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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-one cases of bacterial endocarditis in adult dairy cows were reviewed. Clinical signs were reflective of the stage of the disease. Recurrent or persistent fever, tachycardia and a pounding heartbeat or systolic murmur, polypnea, and lameness were typical. With chronicity, weight loss and poor production developed. The end stage was congestive heart failure. Neutrophilia was typical in early cases. Low-grade anemia and high total serum globulin content developed with chronicity and seemed to be negative prognostic signs. Corynebacterium pyogenes was the organism most frequently identified by blood culture or at necropsy. Twenty cows were necropsied and 2 cows were sent to slaughter. Nine cows in which the diagnosis was made early in the course of the disease responded to long-term penicillin therapy.
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PMID:Bacterial endocarditis in adult dairy cattle. 634 19

Infection of an intracardiac prosthesis, the incidence of which is about 2.5% among patients having undergone valve replacement, is a serious complication with considerable morbidity and mortality. Early prosthetic valve endocarditis (PVE), with an onset within 60 days of valve replacement, accounts for approximately one-third of all cases, while the remaining two-thirds, occur more than two months postoperatively (late prosthetic valve endocarditis). Prosthetic valve endocarditis is most commonly caused by Staphylococcus epidermidis, less frequently by viridans streptococci, Staphylococcus aureus, and gram-negative bacilli. The most likely pathogenetic mechanisms in prosthetic valve endocarditis are intraoperative contamination and postoperative infections at extracardiac sites. Prominent clinical features include fever, new or changing heart murmurs, leukocytosis, anemia and hematuria. The etiologic microorganism can be isolated in more than 90% of all cases. Patients with proven prosthetic valve endocarditis should be examined daily to detect signs of congestive heart failure and changes in murmurs; electrocardiographic monitoring is essential for documentation of arrhythmias. With limitations, echocardiography, especially two-dimensional, may help to demonstrate vegetations or valvular dehiscence. Cinefluoroscopy may reveal loosening or dehiscence of the sewing ring or impaired motion of a radio-opaque poppet due to thrombus or vegetation. Cardiac catheterization, not always necessary even when surgical intervention is anticipated, may provide valuable information on the degree of dysfunction, multiple valve involvement, left ventricular function and extent of concomitant coronary artery disease. In patients with mechanical valves, prosthetic valve endocarditis may be associated with a high incidence of valve ring and myocardial abscesses; the reported frequency of valve ring abscesses is lower with porcine heterografts. Infections on mechanical valves characteristically localize to the sewing ring with subsequent detachment of the prosthesis and valvular incompetence; infections on porcine heterografts tend to localize to the cusps, leading to valvular incompetence because of leaflet destruction. Large vegetations may result in functional stenosis. Over the last ten years the overall mortality of prosthetic valve endocarditis was 53.8%; 73.6% in early and 43% in late prosthetic valve endocarditis. More recently, however, the survival rate appears to be improving. In general, the mortality associated with prosthetic valve endocarditis caused by fungi and Staphylococcus aureus is highest and that of streptococci lowest.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prosthetic valve endocarditis: an overview. 636 38

Renal involvement or "scleroderma renal crisis" developed in 60 patients with progressive systemic sclerosis evaluated at the University of Pittsburgh during the period from 1972 to 1982. Forty-seven of these patients had progressive systemic sclerosis with diffuse scleroderma, representing 18 percent of persons with progressive systemic sclerosis and diffuse scleroderma evaluated during this time period. Ten additional patients did not have truncal scleroderma but were suspected of having incompletely developed diffuse scleroderma. Only three patients were classified as having progressive systemic sclerosis with the CREST syndrome. Renal crisis was observed early in the course of the illness, a mean of 3.2 years after onset. During May and June, this complication developed in fewer patients than expected. Thirty-six patients who had diffuse scleroderma and renal involvement after their initial Pittsburgh evaluation were compared with 212 who had diffuse scleroderma without renal involvement during follow-up. The patients with renal involvement had a shorter mean disease duration at the time of their first evaluation (2.4 versus 4.2 years, p less than 0.05) and less frequently had digital pitting scars (29 versus 54 percent), but no other significant clinical, laboratory, or serologic differences were noted. Data available for 31 patients with renal involvement during the six months preceding the onset of renal disease were analyzed. Blood pressure, serum creatinine, urine protein and red blood cells, and plasma renin levels were similar in these patients and the 212 patients without renal involvement. More patients with renal involvement had anemia or clinical evidence of cardiac involvement during this period compared with the patients without renal involvement. During the 12-month period prior to renal involvement, seven of 16 (44 percent) patients with such involvement had an impressive increase in skin thickening on physical examination compared with only 23 of 180 (14 percent) patients without renal involvement at any time during their course. Thus, the subset of patients with diffuse scleroderma who show rapid progression of their skin thickening early in the illness with development of anemia, pericardial effusion, or congestive heart failure have a high risk of "scleroderma renal crisis."
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PMID:Factors predicting development of renal involvement in progressive systemic sclerosis. 637 52

