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

Thirty-six patients, 19 men and 17 women, presented at age 18 or older between 1952 and 1974 with coarctation of the aorta. Of the 14 (39%) who had associated cardiovascular disease, 12 had aortic stenosis or insufficiency or both. Three patients had infections-two, endocarditis (aortic valve) and one, endarteritis. Three of the seven patients who did not undergo an operation are alive, two at more than 50 years of age. Five patients had myocardial infarctions, two at 35 years of age. Twenty-nine (80%) had operations; in eight instances the patient was over age 40. All 18 patients undergoing repair of isolated coarctation survived, while only 7 of the 11 patients with associated cardiovascular lesions who underwent repair recovered. Aortic valvular disease and myocardial infarction are serious complicating factors in coarctation of the aorta.
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PMID:Coarctation of the aorta in adults. 95 15

In conclusion, patients on chronic maintenance dialysis have an increased incidence of death from cardiovascular disease. Hypertension plays a major role, and these patients must be carefully monitored for complete control of blood pressure. Adequacy of ultrafiltration to maintain normal extracellular volume is an essential part of the dialytic treatment. Hypertensive patients should be screened for excessive renin secretion because of its possible role in unresponsive hypertension in patients on dialysis. Nephrectomy should be used when necessary, where dialysis and antihypertensive medication have not adequately controlled blood pressure. Patients must be monitored for the presence of pericardial disease to avoid subsequent pericardial effusion and the development of constrictive pericarditis with its adverse effect on myocardial function. When constrictive pericarditis is present, it obviously should be relieved by appropriate surgery. Efforts should be made to minimize cardiac output in hemodialysis patients. Whether or not routine transfusions to maintain a higher hematocrit are indicated is a question that cannot yet be answered. However, patients with marginal cardiovascular function who are accepted on hemodialysis and must have an arteriovenous shunt should be supported in any manner to minimize an increase in cardiac output. Early and aggressive treatment of known episodes of sepsis is important in the elimination of valvular endocarditis in this patient population. Perhaps one of the finer indicators of adequacy of hemodialysis will be K rate and peak immunoreactive insulin levels. Continued abnormality of these parameters may contribute to cardiovascular disease. Clearly, further study of the effect of abnormal carbohydrate metabolism on lipid metabolism is in order. Serum triglyceride, serum cholesterol and lipid electrophoretic pattern should be followed to evaluate the beneficial effects of drug therapy and changes in dialytic technique on the development of cardiovascular disease. Careful monitoring of calcium, phosphorus, bone films and parathyroid hormone levels is indicated to assess parathyroid status. The use of aluminum binders and parathyroidectomy to prevent vascular and myocardial calcification is important in the therapy of these patients. The use of cardiac catheterization, coronary artery arteriography, and possibly cardiac vascular repair, should be considered in the chronic hemodialysis patient with coronary artery disease if he is otherwise well. Adequacy of hemodialysis perhaps can be evaluated through its effect on all of the above parameters. Whether or not changes in artificial kidney treatments can correct the final vascular disease remains to be seen.
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PMID:Cardiovascular disease in uremic patients on hemodialysis. 109 1

In a demographic study, the black Ohio residents were characterized by those born in Ohio and those born in other regions of the United States, and comparisons were made of rates for all deaths (1960-1967) for coronary heart disease (420), endocarditis and myocardial degeneration (421-422), hypertensive cardiovascular diseases (440-447), cerebrovascular diseases (300-334), cardiovascular diseases (400-468), and total diseases of the cardiovascular system (300-334) (400-468). The division of the total United States-born Ohio residents by region of birth provided marked differences in the age-adjusted rates in the relative comparisons. The black males and females born in the South had a markedly higher age-adjusted death rate (ages 45 to 64) than those born in Ohio in each of the categories of cardiovascular diseases studied. For coronary heart disease, the age-adjusted death rate for the black males showed a marked excess over the black females, for each region of birth, whereas for hypertensive cardiovascular diseases the black males and females had similar age-adjusted rates for each region of birth. The findings indicate a carry-over among the black of a higher cardiovascular risk among those born in the South and lend support to the concept of the influence of the endemic factors in the early years of life. In the prospective study of black steelworkers, it was observed that migrant and nonmigrant workers had approximately the same mortality for cardiovascular disease overall, and when specific work areas were considered. Selective factors of employment, of medical screening, and capability of continued employment in strenuous environments, were considered the most likely basis for the similar mortality experience.
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PMID:Heart disease mortality among black migrants: a study of Ohio residents (1960-1967). 116 30

