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)

To examine the effects of theophylline toxicity on cardiac rhythm, patients underwent continuous ambulatory ECG recording during acute theophylline toxicity and recovery. The patients, who were recruited form inpatient wards, intensive care units, and emergency departments of a University Medical Center and a Veterans Administration Medical Center, had serum theophylline concentrations (STC) greater than 30 mg/L. There were 14 men and two women with a mean age of 66 years. Fourteen patients had COPD and developed toxicity following long-term theophylline overmedication. Two patients had asthma and ingested an intentional overdose. The STC at the onset of ECG recording ranged from 23 to 67 mg/L. The principal rhythm was sinus in 15 patients; one patient had atrial fibrillation. Sinus tachycardia (heart rate greater than 100/min) was common, and heart rate fell in proportion to STC as toxicity resolved. Supraventricular ectopic beats (SVEs) were noted in seven patients with multiple runs of SVE being present in four. One patient developed multifocal atrial tachycardia (MAT) during toxicity that resolved spontaneously. During the 11 +/- 8 hours of recording during toxicity (STC greater than 20 mg/L), 80 percent of patients had ventricular premature beats (VPBs), 44 percent had paired VPBs, and 25 percent had ventricular runs. One elderly patient with heart disease developed sustained ventricular tachycardia (VT) when STC = 66 mg/L. No other patient had ventricular ectopy that required intervention. During the 10 +/- 6 hours of recording during the "recovery phase" (STC less than 20 mg/L), all patients with VPBs continued to have ectopy; however, the number of VPBs declined significantly. A follow-up 24-hour ECG recording obtained one week after recovery from toxicity in the patient with sustained VT demonstrated marked reduction in the frequency and complexity of VPBs. Patients with frequent (greater than 10/h) or repetitive VPBs were older (p less than 0.05) than those without complex ectopy. There was a trend (p = 0.07) suggesting patients with underlying heart disease were at risk for having complex ventricular ectopy. We conclude that sinus tachycardia, SVE, and VPBs are common among patients with theophylline toxicity; however, sustained ventricular or supraventricular tachyarrhythmias that require antiarrhythmic therapy are uncommon.
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PMID:Cardiac arrhythmias during theophylline toxicity. A prospective continuous electrocardiographic study. 188 98

The relation of ventilatory impairment and chronic mucus hypersecretion to death from all causes and death from obstructive lung disease (chronic bronchitis, emphysema and asthma) was studied in 13,756 men and women randomly selected from the general population of the City of Copenhagen. During the 10 year follow up 2288 subjects died. In 164 subjects obstructive lung disease was considered to be an underlying or a contributory cause of death (obstructive lung disease related death); in 73 subjects it was considered to be the underlying cause of death (obstructive lung disease death). Forced expiratory volume in one second, expressed as a percentage of the predicted value (FEV1% pred), and the presence of chronic phlegm were used to characterise ventilatory function and chronic mucus hypersecretion respectively. For mortality analysis the proportional hazards regression model of Cox was used; it included age, sex, pack years, inhalation habit, body mass index, alcohol consumption, and the presence or absence of asthma, heart disease, and diabetes mellitus as confounding factors. By comparison with subjects with an FEV1 of 80% pred or more, subjects with an FEV1 below 40% pred had increased risk of dying from all causes (relative risk (RR) = 5.0 for women, 2.7 for men), a higher risk of obstructive lung disease related death (RR = 57 for women, 34 for men), and a higher risk of obstructive lung disease death (RR = 101 for women, 77 for men). Chronic mucus hypersecretion was associated with only a slightly higher risk of death from all causes (RR = 1.1 for women, 1.3 for men). The association between chronic mucus hypersecretion and obstructive lung disease death varied with the level of ventilatory function, being weak in subjects with normal ventilatory function (for an FEV1 of 80% pred the RR was 1.2), but more pronounced in subjects with reduced ventilatory function (for an FEV1 of 40% pred the RR was 4.2). A similar though statistically non-significant trend was observed with regard to obstructive lung disease related death. This study shows that impaired lung function is very strongly related to total mortality, obstructive lung disease related mortality, and obstructive lung disease mortality and suggests that chronic mucus hypersecretion, in those with impaired ventilatory function, is also a significant risk factor for death from obstructive lung disease.
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PMID:Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes. 240 19

Although chest pain in children is usually not due to serious organic pathology, its association with heart disease is a source of concern for patients and their families. Most cases of pediatric chest pain are of unknown etiology. Common diagnoses include musculoskeletal disorders, cough, costochondritis, psychogenic disturbance and asthma. A thorough history and a careful physical examination will determine the diagnosis in most children.
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PMID:Chest pain in children. 240 23

Sudden natural deaths of individuals between the ages of 2 and 20 years which occurred during a 20-year period were identified from mortuary records. Necropsy reports and histological sections were reviewed; 169 sudden natural deaths were identified amongst 1012 deaths in that age group. Ninety-two sudden deaths occurred to children with recognized disorders; congenital heart disease, asthma, and epilepsy were the commonest problems identified. Amongst the 77 deaths of apparently healthy children, infection was the most frequently recognized disease. Only 11 deaths were unexplained, comprising 1 per cent of the necropsy population or 6.5 per cent of sudden natural deaths, a much smaller proportion than pertains in infancy. Necropsy examination of children dying suddenly yields useful information.
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PMID:Sudden death in childhood and adolescence. 259 46

