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)

The authors reviewed 3133 consecutive autopsies performed in the 5 year period from 1986 to 1990 in Queen Mary Hospital (Hong Kong), and 96 cases of aortic aneurysms were found. The incidence was 1 in 33 autopsies. The ratio of male to female was 1.8 to 1, and the disease was most common in the eighth decade of life. The majority of death was due to rupture (70%) or related atherosclerotic diseases (14%), and the majority of aneurysms were not suspected before autopsies (62%). Most of the non-dissecting aneurysms were found in the abdominal aorta, the infra-renal portion. For dissecting aneurysms, Daily's type A was much more common. Hypertension was recognized in a high proportion of cases. Accompanying diseases like syphilis, Takayasu's disease, ischemic heart disease, cerebrovascular accident, diabetes mellitus, peripheral vascular disease, and chronic obstructive airway disease were also noted.
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PMID:Aortic aneurysm at autopsy: a five year survey in Hong Kong. 162 28

The incidence of medical diseases in surgical patients was assessed using data gathered from 5944 consecutive anaesthetics. Medical disease which might affect anaesthetic management was present in 23.2% of patients. The commonest diseases were hypertension, anaemia, chronic obstructive airway disease, diabetes mellitus, and pulmonary tuberculosis. No significant difference was detected in sex incidence for ischaemic heart disease and cerebrovascular disease. There was a disproportionate preponderance of males with respiratory diseases. It is suggested that anaesthetics should be administered only by qualified anaesthetists, that the establishment of anaesthetic outpatient clinics is desirable, and that internal medicine should be included in anaesthetic training.
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PMID:Medical diseases in surgical patients in Hong Kong. 670 13

An old lady having septic arthritis of right knee joint underwent arthrotomy under three in one block for femoral, obturator and lateral cutaneous nerve of thigh in inguinal region, with catheter in situ. She was a case of chronic obstructive airway disease with ischaemic heart disease, so operation and postoperative pain management was planned under regional block. Anaesthesia was started by giving regional block with 0.25% bupivacaine at first and maintained with intermittent injection of 0.125% bupivacaine. The patient was pain free and comfortable though out the perioperative period.
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PMID:Three in one block for unilateral knee arthrotomy in an old lady. 1638 17

Mortality and other long-term outcomes of COPD from epidemiological studies of cohorts based on the general population are still rare. In contrast, data from follow-ups of patients from hospitals and general practices are more common and demonstrate often a 5-year mortality of about 50% and even higher. The aim was to study 20-year outcomes, mainly mortality, in a COPD cohort derived from a population study. The Obstructive Lung Disease in Northern Sweden (OLIN) Study's first postal survey was performed in 1985, and 5698 subjects (86%) responded. A stratified sample of symptomatic subjects and controls was invited to clinical examinations including lung function tests in 1986, 1506 (91%) of the invited participated and 266 subjects fulfilled the GOLD criteria of COPD. All alive and possible to trace had participated at least at two follow-up examinations. Of the 266 subjects with COPD 46% were still alive after 20 years. The proportion of survived among subjects with severe and very severe COPD at entry was 19%. Death was significantly related to age, male sex, disease severity and concomitant ischemic heart disease or cardiac failure at entry. Socioeconomic status (manual workers) was significant in the univariate analysis, but failed to reach statistical significance in the multivariate model. The annual decline in FEV(1) among survivors was low to normal. Long-term follow-ups of subjects with COPD derived from population studies provide data reflecting the course of COPD in society better than follow-ups of hospital recruited patients, who represent the top of the iceberg. Surprisingly many with severe COPD were still alive after 20 years.
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PMID:A 20-year follow-up of a population study-based COPD cohort-report from the obstructive lung disease in Northern Sweden studies. 1981 85

A 70-year-old male smoker, with a three-month status of post-balloon angioplasty for ischaemic heart disease, presented with a one-week history of fever, haemoptysis and chest discomfort on coughing. The patient did not report any loss of weight or appetite. On examination, he was febrile. Pulmonary function tests revealed obstructive airway disease. High resolution computed tomography of the lungs revealed fibrosis with bronchiectasis in both the upper lobes, and a spiculating subpleural mass in the posterior aspect of the right lung apex. Subsequent bronchoalveolar lavage (BAL) culture yielded the Scopulariopsis species. Our patient was treated with a four-week course of amphotericin B, followed by itraconazole. At the 24-month follow-up, the patient was asymptomatic. Subsequent BAL cultures revealed no fungal growths, and radiological studies showed a regression in the lesion.
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PMID:Pulmonary Scopulariopsis in a chronic tobacco smoker. 2084 53

