Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this 16-week trial was to determine the safety and efficacy of a step-care regimen of ramipril, an angiotensin converting enzyme inhibitor, from the minimal active dose (2.5 mg) in patients treated for mild to moderate hypertension. The trial was conducted by 102 general practitioners in 770 patients with mild to moderate hypertension. After a response rate to a 4-week placebo therapy of 9.1%, 57.0% of patients given active treatment with ramipril responded to daily doses of 2.5 mg. Ramipril 5 mg daily was effective in 55.6% of the remaining patients. There was no apparent statistically significant difference between the treatments with ramipril 10 mg or a combination of ramipril 5 mg + Lasix 20 mg daily (44.7% and 47.4% response respectively) in a 6-week double-blind arm of the study. In total, more than 90% of patients responded to treatment with ramipril by the end of the study. The incidence of adverse events was generally low, such as headache, cough, dizziness, asthenia, cramps and nausea. The incidence of cough appeared to be related both to the dosage of ramipril given and to outbreaks of influenza syndrome. Thirty-eight patients discontinued active treatment as a result of minor events such as cough, dizziness or diarrhoea, and one case each of myalgia and papular rash. There were no significant variations in laboratory parameters during the study, especially fasting blood glucose and apolipoprotein A1 and B. The results of this study provide evidence of the safety and efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The French multicentre study of ramipril in ambulatory patients with mild-to-moderate hypertension. 130 60

Gastrointestinal involvement by amyloidosis is common, but large clinicopathological studies specifically addressing gastric amyloidosis are lacking. Seventy-nine patients with biopsy-proven, gastric amyloidosis were identified by a retrospective review of our pathology archives, from 2007 to 2013. Amyloid typing was performed by laser microdissection/mass spectrometry (in 44 patients), immunohistochemistry, immunofluorescence, and/or genetic testing. The median age at diagnosis was 62years, with 61% being males. The amyloid was derived from immunoglobulin light chain (67%), transthyretin (ATTR) (18%), serum amyloid A (9%), and apolipoprotein A1 (3%). When other gastrointestinal sites were biopsied, amyloid was demonstrated in the small bowel (89%), colon (81%), and esophagus (33%). The most common gastrointestinal manifestations were weight loss (37%), abdominal pain/dyspepsia (23%), and nausea/vomiting (23%). Endoscopic findings included normal (35%), erythema (33%), erosions (18%), and nodularity (15%) and were not related to amyloid type. No case showed gastric lymphoma. The most common location of amyloid was the muscularis mucosae regardless of the type of amyloid. Lamina propria involvement was less frequent in ATTR than other types. In 22% of patients, the first diagnosis of amyloid was based on the gastric biopsy. Patients' survival at 3years was 60% and was not different by type of amyloid. Our study shows that light-chain amyloidosis is the most common form of gastric amyloidosis, followed by ATTR. Type of amyloid cannot be predicted based on clinical or endoscopic findings, and therefore, biopsy with amyloid typing, preferably by laser microdissection/mass spectrometry, is critical to establish the correct diagnosis, prognosis, and appropriate treatment.
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PMID:Gastric amyloidosis: clinicopathological correlations in 79 cases from a single institution. 2564 8