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)

Sea pilots must be capable of carrying out their work in all situations. Thus, they must not have any disease or defect, that could impair their job performance. By periodic medical examinations attempts are made to ensure their working capacity. In most countries these examinations are carried out by a general practitioner and they include only few if any objective laboratory tests. The aim of the present investigation was to study the effectiveness of the periodic medical examinations to find out in the population of pilots examined persons with health risks, especially risks for cardiovascular diseases. All the pilots examined were over 45 years old (n = 135, response rate 88%). Self-evaluation of health was carried out by a questionnaire. Blood analyses were made and chest X-ray as well as exercise-ECC were taken. The most common subjective symptoms concerned musculoskeletal and gastrointestinal systems; sleep disturbances were also quite common. The three most frequent diseases diagnosed earlier by a doctor were musculoskeletal and gastrointestinal diseases, and arterial hypertension. About 24% of pilots had a lower physical working capacity than predicted. The body mass index indicated at least 11% overweight in half of the cases. At exercise-ECG four pilots appeared to have an ischaemic heart disease and additionally eleven pilots had abnormal ECG. Over 80% of pilots had a serum cholesterol value higher than 5 mmol/l, and serum triglyceride values exceeded the normal value of 2.0 mmol/l in every fourth case. Serum glutamyl transaminase was pathological in over 20% of the cases, and serum glucose level in 8%. The findings by routine physical examinations were very few consisting of stiffness in musculoskeletal system, two cases of elevated blood pressure, two heart murmurs, varicose veins etc. In two cases an inguinal hernia was suspected. The current periodic health examinations does not seem to effectively prevent a person with possible health defect from working as a sea pilot. More objective tests must be included in these examinations and more attention should be paid to prevention of overweight, effective treatment of musculoskeletal symptoms, improving physical working capacity and helping pilots to manage their psychic stress.
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PMID:Is there need for change of health examinations for sea pilots? 134 94

Consecutive patients coming as an emergency with chest pain due to myocardial ischemia or esophageal disease were interviewed on admission to the hospital, before they had been fully investigated. Classical features of angina pectoris were equally common in both groups and "crescendo angina" was often found in patients with esophageal disease. Features that helped to distinguish esophageal from cardiac pain were: an atypical response to exercise, pain that continued as a background ache, retrosternal pain without lateral radiation, pain that disturbed sleep, and the presence of certain esophageal symptoms. A positive diagnosis will be made more often in cases of suspected but unsubstantiated coronary disease by clinicians who are aware that esophageal pain and angina may be indistinguishable.
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PMID:Angina-like esophageal pain: differentiation from cardiac pain by history. 408 42

Depression is a common condition in the geriatric population. A retrospective study of 30 elderly patients suffering from neurotic depression, who were admitted consecutively to a general hospital psychiatric ward, showed a predominance of females (n = 21) over males (n = 9) and young-old (65 to 74 years, n = 22) more than old-old (75 years or over, n = 8). Their ages ranged from 65 to 85 years with a mean of 71.6 years, SD 5.5 years. Co-existing physical disorders were present in every patient, the average being 1.8 per patient, and half (n = 15) had two or more physical disorders. Cardiovascular diseases (e.g. ischaemic heart disease and hypertension) and diabetes mellitus were present in about seven-eighths of the patients. The two commonest symptoms were low mood (n = 18, 60%) and vague somatic complaints inexplicable by any physical pathology (n = 19, 63%). Sleep disturbance bothered 12 patients (40%), while nine (30%) had attempted suicide. Twenty patients (67%) were prescribed antidepressants and 13 (43%) received benzodiazepines in low dosages, mainly as hypnotics. Electroconvulsive therapy was necessary for two patients with high suicidal risk. The mean duration of admission was 15.3 days, SD 12.9 days.
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PMID:Neurotic depression in the elderly. 794 52

