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At least 487 records · Page 27Linked to original sources
PubMed1988

[Pathologicoanatomic evaluation of the sequelae of medical manipulations].

Evaluation of 3576 autopsies conducted in the clinical prosection room of the First Moscow Medical Institute in 1982-1986 suggests a high frequency of manipulation-induced iatrogenic disease which appeared 3 times that of drug-induced one. Manipulative treatment was found to be an underlying cause of death and essential in thanatogenesis in 3.1% of cases, this figure being on the increase. Of the overall iatrogenic pathology registered, the proportion of that due to manipulative treatment reached 72.7%, being 16.4 and 10.9% for diagnostic manipulations, surgical and anesthesia procedures, respectively. Physicians' errors resulted in iatrogenic diseases in 60% of cases, subjective faults entailed these in 30% of cases which intravitally remained undetected. The tendency to the growing occurrence of iatrogenic pathology is believed to arise in response to imperfection of medical equipment and defects of therapeutic policy.

Adult↗
PubMed1995

Serious and life-threatening drug eruptions.

Drug eruptions are common iatrogenic diseases. Although most of these conditions are benign and self-limited when use of the responsible drug is discontinued, several subtypes of drug eruptions are characterized by significant morbidity and mortality. The more dangerous types include erythroderma, leukocytoclastic vasculitis, anticonvulsant hypersensitivity syndrome, Stevens-Johnson syndrome and toxic epidermal necrolysis. Relatively few medications are repeatedly implicated in the pathogenesis of severe reactions. Prompt recognition of drug eruptions and early intervention are necessary to prevent the serious consequences of this group of iatrogenic diseases.

Anticonvulsants↗
PubMed2000

Osteoarticular disorders of renal origin: disease-related and iatrogenic.

Osteoarticular disorders significantly limit the quality of long-term survival with chronic renal failure. beta 2M amyloidosis is a complication of chronic renal failure that has been recognized mostly in patients receiving long-term haemodialysis. Patients with beta 2M amyloidosis typically present with the triad of shoulder periarthritis, carpal tunnel syndrome, and flexor tenosynovitis of the hands. Other musculoskeletal manifestations of beta 2M amyloidosis include destructive spondyloarthropathy, cervico-occipital pseudotumours, bone cysts, and pathological fractures. At present, only renal transplantation may slow or halt the progession of beta 2M amyloidosis. Crystal-induced arthropathy, most commonly caused by basic calcium phosphate crystals, is an important cause of acute joint inflammation in the patient with renal failure. The incidence of bone and joint infection is increased in patients undergoing dialysis. Haemodialysis and peritoneal dialysis are also associated with an erosive or destructive arthropathy of finger joints, which is not explained by local amyloid deposition.

Amyloidosis↗
PubMed1989

Arthritis and the gut.

The term "enteropathic arthritis" describes joint manifestations that occur in conjunction with gastrointestinal disease. Underlying causes include inflammatory bowel disease, reactive arthritis, iatrogenic disease. Whipple's disease, and other gastrointestinal diseases. A possible association between Reiter's syndrome and human immunodeficiency virus infection also has been reported. These arthritic syndromes can be treated symptomatically, but long-term therapy should be directed at the underlying cause. In most cases, prognosis for survival and joint function is good.

Arthritis↗
PubMed1983

Bacterial pneumonia in the elderly.

Bacterial pneumonia in the elderly is common, and causes more morbidity and mortality than in the younger adult. As patients live longer with more underlying disease and more iatrogenic disease, the incidence of nosocomial pneumonia will probably rise. Adequate sterilization of inhalation therapy equipment can reduce the risk of gram-negative nosocomial pneumonia. Methods to prevent colonization and microaspiration need to be investigated. The development of a gram-negative vaccine using Salmonella RE or E. coli J5 mutant would augur well for the future. Most important, the elderly patient with pneumonia should be managed promptly and aggressively in an attempt to determine the specific etiology of the pneumonia. The practice of antibiotic "shotgunning" of the elderly patient is to be avoided. Transtracheal aspiration or sheathed bronchoscopy can be performed if the patient is not able to produce sputum, or Gram stain is difficult to interpret. Morbidity and mortality can be reduced by early appropriate antibiotic therapy directed by Gram stain.

