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)

Most operations on elderly patients are of an urgent nature. If time permits, measures to improve cardiac, respiratory and renal functions in the appropriate ways should be undertaken. During recovery from anesthesia careful but adequate sedation will reduce the risk of myocardial ischemia. Throughout the postoperative period constant encouragement of the older patient is particularly helpful.Transverse abdominal incisions and the frequent use of temporary gastrostomy are advocated.External hernia, hiatus hernia, peptic ulcer, carcinoma of the stomach, biliary disease, appendicits, intestinal obstruction, and carcinoma of the large intestine are discussed specifically, with special reference to the practical details of management in the elderly patient.
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PMID:Some aspects of abdominal surgery in the elderly patient. 582 19

After five years of mild, intermittent urticaria, a man had life-threatening idiopathic anaphylactic reactions associated with transient myocardial ischemia, small bowel obstruction, and orthostatic hypotension. There was no evidence of causes for the anaphylactic reactions over a two and a half year period. The total serum IgE level was increased substantially, with sharp elevations occurring during three episodes of anaphylactic reactions. The elevation in total IgE levels, which was not associated with peripheral blood eosinophilia, is the first recognized serologic abnormality in this syndrome.
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PMID:Life-threatening idiopathic anaphylaxis associated with hyperimmunoglobulinemia E. 670 81

Diltiazem is a widely used calcium channel blocker, and has been found to be effective in the treatment of hypertension, stable, variant and unstable angina, as well as oesophageal spasm. Calcium channel antagonists have been shown to diminish the contractility of gut smooth muscle, but have not as yet been reported to cause clinically significant inhibition of gut motility when used alone. We report a case of reversible functional intestinal obstruction, immediately following diltiazem treatment in a patient with ischaemic heart disease.
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PMID:Paralytic ileus as a result of diltiazem treatment. 820 68

During a period of 4 years, 20 patients with obstructing carcinoma of the left colon were treated by subtotal colectomy with primary ileocolonic anastomosis. Thirteen patients (65%) were 65 years of age or older. All patients presented to the emergency room with large bowel obstruction. Twelve patients (age > 65) suffered other systemic diseases (chronic obstructive pulmonary disease, ischemic heart disease, morbid obesity), placing them in a high risk category. The mortality rate was 5% (1/20), 7.6% if only high risk patients are considered. The one-stage procedure in the treatment of obstructing carcinoma of the left colon offers the patient a number of advantages over stage intervention elimination of colostomy, namely removal of occult lesions in the resected colon, shorter hospitalization and low morbidity and mortality. We found this procedure to be a valid option also in the elderly (> 65) high risk patient. Metastatic disease in our view is not a contraindication, since the elimination of colostomy will improve the quality of life of these patients.
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PMID:Subtotal colectomy with primary ileocolonic anastomosis for obstructing carcinoma of the left colon: valid option for elderly high risk patients. 827 Apr 7

Partial gastrectomy for benign ulcer disease may influence future risk of death, eg, through changes in life-style or metabolism. To reveal such possible long-term effects, we analyzed a population-based cohort of 6459 patients operated on from 1950 through 1958 and followed through 1985. We found a lower overall mortality than in the general Swedish population (standardized mortality ratio = 0.94; 95% confidence interval 0.91-0.97). Mortality was decreased among those with duodenal ulcers, Billroth II operations, and older age at operation but increased as time passed after operation. Mortality was significantly (P < 0.05) increased from tuberculosis, alcoholism, emphysema, stomach ulcer, intestinal obstruction, gallbladder or biliary disease, suicide, and accidental falls but decreased from ischemic heart disease and cerebrovascular disease. Preoperative selection of healthy patients and the probable increased prevalence of risk factors for ulcer disease (smoking, alcoholism, and lower socioeconomic status) in this cohort explain most of these findings. Apart from intestinal obstruction, gallbladder or biliary tract diseases, and tuberculosis, the surgical procedure did not appear to increase mortality beyond one year after operation.
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PMID:Mortality among patients with partial gastrectomy for benign ulcer disease. 831 16

Chilaiditi syndrome is interposition of the intestine between liver and diaphragm. It is often asymptomatic but there were cases presented as acute pain in the abdomen, needing corrective surgical procedure; or as mistaken renal colic, or as suspected subphrenic abscess, or as pneumoperitonium. The interposition of proximal transverse colon was found to be more common than the small intestine. Chilaiditi syndrome was associated with colonic volvulus. The colonic interposition then progressed from mild abdominal discomfort to intermittent bowel obstruction. Some patients needed surgical operation like hepatic extraperitonealization, after replacement of the dislocated gastroenteric tract, bringing the superior surface of the liver again into direct contact with the related diaphragmatic dome. A rare case of Chilaiditi syndrome incidentally associated with hypertension and ischaemic heart disease, in a male aged 50 years is reported.
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PMID:Chilaiditi syndrome with hypertension. 1136 Dec 85

