carcinomas. The finding of dose-effect relationship may lead the clinician to use different modes of administration. Continuous administration at high dose 3 g/m2/day from D1 to D5) in combination or not with cisplatin, or continuously at low dose (300 mg/m2/day from D1 to D31) can reduce hematopoietic toxicity but, in contrast, increases gastrointestinal toxicity.
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PMID:[A case of acute cardiac insufficiency caused by 5-fluorouracil]. 151 65

Primary dysmenorrhea occurs mostly in young women with a painful bleeding pattern. In a recent study, 72% of 19-year-old women had light, 19% had medium to severe, and 8% had severe symptoms. Secondary dysmenorrhea means pathological organic alterations of the genital tract: uterus myomatosus, endometrial polyps, endometriosis, and retroflexed uterus. IUDs can also generate this condition. A certain imbalance of estradiol and progesterone results in defective prostaglandin formation in the endometrium (too much PGF2alpha and too little PGI2) as well as in abnormal and increased uterine contractility and diminished endometrial, blood supply with concomitant painful ischemia. Increased prostaglandin synthesis leads to inflammatory processes and the traumatization of the endometrium (high PGF2alpha level), but IUDs also often cause secondary dysmenorrhea. Treatment calls for the normalization of prostaglandin formation in the uterus by dietary change by increasing fatty acid intake (fish oils and plant fats), and also by the systematic addition of exogenic gestagens (Duphaston 10 mg/day po. Orgametril 5 mg/day), and by the use of the progesterone-releasing IUDs (Biograviplan and Progestasert) that lessen the contractility of the myometrium by reducing PGF2-alpha synthesis. If pregnancy is to be avoided hormonal ovulation inhibitors as optimal, since their effectiveness is over 90% (Cilest, Femovan, Marvelon, and Ortho-Novum 2 mg). If contraception is not sought, nonsteroidal antiphlogistics are recommended: ibuprofen (400 mg 3-4 times/day), naproxen (250 mg 4-5 times/day), flufenamic acid (200 mg/day tid), mefenamic acid (500 mg 3 tid or 250 mg qid), aspirin (650 mg every 4-6 hours), indomethacin (25 mg tid, although it is relatively toxic). Magnesium is a natural calcium antagonist that can influence the intracellular calcium concentration in the myometrium. THe calcium blocker nifedipin (20-40 mg po) and beta-sympathomimetics (Partusisten) also mitigate uterine contractions, but the latter can produce more side effects as a consequence of interfering in the vegetative nervous system.
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PMID:[Drug therapy of dysmenorrhea]. 289 19

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

In Belgium, physicians at Heilig Hart Kliniek in Roeselare removed half of the colon of a 22-year-old woman suffering from obstructing Crohn's disease of the terminal ileum. 2 weeks after leaving the hospital she had diarrhea and abdominal cramps and neither fecal culture nor Clostridium difficile toxin were positive. 2 weeks later she experienced the same symptoms, but the diarrhea was now profuse watery diarrhea mixed with blood. The physicians performed a biopsy of the colonic segment at both ends of the left colon which revealed signs of ischemic colitis (obvious congestion, acute extravasation of blood, and focal desquamation of epithelial cells). So they ordered parenteral feeding for 24 hours, after which she had no more symptoms. She began oral feeding with no complications. When the physicians learned that after discharge she began using the combined oral contraceptive (OC) Trinovum and 2.5 mg dihydroergotaminemesilate to treat migraine, they told her to stop taking the ergotamine alkaloid and recommended that she not use the OC. She agreed to stop using the migraine medication but started using the OC again. 4 months after the biopsy she no longer has side effects. The woman had multiple risk factors of ischemic colitis development: OC use and use of an ergotamine alkaloid. The potentially vasoconstrictory and thrombogenic factors may have irritated underlying vascular injury and the tendency of focal mesenteric thrombosis which is often present in people with Crohn's disease. Therefore, the physicians deducted that OC use and use of ergotamine alkaloid were responsible for the ischemia. In conclusion, ergotamine alkaloid use in association with OC use is contraindicated in women who have predisposing factors, e.g., thrombogenic disease or coagulation abnormalities.
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PMID:Ischemic colitis in a patient with Crohn's disease taking an oral contraceptive and an ergotamine alkaloid. 838 3

Estrogens are potent neuroprotective compounds in a variety of animal and cell culture models, and data indicate that estrogen receptor (ER)-mediated gene transcription is not required for some of these effects. To further address the requirement for an ER in estrogen enhancement of neuronal survival, we assessed the enantiomer of 17beta-estradiol (ENT-E(2)), which has identical chemical properties but interacts only weakly with known ERs, for neuroprotective efficacy. ENT-E(2) was both as potent and efficacious as 17beta-estradiol in attenuating oxidative stress-induced death in HT-22 cells, a murine hippocampal cell line. Further, ENT-E(2) completely attenuated H(2)O(2) toxicity in human SK-N-SH neuroblastoma cells at a 10 nM concentration. In a rodent model of focal ischemia, 17beta-estradiol (100 microgram/kg) or ENT-E(2) (100 microgram/kg), injected 2 h before middle cerebral artery occlusion, resulted in a 60 and 61% reduction in lesion volume, respectively. ENT-E(2), at the doses effective in this study, did not stimulate uterine growth or vaginal opening in juvenile female rats when administered daily for 3 days. These data indicate that the neuroprotective effects of estrogens, both in vitro and in vivo, can be disassociated from the peripheral estrogenic actions.
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PMID:The nonfeminizing enantiomer of 17beta-estradiol exerts protective effects in neuronal cultures and a rat model of cerebral ischemia. 1114 3

