Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There has been much debate among nutritionists and scientists regarding the optimal dietary approach for the treatment of the Insulin Resistance Syndrome, also called Syndrome X. This condition, which may affect as many as 47 million individuals in the United States, significantly increases risk of coronary heart disease and stroke. Major health organizations have historically recommended high-carbohydrate, low-fat (HCLF) diets to reduce chronic disease risk. However, there is evidence that a high intake of carbohydrates may adversely affect one or more of the abnormalities associated with this syndrome. Studies in this area have often had limitations. For example, some studies showing adverse effects of an HCLF diet have not taken into account the dietary fiber content of the diet. This article describes abnormalities often associated with Syndrome X, reviews the beneficial effects of fiber-rich carbohydrates, discusses the effect of fiber-rich carbohydrates on features of this syndrome, and concludes with applications of these findings for those involved in treating individuals with features of this disorder. This review indicates that an HCLF dietary pattern such as that used in the DASH trial, with a level of dietary fiber consistent with the recommendations of the American Dietetic Association (eg, 20-35g/day), containing from 3 to 10 g soluble fiber/day, may be beneficial for treating those with Syndrome X.
 ...
PMID:The effect of fiber-rich carbohydrates on features of Syndrome X. 1252 99

Lower-extremity peripheral arterial disease is a chronic disease process resulting from atherosclerotic obstruction of major vessels supplying the legs. A significant manifestation of systemic atherosclerosis, it is estimated to affect more than 10 million adults in the United States alone. The reported incidence is a conservative estimate, because many patients who suffer from symptoms of peripheral arterial disease attribute them to "normal aging" and may not report them to their physician. Additionally, physicians may miss the diagnosis if a comprehensive history and vascular examination are not a routine part of their assessment. The hallmark symptom of peripheral arterial disease is intermittent claudication, defined as reproducible muscular leg pain that is precipitated by exercise and relieved by rest. Intermittent claudication not only limits functional capacity and adversely affects quality of life but is also an ominous predictor of increased risk for myocardial infarction, stroke, and cardiovascular death. Due to the chronicity of atherosclerosis, medical intervention is most successful when a comprehensive team approach is utilized, involving the patient, family, and vascular health professionals. Treatment for peripheral arterial disease is aimed at first, minimizing symptoms and disease progression via smoking cessation, supervised exercise therapy, pharmacotherapy, and/or revascularization, and second, minimizing the risk of cardiovascular mortality via risk factor identification and reduction, and the use of antiplatelet therapy.
 ...
PMID:Pharmacotherapy and behavioral intervention for peripheral arterial disease. 1268

Various integrins are thought to be intimately involved in several pathological processes, including cancers (solid tumors and metastasis), cardiovascular diseases (stroke and heart failure), inflammatory diseases (rheumatoid arthritis) and ocular pathologies. The mechanism of the involvement of integrins in these acute and chronic disease states is slowly being elucidated. Recently, various therapeutic candidates, including antibodies, cyclic peptides and peptidomimetics, have been clinically evaluated and have been shown to successfully modulate certain disease processes. This review focuses on the key role of the alpha(v) integrin (alpha(v)beta(3)) in the angiogenic processes in diseases such as cancer, restenosis following percutaneous transluminal coronary angioplasty, stroke, ocular disease and rheumatoid arthritis.
 ...
PMID:Alpha(v)beta(3) integrin in angiogenesis and restenosis. 1281 20

Atherosclerosis is a chronic disease that affects medium and large arteries. This process originates from the interaction between cells of the arterial wall, lipoproteins and inflammatory cells, leading to the development of complex lesions or plaques that protrude into the arterial lumen. Plaque rupture and thrombosis result in acute clinical complications such as myocardial infarction and stroke. Owing to the heterogeneous cellular composition of the plaques, a proteomic analysis of the whole lesion is not appropriate. Therefore, we have studied the proteins secreted by human carotid atherosclerotic plaques, obtained by endarterectomy. Normal artery segments and different regions of the surgical pieces (noncomplicated plaque, complicated plaque with thrombus) were cultured in protein-free medium and the secreted proteins (supernatants) analyzed by two-dimensional gel electrophoresis. Normal artery segments secreted a moderate number of proteins (42 spots). However in the two-dimensional (2-D) gels (pH 3-10) of segments bearing a plaque, the number of spots increased markedly (154). The number of spots also increased (202) in the 2-D gels of artery segments with a ruptured plaque and thrombus. Thus, the more complicated the lesion, the higher the number of secreted proteins, suggesting the production of specific proteins relating to the complexity of the atherosclerotic lesion.
 ...
PMID:Proteomic analysis of human vessels: application to atherosclerotic plaques. 1283 22

