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 objectives of this research were to study the distribution of in- and out-hospital deaths and causes of death in male alcoholics and in particular to analyze obscure cases. In a population-based sample of 1123 men treated in one detoxification unit during 1986-1989, 97 patients with alcohol dependence (DSM-III-R) died < or = 1 year after in-hospital detoxification. In each case, the cause and the manner of death were assessed by scrutiny of information in hospital and autopsy records, toxicological examinations, and police reports. The results were that 71 of the 97 men died outside hospital. The overall autopsy rate was 89%. Ischemic heart disease accounted for 18 out of 41 evaluable natural out-hospital deaths. Epileptic seizures were judged to be the cause of death in five cases and could also have contributed to seven out of eight obscure out-hospital deaths. Ethanol in blood or urine was detected in 19 of the 23 deaths attributed to trauma or intoxication, whereas only four out of the 18 out-hospital deaths from ischemic heart disease were ethanol-positive. It was concluded that early detection and adequate treatment of ischemic heart disease and epilepsy might improve prognosis in patients with alcohol dependence. The use of clinical information could be of crucial importance in evaluating possible causes of death, especially in obscure cases.
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PMID:Ischemic heart disease and epilepsy: two major causes of out-hospital natural death in male alcoholics. 775 Aug 79

About 70% of noncardiac chest pain (NCCP) patients have mental disorders as reported from Western countries. The phenomenon of somatization is considered to be aetiologically important in the genesis of NCCP. Though somatization is generally considered as more prevalent among non-Western cultures, systematic studies of mental disorder among NCCP patients are rare from developing countries. Based on treadmill test, 54 male inpatients in a cardiology general ward in India were divided into a group having ischaemic heart disease (IHD) and another group of NCCP. A psychiatric interview was conducted blindly on these subjects with the help of a structured interview schedule, and DSM-III-R diagnosis was made. Sixty-eight percent in the NCCP group and 27% in the IHD group had a mental disorder. The total number of subjects with a mental disorder, including panic disorder and major depression, were significantly more in the NCCP group. Mental disorders appears to be equally common among NCCP patients in developing countries also and detailed psychiatric assessment is warranted in patients with chest pain of non-IHD origin.
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PMID:Mental disorders in patients with noncardiac chest pain. 806 65

Delirium is a common postoperative complication that is associated with substantial patient morbidity and mortality. Because of the variability in its presentation, delirium has the potential to be overlooked or misdiagnosed. There are few well-designed prospective studies looking at the incidence of delirium; however, retrospective data reveal it to be highly variable. The cause is multifactorial, with the largest predisposing factors being patient age, cerebral disease, and poor preoperative medical status. Common precipitants of delirium postoperatively include infection, hypoxia, myocardial ischemia, metabolic derangements, and anticholinergic drugs. The pathogenesis of delirium is incompletely understood; cholinergic pathways appear to play a crucial role. Physicians evaluating postoperative patients for mental status changes need to identify delirium accurately (the diagnostic criteria for which are clearly set out in the DSM-IV). Further investigations center on searching for organic precipitants, which can be treated effectively. The diagnostic workup is not algorithmic and must be tailored to the specifics of each individual case. If there is no readily identifiable cause, treatment should focus on the disorder itself. Supportive care should consist of a multidisciplinary approach aimed at preventing functional decline. Pharmacologic therapy, usually with haloperidol, may be indicated if patients remain agitated. Investigations have supported the premise that delirium is a potentially preventable condition. This prevention can be accomplished by maximizing the patient's medical status and conscientiously avoiding the conditions that are known to precipitate delirium.
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PMID:Postoperative delirium. 1156 96

The prevalence of depression after stroke shows considerable variability. Predictors of depression are also not consistent between studies. The aim of this study was to study the prevalence of depression, as well as to study different determinants for depression and life satisfaction one year after a first-ever stroke. One year after the event, we screened survivors (n=253) in a population-based stroke study for depression using the Geriatric Depression Scale. The DSM-IV criteria were used to diagnose depression. Patients were asked how well they were satisfied with life in general. Predictors were evaluated in univariate and multivariate regression models. We found that 37% of the patients crossed cutoff on the Geriatric Depression Scale, and that 27% had a minor or major depression according to the DSM-IV criteria. Independent predictors in multivariate analysis were functional outcome, as measured by the Modified Rankin Scale, ischemic heart disease, and non-lacunar infarction. Independent predictors for a low life satisfaction were depression and functional outcome. We concluded that a low functional outcome predicts depression. Depression has a major impact upon life satisfaction one year after a stroke. Other potential predictors evaluated in this study were of less importance. Active rehabilitation may improve functional outcome, and thence influence depression positively. Also, depression is medically treatable. Follow-up strategies should include measures to detect and manage depression. Traditional scales and definitions of depression may be less reliable in the oldest old.
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PMID:Prevalence and predictors of depression at one year in a Swedish population-based cohort with first-ever stroke. 1790 50

Chest pain is one of the most common symptoms in psychiatric and primary care practice and a frequent reason for extensive diagnostic work-up. Despite extensive investigations no recognizable medical cause to account for these symptoms is detected in many patients with chest pain. Studies of patients with non-cardiac chest pain have revealed that many continue to report symptoms and disability despite medical reassurances.The aims of the study were to evaluate the prevalence of psychiatric morbidity, personality profile and stressors along with functional impairment in patients with chest pain and normal angiographic findings and compare the same with patients who have chest pain but abnormal angiographic findings and a diagnosis of ischemic heart disease.The study included 30 consecutive patients in each group. The scales used were SCID-I of DSM-III-R, 16-PF, semi structured questionnaire for assessment of type A behaviour, PSLES and GAF scale of DSM-III-R.Panic disorder and depression were highly prevalent in patients with atypical chest pain. These patients had lower prevalence of type A behaviour, a unique 16-PF profile, experienced more stresses at any given point in time and significant impairment in day-day and in socio-occupational functioning.
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PMID:A comparative study of psychological factors in patients with normal and abnormal angiographic findings. 2143 Aug 3