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)

Forty-nine normal pregnant women were recruited late in the third trimester for serial determinations of creatine kinase (CK) and its MB isoenzyme fraction (CK-MB) at four different times: (1) on recruitment between 36 and 40 weeks' gestation, (2) on admission in active labor, (3) immediately after delivery, and (4) on the first postpartum day. In the patients with vaginal delivery (n = 43) total CK was significantly elevated at time 4 compared with times 1, 2 and 3 (P value < .0001). CK-MB fraction was also significantly elevated at time 4 compared with times 1, 2 and 3 (P value < .0001). In 35.7% of the patients at time 4, CK-MB was sufficiently elevated to give the laboratory interpretation of "borderline" or "consistent with a myocardial infarction," even though none of the patients had cardiac symptoms or complications. A review of the literature shows that CK-MB is found not only in myocardium but also in uterus and placenta. The implication of this study is that elevations in total CK and CK-MB should be used with caution during the peripartum period to diagnose myocardial ischemia or infarction.
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PMID:Creatine kinase and its MB isoenzyme in the third trimester and the peripartum period. 146 Jun 8

From January 1987 and onwards all cases of hip fracture in Arhus County, Denmark, were registered in a prospective multicenter investigation. Until December 1990, 2273 postmenopausal women (greater than 50 years) with first hip fractures were registered. Of these 643 sustained a hip fracture in 1988. Life tables were constructed for different age groups; the excess mortality (in comparison with the reference population) for each age group ranged from 10 to 20 percent. The years of potential life lost (YPLL) (life expectancy method) were calculated for the 1988 cohort and compared with the YPLL due to other selected conditions calculated from official vital statistics. The YPLL rates (per 1000 persons) were as follows: hip fracture 9.2, ischemic heart disease 73, cerebrovascular disease 29, breast cancer 20 and cancer of the uterus 6.7. We propose that hip fracture mortality data should be continuously registered and evaluated using the YPLL method to detect changes caused by the expected increase in the number of hip fractures.
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PMID:Years of potential life lost after hip fracture among postmenopausal women. 160 93

Death rates for Ontario females aged 15 to 44 during the years 1959-61 and 1966-68 have been compared to see if there have been any changes in these rates which might be related to the widespread use of oral contraceptives since 1961. Overall mortality (all causes) has declined significantly during this time, as have the rates for deaths due to child-birth and pregnancy, and from cancer of the uterus. Death rates from ischemic heart disease and cancer of the breast have not shown any significant change, but there has been a substantial increase in the rates ascribed to venous thromboembolism and suicide.It must be stressed that a change in the recorded death rate does not necessarily mean that there has been a corresponding change in the incidence of the disease in question, or that such a change is related to the use of oral contraceptives. However, if oral contraceptives do cause an increase in a fatal disease, the effect should show up, sooner or later, in routine mortality statistics, and periodic examination of death rates may therefore provide a useful starting point for more detailed epidemiological investigation.To assist physicians in counselling patients, a diagram has been prepared showing the relative importance of some selected causes of death in females aged 15 to 44, and the extent to which these death rates have changed since the introduction of oral contraceptives.
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PMID:Oral contraceptives and female mortality trends. 542 Sep 95