Of the leading causes of death among adults in developed nations (coronary heart disease, cancer and stroke) most are influenced by diet. Dietary intake is also associated with diseases causing significant morbidity, including hypertension, diabetes mellitus and osteoporosis. Although nutritional epidemiology is inexact as a science, certain reproducible studies have implicated links from nutrient availability in the body to chronic disease. Dietary calcium is one nutrient that has been the focus of multiple studies in an effort to discover its preventive effects. It has been implicated in the reduction of risk in osteoporosis, but kidney stone formation, obesity, hypertension and even cancer are lesser known areas in which increasing dietary calcium has yielded positive outcomes.
 ...
PMID:The role of dietary calcium in disease prevention. 1285 18

Millions of women are treated with hormone replacement therapy (HRT) for relief of menopausal symptoms, including vasomotor flushes and sweats for which oestrogen is uniquely and highly effective. Others may continue longer-term treatment in the hope that HRT will help to prevent chronic disease. The preservation of bone mass with continuing oestrogen therapy and reduction of subsequent risk of fracture is well established. Observational studies of the metabolic and vascular effects of oestrogens have suggested a potential benefit in reducing the risk of vascular disease, but recently published randomized controlled trials demonstrate no evidence of benefit in women with established vascular disease or in apparently healthy women. The increased risks of breast cancer and thromboembolic disease have been confirmed in these trials, with evidence of increased risk of stroke. Observational data suggest there may be a small increased risk of ovarian cancer associated with longer-term use of HRT. The premature termination of one arm of the Women's Health Initiative randomized controlled trial caused concern among patients, doctors and pharmaceutical companies. There are difficulties in extrapolating the results from trials using a specific HRT product to advise women on the wide range of other hormone products, doses, combinations and routes of administration. However, in the absence of evidence that other products are safer, the data suggest that for many women the risks associated with long-term use of HRT outweigh the benefits. There are nonhormonal strategies for the prevention and treatment of osteoporosis. HRT is not, and has never been, licensed in the UK for the prevention or treatment of vascular disease, and the data suggesting potential benefit should now be regarded as biased. The absolute incidence of an adverse event is low, and the risk in an individual woman in a single year is very small, but the risks are cumulative over time with long-term use. The risk-benefit balance of each woman needs regular reappraisal with continued use.
 ...
PMID:Recent concerns surrounding HRT. 1286 90

Hormone replacement therapy (HRT) is frequently prescribed to healthy women to ameliorate menopausal symptoms. HRT is used long term (> or = 1 year) to prevent chronic disease in older women. The objective of this study was to review the benefits and risks of HRT and studies of menopause or HRT in Taiwan via a MEDLINE search. Recommendations are provided for future HRT research in Taiwan. Randomized, double-blind, placebo-controlled clinical trials are considered the gold standard of scientific evidence. A MEDLINE literature search (January 1966-July 2002) identified 23 papers on trials (> or = 1 year) that met the inclusion criteria. The results showed that various HRT regimens used for more than 1 year caused more harm than good in healthy menopausal women and that there was no benefit for women with coronary artery disease, Alzheimer's disease, hysterectomy, hysterosalpingo-oophorectomy, and ischemic stroke. None of this research was conducted in Taiwan. A MEDLINE search using the key words "estrogen replacement therapy and menopause in Taiwan" identified 16 studies. There was only one, short-term, HRT trial. No evidence suggested benefits from long-term HRT in menopausal women in Taiwan.
 ...
PMID:Hormone replacement therapy and menopause: a review of randomized, double-blind, placebo-controlled trials. 1287 34

Stroke is a leading cause of individual and public health burden in the United States. A better understanding of the relation among stroke knowledge, lifestyle, and stroke-related screening results may be useful for improving prevention efforts. This paper assesses the relation among demographics, lifestyle, stroke awareness, and the presence of stroke risk factors determined by screening tests for a select elderly population. A population of 322 participants in the 1999 World Senior Games received 1 or more free screening tests and completed a stroke awareness questionnaire. Results indicate that stroke education efforts should be targeted at the very elderly, those who have less than a college education, and those who do not have a history of chronic disease. It also may be effectively directed toward those with higher cholesterol.
 ...
PMID:Relation among stroke knowledge, lifestyle, and stroke-related screening results. 1457 Dec 47

