Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients on dialysis have an age-adjusted death rate 3.5 times that of the general population. The most common cause of death in patients on dialysis is cardiovascular disease. We prospectively followed a cohort of 433 patients in three centers for a mean of 41 months. Mean hemoglobin level at the beginning of dialysis was 8.39 (+/- 1.7) g/dL, and the mean hemoglobin level during follow-up was 8.84 (+/- 1.5) g/dL. Using Cox's regression model, we found that anemia predicted mortality independently of age, diabetes mellitus, cardiac failure, hypoalbuminemia, serum creatinine, mean arterial pressure, or echocardiographic heart disease. The independent relative risk (RR) of mortality was 1.18 per 1.0 g/dL decrease in hemoglobin level. Anemia also independently predicted the de novo occurrence of congestive heart failure when the same covariates were controlled for (RR, 1.49 per 1.0 g/dL decrease). Anemia was also independently predictive of heart failure at the start of dialysis (RR, 1.14 per 1.0 g/dL decrease) and heart failure recurrence (RR, 1.25 per 1.0 g/dL decrease). Left ventricular hypertrophy is present in 75% of patients on dialysis at the start of therapy for end-stage renal disease. It independently predicts mortality. Our prospective cohort study identified increasing age, hypertension, and anemia as risk factors for its development. One controlled study and several uncontrolled studies demonstrated improvement (but not complete regression) of elevated left ventricular mass in patients on dialysis treated with recombinant human erythropoietin (epoetin).
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PMID:Cardiac function and hematocrit level. 770 71

The prevelance of IDA in industrialized countries has declined in recent decades, but there has been little change in the worldwide prevalence. IDA is currently estimated to affect more than 500 million people. Recent studies have indicated that anemia per se, the most common manifestation of iron deficiency, is less important from a public health standpoint than liabilities associated with tissue iron deficiency. The most important of the latter are an impairment in psychomotor development and cognitive function in infants and preschoolers, a deficit in work performance in adults, and an increase in the frequency of low birth weight, prematurity, and perinatal mortality in pregnancy. There have been several recent advances in combatting nutritional iron deficiency. One of the major problems has been in distinguishing iron deficiency from other causes of anemia seen epidemiologically such as malaria, HIV infection, chronic inflammation, hemoglobinopathies, and protein energy malnutrition. When combined with serum ferritin and hemoglobin determinations, the serum transferrin receptor assay is a valuable addition in epidemiologic surveys because it provides a quantitative measure of functional iron deficiency and it distinguishes true IDA from the anemia of chronic disease. The most difficult challenge is to develop effective methods of supplying iron to large segments of a population. Supplementation with iron tablets is suitable for only brief periods of need such as during pregnancy. The poor compliance with existing supplementation programs is believed to be due mainly to the gastrointestinal side effects of oral iron which can be eliminated by the use of a gastric delivery system. The most effective long-term strategy is to increase the intake of bioavailable iron in the diet. The customary approach has been to fortify a food staple such as wheat, rice, sugar, or salt, and thereby increase the iron intake of the entire population. However, because of concerns about the risk of cancer and heart disease in individuals with high iron stores, there is an increasing reluctance to supply iron to individuals who do not require it. A more effective strategy is to fortify food vehicles that are targeted to segments of the population at greatest risk of iron deficiency such as infants and school children. Because of the strong inhibitory properties of diets in regions of the world where iron deficiency is most prevalent, the use of NaFeEDTA has important advantages for food fortification.
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PMID:Iron deficiency: the global perspective. 788 26

At the Rizzoli Orthopaedic Institute, as part of our autotransfusion program, we have recently had the possibility to introduce plasma predeposit by means of productive plasmapheresis in patients undergoing major orthopaedic surgery, in which bleeding more than 50-60% of circulating blood mass was expected and so a greater quantity of plasma compared to red blood cells was considered necessary. Red cells and fresh frozen plasma predeposits and perioperative blood recovery was sufficient to cover transfusional needs. In our opinion, plasma predepositing by plasmapheresis is indicated in patients with anaemia, cardiopathy and/or vasculopathy, minute constitution.
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PMID:Plasma predeposit: the role of productive plasmapheresis. 801