Application and feasibility of automated ambulatory blood pressure measurement (ABPM) in the elderly are comparable to younger age groups. Major side-effects are sleep disturbances and pain during cuff-inflation. The main indications for ABPM are diagnosis and control of treatment in hypertensive patients. Further indications are the diagnosis of syncope or hypotensive disorders and the diagnostic work-up of symptoms like vertigo, dizziness and dyspnea. In hypertensives, ABPM can easily assess the "white coat" effect and cases of "white coat" hypertension (prevalence in the elderly 15-25%). The prognostic implications of "white coat" hypertensions remain to be determined. Recording of the total 24-h blood pressure profile with analysis of circadian blood pressure changes, the day-night difference and the early morning surge raises the possibility to assess age-specific patterns. The drop in blood pressure at night (during sleep) is usually decreased and less frequently observed in elderly hypertensives. Possible explanations include decreased daytime activity, an altered sleep pattern in the elderly and secondary forms of hypertension. So-called "non-dippers", with no adequate drop in night-time blood pressure, show a significant increase in cardiovascular complications. Control of treatment via ABPM can assess non-responders and cases of overtreatment, and permits a fairly objective analysis of side-effects. Episodes of transient myocardial ischemia and possible trigger mechanisms can be assessed by simultaneous application of ABPM and Holter monitoring. The insufficient control of hypertension in the majority of elderly patients and the current lower target blood pressures in the elderly call for new methods to improve the level and quality of antihypertensive treatment. Although ABPM provides a closer correlation to target organ damage than measurement of office (casual) blood pressure, and ABPM frequently improves or at least facilitates the care of elderly hypertensive patients, it remains to be determined whether ABPM can finally improve the long-term outcome of these patients.
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PMID:Automated blood pressure measurement (ABPM) in the elderly. 889 6

The growing size of world cities and ever more competitive working conditions are thought to cause subjective stress, anxiety and depression, with a resulting decrease in the quality of life, sleep disturbances, drug and alcohol abuse and poor productivity. Acute stress may suppress immune function, leading to an increased incidence of infections, and chronic stress may predispose to a number of ailments, including digestive disturbances, hypertension, ischaemic heart disease and neoplasia; jointly, these factors cause a substantial shortening of life expectancy. The control of stress thus makes an important contribution to health. Stress levels can be reduced by anxiolytic drugs, or by a variety of psychological techniques; however, an appropriate programme of physical activity may be the preferred option, since exercise has many positive effects on health that are unrelated to stress. If exercise is to be effective in inducing relaxation, it must be noncompetitive, moderate in intensity, and pursued in pleasant surroundings.
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PMID:Exercise and relaxation in health promotion. 916 Apr 78

Association of ischemic heart disease (IHD) with vascular affections of the brain is the cardiocerebrovascular syndrome having common pathogenetic mechanisms of formation in the structure of cardiovascular pathology. Some specificities were studied of the clinical course of IHD concomitant with hypertensive dyscirculatory encephalopathy (HDE) in 35 patients (main group), with 25 IHD controls free from manifestations of neurological symptomatology. In IHD HDE patients the anginous syndrome is characterized by a lesser dependency on time in each period of 24 hours and physical load and greater dependency on arterial pressure, meteofactors, it is often accompanied by cephalgia appearing with the intake of antianginal drugs, dizziness, memory, sleep disturbances. The main group patients demonstrated elevated levels of LPO products, those of lipid metabolism, and the AO system tension.
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PMID:[Characteristics of the clinical course of ischemic heart diseases in patients with hypertensive dyscirculatory encephalopathy]. 1145 23