The present level of understanding of the known risks of oral contraceptive (OC) use are summarized. The findings of many investigations in the late 1960s and early 1970s may no longer be totally appropriate because OCs available then had higher dosages than today. Also, early studies enrolled predominantly women in their 20s, who are now almost all more than 35 years old. Thus, the risks observed in these studies may not be applicable to younger women using OCs today. Another consideration has been underscored by the results of the Walnut Creek Study. Behavioral characteristics such as smoking, drinking, and sexual activity are factors which can strongly confound risks of OC use and must be considered when assessing current and future investigations. Many studies have clearly shown that the most serious life threatening danger associated with OC use is that of cardiovascular complications arising from the interaction of OC use and smoking. The increased risks attributable to smoking while using OCs account for a substantial number of the deaths recorded. The Walnut Creek Study showed a somewhat different outcome. Its data suggest no significant risk of myocardial infarction (MI), ischemic heart disease, cerebral thrombosis, or ischemic cerebrovascular disease associated with OC use, but there were nonsignificant increases noted in some cardiovascular diseases which appeared to be explained by a synergism between current use and heavy smoking. Age also has a strong influence on risk for cardiovascular disease. The results of earlier studies seem to indicate that OC use is associated with a risk of subarachnoid hemorrhage. The Walnut Creek Study also noted an increased risk of subarachnoid hemorrhage associated with OC use and found that risk increased with use. Several studies have shown that the incidence of venous thrombosis seems dependent on the dosage of the OC used. An overwhelming majority of studies on the carcinogenicity of OCs have found no increased incidence of cancer of the ovaries, uterus, or breast among users. In regard to both ovaries and endometrium, there is some evidence that OCs may be protective. Several studies have concluded that OC users have a slightly increased risk of developing malignant melanoma. The results of the Oxford/Family Planning Study show that although previous use of OC by nulliparous women may delay future childbearing by several months, it does not impair longterm potential for pregnancy. No increase in risk of clinically apparent diabetes mellitus has been reported in users. In addition to their possible protection against ovarian and endometrial cancer, OCs may reduce the risk of at least 5 other diseases: benign breast disease; deficiency anemia; arthritis, pelvic inflammatory disease; and ovarian cysts.
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PMID:The pill: an evaluation of recent studies. 704 36

In Denmark, about 6000 hysterectomies are performed annually, and about 75% are performed on benign indications in women less than 50 years of age. When deciding on oophorectomia per occasionem, the risk of disease in the retained ovaries must be weighed against the advantages of continued ovarian function. The literature about ovarian function after hysterectomy consists predominantly of older, retrospective and uncontrolled investigations describing earlier menopause, increased frequency of climacteric symptoms and increased risk of benign ovarian cysts. Hysterectomy is followed by histological changes in the retained ovaries, but a significant reduction in the ovarian hormone production is not documented. Several studies have indicated that hysterectomy is followed by an increased risk of ischaemic heart disease, but the literature is equivocal. A possible explanation for the altered ovarian function after hysterectomy is reduced ovarian blood supply caused by the operation, but the existence of a direct endocrine function of the uterus can not be excluded. Solid prospective studies of the ovarian function following hysterectomy are needed.
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PMID:[Ovarian function after premenopausal hysterectomy]. 811

Gestational hypertension and malnutrition are associated with hypertension and ischemic heart disease in the adult human. The impact of the gestational environment on the adult blood pressure in two well-characterized genetically homogeneous rat strains, the hypertensive SS/jr and normotensive SR/jr, was studied by cross-fostering within 6 hours of birth and by embryo transplantation with the recipient dam nursing the transplanted pups. Systolic blood pressure (BP) was measured by tail-cuff plethysmography twice a week after the age of 7 weeks. The lactational environment (cross-fostering) had no effect on blood pressure. Embryo transfer between like strains had no effect on the development of hypertension, nor did the BP of R transferred to S (RetS) differ from that of normal R or RetR. At 7 weeks of age, the BP of SetR was significantly lower than that of S or SetS (P<.01) and was similar to that of RetR and R. With age, the blood pressures of the S, SetS and SetR increased at approximately the same rate but from a significantly different baseline. Salt-sensitivity in the S and resistance in the R were not altered. The protective effect of the R gestational environment on SetR female BP was abrogated during whelping and lactation. Embryo transfer and cross-fostering did not alter the weight of rats older than 7 weeks. Because the BP of the R dams were significantly lower than that of the S dams, these studies do not distinguish between the effects of the R dams' lower blood pressure per se and hormonal influences of the R uterus on the S blood pressure phenotype.
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PMID:Modulation of blood pressure in the Dahl SS/jr rat by embryo transfer. 945 59