Over the last 22 years, two children were operated on for supraventricular aortic stenosis at the Institute of Cardiovascular Diseases in Bratislava. Both cases presented a localized form of supravalvular aortic stenosis. Simple elipsoid flaps were used without extended aortoplasty. One of the two children, a 12-year-old boy with Williams' syndrome died of endocarditis in the early postoperative period. In the 10-year-old girl with familial supravalvular aortic stenosis the operation was successful, although the defect was combined with supravalvular muscular obstruction. The authors emphasize the possibility of choice between two surgical procedures according to the localization of the stenosis with respect to the valvular apparatus.
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PMID:[Surgical treatment of supravalvular aortic stenosis]. 139 37

Cocaine-related cardiovascular events escalated during the 1980s as cocaine became purer, cheaper, and easier to obtain. Cocaine abuse is a risk factor for myocardial ischemia and/or infarction, cardiac arrhythmias, pulmonary edema, ruptured aortic aneurysm, cerebral infarction, infective endocarditis, vascular thrombosis, myocarditis, and dilated cardiomyopathy. As medical and social complications of cocaine have become evident, and with the growing negative image of cocaine, the number of first-time users has begun to decline. Cocaine abuse is seen on all levels of our society and has emerged as an issue of significant medical and public health importance. All routes and forms of cocaine abuse are potentially cardiotoxic and can be lethal. Fatal cardiac complications can occur in a first-time user. All physicians should be alert for cocaine abuse when confronted with unexplained cardiac symptoms. Cocaine is the newest and sometimes unrecognized risk factor for cardiovascular disease in young individuals otherwise free of cardiovascular risk factors.
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PMID:Cocaine: the newest risk factor for cardiovascular disease. 181 Jun 80

Medical status of 1,500 patients attending a primary health care dental practice was examined by means of patient self-completed health questionnaire and by structured verbal interview by a dentist. Relevant medical histories and/or drug therapies affecting the practices of dentistry were found in 27.7% of patients. Problems identified included cardiovascular disease (10.4%), endocarditis risks (5.8%), hepatitis (7.9%), leukaemias (0.3%), bleeding tendencies (3%), drug allergies (7.0%), including penicillin allergy (3.6%) and intake of drugs affecting dentistry (6.0%). For most of these categories there was a marked increase in prevalence with increasing age and many categories contained many more women than could be expected from the male/female distribution of the total patient group.
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PMID:Medical status of patients attending a primary care dental practice in Ireland. 181 12

Eighty-eight cases of group C streptococcal bacteremia were reviewed retrospectively. Most patients had underlying diseases (72.7%), predominantly cardiovascular disease (20.5%) or malignancy (20.5%). The infection originated most often from the upper respiratory tract (20.5%), the gastrointestinal tract (18.2%), or the skin (17.1%). Prior exposure to animals or animal products was reported in 23.9% of cases. The most common clinical manifestations of group C streptococcal bacteremia were endocarditis (27.3%), primary bacteremia (22.7%), and meningitis (10.2%). Of streptococcal isolates, 61.4% were not speciated, 19.3% were Streptococcus equisimilis, 17.1% were Streptococcus zooepidemicus, and two (2.3%) were Streptococcus equi. The isolates were sensitive to most antibiotics, and most patients were treated with beta-lactam agents. Mortality was high (25.0%), especially among older patients and patients with endocarditis, meningitis, and disseminated infection. Group C streptococcal bacteremia does not differ from bloodstream infection caused by other beta-hemolytic streptococci with regard to clinical presentation, treatment, or outcome.
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PMID:Group C streptococcal bacteremia: analysis of 88 cases. 196 83

