Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The fifth leading cause of death in the United States, chronic obstructive respiratory conditions, cannot be cured but can be considerably ameliorated by appropriate management. Many patients with COPD have a combination of chronic bronchitis, asthma, and emphysema. While the damage due to emphysema is permanent, many of the pathophysiologic changes of asthma and bronchitis can be reversed to some extent, and such reversal should be a goal of therapy. Smoking cessation will help the patient more than any other medical treatment. Bronchodilator therapy is best given by inhalation from a metered dose inhaler and on a maintenance basis. Be sure to check inhaler technique. An anticholinergic agent, eg, ipratropium bromide, is probably most effective, but many patients prefer a beta 2-selective adrenergic agent. Xanthines are currently third choice but are very useful to cover nocturnal dyspnea. Corticosteroids are usually only used in acute exacerbations and then only for short courses. If prolonged use is required, however, the inhalation route minimizes side effects to which these patients are particularly prone. Antibiotics are also usually only used in exacerbations, but one can be liberal with them. Use the less expensive broad-spectrum options for ten days. Some clinicians believe that hydration is an effective expectorant. Mucolytic therapy is extensively used outside the United States. The appropriate role of mucolytic therapy in the treatment of bronchitis remains to be more fully explored. Low-flow oxygen is only used in the prevention or treatment of cor pulmonale when the PaO2 is persistently at or below 55, or with a rising hematocrit and right-sided cardiac changes. If used, oxygen is helpful only when given long term for at least 18 h per day, not on a prn basis. Cardiac glycosides are probably of little benefit, but diuretics have an important role in treatment of fluid retention. Pulmonary vasodilator therapy is still experimental, as is almitrine. Prophylaxis with pneumococcal vaccine and annual influenza vaccine is rational but has not been proven to be of value. Exercise and activity should be encouraged for all except those with frank congestive heart failure. The role of "breathing exercises" is currently being reevaluated. Surgery has almost no place in the management of COPD. Anesthesia often results in postoperative complications in this disease. Avoid all sedatives and tranquilizers.
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PMID:Chronic obstructive pulmonary disease. Current concepts and therapeutic approaches. 240 8

The prevalence of illicit drug use is higher among men than women, but new drug use occurs at twice the rate for females as for males. Recent data from emergency rooms and medical examiners support this pattern, but females were more likely than males to report use of tranquilizers, antidepressants, and some nonbarbiturate sedatives. Recent data show that men outnumbered women in drug treatment admissions for all drugs except tranquilizers. However, the 1984 National Institute of Mental Health Epidemiologic Catchment Area Survey shows drug abuse and dependence to be the second most commonly reported disorder for women. Smoking is the most common form of drug dependence in our society, and it has a major impact on women's health. Lung cancer is now the leading cause of cancer deaths among women. Smoking poses a special risk of coronary heart disease for women using oral contraceptives. The incidence of emphysema among women has also risen sharply. Smoking during pregnancy carries special, serious risks. Research strongly suggests that the use of marijuana during pregnancy carries significant risks, including low birth weights and fetal abnormalities. Opiate addiction among women is uncommon, but it carries disproportionate health risks for these women and their offspring; infants born of addicted mothers have much higher morbidity and mortality rates than infants in general. Acquired immune deficiency syndrome is a grave risk to women using intravenous drugs and to their children. There are a number of health problems associated with psychoactive drug use among elderly women. In addition to research, the National Institute on Drug Abuse has focused a number of its activities on the special problems and needs of women. The Institute is collaborating with the health care community to place increased emphasis on prevention and treatment services for women and is working with organizations in the public and private sector to ensure that current information about drug use is effectively disseminated.
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PMID:Substance abuse and women's health. 312 Feb 20

The authors examined the relationship of noise sensitivity with health status and psychological factors in individuals <70 yr of age in Finland. Subjects (n = 1,355) were selected from a 1988 case-control study, based on the Finnish Twin Cohort, that assessed noise sensitivity, lifetime noise exposure, and hypertension. Other health status and psychological factors were obtained from a questionnaire that had been administered to the same individuals in 1981. Statistical analysis showed that noise sensitivity was associated significantly with hypertension, emphysema, use of psychotropic drugs (i.e., sleeping pills, tranquilizers, and pain relievers), stress, smoking, and hostility, even after adjustment for lifetime noise exposure. These results indicate that noise sensitivity has both psychological and somatogenic components.
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PMID:Somatic and psychological characteristics of noise-sensitive adults in Finland. 1626 17