ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Despite considerable progress in understanding disease mechanisms and risk factors, improved treatments, and public education efforts, cardiovascular disease (CVD) remains the leading cause of death in the United States. Obesity and physical inactivity, 2 important lifestyle-related risk factors for CVD, are prevalent in the southeastern United States and are becoming more prevalent in all racial groups and areas of the country. In reviewing these risk factors, we explored topics including prevalence and trends in population data; associated psychosocial and environmental factors; and some of the mechanisms through which these risk factors are thought to contribute to CVD. We identified significant, but as yet poorly understood, racial disparities in prevalence of obesity, low levels of physical activity, and correlates of these risk factors and examined important differences in the complex relationship between obesity, diabetes, and cardiovascular disease risk between African American and European American women. The Jackson Heart Study will provide important and unique information relevant to many unanswered questions about obesity, physical inactivity, and obesity in African Americans.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Obesity is the most common nutritional disorder in the United States. Growing evidence suggests that obesity initiates a cascade of disorders including hypertension, diabetes, atherosclerosis, and chronic renal disease, many of which are interdependent. Abnormal kidney function, caused by increased renal tubular reabsorption, initiates volume expansion and increased blood pressure during excess weight gain, and the hypertension and metabolic abnormalities associated with obesity, in turn, contribute to chronic renal disease. Obesity causes cardiac and vascular disease through well-known mediators such as hypertension, type II diabetes, and dyslipidemia, but there is evidence for less well-characterized mediators such as chronic inflammation and hypercoagulation. Although obesity is increasingly recognized as a serious health problem, there are still many unanswered questions about how the multiple disorders associated with excess weight gain interact to cause cardiovascular and renal disease. Also, there are few studies that have examined whether sustained weight loss in obese subjects can reverse these changes. In view of the “epidemic” of obesity in our country and the excess burden of cardiovascular and renal disease in minority populations, addressing these issues is of paramount importance for the Jackson Heart Study, as well as for other national health initiatives.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Cardiovascular disease (CVD) is the No. 1 cause of death in patients with end-stage renal disease (ESRD) and is approximately 3 to 5 times that of nonuremic control subjects. Moreover, higher rates of CVD are seen in patients with moderate and even mild renal dysfunction, particularly if the patient has hypertension or diabetes. Recent studies have indicated that even modest elevations in serum creatinine and urinary albumin excretion are associated with increased CVD risk, not only in persons with diabetes or hypertension but also in the general population. In addition, recent studies have suggested that targeting the kidney and/or kidney specific endpoints (via the renin-angiotensin-aldosterone-kinin system) in the treatment of hypertension, diabetes, and heart failure slows progression of renal disease and reduces the risk of extra-renal micro- and macrovascular complications. We conclude that it is important to screen for renal disease in those with hypertension, diabetes, and other CVD risk factors because it predicts those who are at high risk for major CVD events.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The science of medicine has evolved dramatically over recent years, with better understanding of the mechanisms of disease leading to innovative new treatments. However, the critical care patient still suffers from a high mortality rate with few advances from the traditional modalities of therapy. Arginine vasopressin has been explored as a vasoconstrictor in the treatment of the hypotension associated with septic shock. This drug has also recently been added to the advanced cardiac life support protocol for the resuscitation of pulseless ventricular tachycardia and ventricular fibrillation. Studies of arginine vasopressin in these situations have been promising but still have yet to prove a survival benefit over traditional therapies. Newer and larger trials are necessary to determine whether any mortality benefit can be sustained from the use of arginine vasopressin in critical care patients with septic shock and cardiac arrest secondary to pulseless ventricular tachycardia and ventricular fibrillation.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been well described in patients with meningeal spread from metastatic carcinomatosis and bacterial or mycobacterial infections. We describe a 39-year-old white man who was diagnosed with coccidioidomycosis pneumonia 7 years before presentation. He displayed evidence for meningitis with the onset of SIADH. We reviewed the diagnosis of coccidioidomycosis and radiological findings in the central nervous system. Last, we discussed the findings that led to the diagnosis of SIADH.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

We describe a case of myotonic dystrophy presenting with a disturbed circadian rhythm of the serum cortisol and an isolated thyrotropin deficiency. The diagnosis of myotonic dystrophy was based on clinical characteristics, positive electromyographic findings, and increased number of CTG repeats in the dystrophia myotonica protein kinase (DMPK) gene. The patient presented with a variable circadian rhythm of the serum cortisol, increased excretion of urinary free cortisol, and a high adrenocorticotropin hormone responses to corticotropin-releasing hormone. The basal serum thyrotropin concentration was low and did not increase after thyrotropin-releasing hormone stimulation. The protein encoded by theDMPKgene may act as a second messenger in signal transduction, like a protein kinase. The present patient had a diverse pattern of disturbances in the hypothalamus-pituitary-endocrine organ axis, probably mediated by differences in the action or expression of the gene products in each endocrine cell.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Neoplasm-related nephrotic syndrome exhibiting focal segmental glomerulosclerosis (FSGS) has been reported mainly in patients with hematologic malignancies. The association of FSGS with carcinoma is very rare and nephrotic syndrome caused by FSGS has not yet been reported in patients with lung cancer. We report a case of nephrotic syndrome caused by FSGS in a 61-year-old man with advanced non–small-cell lung cancer. In addition, platelet dysfunction evidenced by prolonged bleeding time was noted. The renal problem and prolonged bleeding time resolved dramatically during radiotherapy for lung cancer. We speculate that both FSGS and prolonged bleeding time are paraneoplastic syndromes associated with lung cancer, although the underlying mechanisms of both conditions remain to be elucidated.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

We present a case of isochromosome 14q-related myeloid cell disorder. To our knowledge, this report describes the first case of an unclassifiable chronic myeloproliferative disorder associated with this karyotypic abnormality.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Autonomic failure is rare in patients with Sjögren syndrome (SS). We report the case of a 46-year-old woman with severe autonomic cardiovascular failure, manifested by incapacitating postural hypotension, as the first symptom of primary SS. Treatment with glucocorticoid resulted in a dramatic improvement of her symptoms and objective findings of autonomic cardiovascular dysfunction. We suggest that SS should be considered in patients with idiopathic autonomic cardiovascular neuropathy, especially in those with idiopathic orthostatic hypotension. Furthermore, glucocorticoid therapy seems to be very efficacious in the treatment of SS-associated autonomic cardiovascular neuropathy.

ISSN:0002-9629    

出版商:OVID    

年代:2002

数据来源: OVID