Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The etiology of valvular heart diseases (VHD) has changed in the last 50 years in the industrialized countries. A significant reduction in the incidence of rheumatic fever and its sequelae, increase in life expectancy, recognition of new causes of VHD and advancement in technology are responsible for the metamorphosis of the etiology of VHD. Heritable disorders of connective tissue (marfan syndrome, Ehlers-Danlos syndrome, adult polycystic kidney disease, floppy mitral valve/mitral valve prolapse); congenital heart disease (bicuspid aortic valve); inflammatory/immunologic disorders (rheumatic fever, AIDS, Kawasaki disease, syphilis, seronegative spondyloarthropathies, systemic lupus erythematosus, antiphospholipid syndrome); endocardial disorders (nonbacteremic thrombotic endocarditis, infective endocarditis, endomyocardial fibroelastosis); myocardial dysfunction (ischemic heart disease, dilated cardiomyopathy, hypertrophic cardiomyopathy); diseases and disorders of other organs (chronic renal failure, carcinoid heart disease); aging (calcific aortic stenosis, mitral annular calcification); postinterventional valvular disease; drugs and physical agents are all clinical entities associated with VHD. It should be emphasized that VHDs still constitute a major health problem which will increase with the aging population.
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PMID:Etiology of valvular heart disease. 1503 Feb 51

Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDUs). In particular, Human Immunodeficiency Virus (HIV) and hepatitis C Virus (HCV) have become endemic in many settings and bacterial and viral infections, such as endocarditis and cellulitis, have become extremely common among this population. In an effort to reduce these public health concerns and the public order problems associated with public injection drug use, in September 2003, Vancouver, Canada opened a pilot medically supervised safer injecting facility (SIF), where IDUs can inject pre-obtained illicit drugs under the supervision of medical staff. The SIF was granted a legal exemption to operate on the condition that its impacts be rigorously evaluated. In order to ensure that the evaluation is appropriately open to scrutiny among the public health community, the present article was prepared to outline the methodology for evaluating the SIF and report on some preliminary observations. The evaluation is primarily structured around a prospective cohort of SIF users, that will examine risk behavior, blood-borne infection transmission, overdose, and health service use. These analyses will be augmented with process data from within the SIF, as well as survey's of local residents and qualitative interviews with users, staff, and key stakeholders, and standardised evaluations of public order changes. Preliminary observations suggest that the site has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use. However, each of the indicators described above is the subject of a rigorous scientific evaluation that is attempting to quantify the overall impacts of the site and identify both benefits and potentially harmful consequences and it will take several years before the SIF's impacts can be appropriately examined.
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PMID:Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users. 1553 85

A retrospective review of a five year period (1994-1998) revealed that opportunistic mycoses caused by ubiquitous fungal pathogens are a serious problem in the immunocompromised patient population of Kuwait. Patients with renal transplantation and diabetes mellitus were most susceptible to aspergillosis, cryptococcosis, and zygomycosis, whereas patients with candidemia/hematogenous candidiasis had multiple risk factors. Basidiobolomycosis of the rectum in a Bangladeshi male, cryptococcosis due to Cryptococcus neoformans var. gatti in an AIDS patient,fungal peritonitis due to Absidia corymbifera in a patient on peritoneal dialysis, and endocarditis due to Aspergillus terreus detected by direct microscopic examination and culture of the blood clot are some of the notable cases diagnosed during the period under review. The predominance of Candida species other than C. albicans as bloodstream pathogens is another noteworthy observation. Although outbreaks of C. parapsilosis candidemia in neonatal intensive care units contributed significantly to this shift in favour of non-albicans Candida species, a surveillance strategy comprising of molecular, epidemiologic and antifungal susceptibility studies is warranted. With the proposed expansion of organ and bone marrow transplantation facilities in Kuwait, the incidence of opportunistic fungal infections is likely to increase.
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PMID:Invasive fungal infections in Kuwait: A retrospective study. 1559 75