Acinetobacter↗
PubMed1999

Bloody pericardial effusion in patients with cardiac tamponade: is the cause cancerous, tuberculous, or iatrogenic in the 1990s?

STUDY OBJECTIVES: The decrease in incidence of tuberculosis, along with the increase in invasive cardiovascular procedures, may have changed the frequency of causes of bloody pericardial effusion associated with cardiac tamponade, although this is not yet recognized by medical textbooks. We analyzed the causes of bloody pericardial effusion in the clinical setting of cardiac tamponade in the 1990s; patients' survival; the effect of laboratory results on discharge diagnosis; and how often bloody pericardial effusion is a presenting manifestation of a new malignancy or tuberculosis. DESIGN: Retrospective, observational, single-center study. SETTING: A community hospital. PATIENTS: The charts of all patients who underwent pericardiocentesis for cardiac tamponade and had bloody pericardial effusion were retrospectively reviewed. RESULTS: Of 150 patients who had pericardiocentesis for relieving cardiac tamponade, 96 patients (64%) had a bloody pericardial effusion. The most common cause of bloody pericardial effusion was iatrogenic disease (31%), namely, secondary to invasive cardiac procedures. The other common causes were malignancy (26%), complications of atherosclerotic heart disease (11%), and idiopathic disease (10%). Tuberculosis was detected as a cause of bloody pericardial effusion in one patient and presumed to be the cause in another patient. Bloody pericardial effusion was found to be a presenting manifestation of a newly diagnosed malignancy in two patients. The patients in the idiopathic and iatrogenic groups were all alive and had no recurrence of pericardial effusion at 24 +/- 27 and 33 +/- 21 months after hospital discharge, respectively, whereas 80% of patients with malignancy-related bloody effusions died within 8 +/- 6 months. CONCLUSIONS: In a patient population that is reasonably representative of that in most community hospitals in the United States, the most common cause of bloody pericardial effusion in patients with signs or symptoms of cardiac tamponade is now iatrogenic disease. Of the noniatrogenic causes, malignancy, complications of acute myocardial infarction, and idiopathic disease predominated. Hemorrhagic tuberculous pericardial effusions are uncommon and may likely reflect a low incidence of cardiac tuberculosis in community hospitals in the United States.

Adult↗
PubMed2006

[Long-term care elderly residents in general hospitals].

Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases, delirium, and functional decline, which may deteriorate patients' general condition and their quality of life during and/or after hospitalization. This study aimed at addressing specific aspects of assessment, treatment and management of nursing home elderly who require to be hospitalized, especially focusing on their effective care. Common conditions such delirium, iatrogenic diseases, poor nutrition, functional decline, hospice care and special characteristics of nursing home elderly during their admission to general hospitals are discussed.

Aged↗
PubMed2002

Herb-drug, food-drug, nutrient-drug, and drug-drug interactions: mechanisms involved and their medical implications.

Adverse drug reactions (ADRs) and iatrogenic diseases have been identified as significant factors responsible for patient morbidity and mortality. Significant studies on drug metabolism in humans have been published during the last few years, offering a deeper comprehension of the mechanisms underlying adverse drug reactions and interactions. More understanding of these mechanisms, and of recent advances in laboratory technology, can help to evaluate potential drug interactions when drugs are prescribed concurrently. Increasing knowledge of interindividual variation in drug breakdown capacity and recent findings concerning the influence of environment, diet, nutrients, and herbal products can be used to reduce ADRs and iatrogenic diseases. Reviewed data suggest that drug treatment should be increasingly custom tailored to suit the individual patient and that appropriately co-prescribed diet and herbal remedies, could increase drug efficacy and lessen drug toxicity. This review focuses mainly on recently published research material. The cytochrome p450 enzymes, their role in metabolism, and their mechanisms of action are reviewed, and their role in drug-drug interactions are discussed. Drug-food and drug-herb interactions have garnered attention. Interdisciplinary communication among medical herbalists, medical doctors, and dietetic experts needs to be improved and encouraged. Internet resources for obtaining current information regarding drug-drug, drug-herb, and drug-nutrient interactions are provided.

Adverse Drug Reaction Reporting Systems↗
PubMed2000

[Iatrogeny in cardiology].