In this retrospective analysis, all patients (n=714; male=590; female=124 and female male ratio = 1: 4.76) came to Pulsar, a sleep laboratory of Kolkata, for polysomnography during ten years period were analyzed. More than half (62.46%) cases were between 41-60 years and 14.43% cases between 61-80 years age group. Fifty-two percent cases were referred by pulmonologists, followed by internist (15%), and 7% cases were self referred. Though obstructive sleep apnea was responsible for increased cardiovascular mortality and resistant hypertension, only 4% cases were referred by cardiologists. We observed hypertension as co-morbidity in 52.63% cases and ischemic heart disease in 22.83% cases. Snoring was the presenting complain in 98.88% cases, chocking was present in 48.88% cases and excessive daytime sleepiness was found in 96.64% cases. Females showed comparatively higher frequency of sleep disordered breathing than males with increasing basal metabolic rate. Nocturnal fall of SPO2 below 90% was observed in 86.97% of study population. We found abnormal respiratory disturbance index (> 5/hr of sleep) in 84.59% of our patients, normal respiratory disturbance index (< or = 5/hr of sleep) in 9.94% cases and isolated nocturnal hypoxemia in 5.46% cases (74.36% of the last category having obstructive airway disease). Snoring with respiratory disturbance index (RDI) < or = 5/hr was observed in 102 cases, of them 81.37% had simple snoring without significant arousal whereas 18.63% had multiple sleep fragmentation. We estimated that 84.06% of males, 87.10% of females and 84.59% of study population had obstructive sleep apnea. Split night polysomnography was performed in 362 cases, and of them 15.47% cases could not tolerate continuous positive airway pressure (CPAP) due to local or psychological reasons. In the present one time split-night CPAP titration study, we could not correct OSA in 19.06% subjects. Inadequate correction of hypoxemia due to co-morbid condition like COPD, asthma, obesity, hypothyroidism was the main responsible factor (49.28%). Treatment with CPAP was effective in 68.23% cases in first attempt. More than half of the cases (62.42%) required 10 cm of H20 or less CPAP.
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PMID:Polysomnographic profile in a sleep laboratory in Kolkata: a retrospective analysis of 714 cases. 2112 Dec 4

The Centers for Medicare and Medicaid Services has identified early rehospitalization of patients with chronic obstructive pulmonary disease (COPD) exacerbations as a performance measure for hospital care. We retrospectively reviewed patients with COPD who were admitted to University Medical Center, Lubbock, Texas, USA, between October 2010 and March 2011. There were 81 COPD patients with 103 hospitalizations. The mean age was 73.9 years. Pulmonary function tests using the Global initiative for chronic Obstructive Lung Disease criteria had been done in 36 patients (44.4%) and revealed 1 mild (2.8%), 7 moderate (19.4%), 20 severe (55.6%), and 8 very severe (22.2%) cases. Only 38.4% of the patients had prior influenza vaccine. Most patients were treated with antibiotics (81.8%) and corticosteroids (87.9%). The mean length of stay was 4.9 days, and 4 patients died. Most of the patients were discharged home (63.6%) with a median follow-up interval of 14 days. Thirty-two percent did not have long-acting bronchodilators and/or inhaled corticosteroids prescribed on discharge. There were 14 early rehospitalizations within 30 days. Logistic regression analysis indicated that a history of coronary artery disease (odds ratio (OR) 6.4, 95% confidence interval (CI) 1.1-37.4) and unilateral pulmonary infiltrates (OR 12.8, 95% CI 1.9-86.4) significantly increased the early rehospitalization rates. Acute exacerbations of COPD in patients with a history of ischemic heart disease or unilateral pulmonary infiltrates are at increased risk for early readmission. These risk factors should be identified during hospitalization; early follow-up or other interventions may reduce readmissions. Influenza vaccine, maintenance bronchodilators and/or inhaled corticosteroids, and pulmonary function tests were underused, and these standards of care should be provided to improve care.
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PMID:Factors affecting chronic obstructive pulmonary disease early rehospitalization. 2239 74