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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Aortic valve endocarditis with extension to the tricuspid annulus and ventricular septum in an intravenous drug abuser - with Mycobacterium avium-intracellulare identified as the offending organism - forms the basis of this report. The aortic root and ventricular septal defect were successfully repaired using an aortic cryopreserved homograft. This case is of particular interest because M avium-intracellulare has not been recognized as a cause of endocarditis. The incidence of atypical organisms as a cause of endocarditis may increase in the future because of the rise of drug abuse and the acquired immune deficiency syndrome in North America.
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PMID:Mycobacterium avium-intracellulare endocarditis causing rupture: replacement and repair with aortic homograft. 850 28

In the last years the number of HIV-positive patients needing cardiac surgery has greatly increased. Cardiopulmonary bypass is suspected to have a role in the progression of HIV-infection to acquired immunodeficiency syndrome (AIDS). From October 1988 to December 1990, 6 intravenous drug addicts underwent cardiac surgery for infective endocarditis at our Department. Preoperative and postoperative absolute lymphocyte T-helper (CD4) and T-suppressor (CD8) counts did not show a close association between the temporary lymphopenia induced by cardiopulmonary bypass and progression to AIDS.
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PMID:Cardiac surgery in HIV-positive intravenous drug addicts: influence of cardiopulmonary bypass on the progression to AIDS. 148 17

To estimate the impact of intravenous drug use (IVDU) on mortality in the general population of young adults in Rome, Italy, the Population Attributable Risk (PAR) was calculated for the overall and cause-specific mortality in the 15-34 years age group. Relative risks were derived from a previous historical cohort study on mortality among 4200 intravenous drug users (IVDUs) in Rome, in which increased mortality from cardiovascular, respiratory, and gastrointestinal diseases as well as from violence, overdose and AIDS had been observed. The prevalence of the risk factor (i.e. the proportion of IVDUs) in the general population was estimated using the 'multiplier formula' and 'capture-recapture' methods. The proportion of all deaths attributable to IVDU in the 15-34 age group in the Roman population was 16% and 9% in males and females, respectively. The cause-specific attributable proportions were 66% for endocarditis and 37% for cirrhosis in males, and 36% for endocarditis and pneumonia in females. These findings further document the relevant health consequences of IVDU on the general population of a large metropolitan area.
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PMID:The impact of intravenous drug use on mortality of young adults in Rome, Italy. 149 77

Following a case of cardiac tamponade in a patient with the acquired immunodeficiency syndrome (AIDS), we examined the frequency and clinical spectrum of pericardial effusions associated with human immunodeficiency virus infection (HIV) at our institution. Of 187 hospitalized patients documented to have pericardial effusions over a one-year period, 14 (7 percent) were known to be HIV-positive at the time of their echocardiograms. One patient presented with a large effusion and cardiac tamponade, three had moderate effusions, and ten had small effusions. The probable effusion etiology was established in four cases and included endocarditis (2), lymphoma (1), and myocardial infarction (1). In hospital mortality was 29 percent (4 of 14). From our study, as well as a growing number of reports in the literature, we conclude that HIV-associated pericardial effusions are frequently seen and that their clinical spectrum is broad.
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PMID:HIV-associated pericardial effusions. 151 33

A historical cohort study was carried out in Rome to examine overall and cause-specific mortality among intravenous drug users (IVDUs). A total of 4200 IVDUs (3411 men and 789 women) enrolled in methadone treatment centers between 1980 and 1988 were studied. There were 239 deaths during the follow-up period. The overall SMR was 10.10 in the entire cohort (95% confidence interval, 8.86-11.47), 9.30 in males and 18.07 in females. A large excess of mortality in both sexes was found for infectious, circulatory, respiratory, and digestive diseases as well as for violence, overdose, AIDS, and unknown or ill-defined causes. Tumors and suicide were excessive only in males. Deaths due to drug overdose, violence or trauma, and cirrhosis accounted for 63.6%, AIDS for 7.1%, endocarditis and other bacterial infections for 7.1%, and neoplasms for 3.8% of total mortality. These findings document serious health consequences of drug abuse in Italy.
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PMID:Mortality of intravenous drug users in Rome: a cohort study. 192 19

The influence of glucocorticosteroids (GKS) therapy on clinical status, T4 lymphocyte count in peripheral blood and T4/T8 lymphocyte ratio was investigated in five HIV infected patients: two were asymptomatic, while three had clinically overt disease. The reasons for GKS therapy were: thrombocytopenia in two patients, pancytopenia in two and sepsis with severe endocarditis in one. No influence of GKS on the clinical course of HIV infection was observed. The prospective determinations of T4 lymphocyte count and T4/T8 lymphocyte ratio were relatively constant in two cases, in one case increased and in two patients, one of whom had AIDS, a decrease in both parameters was observed. It seems that GKS therapy does not seriously influence the course of HIV infection in most patients and can be instituted without risk of severe worsening of the immune status.
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PMID:[Influence of therapy with glucocorticosteroids on clinical status, t4 lymphocyte count and t4/t8 lymphocyte ratio in people infected with AIDS]. 168 96