The word iatrogeny derives from the Greek and concerns any disorder caused to the patient by inaproppriate medical practice. Unfortunately, the rise of an iatrogenic disease is related to the daily handline of cardiac disease. There are two types of iatrogeny: that caused by a medical action and omission iatrogeny, caused by the lack of a medical action. Iatrogeny occurs in all steps of medical practice starting with the patient-doctor relationship including diagnosis treatment and finally prevention of diseases. This article makes a brief commentary about iatrogenic heart disease and mentions some examples of it.

Adolescent↗
PubMed2005

[Iatrogenic neurological disorders in old people: a review].

Aged people are frequently the victims of iatrogenic diseases, especially adverse effects of drugs since they are affected by many age-related diseases and are given many drugs. Geriatric medicine in Japan has a bitter history of having produced many victims by adverse effects of cerebral vasodilators and cerebral stimulants; they included parkinsonism and depression induced by flunarizine and cinnarizine, and Reye-like encephalopathy induced by calcium hopantenate. Parkinsonism induced by sulpiride, tiapride, metoclopramide or atypical anti-psychotics, dyskinesia induced by anti-parkinsonian drugs or anti-psychotics, and psychotic symptoms induced by anti-parkinsonian drugs, anti-cholinergic drugs, anti-depressants or histamine H2 antagonists are still very common. Wernicke encephalopathy caused by intravenous glucose infusion without thiamine, central pontine myelinolysis by too rapid correction of hyponatremia are important though infrequent. Iatrogenic Creutzfeldt-Jakob disease by dura grafts is a warning against the easy use of medical materials produced with human organs or blood. Iatrogenic diseases are preventable, and geriatricians have to pay attention to the information on adverse effects of drugs and medical materials and carefully observe the early signs of iatrogenic diseases.

Aged↗
PubMed2002

Thoughts on prevention of thyroid disease in the United States.

In the realm of preventive medicine, there are three distinct types of prevention that can be defined. Primary prevention is the prevention of new disease in previously healthy individuals, usually achieved by decreasing risk factors for disease. Secondary prevention is the prevention of progression of mild or latent disease to more severe disease, and typically involves screening for occult disease. Tertiary prevention is the term used by some to describe medical care intended to improve already established disease. The role of primary prevention of thyroid disease in the United States is uncertain, because iodine deficiency is not clearly known to be a problem. In the case of secondary prevention of thyroid disease, this would necessarily involve screening of individuals for subclinical hyperthyroidism or hypothyroidism with thyrotropin (TSH) testing. Using data from a large prevalence study and from the 2000 U.S. Census, it can be calculated that approximately 15 million adults have unrecognized thyroid disease, mostly subclinical hypothyroidism. If detected, secondary prevention might also entail treatment with antithyroid drugs/radioiodine or thyroxine to prevent sequelae or progression to a more advanced degree of thyrotoxicosis or thyroid failure, respectively. Over the next 20 years, it can be calculated that approximately 5 million people, mostly with subclinical hypothyroidism, will progress to overt disease. Tertiary prevention of thyroid disease would involve avoiding iatrogenic disease, such as thyroid hormone overdose. From epidemiologic data it can be calculated that approximately 600,00 elderly individuals have iatrogenic hyperthyroidism from thyroid hormone overdose, putting them at risk for atrial fibrillation and osteoporosis. Together, these data suggest that the notion of preventive medicine in the United States should be expanded to include thyroid disease as a target for secondary and tertiary intervention.

Humans↗
PubMed1987

Some unexplored regions of psychosomatic medicine.

The history of psychosomatic medicine in the 20th century is predominantly marked by a concern with studies of major diseases (e.g., angina pectoris, bronchial asthma, diabetes mellitus, essential hypertension, neurodermatitis, rheumatoid arthritis, etc.). Traditional physicians also narrowly focus on disease--a trend that began with Morgagni in the 18th century. But disease (defined by structural alterations) is not the only cause of illness and disability. In fact, most persons seeking health care are ill without having a disease. It is only recently that this distinction has been fully made. The various manifestations of ill-health go by a variety of descriptive names--the functional or irritable bowel and hyperventilation syndromes, fibromyositis, psychophysiological, functional and somatoform or somatization disorders. They lead to loss of productivity, cost the health care system excessively, produce negative reactions in physicians, and are fertile ground for iatrogenic disease. They do not constitute discrete syndromes but overlap, each also being closely associated with anxiety and depression, sleep disturbances or marital disruption. They are the manifestations of sick persons not only of disturbances of bodily systems. They may be precipitated by unemployment, marital discord, bereavement, and job dissatisfaction. Curiously, ill-health has not been the major area of investigative interest of psychosomatic medicine. This presentation will emphasize why it should be, and why proper interventions may radically reduce the cost of medical care, prevent iatrogenic disease, and reduce the use of ill-advised procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1996

Differential diagnosis of abnormal uterine bleeding.