Presented is material of 277 patients, who were treated due to acute abdomen illness in Intensive Therapy Unit at 2nd Department General Surgery Collegium Medicum Jagiellonian University during the time: from 01.07.1997 till 30.06.2002. This material regards only geriatric patients (patients > 65 years old). Patients analysis was divided into two main groups: patients with haemorrhagic shock caused by gastrointestinal bleeding (49 patients--group A) and by ruptured abdominal aneurysm (16 patients--group B), patients with hypovolemic and/or septic shock owing to diffuse peritonitis (150 patients--group C), and intestinal obstruction (62 patients--group D). The other principles of therapeutic procedures were described for every main group. In every illness group was showed: multiorgan dysfunction (acute myocardial ischemia with enzymatic and/or electrocardiographic changes, pulmonary oedema as acute left ventricular failure, respiratory and renal failure and metabolic dysfunction), actual punctuation into two scoring systems: APACHE II (28.8 points) and TISS-28 (44.5 points), time of hospitalization in the intensive therapy unit (mean 7.1 days), hospital's time of treatment (mean 17.5 days), mortality (for all patients 57.8%). These dates compared with dates from publications.
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PMID:[Treatment results in geriatric patients with acute abdomen in the intensive care unit]. 1467 91

Symptomatic hepato-diaphragmatic interposition of a bowel loop or Chilaiditi's syndrome is a peculiar anatomical condition most often found by chance. Its described symptoms range from intermittent, mild abdominal pain and dyspepsia to acute intestinal obstruction. We report a case of hepato-diaphragmatic migration of the hepatic flexure of the colon associated to an unusual, heretofore unreported, angina-like pain exclusively evoked by the left lateral decubitus. To maximize the chance of observing anatomical changes in different postures, computed tomography of the chest and abdomen was performed after air insufflation into the colon. While frank herniation into the chest was excluded, the scan showed that the hepatic flexure-with the interposition of the diaphragm-came in contact with the right side of the heart in the left lateral, but not in the supine, decubitus. This finding was reproduced by echocardiography which also showed virtually unaltered hemodynamics after the change of posture. ECG, left and right ventricular global and regional function as well as cardiac injury markers also remained unchanged during the maneuver, indicating that the pain evoked by the latter was unlikely due to myocardial ischemia. This case suggests that Chilaiditi's syndrome should be included among the possible, although rare, causes of unexplained angina-like symptoms.
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PMID:Heart-touching Chilaiditi's syndrome. 1605 99

The presentation of cerebral palsy can be global mental and physical dysfunction or isolated disturbances in gait, cognition, growth, or sensation. It is the most common childhood physical disability and affects 2 to 2.5 children per 1,000 born in the United States. The differential diagnosis of cerebral palsy includes metabolic and genetic disorders. The goals of treatment are to improve functionality and capabilities toward independence. Multispecialty treatment teams should be developed around the needs of each patient to provide continuously updated global treatment care plans. Complications of cerebral palsy include spasticity and contractures; feeding difficulties; drooling; communication difficulties; osteopenia; osteoporosis; fractures; pain; and functional gastrointestinal abnormalities contributing to bowel obstruction, vomiting, and constipation. Valid and reliable assessment tools to establish baseline functions and monitor developmental gains have contributed to an increasing body of evidenced-based recommendations for cerebral palsy. Many of the historical treatments for this ailment are being challenged, and several new treatment modalities are available. Adult morbidity and mortality from ischemic heart disease, cerebrovascular disease, cancer, and trauma are higher in patients with cerebral palsy than in the general population.
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PMID:Cerebral palsy: an overview. 1641 71

With the development of endovascular aneurysm repair, abdominal aortic aneurysms with short infrarenal necks (< or =10 mm, AAASN) are considered juxtarenal aneurysms. Minimally invasive treatment consists of hybrid procedures or fenestrated endografts. We present our experience with direct aortic repair for AAASN performed via a total laparoscopic approach. Data are expressed as median values with extremes. From February 2002 to December 2007, 32 patients had total laparoscopic AAASN repair. Length of the infrarenal aortic neck was 5 mm (0-10). Median age of the 29 men and three women was 70 years (range 50-84). Nine patients presented with preoperative grade 1 renal insufficiency (28.1%). The procedure was totally laparoscopic in 30 patients (93.7%). Aortic approaches included left retrorenal (n = 24) and transperitoneal left retrocolic (n = 8) exposures. Median operative and clamping times were 270 (range 215-410) and 83 (range 36-147) min, respectively. Aortic clamping was suprarenal in 14 cases (43.7%), with suprarenal clamping time of 24 min (range 9-37). Median blood loss was 850 mL (range 215-2,400). Thirty-day mortality was 3.1% (one patient died from myocardial infarction). Two patients presented with severe systemic complications (6.4%, postoperative coagulopathy with hemorrhagic syndrome, pneumopathy). Seventeen patients developed mild or moderate systemic nonlethal complications (53.1%): transient renal insufficiencies (n = 12), grade 1 ischemic colitis (n = 1), surrenal insufficiency (n = 1), myocardial ischemia (n = 1), and cardiac arythmia (n = 2). One patient was reoperated for an intestinal obstruction. Liquid diet was reintroduced after 1 day (range 1-13). Most patients were ambulatory by day 3 (range 2-17). Median lengths of stay were 48 hr (range 12-552) in the intensive care unit and 10 days (range 4-37) in the hospital. With a median follow-up of 27 months (range 1-50), 28 patients are alive, with complete recovery without graft anomalies. Three patients died, from pneumopathy (n = 1) and carcinoma (n = 2), respectively, at 29, 19, and 44 months' follow-up. Two patients presented stable juxta-renal aortic dilation <35 mm. Total laparoscopic juxtarenal AAA repair is feasible and worthwhile for patients with AAASN. Short- and midterm results match well with those of open surgery. Total laparoscopic repair in AAASN reduces the trauma of extensive surgical approaches. Based on these encouraging early results, we elected to perform laparoscopy whenever possible in good surgical risk patients with AASN.
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PMID:Total laparoscopic repair of abdominal aortic aneurysm with short proximal necks. 1913 10


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