A study of the geographical distribution of cerebrovascular disease in Scottish communities during three quinquennia between 1959 and 1983 showed a marked tendency for high SMRs to be present in the west of Scotland and low SMRs in the east. Cerebrovascular disease was significantly correlated with coronary heart disease, with bronchitis, emphysema and asthma, and to a lesser extent with other heart disease, with other circulatory disease and with indices of overcrowding. It was not associated with either urbanization or industrialization.
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PMID:Cerebrovascular disease in Scotland during 1959 to 1983: its geographical distribution and associations. 263 12

Reactive airway disease has only rarely been associated with pulmonary hypertension. We treated two patients with congenital heart disease and asthma who had increased pulmonary arterial pressure at cardiac catheterization. Pulmonary hypertension could not be explained solely by the cardiac lesion, nor by respiratory mechanical factors, as the patients did not have wheezing during the catheterization study. After long-term treatment with bronchodilators, corticosteroids, and oxygen, and coincident with improvement in the airway disease, there was catheterization-proved diminution of pulmonary hypertension. Whether asthma and pulmonary hypertension were causally linked is unknown, but further work seems indicated to elucidate the relationship between bronchoconstriction and pulmonary vasoconstriction. Furthermore, aggressive management of even mild reactive airway disease may be warranted in patients with pulmonary hypertension, regardless of apparent cause.
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PMID:Pulmonary hypertension and asthma in two patients with congenital heart disease. 275 75

We retrospectively reviewed charts of asthmatics who have coexistent cardiac disease. Twenty-nine patients with a mean age of 64.6 received 621 injections of epinephrine for acute asthma. Clinical improvement in asthma was noted and only three patients experienced a total of five (0.8%) adverse reactions temporally related to the administration of epinephrine. Twelve asthmatic patients were treated with beta adrenergic receptor blockers for a coexistent cardiac disease. In general, these patients tolerated the beta-blocker without a significant deterioration in respiratory function. Epinephrine and beta-blockers may be used safely in some asthmatics with heart disease when the medication is indicated and cautiously administered.
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PMID:The management of coexisting asthma and cardiac disease. 289 20

The parents of 436 disabled pre-school children were interviewed about habits and problems relevant to dental health. The children, who represented 10 different disabling conditions, were examined and dmft registered. The purpose was to study the relationship between different background variables and caries experience. The dmft score was analyzed in accordance with several sociocultural, medical, and habitual variables, using a multiple classification analysis (MCA). The number of daily carbohydrate intakes, duration of use of nursing bottle, family income, and diagnosis were the variables with the strongest association with dmft. Children with congenital heart disease, asthma, and cystic fibrosis had a considerably higher adjusted dmft than the other diagnostic groups. The proportion of children with caries experience was higher in the present survey than in groups of Norwegian children of corresponding age.
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PMID:Caries experience in disabled pre-school children. 293 82

To detect the differences in patterns of prescribing between general practitioners with high and low costs, the costs in prescribing seven symptomatic and seven systematic drug groups were studied in 23 practices with low costs and 23 with high costs in the Belfast area. This was done by extracting information about the individual practices from the Department of Health and Social Services (Northern Ireland) information technology unit's database on prescribing. General practitioners in practices with high costs issued prescriptions more often and for larger quantities of medicine than did their colleagues in practices with low costs for all of the drug groups studied. There was a lower patient to doctor ratio in the practices with high costs (1786:1 v 2039:1). The prescribers with high costs offered more surgery sessions than their colleagues with low costs, amounting to an average of 6.5 extra surgery sessions per 1000 patients per month. Half as many more patients with heart disease, asthma, diabetes, and thyroid disease seemed to be treated by doctors in practices with high costs than in practices with low costs. A higher rate of prescribing symptomatic drugs by these same doctors was also seen, and further study is recommended in view of the risks associated with these drugs.
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PMID:Some patterns of prescribing by urban general practitioners. 312 67

In this work, we tried to correlate the usefulness of the Koup nomogram for dosage prediction of continuous theophylline Dm therapy as compared with the usual method of dosification. To do this, a first group of 20 patients (5 with chronic bronchitis and 15 with bronchial asthma) without clinical or biochemical evidence of hepatic or heart disease (3 with smoking habit), were chosen. They were given a loading dose of theophylline 5 mg/kg over 30 min (as aminophylline). A blood sample was then taken after six hours. The result of this value and in accordance with the nomogram determines the individual oral dose of theophylline administered to attain a serum concentration of 10 mg/ml. The oral dose of theophylline, based according to Hendeles was given to another group of 16 asthmatic patients without smoking habit and clinical or biochemical signs of hepatic or heart disease. Two commercial preparations of theophylline were chosen (Theolair or Theodur). We concluded that: 1) Koup's nomogram is useful in estimating the dose requirement of oral theophylline to reach 10 mcg/ml (Css) at steady state, although it could not be useful in greater Css. 2) Among the patients given the dose according to Hendeles, 37.5% showed toxic serum concentrations. 3) Therapeutic serum concentrations could be obtained in the greater number of patients with twice daily doses, independently of the commercial product. 4) A great number of subjects showed the side effects (discomfort of the stomach, irritability, headache) which appeared to have little direct relationship to serum concentration.
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PMID:Clinical utility of the single point method for theophylline maintenance dose prediction. 344 76


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