Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 6-year-old boy developed a flaccid hemiplegia and dysarthria following several transient episodes of nausea, vomiting, and ataxia. An anomly of the dens was discovered, permitting subluxation of C-1 on C-2. A segmental occlusion of the right vertebral artery and an aneurysm of the left vertebral artery were found at the C-2 level, as well as a thromboembolic occlusion of the rostral end of the basilar artery. It appeared that the repeated cervical subluxation produced occlusive, aneurysmal, and embolic vascular disease, and that clinical symptoms were the result of ischemia in the territory perfused by the vertebrobasilar arteries.
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PMID:Occlusive vertebrobasilar artery disease associated with cervical spine anomaly. 113 Mar 56

In addition to oral contraceptives (OCs), the morning-after pill, the minipill, and depot preparations also belong to hormonal contraceptives. The latter two contraceptives have not become established among young women because of inadequate cycle control. For postcoital contraception in Austria, Neogynon and Stediril-D, consisting of 0.05 mg of ethinyl estradiol (EE) + 0.25 mg of levonorgestrel, are used within 48 hours of unprotected intercourse. Lower dose OCs have considerably reduced the risks of side effects. Micropills are the optimal OCs with EE under 50 mcg combined with the new generation of gestagens. The beneficial effects include menstrual regularity and the prevention of anemia, ovarian cysts, and fibrocystic mastopathy. Nausea, headache, spotting, and weight gain do occur in individual cases, even among young people. The potential risk of thromboembolism is the most important, although arterial cardiovascular risk is minimal in young age. The probability of postpill amenorrhea is less than 1%. Micropills can be used by young diabetics provided the disease is not beyond 10 years' duration and there is no angiopathy. Acne, seborrhea, and hirsutism are beneficially influenced by a combination of 0.035 mg of EE with 2 mg of cyproterone acetate. The relative risk of endometrial and ovarian cancer are only about half as high among OC users as among nonusers. The risk of breast cancer in young OC users has not been conclusively explained. Regular colposcopy and cytology is recommended for young OC users to preclude the risk of malignancies of the genital tract. Sex education and the use of OCs that are the most suitable and effective for young people can reduce the number of unwanted pregnancies and abortion. The comparison of two 5-year periods in the 1970s and 1980s at the University Obstetrical-Gynecological Clinic in Graz showed that the incidence of births among women under 18 years of age decreased from 3.6% (778) to 1.6% (353).
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PMID:[Benefits and risks of hormonal contraception]. 146 64

Angioedema is characterized by a well-demarcated swelling on the skin, oropharyngolaryngeal tissue, or the gastrointestinal wall. Underlying mechanisms may include IgE-mediated reactions, complement activation, inhibition of the cyclo-oxygenase pathway of arachidonic acid metabolism, direct release of mediators from mast cells, and activation of the kinin-forming system. Foods, drugs, inhalants, insect bites, blood transfusion, collagen vascular disease, infections, physical factors, neoplasms, and hereditary factors can cause angioedema through one or more of these mechanisms. Chronic angioedema lasts more than 6 weeks or recurs during this period. Acute angioedema is a self-limited disorder and resolves spontaneously, or with simple therapy, in several days; the patient rarely requires a complete work-up. Chronic angioedema may necessitate a detailed history, physical examination, and limited clinical or laboratory tests to exclude serious underlying illnesses. The H1 antihistamines are used for the treatment of both acute and chronic angioedema. An H2 antihistamine, a second H1 antihistamine, or rarely even a low dose of corticosteroid may be added to the regimen if H1 antihistamine alone fails to control chronic angioedema. Hereditary angioedema is an autosomal dominant disease that is caused by C1INH deficiency. In patients with this disorder, swelling of the lip, pharynx, and extremities may follow trauma to soft tissue. Other clinical manifestations include abdominal pain, nausea, vomiting, and suffocation because of laryngeal swelling. Diagnosis can be confirmed by the finding of low levels of C4 and C2 and the absence of nonfunction of C1INH. Androgens reverse the biochemical defects.
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PMID:Angioedema. 286 18