The causes of abnormal uterine bleeding include a wide spectrum of diseases of the reproductive system and nongynecologic causes as well. The differential diagnosis of abnormal excessive uterine bleeding includes organic causes that may be subdivided into reproductive tract disease, iatrogenic causes, and systemic disease. Reproductive tract disease that may result in abnormal uterine bleeding comprises the complications of pregnancy (threatened, incomplete, or missed abortion, ectopic pregnancy, trophoblastic disease, placental polyp, and subinvolution of the placental site), malignant tumors (endometrial, cervical, vaginal, vulvar, and oviduct malignancies and granulosa theca cell ovarian tumors), infection (endometritis, salpingitis), and other benign pelvic disorders (traumatic lesions of the vagina, severe vaginal infections, foreign bodies, cervical polyps, cervical erosion, cervicitis, submucous uterine leiomyomas, adenomyosis, endometriosis, and endometrial polyps). Iatrogenic causes of abnormal uterine bleeding include sex steroids, hypothalamic depressants, digitalis, phenytoin, anticoagulants, and intrauterine contraceptive devices. Systemic diseases that may cause abnormal uterine bleeding include hypothyroidism, cirrhosis, and coagulation disorders. Abnormal uterine bleeding that occurs in a woman of reproductive age should be considered the result of complication of pregnancy until proved otherwise. Abnormal uterine bleeding occurring in a woman of perimenopausal or postmenopausal age should be considered the result of a malignancy until proved otherwise. Menorrhagia occurring in an adolescent should be attributed to a coagulopathy until proved otherwise. When an organic cause of abnormal uterine bleeding cannot be found, then by exclusion the diagnosis of dysfunctional uterine bleeding is assumed. Coagulation disorders, particularly von Willebrand disease, are more common than many physicians realize. Women with a history of high-risk factors, all adolescents with menorrhagia, women with anovulatory dysfunctional uterine bleeding who fail medical or surgical therapy, and women with ovulatory dysfunctional uterine bleeding without an anatomic uterine lesion should be screened for a coagulopathy.

Diagnosis, Differential↗
PubMed2003

Corneal toxicity: the epithelium and stroma in iatrogenic and factitious disease.

Corneal toxicity is caused by chemical trauma and by iatrogenic and factitious disease, which are often overlooked, and which are reviewed here. The clinical signs of iatrogenic disease are usually nonspecific and identical to those resulting from other causes of surface disease. Factitious disease is either the result of mechanical trauma or the abuse of toxic eye drops. One epidemiological study, in a tertiary setting, identified 13% of keratoconjunctivitis cases as iatrogenic. Healing was prolonged taking 7-93 (median 28.5) days. Pathogenic mechanisms vary widely with different drugs and include subclinical scarring, pseudopemphigoid, drug-induced ocular cicatricial pemphigoid, and toxic follicular reactions. There is little readily available data either on the probability of the development of adverse reactions or for the comparison of different drugs. The assessment of the toxicity of topical drugs is currently by the Draize test in rabbits. New in vitro tests on human corneal epithelial cell cultures include ATP assays for cell viability, scanning EM of epithelial microvilli, and vital staining to assess cell membrane permeability and intracellular esterase. Despite their simplicity, these test systems can correlate well with clinical toxicity and provide a toxicity index for drug comparisons. Treatment requires drug withdrawal or substitution by non-preserved and less toxic preparations. Factitious injury is rare, difficult to diagnose, and should only be considered when all other diagnoses have been excluded. Prevention requires a high level of awareness of the potential for iatrogenic disease, particularly in the high-risk setting of chronic ocular surface disease.

Corneal Diseases↗