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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pseudomonas osteochondritis of the chest wall and sternum has rarely been reported, but when present it has been extremely difficult to eradicate. Multiple operations to debride the involved areas and use of antibiotics have often been inadequate to control this resistant infection. This report describes our experience with three patients who had the late development of Pseudomonas osteochondritis of the chest wall. The infection occurred following crush trauma, sternotomy for congenital heart disease, and mastectomy and amputation of the upper extremity for carcinoma of the breast. Antibiotic therapy alone and with limited operations was unsuccessful in controlling the infection in all three instances. Eventually, each patient required extensive regional surgical removal of involved bone and cartilage. Complete healing followed. Our experience favors the early wide removal of bony and cartilaginous tissues in the involved region with preoperative and postoperative coverage by appropriate antibiotics. Operative management is detailed.
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PMID:Pseudomonas infection of the sternum and costal cartilages. Report of three cases. 70 78

The authors report a case of cardiotoxicity secondary to 5-FU, the 67th in literature in a 46-year-old woman subjected to adjuvant therapy with a CMF protocol after surgical treatment for carcinoma of the breast, and presenting onset of clinical symptoms 16 hours after administration of the first dose. Analysis of previous cases reported in literature revealed no evidence of age or sex as risk factors. Doubts exist as to whether or not pre-existing heart disease and thoraco-mediastinic radiotherapy increase the risk. With regard to the causes of the syndrome, the authors are inclined to attribute its onset to an auto-immune mechanism. 5-FU-induced cardiotoxicity, though rare, should be borne in mind and the use of the drug should be discontinued at the first signs of cardiotoxicity.
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PMID:5-Fluorouracil cardiotoxicity. 217 Jan 40

Progestogens should be added to estrogen replacement therapy, not only to prevent endometrial cancer in women with a uterus, but also to reduce the risk of breast cancer in some women. Smoking should be discouraged to reduce the risk for both lung cancer and heart disease. Recommendations should be made to increase fiber intake to lessen the risk for carcinoma of the colon. Reducing fat intake also decreases risk for colon cancer, as well as carcinoma of the breast. Postmenopausal bleeding must be investigated for early diagnosis of endometrial cancer and, when endometrial hyperplasia is the finding, it should be treated with progestogens to prevent adenocarcinoma. The progestogen challenge test is recommended for all women with a uterus, and if bleeding occurs, the progestogen should be continued for 13 days each month. Use of mammograms and other diagnostic modalities should be increased to make the earliest possible diagnosis of breast cancer.
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PMID:Cancer in the older woman: diagnosis and prevention. 304 28

Twelve patients underwent cardiac surgical procedures after having previously received irradiation of the mediastinum for various types of malignancies (Hodgkin's disease, carcinoma of the breast and seminoma). The patients' ages ranged from 39 to 69 years (mean 57 years); nine patients were female and three male. The average length of time from radiation to surgery was 15 years (3-24 years interval). The patients were divided into two groups according to the type of heart disease: Group I included seven patients who developed coronary artery disease (CAD) despite minimal risk factors. Three asymptomatic patients developed sudden myocardial infarction. In two patients the myocardial infarction was complicated (with ventricular septal defect in one and ventricular septal defect plus ventricular aneurysm in the other). All seven patients were surgically managed. Internal thoracic artery (ITA) was used in three patients as a conduit of myocardial revascularization. There were two hospital deaths in this group. The five patients in Group II underwent aortic valve replacement for aortic stenoses. Prior to the irradiation, none of the patients had a documented history of rheumatic fever, bacterial endocartitis, significant murmur, etc. There were no deaths in this group. Intraoperative findings for both groups included thickening and/or fibrosis of the ascending aortic wall, coronary arteries and aortic valve tissue. Epicardium was whitish colored and thickened.
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PMID:Heart diseases following mediastinal irradiation: surgical management. 760 44

It is well known from autopsy series that metastatic tumors of the heart can be found in 1.5% to 21% of patients with malignancies and the incidence of cardiac metastases is showing a gradual increase in recent years. The most common cause of metastatic heart disease is bronchial carcinoma followed by carcinoma of the breast, pleural mesothelioma, malignant melanoma, leukemia and lymphoma, in decreasing order of frequency. However metastatic cancer to the heart is not commonly diagnosed prior to death. Atrial extension has been reported as a common route of local spread in patients with bronchial carcinoma, but cardiac conduction system invasion is infrequent. The purpose of this report is to describe an unusual case of pulmonary adenocarcinoma that presented with cardiac manifestations mimicking atrioventricular (AV) block. This AV block was corrected by pacemaker. Chest radiography and bidimensional echocardiography didn't visualize important lesions. The cardiac findings at autopsy were remarkable not only for the severity of epicardial, myocardial and endocardial involvement, but for the metastatic implants into the His bundle and for the elective and wide infiltration of bifurcating His bundle. On addition histological examination revealed neoplastic emboli in the myocardial lymphatics. No valvular involvement was noted. Technical annotation: histological examination of the conduction system of the heart has been carried out on serial sections with the technique devised by one of the present authors. Bichromic (hematoxylin-eosin) and trichromic (Heidenhain-azan) stainings have been routinely employed.
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PMID:[Cardiac block caused by metastasis of lung adenocarcinoma to the bundle of His]. 849 66

People are so conscious of the possible risks involved in using contraceptives that they sometimes overlook the many benefits of contraceptive use for most women. Most women have only minimal risk factors from contraceptive use and can safely choose from all available contraceptives. There are, however, some women for whom pre-existing medical conditions may increase the risk factors associated with using certain contraceptives. Recommendations are given for safely prescribing for patients with some of the more common problems associated with contraceptive use. The following conditions are considered: insulin-dependent diabetes mellitus, epilepsy, hypertension, migraine headaches, sickle-cell disease, personal or family history of venous thromboembolism, personal or family history of heart disease or stroke, personal or family history of carcinoma of the breast, and pelvic inflammatory disease and ectopic pregnancy.
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PMID:Action plans for safe prescribing. 992 92