An elderly man with ischaemic heart and peripheral vascular disease presented with a 3-month history of increasingly severe postprandial epigastric pain, nausea, vomiting, diarrhoea and weight loss, associated with gastroscopic evidence of superficial antral ulceration and discoloration. The patient died shortly after admission to hospital. Autopsy showed evidence of mesenteric vascular disease and ischaemic bowel. The literature on chronic mesenteric ischaemia is briefly reviewed, and the role of arteriography is discussed.
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PMID:Mesenteric ischaemia--a diagnostic triad? 740 11

The association of large pituitary mass, lack of clinical syndromes of pituitary hypersecretion, hypopituitarism and visual field defects suggests the diagnosis of nonfunctioning pituitary adenoma, but the same characteristics can be present in patients affected by other tumorous lesions, cysts, inflammatory processes or vascular disease. The management of these patients depends on a correct diagnosis. A 53-year-old woman was admitted for nausea, vomiting and severe hypotension. For three months she had complained of weakness, sleepness, skin-dryness and loss of weight. Imaging and endocrine evaluations revealed an intra and extrasellar mass causing hypopituitarism without diabetes insipidus. Histological examination of the tissue obtained at transsphenoidal surgery showed a Rathke's cleft cyst, surrounded by areas of noncaseous granulomatous tissue with scattered multinucleated giant cells of foreign body type, similar to a sarcoid lesion. Other systemic sarcoidosis localizations were absent. After two years of full well-being, the patient reported a sudden visual impairment, due to sarcoidosis involvment of the prechiasmatic tract of the optic nerve, that promptly improved with corticosteroid treatment. This report emphasizes the overlap of signs and symptoms between non functioning tumors and nontumoral masses of hypothalamic-pituitary region and underlines the fact that a correct diagnosis is feasible only on histopathological basis. Although, occasionally, the coexistence of Rathke'cyst with pituitary adenoma has been reported, to the best of our knowledge, this is the first report of the association between Rathke's cleft cyst and noncaseating granuloma tissue. Finally, the remission of neurolgical symptoms following corticosteroid therapy confirms this treatment as a valid medical approach and suggests its use in a short therapeutic trial when the diagnosis is doubtful.
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PMID:Granulomatous sarcoidotic lesion of hypothalamic-pituitary region associated with Rathke's cleft cyst. 912 87

This article answers some questions about use of emergency contraceptive pills (ECP) in the US. It is acceptable to prescribe ECPs over the telephone. ECPs should not be given to women with severe migraine headaches with neurologic impairment. ECPs are acceptable for women who are smokers and over 35 years old, diabetics with vascular disease, women with a history of severe migraine, and women with a benign or malignant liver tumor. Women who seek ECPs over 72 hours after unprotected sexual intercourse could have ECPs, insertion of a Copper T380 IUD, or Ru-486, when available in the US. Lo-Ovral4+4 is the preferred ECP. Ovral2+2 is less often available and tends to cost more. An ECP prescription might indicate Phenergan (25 mg), 4 tablets, taken between 6 and 7 PM, and repeated in 12 hours. Another ECP prescription might indicate Lo-Ovral (21-pill pack), 4 tablets taken one half hour after anti-nausea medication, and repeated in 12 hours. If nausea is severe from the first or second dose of Lo-Ovral, an extra tablet of Phenergan may be taken. For continued contraception, the patient should be prescribed a low-dose pill and not a 50 mcg pill. The most common transition from ECP combined pills to regular oral contraception is to prescribe 4 tablets followed by 4 tablets 12 hours later, and to start a new package of pills the Sunday after menstruation begins. Nonlapsed pill taking involves taking the 4 tablets, followed by 4 tablets in 12 hours, and 1 tablet taken daily for the next 13 days (with backup contraception the first 7 days), and a lapse for 7 days. Nothing needs to be done for vomiting. Women are not likely to abuse this option. It should be widely known and appreciated that mistakes do happen, emergency contraception does work, and women should be aware of ECPs. 98% of women bleed by 21 days after ECP use. There appears to be no increased risk of birth defects among pill users who become pregnant.
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PMID:10 common questions on emergency contraception. 1234 14