The common underlying heart diseases were ischemic heart disease (39%), valvular heart disease (27%), hypertensive heart disease (10%) in 104 patients (mean age 79 yrs) with congestive heart failure (CHF). Cardiomyopathy (5%) and congenital heart disease (2%) such as atrial septal defect were less common. In addition, many extracardiac diseases including anemia, hypothyroidism, renal failure and pulmonary disease contributed to the etiology of CHF in the elderly. Cardiac amyloidosis should be considered as an uncommon cause of refractory CHF. While the precipitating factor was not found in half of the 104 patients with CHF, the most common factors were respiratory infection, myocardial ischemia and arrhythmia. In addition, inappropriate drug usage including poor drug compliance, the use of beta-blockers and excessive intake of sodium and fluid precipitated or exacerbated heart failure. Renal failure was a most important complication and predisposed to refractory CHF. Aged patients with mild CHF (NYHA class II) showed an insufficient production of cyclic AMP and GMP in proportion to the increases of norepinephrine and atrial natriuretic peptide in comparison with health aged subjects after the submaximal treadmill exercise test. This finding may suggest that an inadequate compensation of neurohumoral factors is prone to cause CHF in the elderly. Appropriate management of acute CHF in the elderly begins with recognition of the underlying heart disease, complications and the severity of cardiac function. In addition to medical management including loop diuretics, vasodilator, beta-receptor agonist and phosphodiesterase inhibitor, cases associated with respiratory and renal failure require mechanical ventilation and continuous hemofiltration.
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PMID:[The etiology and management of congestive heart failure in the elderly]. 820 67

This study examined the records of 252 admissions to an inpatient drug rehabilitation program for African American women between July 1989 and July 1991 to determine the prevalence and treatability of the medical conditions found on screening evaluation. All but 0.7% of subjects were on General Relief, Medicare, Medicaid, or had no payment source. The results showed a high prevalence of problems related to life style such as sexually transmitted diseases, anemia, and dental disease. Significant medical illness such as heart disease, abdominal surgical conditions, and breast masses were also found along with a high level of somatic discomfort of a subacute nature. Only 58% of patients referred to specialists kept the initial appointment. These results suggest that medical evaluation of impoverished African American women seeking rehabilitation for addiction may reveal many other health problems but that non-compliance severely limits the effectiveness of treatment. The role of the medical screening evaluation in determining fitness to participate in an inpatient program, detecting undiagnosed medical conditions, and patient education is discussed.
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PMID:Medical evaluation of African American women entering drug treatment. 829 38

The correction of renal anemia by recombinant human erythropoietin (rHuEPO) makes it possible to assess the effect of anemia on uremic cardiopathy (UC). So far, conflicting results have been reported. We studied 10 hemodialyzed patients aged (51 +/- 18 years, dialytic age 47 +/- 18 months) before and after rHuEPO treatment. All patients underwent an echocardiogram before, and six months after stable hematocrit (31 +/- 2) was obtained. The results show a reduction in LVDD. No improvement in ejection fraction and in ventricular hypertrophy was observed, probably owing to an increase in blood pressure. Finally, there is a possibility that the myocardium of hemodialyzed patients undergoes anatomical changes which may not improve, even after anemia correction.
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PMID:Does anemia correction by rHuEPO improve uremic cardiopathy? 832 Sep 49

Decreased arterial oxygen saturation in cyanotic congenital heart disease causes a compensatory rise in haemoglobin and haematocrit levels. There is an inverse correlation between arterial oxygen saturation and haemoglobin/haematocrit. This holds true as long as the erythropoiesis is not restricted by other factors. The haematological values and arterial oxygen saturations of three children with cyanotic congenital heart disease are presented. They illustrate how iron deficiency causes discrepant values for arterial oxygen saturation and haemoglobin/haematocrit and that "normal" haemoglobin/haematocrit levels in such children may constitute anaemia. Measurements of MCV, MCH and serum ferritin reveal the existence of iron deficiency anaemia. Low grade iron medication is recommended for children with cyanotic congenital heart disease.
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PMID:[Normal hemoglobin levels in children with cyanotic heart disease. Is it iron deficiency anemia?]. 832 97