The doctor-patient interaction in the methadone maintenance treatment clinic is qualitatively different from general medical settings. The patient presents with a specific request for treatment of opioid dependence, most often having already selected the methadone treatment modality, and the initial contact is centered around obtaining methadone. Addiction and needle use increase susceptibility to life-threatening illnesses, such as syphilis, endocarditis, tuberculosis, and AIDS. The physician is working with counselors, nurses, therapists and 12-Step programs, incorporating the best of the medical, psychodynamic, behavioral, and recovery models into treatment. Federal and state governments also control and regulate methadone treatment. Given this complex picture, the basic techniques of methadone maintenance treatment are reviewed, including the intake examination, the annual examination, dose adjustment, withdrawal from methadone maintenance, management of pregnant patients, dual diagnosis patients, and severely ill or medically disabled patients.
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PMID:Methadone maintenance treatment: a primer for physicians. 176 90

Aside from disease induced by the direct pharmacological effect of heroin or cocaine, the occurrence of several medical complications not directly related to the drug itself is becoming an increasingly serious problem. In addition to the well-known occurrence of infective diseases, including AIDS, related to the i.v. use of heroin, heroin addicts also seem significantly more at risk for chronic nephropathy. Amyloidotic nephropathy is especially frequent in addicts who use heroin by subcutaneous route (skin popping); it seems to be mediated by an immunologic mechanism. Amyloidotic nephropathy is the main cause of renal failure among drug addicted subjects. Cardiovascular and cerebrovascular diseases are the most frequent medical complications observed in cocaine users. However, the occurrence of infective disease, such as endocarditis or hepatitis related to the parenteral use of the drug, is becoming frequent in these patients. Pulmonary disease is also common due to the route of administration of crack. These medical complications of drug addiction belong to the specific field of internal medicine and should be promptly recognized and treated by the physician.
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PMID:[Medical complications connected with the use of drugs]. 177 47

Between 1980 and 1989, 8 patients (5 men, 3 women; mean age 30 years) were operated upon in our department of right-sided infective endocarditis. Six patients were heroin addicts and among these 3 were HIV positive and 2 had confirmed AIDS. The most frequently encountered microorganisms (6 cases) were staphylococci. It was decided to operate because of persistent infection and haemodynamic deterioration. The infection involved the pulmonary valve in only 1 of the 8 patients. Surgery was performed during the acute phase in 5 patients and was conservative in 6 patients, consisting of excision of the vegetations or valvulectomy combined or not with valvuloplasty. A high mortality rate (3/8 cases) was observed only among patients operated upon in the acute phase. This may be due to the underlying immunodeficiency and poor haemodynamic state of these patients. Among survivors, the long-term results were excellent, with no recurrent endocarditis and no death, and with only one subsequent operation, 4 years after the first one, for residual tricuspic valve regurgitation. This study shows that patients with right-sided infective endocarditis should be operated upon outside the acute phase of the disease and as soon as complications appear, and that surgery should preferably be conservative.
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PMID:[Surgical treatment of right-sided infective endocarditis]. 183 Jan 43

Cardiac involvement is being identified more often clinically and at autopsy in patients with AIDS. Recent estimates suggest that in the United States as many as 5000 patients per year may have cardiac complications resulting from HIV infection. Patients with AIDS may have pericardial, myocardial, and/or endocardial disease. Pericardial tamponade and/or constriction may be related to neoplasms, infections, or nonspecific effusions. Myocardial dysfunction may result from specific neoplastic infiltration or myocarditis. Particularly intriguing is the role of HIV-1 in the nonspecific myocarditis and dilated cardiomyopathy that occurs in patients with AIDS. As in other debilitating conditions patients with AIDS can have nonbacterial thrombotic endocarditis. Infective endocarditis may be a complication, especially in AIDS associated with intravenous drug abuse. Most patients with AIDS have no overt clinical evidence of cardiac disease. When cardiac dysfunction does develop, the signs and symptoms are often misinterpreted to be the result of noncardiac causes (pulmonary failure or infection) which can mimic heart failure. This review is intended to alert the reader to the cardiac manifestations of AIDS, which present a number of diagnostic and therapeutic challenges.
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PMID:Cardiac manifestations of acquired immune deficiency syndrome: a 1991 update. 185 38


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