To identify prognostic indicators of survival at different CD4 cell levels, independent of highly active antiretroviral therapy (HAART), among injection drug users (IDUs). A community-recruited cohort of injection drug users followed semiannually from 1988 through 2000. Five partially overlapping subcohorts were defined by when participants first reached a CD4 cell level of 351 to 500, 201 to 350, 101 to 200, 51 to 100, or </=50 cells/microL. Prognostic factors were measured at entry into each category. Kaplan-Meier survival estimates for HIV-related death and Cox regression models were constructed by CD4 category. Among the 1030 HIV-infected IDUs, survival improved in the HAART-era with hazard ratios 0.42, 0.36, 0.24, 0.21, and 0.25, respectively, for CD4 cell groups of 500 to 351, 350 to 201, 200 to 101, 100 to 51, and </=50 cells/microL. Shorter survival was associated with prior hospitalization, AIDS, and sexually transmitted disease, with similar effects in the pre-HAART and HAART eras. For the lowest CD4 cell level, prior sepsis or endocarditis, outpatient/emergency room visits, and alcohol use provide additional prognostic value. Survival among HIV-infected IDUs improved since the introduction of HAART, even though utilization of HAART was incomplete. Clinical and behavioral variables provided prognostic information about survival, including substance use indicators.
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PMID:Prognostic factors for survival differ according to CD4+ cell count among HIV-infected injection drug users: pre-HAART and HAART eras. 1560 29

Recent advances in the knowledge of human immunodeficiency virus (HIV) replication and transmission as well as the emergence of effective antiretroviral therapies are leading to longer survival times for HIV-infected individuals. As a result, organ related manifestations of late stage HIV infection, including HIV-related heart diseases have emerged. It is now clear that cardiac involvement in HIV seropositive patients is relatively common and is associated with increased morbidity and mortality. Cardiac involvement in HIV infection is multifactorial. The epidemiology has changed dramatically since the introduction of highly active antiretroviral therapy (HAART), but studies carried out before the introduction of HAART remain relevant because of limited access to this treatment in many areas of the world. A variety of cardiac lesions have been reported in HIV infection and AIDS, including pericardial disease with effusion and tamponade, nonspecific or infectious myocarditis, dilated cardiomyopathy with global left ventricular dysfunction, endocardial valvular disease due to marantic or infective endocarditis, arrhythmias, pulmonary hypertension and neoplastic invasion. In the post HAART-era, coronary artery disease and dyslipidaemia, drug related cardiotoxicity and cardiac autonomic dysfunction are becoming increasingly prevalent. In this review, we highlight the importance of cardiac complications in HIV disease and discuss measures that can be taken to improve survival.
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PMID:Human immunodeficiency virus (HIV) related heart disease: a review. 1577 20

We present a case of a 46-year-old man with advanced acquired immunodeficiency syndrome and congenitally bicuspid aortic valve endocarditis caused by methicillin- and gentamicin-resistant Staphylococcus aureus. Endocarditis led to root abscess formation, a complete heart block, and fistulous tract formation between the ascending aorta and the right ventricle. Although perivalvular abscess is not an unusual complication of native valve endocarditis, a fatal fistulous communication between the ascending aorta and the right ventricle is exceedingly rare.
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PMID:Fatal ascending aorta-to-right ventricle fistula formation after Staphylococcus aureus endocarditis of bicuspid aortic valve. 1632 63

Bacteria-free verrucae has been recognized as a condition associated with several clinical conditions such as bone marrow transplantation, malignant tumors, autoimmune disorders, and acquired immunodeficiency syndrome, but it has not been reported in relation to lung transplantation. We report the case of a patient who underwent bilateral lung transplant and died 3 days later. Histologic examination revealed, among other lesions, the presence of nonbacterial thrombotic endocarditis in the right atrium and mitral and tricuspid valves that was not present in the preoperative echocardiographic studies. Even with transesophageal echocardiography, a reliable detection of vegetations may not be possible. Hypoxigenic pulmonary states developed in the course of lung transplant could be the factor that triggers the interaction between the coagulation system, platelets, and endothelial cells that induce the formation of bacteria-free verrucae.
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PMID:Nonbacterial thrombotic endocarditis after lung transplantation. 1632 64