Angina pectoris is usually the first clinical sign of underlying myocardial ischemia, which results from an imbalance between oxygen supply and oxygen demand in the heart. This report describes the pharmacology of beta-adrenoceptor antagonists as it relates to the treatment of angina. The beta-adrenoceptor antagonists are widely used in long-term maintenance therapy to prevent acute ischemic episodes in patients with chronic stable angina. Beta-adrenoceptor antagonists competitively inhibit the binding of endogenous catecholamines to beta1-adrenoceptors in the heart. Their anti-ischemic effects are due primarily to a reduction in myocardial oxygen demand. By decreasing heart rate, myocardial contractility and afterload, beta-adrenoceptor antagonists reduce myocardial workload and oxygen consumption at rest as well as during periods of exertion or stress. Predictable adverse effects include bradycardia and cardiac depression, both of which are a direct result of the blockade of cardiac beta1-adrenoceptors, but adverse effects related to the central nervous system (eg, lethargy, sleep disturbances, and depression) may also be bothersome to some patients. Beta-adrenoceptor antagonists must be used cautiously in patients with diabetes mellitus, peripheral vascular disease, heart failure, and asthma or other obstructive airway diseases. Beta-adrenoceptor antagonists may be used in combination with nitrates or calcium channel blockers, which takes advantage of the diverse mechanisms of action of drugs from each pharmacologic category. Moreover, concurrent use of beta-adrenoceptor antagonists may alleviate the reflex tachycardia that sometimes occurs with other antianginal agents.
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PMID:Antianginal actions of beta-adrenoceptor antagonists. 1799 92

Sleep disturbance is a common problem in general adult population. Recent evidence suggests the link between the occurrence of cardiovascular events and several sleep disturbances including sleep apnea syndrome, insomnia and periodic limb movements during sleep. Sleep duration may affect the cardiovascular outcome. Shift work also may increase the risk of ischemic heart disease. Normalization of sleep rhythm has a potential to be a therapeutic target of ischemic heart diseases, although further study is required to evaluate the preventive effect on cardiovascular events. Here we describe the current understandings regarding the roles of sleep disorders during the pathogenesis of cardiovascular events.
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PMID:[Sleep rhythm and cardiovascular diseases]. 2284 4

Sleep disturbance induced by night-time noise is a serious environmental problem that can cause adverse health effects, such as hypertension and ischemic heart disease. Night-time noise indices are used to facilitate the enforcement of permitted noise levels during night-time. However, existing night-time noise indices, such as sound exposure level (SEL), maximum sound level (LA max) and night equivalent level (L night) are selected mainly because of practical reasons. Therefore, this study proposes a noise index based on neurophysiological determinants of the awakening process. These determinants have revealed that the potential on awakening is likely integrated into the brainstem that dominates wakefulness and sleep. From this evidence, a night-time noise index, N awake,year, was redefined based on the integration of the awakening potential unit (p unit) estimated from the existing dose-response relationships of awakening. The newly-defined index considers the total number of awakenings and covers a wide-range and number of noise events. We also presented examples of its applicability to traffic noise. Although further studies are needed, it may reveal a reasonable dose-response relationship between sleep disturbance and adverse health effects and provide a consistent explanation for the risks of different sound sources where the characteristics of noise exposure are quite different.
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PMID:Night-Time Noise Index Based on the Integration of Awakening Potential. 2693 46

Constructing statistical models using personal sensor data could allow for tracking health status over time, thereby enabling the possibility of early intervention. The goal of this study was to use machine learning algorithms to classify patient-reported outcomes (PROs) using activity tracker data in a cohort of patients with stable ischemic heart disease (SIHD). A population of 182 patients with SIHD were monitored over a period of 12 weeks. Each subject received a Fitbit Charge 2 device to record daily activity data, and each subject completed eight Patient-Reported Outcomes Measurement Information Systems short form at the end of each week as a self-assessment of their health status. Two models were built to classify PRO scores using activity tracker data. The first model treated each week independently, whereas the second used a hidden Markov model (HMM) to take advantage of correlations between successive weeks. Retrospective analysis compared the classification accuracy of the two models and the importance of each feature. In the independent model, a random forest classifier achieved a mean area under curve (AUC) of 0.76 for classifying the physical function PRO. The HMM model achieved significantly better AUCs for all PROs (p < 0.05) other than Fatigue and Sleep Disturbance, with a highest mean AUC of 0.79 for the physical function-short form 10a. Our study demonstrates the ability of activity tracker data to classify health status over time. These results suggest that patient outcomes can be monitored in real time using activity trackers.
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PMID:A Machine Learning Approach to Classifying Self-Reported Health Status in a Cohort of Patients With Heart Disease Using Activity Tracker Data. 3119 76


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