Severe congestive cardiac failure developed in a few weeks in a 44 year old man who had undergone porto-caval anastamosis for post-hepatitis cirrhosis one year previously and then treated for anaemia by repeated blood transfusion and chronic daily oral iron therapy. Infiltrative, congestive and restrictive cardiomyopathy was diagnosed in the presence of global cardiomegaly, electrocardiographic changes (microvoltage, diffuse ST-T wave changes), echocardiographic appearances (dilatation of the left ventricle, with hypertrophic and hypokinetic walls), and hemodynamic signs of adiastole with equalisation of filling pressures at 15 mmHg and a cardiac index of 1,88 l/min/m2. Cardiac haemochromatosis was confirmed by the laboratory (serum iron: 35 mumol/l; siderophilin saturation: 100 p. 100; serum ferritin: 1854 ng/ml; induced siderouria: 51 mg/24 hours) and histological findings (endomyocardial biopsy showing pigment overload). The absence of a family history, of homozygote A3 antigen, of diabetes, of iron overload on hepatic biopsy one year previously, excluded the diagnosis of familial idiopathic haemochromatosis. A secondary form of the disease was diagnosed on a possible genetic predisposition (heterozygote A3 antigen) and on environmental factors (blood transfusions, iron therapy, cirrhosis, alcoholism and perhaps the porto-caval anastamosis. Cardiac haemochromatosis was cured in this case by iron chelating therapy comprising daily subcutaneous infusions of 2 g of desferrioxamine for 2 months. The cure was confirmed by regression of the signs of clinical cardiac failure and of cardiomegaly, the increase in QRS voltages and the near normalisation of the hemodynamic and laboratory findings.
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PMID:[Adiastole caused by a secondary cardiac hemochromatosis. Successful treatment with an iron chelating agent]. 641 3

The performance of a nurse practitioner, under the supervision of an internist, in managing inpatients in a rehabilitation hospital was assessed by comparison with three similar groups managed by internists. Criteria were chosen to reflect both quality of care and cost-effectiveness. The medical records of 25 patients discharged consecutively on each service were examined to determine length of stay, laboratory and x-ray costs per day, number of consultations, and mean score on six index conditions. The index conditions score was designed to reflect proper recognition and management of the following common medical problems: urinary tract infection, congestive heart failure, anemia, diabetes, hypertension, and hypokalemia. No statistically significant differences were found between the patient groups managed by the supervised nurse practitioner and the independent internists.
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PMID:Inpatient management by a nurse practitioner: effectiveness in a rehabilitation setting. 641 11

The risk of aggravated heart failure due to expanded blood volume and augmented left-ventricular filling pressure poses a challenge when transfusion is indicated by severe anemia complicating congestive heart failure. Intravenous (IV) nitroglycerin therapy produces a favorable redistribution of circulating blood volume and may be used to surmount these hemodynamic constraints during transfusion. In four patients with severe anemia and cardiac failure, IV nitroglycerin permitted rapid and large-volume blood transfusion without compromising cardiac function. In two of the four patients, recalcitrant unstable angina abated after the correction of anemia.
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PMID:Intravenous nitroglycerin in transfusion therapy for severe anemia. Association with congestive heart failure. 642 Dec 58

A prospective study of congestive cardiac failure in 221 elderly Nigerians seen at Ahmadu Bello University Hospital, Zaria, and Ife University Teaching Hospitals Complex, Ile-Ife from 1974 to 1979 is reported. Hypertension, iodopathic cardiomegaly and pulmonary heart disease were major causes of cardiac failure. No case of coronary atherosclerotic heart disease was seen. Ventricular conduction defect was the commonest E.C.G. abnormality recorded. In over half of the patients, there was coexisting disease, mild to moderate anaemia being the most common.
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PMID:Congestive cardiac failure in elderly Nigerians: a prospective clinical study. 645 36