The development of new therapies for treatment of chronic wounds has not matched the availability of treatment modalities forecast by the pharmaceutical industry. This is attributable in large part to difficulties encountered in clinical trials as well as in isolating study design variables. Our hypothesis attempts to address this shortcoming. We are proposing that chronic wound pathogenesis is based on 3 fundamental factors: the cellular and systemic changes of aging, repeated ischemia-reperfusion injury, and bacterial colonization with resulting inflammatory host response. The derivation of this hypothesis is founded on the observation that the 3 primary categories of chronic wounds--pressure ulcers, diabetic ulcers, and venous ulcers, which are the overwhelming majority of chronic wounds--have these common causative factors. Our hypothesis incorporates major implications for treatment modalities based on these factors. Addressing the first issue, the cellular and systemic changes of aging, Regranex (Ortho-McNeil Pharmaceutical, Inc, Raritan, NJ), a platelet-derived growth factor drug, has shown great promise. Additional treatment modalities that address the second and third problems, repeated ischemia-reperfusion injury and bacterial colonization, include vacuum-assisted closure, warming of local tissue, and water irrigation using pulsed lavage. Additionally, treatment comprising a combination of these approaches has demonstrated success.
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PMID:Understanding chronic wounds: a unifying hypothesis on their pathogenesis and implications for therapy. 1514 94

Plastic and reconstructive ENT surgery serves for reconstruction of form and function. Frequent indications in ENT surgery are the covering of large tissue defects after tumor operations, firing and/or explosion injuries, accidents, burns or massive infections. A high revision rate of up to 20 % in selective patient groups show that more knowledge of both monitoring and ischemia-/reperfusion mechanisms is necessary. Besides improved monitor proceedings biochemical cell procedures in pedicled and free flaps are getting more focused. In the last years certain physical and medical factors appear, which have influence on the long-term surviving of a pedicled or free flap, e. g. pre- and/or postconditioning. The increasing knowledge of changes in perfusion and oxygenation, which prevail in the flap, as well as different options of physical and pharmacological therapies permit a promising view into the future, in order to achieve an improved surviving of a pedicled or free flap in combination with improved monitor proceedings.
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PMID:[Monitoring and conditioning in plastic and reconstructive ENT-surgery]. 1708 4

Many patients call the ENT emergency department because of vertigo and sudden hearing loss. The majority of cases are due to peripheral or neurootological reasons. A serious and ongoing problem is that life-threatening ischemic, hemorrhagic and inflammatory diseases of the central nervous system may cause identical symptoms, making it difficult to differentiate between them. On the basis of our own patients with cerebellar ischemia, basilar thrombosis, dissection of the vertebral artery, cerebellar abscess, brain tumor and cholesteatoma and on the basis of expert opinions, typical sets of symptoms in patients with neurootological symptoms of a central cause are defined. To ensure early detection of these rare differential diagnoses, physicians should place particular importance on modern imaging diagnostics and neurological, interdisciplinary cooperation.
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PMID:[Life-threatening differential diagnoses of vertigo and sudden hearing loss]. 1856 85

Pyrimidine and purine nucleosides and their derivatives have critical functions and pharmacological applications in the brain. Nucleosides and nucleobases are precursors of nucleotides, which serve as the energy-rich currency of intermediary metabolism and as precursors of nucleic acids. Nucleosides (e.g., adenosine) and nucleotides are key signaling molecules that modulate brain function through interaction with cell surface receptors. Brain pathologies involving nucleosides and their metabolites range from epilepsy to neurodegenerative disorders and psychiatric conditions to cerebrovascular ischemia. Nucleoside analogs are used clinically in the treatment of brain cancer and viral infections. Nucleosides are hydrophilic molecules, and transportability across cell membranes via specialized nucleoside transporter (NT) proteins is a critical determinant of their metabolism and, for nucleoside drugs, their pharmacologic actions. In mammals, there are two types of nucleoside transport process: bidirectional equilibrative processes driven by chemical gradients, and unidirectional concentrative processes driven by sodium (and proton) electrochemical gradients. In mammals, these processes, both of which are present in brain, are mediated by members of two structurally unrelated membrane protein families (ENT and CNT, respectively). In this Chapter, we review current knowledge of cellular, physiological, pathophysiological and therapeutic aspects of ENT and CNT distribution and function in the mammalian brain, including studies with NT inhibitors and new research involving NT knockout and transgenic mice. We also describe recent progress in functional and molecular studies of ENT and CNT proteins, and summarize emerging evidence of other transporter families with demonstrated or potential roles in the transport of nucleosides and their derivatives in the brain.
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PMID:Molecular biology of nucleoside transporters and their distributions and functions in the brain. 2140


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