The clinical findings relating to 11 patients in Hong Kong (HK) and to 43 patients described elsewhere, all with Streptococcus zooepidemicus septicaemia, are reviewed. There was a particular association with cardiovascular disease (27%) with seven cases of endocarditis, three of abdominal aortic aneurysm and two of deep venous thrombosis. Associations not previously reported included two cases of pharyngitis and two patients with persistent post-operative fever. The overall mortality was 22%. Both human and porcine strains of S. zooepidemicus from HK did not hydrolyse aesculin in contrast to the aesculin-positive biotypes reported previously. HK strains also had very mucoid colonies and capsules of hyaluronic acid were seen in electron micrographs. Samples of chromosomal DNA, extracted by means of HindIII restriction endonuclease, of strains from human beings and pigs were identical. The MIC of penicillin for all strains was less than or equal to 0.03 mg/l but the MBC for all was greater than 32 mg/l. Penicillin alone is generally sufficient for cure but combination with an aminoglycoside may be indicated in seriously ill patients. In our locality, pigs were incriminated as a possible source of human infection whereas consumption of contaminated dairy products is important elsewhere.
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PMID:Streptococcus zooepidemicus (Lancefield group C) septicaemia in Hong Kong. 227 71

The frequency of mesangial IgA deposition was examined in 250 consecutive autopsy cases without known renal disease. Diffuse granular mesangial deposits of IgA were detected in 12 of 250 cases (4.8%). In six patients IgA deposits were associated with liver cirrhosis. Six patients (2.4%) suffered from various other conditions including endocarditis, bronchial asthma, cardiovascular disease, and neoplasia. Two of these patients had completely negative urine analysis on repeated investigations, whereas three patients exhibited microscopic haematuria and/or mild proteinuria. IgA1 was the major constituent in all specimens. C3c deposits in glomeruli were detected in one kidney. Our findings indicate that clinically overt renal disease is present in only a limited proportion of individuals with mesangial IgA deposits. Apparently, it represents the tip of an iceberg.
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PMID:Frequency of mesangial IgA deposits in a non-selected autopsy series. 251 84

The combination of chronic renal failure and cardiovascular disease is identified frequently and results in high morbidity and mortality without appropriate medical and surgical therapy. Experience during the last eighteen years has shown that cardiac operations can be undertaken in this high-risk group with acceptable morbidity and mortality and with reasonable expectation of symptomatic improvement. In a six-year period, 17 patients with chronic renal disease underwent cardiac procedures at the Vanderbilt University Affiliated Hospitals. Ten patients were on long-term hemodialysis, and 7 had a functioning renal transplant. Thirteen patients had a coronary artery bypass procedure alone, 1 had a bypass procedure plus aortic valve replacement, 1 had a bypass procedure plus repair of the mitral valve, 1 had a bypass procedure and resection of a left ventricular aneurysm, and 1 had aortic valve and mitral valve replacement for endocarditis. Sixteen patients survived and were discharged. The hospital stay was shorter for patients with a renal transplant than for those on hemodialysis (mean, 11 days versus 22 days, respectively), and perioperative complications were less frequent in the transplant group. There has been 1 late death unrelated to the operative procedure. Fifteen long-term survivors have been followed a mean of 26 months (range 7 to 108 months). All have achieved symptomatic improvement and are in New York Heart Association Functional Class I or II. These results in this high-risk patient group provide a basis for cautious optimism and for a continued aggressive approach in patients with chronic renal disease who require cardiac operation.
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PMID:Cardiac surgery in patients with chronic renal disease. 352 92


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