Despite biologically plausible mechanisms for cardiac protection from estrogen therapy and observational data suggesting that hormone therapy confers cardiovascular benefit, the outcomes of well-designed and conducted primary and secondary prevention randomized clinical trials have documented cardiovascular risk rather than benefit. Menopausal hormone therapy failed to prevent clinical cardiovascular events in healthy menopausal women and in those with established coronary heart disease. Rather, it increased the risk of coronary heart disease events, particularly myocardial infarction, stroke, and venous thromboembolism, as well as that of breast cancer. Recommendations from the US Preventive Services Task Force emphasize that, for most women, the harms of hormone use are likely to exceed the benefits for the prevention of chronic disease. Women should talk with their health care providers about such proved approaches to coronary risk reduction as smoking cessation, heart-healthy diet, physical activity, weight management, and pharmacologic control of hypertension and hypercholesterolemia.
 ...
PMID:Menopausal hormone therapy and cardiovascular protection: state of the data 2003. 1464 Feb 54

Antiphospholipid syndrome has received considerable attention from the medical community because of its association with a number of serious clinical disorders, including arterial and venous thromboembolism, acute ischemic encephalopathy, recurrent pregnancy loss, thrombocytopenia, and livido reticularis. It can occur within the context of several diseases, mainly autoimmune disorders, and is then called secondary antiphospholipid syndrome. However, it may be also be present without any recognizable disease, or so-called primary antiphospholipid syndrome. There is no defined racial predominance for primary antiphospholipid syndrome, although a higher prevalence of systemic lupus erythematosus (SLE) occurs in African Americans and the Hispanic population. Multiple terms exist for this syndrome, some of which can be confusing. Lupus anticoagulant syndrome, for example, is a misleading term, because patients may not necessarily have SLE, and it is associated with thrombotic rather than hemorrhagic complications. To avoid further confusion, antiphospholipid syndrome is currently the preferred term for this clinical syndrome. Antiphospholipid antibodies are found in 1% to 5% of young healthy control subjects; however, the incidence increases with age and coexistent chronic disease. The syndrome occurs most commonly in young to middle-aged adults; however, it also can occur in children and the elderly. Among patients with SLE, the prevalence of antiphospholipid antibodies is high, ranging from 12% to 30% for anticardiolipin antibodies, and 15% to 34% for lupus anticoagulant antibodies. In general, anticardiolipin antibodies occur approximately five times more often then lupus anticoagulant in patients with antiphospholipid syndrome. This syndrome is the most common cause of acquired thrombophilia, associated with either venous or arterial thrombosis or both. It is characterized by the presence of antiphospholipid antibodies, recurrent arterial and venous thrombosis, and spontaneous abortion. Rarely, patients with antiphospholipid syndrome may have fulminate multiple organ failure, or catastrophic antiphospholipid syndrome. This is caused by widespread microthrombi in multiple vascular beds, and can be devastating. Patients with catastrophic antiphospholipid syndrome may have massive venous thromboembolism, along with respiratory failure, stroke, abnormal liver enzyme concentrations, renal impairment, adrenal insufficiency, and areas of cutaneous infarction. According to the international consensus statement, at least one clinical criterion (vascular thrombosis, pregnancy complications) and one laboratory criterion (lupus anticoagulant, antipcardiolipin antibodies) should be present for a diagnosis of antiphospholipid syndrome. The hallmark result from laboratory tests that defines antiphospholipid syndrome is the presence of antibodies or abnormalities in phospholipid-dependent tests of coagulation, such as dilute Russell viper venom time. There is no consensus for treatment among physicians. Overall, there is general agreement that patients with recurrent thrombotic episodes require life-long anticoagulation therapy and that those with recurrent spontaneous abortion require anticoagulation therapy and low- dose aspirin therapy during most of gestation. Prophylactic anticoagulation therapy is not justified in patients with high titer anticardiolipin antibodies with no history of thrombosis. However, if a history of recurrent deep vein thrombosis or pulmonary embolism is established, long-term anticoagulant therapy with international normalized ratio (INR) of approximately 3 is needed.
 ...
PMID:Antiphospholipid syndrome. 1467 58


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>