A 4-year-old girl was admitted to our department with the complaints of severe headache, nausea, vomiting, and photophobia. She had a 1-year history of migrainelike headache that occurred every 1 to 2 months. Her neurologic examination was normal, but T-weighted axial magnetic resonance imaging (MRI) of the brain showed flow void within the basal ganglia owing to parenchymal vascular collaterals. Magnetic resonance angiography and digital substraction carotid angiography showed both occlusion of the internal carotid artery in the supraclinoid portion and extensive parenchymal vascular collaterals. Because there was no evidence of risk factors for cerebral arterial occlusion and cerebral infarct or hemorrhage, she was diagnosed as having moyamoya disease. In any case of atypical migrainelike headache, a detailed investigation should be kept in mind to detect an underlying vascular disease such as moyamoya.
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PMID:Moyamoya disease presented with migrainelike headache in a 4-year-old girl. 1282 23

Dissection of cervical arteries causes ischemic stroke in young adults. This reports the clinical, ultrasonographic, and neuroradiological findings in 24 patients with 28 vertebral artery dissections in the neck (4 occurring bilaterally). In 20 patients (83%), the dissection was temporally related to trauma. No patients had an underlying vascular disease, for example, atherosclerosis or fibromuscular dysplasia. In all, the major initial manifestation was pain in the occipital or neck region. The next most common symptoms were vertigo and nausea (in 17 patients). Clinical manifestations were vertebrobasilar transient ischemic attack (TIA) (5 patients: in 2 patients vestibulocerebellar TIA, in 1 patient visual TIA, in 1 patient motor TIA, and in 1 patient brain stem TIA with perioral paresthesia), cerebellar infarction (10 patients, in 4 patients bilateral), brainstem infarction (5 patients), posterior cerebral artery territory infarction (1 patient), and multiple vertebrobasilar ischemic lesions (3 patients). Typical angiographic findings were irregular narrowing of the vessel lumen or a tapering stenosis with distal occlusion. Magnetic resonance imaging showed a thickened vessel wall with hematoma signal at the site of the dissection. Duplex color-flow imaging was valuable for the early diagnosis of extracranial vertebral artery dissection and for follow-up examinations. The distal V1- and the proximal V2-segment (at the level of C6 vertebra) was the most frequent localization of dissections (in 43%). The outcome was favorable except for 2 patients with basilar artery occlusion. Embolism to the basilar artery may be avoided by early administration of anticoagulants.
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PMID:Dissection of the extracranial vertebral artery: clinical findings and early noninvasive diagnosis in 24 patients. 1648 73

A 63-year-old woman suffering from confusion, restlessness, vertigo and nausea had multiple old cortical and subcortical microhaemorrhages on MR gradient echo imaging, consistent with amyloid angiopathy.
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PMID:[Diagnostic image (270). A confused and restless woman]. 1667 14

Dolichoectasia of the intracranial arteries is a rare condition, and the vertebrobasilar system and the internal carotid artery is most commonly involved. We describe a rare case of a 60-year-old man with dolichoectasia of the anterior cerebral artery (ACA). The patient presented with continuous vertigo and nausea. CT and MR imaging showed a prominent serpentine structure with calcification and flow void in the region of the interhemispheric fissure, findings which were suspicious for arteriovenous malformation (AVM) or fistula (AVF). A cerebral angiogram demonstrated an extensive dilatation of the ACA above the level of the anterior communicating artery. There was no evidence of AVM or AVF. Although SPECT study revealed a decrease of cerebral blood flow (CBF) in the right frontal lobe, cerebrovascular reserve, as demonstrated by acetazolamide challenge was sufficient for maintenance. Decrease of CBF may have resulted from diaschisis or selective neural cell elimination by old cerebral infarction. The patient was treated with an anti-platelet agent conservatively and the symptoms gradually improved. Cerebral angiography may be needed for definitive diagnosis because cerebral dolichoectasia may mimic CT and MR imaging findings of AVF or AVM. Cerebral hemodynamics must be examined strictly in addition to demonstrating vascular disease by angiography, and SPECT study may play a role in the detection of hemodynamic change induced by dolichoectasia.
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PMID:[A case report of dolichoectasia of the anterior cerebral artery]. 2062 91


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