Two pregnancies complicated by severe Rh-isoimmunization and the development of sinusoidal fetal heart rate patterns immediately after intrauterine transfusions are presented. An intermittent sinusoidal pattern resolved, in one fetus, with sonographic evidence of delayed but complete absorption of transfused red blood cells. In contrast, the second fetus exhibited a continuous sinusoidal pattern coincident with cardiac decompensation detected by echocardiography, severe anemia, and failure to absorb transfused red blood cells. Possible pathophysiologic mechanisms for the development of sinusoidal patterns after fetal transfusions are discussed. It is concluded that a sinusoidal fetal heart rate pattern may occur after fetal transfusion and that the subsequent course of this pattern provides meaningful information about fetal condition as well as the success of intrauterine transfusion.
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PMID:Sinusoidal fetal heart rate pattern after intrauterine transfusion. 647 45

Echocardiographic assessment of cardiac function was made on 24 children with chronic renal failure of varying etiology and severity. In 20 patients without evidence of cardiac failure, parameters of left ventricular performance as represented by PEP/LVET and mean velocity of circumferential fiber shortening were within normal limits in the majority of patients. In addition, ejection fraction and shortening fraction were, in most children, within the 95% confidence limits for their age. In 4 patients who presented with congestive heart failure, marked left ventricular dilatation was noted in association with decreased shortening and ejection fractions and depressed mean velocity of circumferential fiber shortening. Also the PEP/LVET in these patients suggested the presence of a uremic cardiomyopathic condition. These studies, in addition to our own studies on children who have undergone fistula construction, hemodialysis, and transplantation, suggest that cardiac performance, in the majority of pediatric patients with end-stage renal disease, is well maintained and that the major factor involved in reducing exercise tolerance is the presence of uremic anemia. Only a minority of patients may develop severe uremic heart disease.
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PMID:Echocardiographic assessment of cardiac function in children with chronic renal failure. 658 80

Based on the findings of 50 patients with infective endocarditis, 37 affecting the aortic, six the mitral and seven both the aortic and mitral valves, in addition to analysis of predisposing factors, prominent signs and symptoms distinctive for the clinical entity were assessed (Tables 1 to 3). Preexistent conditions such as aortic valve lesions including bicuspid aortic valve as well as mitral valve lesions including mitral valve prolapse were proven in 66%. Factors which may have compromised host defense mechanisms such as cachexia and chronic alcohol or intravenous drug abuse were present in isolated cases. In 38% of the patients, a diagnostic or therapeutic manipulation, suspected to have given rise to the bacteremia, antedated the onset of endocarditis. Malaise, fatigue and chills were the most frequent symptoms (Table 4). Fever and cardiac murmurs were observed in all patients, anemia and bacteremia in 74% of the patients, respectively (Tables 4 to 6). In blood cultures, the most common microorganisms were found to be hemolytic and nonhemolytic streptococci accounting for 65% of positive findings, followed by enterococci and gram-negative bacteria each with 14% respectively (Table 6). Congestive heart failure predominated among cardiac complications with its occurrence in 84% of the patients. Valvular ring or myocardial abscess, aortic or sinus of Valsalva aneurysm, occasionally with perforation, were found in 24% of our patients. Coronary embolism was documented in 6%; infection-associated pericarditis was observed only rarely (Table 7). Extracardiac complications involved the skin, central nervous system, spleen and kidneys, respectively, in 20 to 30% of the patients. Complications afflicting the eyes, lungs, gastrointestinal tract and the musculo-skeletal system were seen with a lesser frequency of 0 to 12% (Table 8). The diagnosis of infective endocarditis, rendered highly-probable by the constellation of fever, cardiac murmur, bacteremia and anemia, necessitates, however, confirmation through cardiac examinations. In this respect, electrocardiographic and radiologic findings are of limited value, although they may be useful in the detection of cardiac complications. In 6% of the patients, positive criteria for myocardial infarction were indicative of coronary embolism and, i 30%, atrioventricular or fascicular block suggested the presence of abscess formation (Table 9). As radiologic evidence of heart failure, 74% of the patients were found to have pulmonary vascular congestion (Table 10).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Detection and evaluation of infectious endocarditis]. 664 98


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