The heart and great vessels are not the sites most frequently affected by opportunistic infections and neoplastic processes in patients with acquired immune deficiency syndrome (AIDS). However, cardiovascular complications occur in a significant number of such patients and are the immediate cause of death in some. The spectrum of cardiovascular complications of AIDS that may be depicted at imaging includes dilated cardiomyopathy, pericardial effusion, human immunodeficiency virus-associated pulmonary hypertension, endocarditis, thrombosis, embolism, vasculitis, coronary artery disease, aneurysm, and cardiac involvement in AIDS-related tumors. To aid accurate diagnosis and appropriate treatment planning, radiologists should be familiar with the imaging appearance of each of these complications.
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PMID:Cardiovascular complications of human immunodeficiency virus infection. 1641 53

Human Ehrlichia chaffeensis infections have been reported in North America, Asia and Europe, but only recently have human cases been reported in Brazil. Nine new human cases of E. chaffeensis infection diagnosed on a clinical and serological basis are reported. Serological tests were performed with indoor slides prepared with CDC stock DH-82 cells infected with E. chaffeensis (Arkansas strain). All but two patients were adults. Seven patients were male and two female. The fever duration varied from 4 to 120 days with a median of 6 days. All patients recalled previous tick attack. IgM was detected in four cases. Influenza like syndrome was the most frequent clinical form affecting five patients. Two patients had fever of unknown origin (FUO), one patient had blood culture-negative endocarditis and one had encephalitis. All patients except one recovered. Two patients were correctly treated. One patient with FUO had AIDS and unexplained pancytopenia. The occurrence of human ehrlichiosis by E. chaffeensis remains to be proved in Brazil; the cases reported here highlight the possibility of such disease occurrence in Brazil.
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PMID:More about human monocytotropic ehrlichiosis in Brazil: serological evidence of nine new cases. 1676 8

Having noted the good clinical status of some HIV patients who were referred for but refused surgery, we undertook surgery with the aim of determining outcome, risk-to-benefit ratio and, if possible, the effect of surgery with cardiopulmonary bypass (CPB) on the progression of their HIV disease. Antiretroviral drugs (ARVD) were not available to these patients. The records of 49 patients, 17 males and 32 females, aged between 17 and 67 years, undergoing surgery with cardiopulmonary bypass over a nine-year period, were reviewed. Forty-eight of these underwent cardiac surgery and one aortic dissection repair. Four HIV-infected patients underwent surgery with good early outcome. Thereafter an absolute CD4 cell count greater than 400/microl (normal 550*1 955/microl) and the absence of the stigmata of AIDS in patients fulfilling the normal criteria for surgery allowed cardiac surgery using CPB. Fifty operations were performed. Three patients with CD4 counts of 37, 868 and 1 245/microl died early, giving a 30-day mortality of 6% for 50 procedures. Six patients with active infective endocarditis (IE) underwent emergency surgery. Three of these, one with a pre- and two with only post-operative counts all below 250/microl, died within three months. Sixteen complications occurred in the remaining 46 patients (34.7%). Pre-operative CD4 cell counts taken in 42 patients averaged 685/microl. Pre- and post-operative counts known in eight showed variations, as did repeated counts in those awaiting surgery. Forty-one patients left hospital in the New York Heart Association (NYHA) class I, five in class II and one in class III. Prior to surgery, the majority (38) were in class III and seven were in class IV. Follow up ranging from two to 70 months averaged 23.1 months. Eight late deaths occurred, three related to AIDS. We found surgery to be worthwhile in selected HIV-infected patients. Early outcome paralleled that in the uninfected, giving a low risk-to-benefit ratio. Emergency surgery in those with active infective endocarditis and marked immune compromise met with high mortality. It is essential in our population to test and stage all patients for HIV. We could not show that CPB accelerated progression to AIDS. This experience and the present availability of ARVDs would enable us to review our selection criteria for surgery.
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PMID:An experience with cardiopulmonary bypass in HIV-infected patients. 1700 20


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