Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent epidemiological evidence suggests that the risk of serious cardiovascular complications from oral contraceptives (OCs) may be related not only to the amount of estrogen in each product but also to the potency of the progestin. Combination OCs with 30-35 mcg of estrogen have the same potency as those with 50 mcg with less risk of cardiovascular side effects, especially in women over age 35 who are smokers. More potent progestins have been associated with higher plasma concentration of low-density lipoprotein (LDL) cholesterol and lower concentrations of high-density lipoprotein (HDL) cholesterol; high LDL and low HDL cholesterol levels have been associated with an increased risk of coronary heart disease. 1 large survey of OC use in the UK found an association between progestin dose and the incidence of death due to stroke and ischemic heart disease. Many of these findings used progestin doses higher than those found in contraceptive tablets currently available in the US. Some disadvantages of low dose OCs are higher rates of spotting, breakthrough bleeding, and amenorrhea. OCs containing over 20 and less than 50 mcg of estrogen with a low potency progestin offer the best combination of effectiveness and safety from combinations.
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PMID:Oral contraceptives and the risk of cardiovascular disease. 686 50

Polycystic ovary syndrome is a diagnosis made in 5%-10% of women between late adolescence and the menopause. Patients may present with oligomenorrhoea or amenorrhoea, anovulation or infertility, hirsutism or acne. Women with the syndrome have at least seven times the risk of myocardial infarction and ischaemic heart disease of other women, and by the age of 40 years up to 40% will have type 2 diabetes or impaired glucose tolerance. Polycystic ovary syndrome is associated with insulin resistance, with consequent hyperinsulinaemia and (frequently) hyperlipidaemia and obesity. Recent research has shown that the application of diabetes management techniques aimed at reducing insulin resistance and hyperinsulinaemia (such as weight reduction and the administration of oral hypoglycaemic agents) can not only reverse testosterone and luteinising hormone abnormalities and infertility, but can also improve glucose, insulin and lipid profiles. The management of polycystic ovary syndrome should now include patient education and attention to diabetes and cardiovascular risk factors such as hyperlipidaemia, obesity, physical exercise, glucose intolerance, hypertension and cigarette smoking.
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PMID:Polycystic ovary syndrome: a new direction in treatment. 986 12

This review summarizes more than 25 years of experience with the use of systemic chemotherapy in the adjuvant setting in patients suffering from stage II breast cancer. The use of the CMF combination in the early 70's marks the onset of the modern era of this modality. Adjuvant chemotherapy must be given at optimal doses and schedule, usually for a period lasting about six months, beginning shortly after the resection of the primary tumor. The incorporation of the anthracyclines, adriamycin and epirubicin represent an important milestone in the developmental history of the adjuvant chemotherapy of breast cancer. The sequential administration of adriamycin followed by CMF in patients with 4 or more involved axillary lymph nodes deserves particular emphasis. Meta-analysis of multiple clinical trials including several tens of thousands of patients with stage II breast cancer indicate that adjuvant chemotherapy results in a significant increase in both recurrence-free and overall survival as compared to locoregional treatment only. This holds true with long-term follow-up of 20 years and more as illustrated by the CMF experience, showing about a 35% decrease in the relative risk of recurrence. Efforts in recent years are investigating the role of newer cytotoxic agents such as the taxanes in the adjuvant setting. Furthermore, clinical trials are now ongoing with the use of the monoclonal antibody herceptin in patients with stage II breast cancer whose tumor over-expresses the oncogene Her2neu. The administration of adjuvant chemotherapy has the potential for undesirable side effects such as an increased risk of osteoporosis and ischemic heart disease in younger patients in whom amenorrhea develops, or cardiotoxicity from anthracyclines. Most clinical trials to date have not shown an increase in the occurrence of second primary tumors among patients receiving adjuvant chemotherapy for breast cancer. Adjuvant chemotherapy has become an integral part of the treatment of stage II breast cancer.
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PMID:[The use of adjuvant chemotherapy in stage II breast cancer in the last 25 years--a brief review]. 1201 95

Premature ovarian failure (POF) is the term usually used to describe women aged younger than 40 years, who present with amenorrhoea, hypergonadotropic hypogonadism, and infertility. POF is a devastating diagnosis for reproductive-aged women. The clinical presentation is diverse, and several different disorders can lead to premature ovarian failure. POF has serious health consequences, including psychological distress, infertility, osteoporosis, autoimmune disorders, ischaemic heart disease, and increased risk of mortality. Hashimoto's disease is the most frequent autoimmune disorder associated with premature ovarian failure. Management should be initiated immediately to prevent long-term consequences. Oestrogen therapy is the mainstay of management. Hormone therapy should be provided to eliminate symptoms of oestrogen deficiency.
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PMID:Premature ovarian failure. 2872 Nov 30