This study describes the demographic and biophysical characteristics of rural menopausal women in Western Kenya. Menopause occurs as the gradual unresponsiveness of the human ovary to gonadotropins, premature ovarian failure at under 40 years, and menopause following surgical procedures of the uterus and ovaries. A 3-phase process starts with low serum estradiol and progesterone, followed by a rise in follicle stimulating hormone, and a rise in luteinizing hormone. Clinical symptoms include vasomotor ones, genitourinary ones, osteoporosis and increased incidence of bone fractures, increased incidence of thromboembolic and ischemic heart disease, and psychological symptoms of anxiety, depression, and memory loss. The age of menopause varies with socioeconomic conditions, race, parity, height, weight, skinfold thickness, lifestyle, and education. Data were obtained for this study from a sample of 1078 women from 7 sublocations in Vihiga division, Kenya. Women were aged 40-60 years. The most populous ethnic group was the Luhya. 81.6% were married, 15.6% were widowed, and 0.7% were divorced. 4 women had never been married. 75.1% had a primary school education; 18.6% had not received any formal education. 30.1% had husbands who were unskilled workers, 28.8% had husbands who were farmers, and 20.6% had husbands who were skilled workers. 1.3% had no children, and 1 woman had 17 children. The average number of children was 7.74. 9 of the nulliparous women were menopausal. The mean height was 161.1 cm. The median age at menopause was 48.28 years. Almost all women were menopausal by 55 years. The total fertility period averaged 35 years. Female life expectancy was 59 years.
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PMID:Median age at menopause in a rural population of western Kenya. 952 44

A case of transient myocardial ischemia following subendometrial vasopressin infiltration in intractable intra-operative postpartum bleeding due to placenta accreta is described. In our experience, the rate of this side effect is one in 14 patients (rate of 7.1%). We believe that the benefits of the treatment outweigh the risks, since the uterus was saved in all 14 patients. Nevertheless, this case emphasises that extreme precaution is needed with subendometrial vasopressin infiltration. It should be emphasised that the needle must not be within a blood vessel because intravascular injection of vasopressin solution can precipitate acute arterial hypertension, bradycardia and even death. We suggest that local vasopressin infiltration into the placental site is indicated in cases of intractable bleeding at cesarean section after other conventional obstetric and pharmacological maneuvers have failed.
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PMID:Transient myocardial ischemia may occur following subendometrial vasopressin infiltration. 1081 86

A carefully taken history and clinical examination are necessary for assessing the relative benefits and risks of estrogen replacement therapy for an individual patient. The patient's weight, blood pressure and urine need to be checked. Benefits of estrogen replacement are seen in relation to vasomotor symptoms, atrophy of the genital tract, bone metabolism, psychological symptoms, libido, skin, and cardiovascular effects. Estrogens are contraindicated with a history of previous deep vein thrombosis, ischemic heart disease or carcinoma of the breast. Care needs to be taken with liver disease, hyperlipidemias, diabetes, gallbladder disease, gross obesity, or in heavy smokers. Progesterones should always be administered if the uterus is present to prevent endometrial hyperplasia and adenocarcinoma. When properly selected and carefully monitored, many women may be relieved of unnecessary suffering due to menopause.
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PMID:Estrogen replacement therapy: its benefits and risks. 1227 83

In the Netherlands, a considerable reduction in the annual number of deaths occurred in 2004. This reduction was largely caused by a decrease in the number of deaths from cardiovascular disease. - The risk of dying from cardiovascular disease has decreased in an almost linear manner during the past few decades. This reduction, which was well above average in the case of ischaemic heart disease, was registered for both sexes and across all age groups. The risk reduction in men aged 30-59 years was particularly large. - The contribution of neoplasms to total mortality continues to increase. However, the risk of dying from certain forms of cancer (lung for men, colon for women, stomach, gall-bladder, breast, prostate, uterus and ovaries) has been decreasing since the 1990s. - The risk of dying from breast cancer has decreased since the end of the 1990s. If present trends continue, Dutch women will be more likely to die from lung cancer than breast cancer from 2007 onwards. - The remarkably low mortality in 2004 may be attributed to the equable climatic conditions and the absence of an influenza epidemic. The drop in mortality was short-lived: in the first quarter of 2005, influenza caused a very strong increase in mortality among those aged over 80 years. - Even a further substantial reduction in mortality risks will not be able to prevent the predicted increase in the annual number of deaths in the Netherlands. This increase is estimated to end by the middle of this century.
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PMID:[Background on recent trends in mortality in the Netherlands]. 1632 Jun 64


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