We report herein a case of 62-year-old woman with hereditary spherocytosis (HS) and congestive heart failure (CHF). Although her history revealed jaundice in the early neonatal period, she had never undergone a physical examination and thus, the diagnosis of HS and CHF was not made until the age of 61 when she complained of dyspnea and palpitations on exertion. The CHF was subsequently found to be related to severe anemia in the presence of underlying heart disease. Splenectomy was performed in an attempt to relieve the severe hemolytic process. Following this, all the symptoms improved without the need for any cardiovascular drugs and she has been well throughout the 34 months follow up.
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PMID:Hereditary spherocytosis with congestive heart failure: report of a case. 832 41

Data was compiled from a wide variety sources in order to construct a demographic profile of elderly women in Latin America. Data was organized into a cross-classification matrix based on three age groups (midlife, young old, and old old) and three country types (highly rural, mixed, and highly urban). The macro-level overview takes into account such factors as education, family structure, and employment. Smaller reports and research project reports of micro conditions are used to help explain the macro trends. Women older than 40 represented 9-20% of the population of the region (of 21 Latin American and Caribbean countries). 6-14% of midlife women were widowed, with the highest concentrations in urban countries. Widows and single women comprised about 20-35% of midlife women and 50-65% of older women. Female household headship increased with age from 9-23% in midlife to 24-41% among women 60 years and older. In all countries with the exception of Uruguay, women had less primary schooling than men. Women's salaried employment in the formal sector decreased rapidly with increasing age. For example, in highly urban countries the range of employment was from 34% of women in midlife to only 4% among women 65 years and older. Women were working, but often in the informal sector or as prostitutes or beggars. Women's health conditions included 12-37% with chronic anemia and many with signs of premature aging (early onset of diabetes, hypertension, and osteoarthritic joint changes). Depression among older women may have been as high as 40%. The strain of maintaining a double work load of child care and housekeeping and employment is unmeasured. Regardless of the level of development, older women suffered primarily from heart disease. Breast cancer was more common in urban countries. Highly rural or mixed countries had greater incidence of cervical cancer. Chronic liver disease was appearing in some countries. In highly rural countries infectious diseases and malnutrition still contributed significantly to causes of death. Most women did not have social security coverage. Evidence points to women's remarkable responses (creativity, initiative, and persistence) to fulfilling survival needs.
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PMID:Older women in Latin America: the health and socioeconomic situation of this important subgroup. 857 13

Of the total 25381 delivered in our Department, in the time from January 1987 to December 1993, 175 (0,69%) were from pregnancies with complicated by diabetes mellitus. 171 of that number ended with healthy babies (172), which is a relatively satisfactory outcome. Only 4 patients lost their babies. They were 3 patients admitted to our programme late in their pregnancy period. Already during their first medical examination the diagnosis was a) nonviable pregnancy in 1 case and b) multiple, congenital defects in the remaining 2 cases. 1 baby was died three days after delivery (congenital heart disease). All patients attended classes of special diabetes mellitus education in the Pathology Ward. Each patient underwent programmed control visits by obstetrician and diabetologist; metabolic therapy reached the level of near normoglycemia. In each case the time of delivery was selected individually. As result of such approach majority of patients gave natural birth. Only in 29 cases (16,6%) caesarean operation was performed. The reason for caesarean operation in 12 of the 29 cases was a previous operation of this kind. In the other 5 cases natural birth was impossible, because of the big foetus. Observation of the newborn babies during their first days of life showed that most of them suffered from the following complications: hypoglycaemia (39,8%), hyperbilirubinemia (25,1%), anaemia (12,9%) and hypocalcaemia (7%). All the babies being in generally good condition were discharged from the hospital on the 5th-10th day together with their mothers. It seems that such good results could obtained owing to special programme, which could by applied also in Regional Gynecological-Obstetrical Ward with help of a local diabetologist.
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PMID:[Diabetes mellitus complicating pregnancy]. 875 96


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