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

It is accepted medical practice to prevent bacterial endocarditis in patients with susceptible congenital or acquired cardiac malformations who are likely to experience predictable procedure-related bacteremia. Patients in general, those with congenital heart disease specifically, are insufficiently aware of the need for such prophylaxis. It is responsibility of the physician to determine which patients are susceptible to endocarditis and the need for endocarditis prophylaxis for each patient for any given instance and to educate the patient as to this need. The American Heart Association provides wallet-sized cards that may be given to each patient. Those patients not previously known to have heart disease are, of course, not eligible for chemoprophylaxis. Because these represent many of the patients with endocarditis each year, it can be argued that only a minority of patients have preventable cases. Regarding the clinical application of anti-infective endocarditis prophylaxis, the American Heart Association gives this perspective: This statement represents recommended guidelines to supplement practitioners in the exercise of their clinical judgement and is not intended as a standard of care for all cases.... Because no adequate, controlled clinical trials of antibiotic regimens for the prevention of bacteria endocarditis in humans have been done, recommendations are based on vitro studies, clinical experience, data from experimental animal models, and assessment of both the bacteria most likely to produce bacteremia from a given site and those most likely to result in endocarditis. Bacterial endocarditis is one of the few infectious disease that almost always result in death unless treated. The dramatic nature of the morbidity and mortality of infective endocarditis in those so afflicted makes the prevention of even a few cases worth the effort.
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PMID:Risks for and prevention of infective endocarditis. 885 28

In many parts of the world, green tea and black tea are produced from the plant Camellia sinensis. Tea is one of the most widely consumed beverages, second only to water. It is one of the safest beverages since it is made with boiling, sterile water and has been popular for over 4000 years. Dogma has it that people knew it might have health promoting properties since it was frequently used as fluid supply for patients suffering from infectious diseases. However, detailed, focused research on the health benefits of tea is of recent vintage. Initially, such research was carried out in Japan and China and, because the local customs, this research involved green tea. Now, a number of other scientists in Europe and in the United States have conducted investigations on black tea, and in some laboratories exacting comparative studies were performed utilizing black and green tea. The major interest in tea and health stems from the high level of antioxidant tea polyphenols in green tea and black tea. The chemistry of the tea polyphenols has been worked out to some extent. Thus, their role in lowering the risk of heart disease and of a number of types of cancer begins to be understood. Most productive are multi-disciplinary approaches, considering data from epidemiology and field studies, and laboratory research in animal models for heart disease and cancers of various types, as well as through in vitro experiments.
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PMID:Tea and health: a historical perspective. 910 20

Kawasaki disease (KD) is the major cause of acquired heart disease in children. KD is suspected of being an infectious disease, but the etiology has not yet been clarified. Immunologically, the disease is associated with the activation of T cells, monocytes, and macrophages resulting in highly elevated levels of several cytokines. Recently, expansions of T cells expressing TCRBV2 and TCRBV8 chains have been reported, and this suggests the involvement of a superantigen in the pathogenesis of KD. To address the role of a superantigen in KD, we investigated clonal expansion of T cells by estimating the complementarity-determining region 3 size profile among T cells expressing TCRBV1, TCRBV2, TCRBV4, TCRBV5, TCRBV8, TCRBV14, TCRBV16, TCRBV17, TCRBV18, and TCRBV20 chains during acute KD, during subacute KD, and during the long term follow-up period. During the acute phase of KD, several clonal expansions were found mainly in the CD8+ T cells that disappeared during the long term follow-up period. Our data suggest that the conventional Ags rather than a superantigen were involved in the pathogenesis of acute KD.
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PMID:Clonal expansion of CD8+ T cells in Kawasaki disease. 920 Apr 89

The aim of this study was to study stroke survival in Chile in a historic cohort from a random sample of 333 inpatients. All alive selected patients were visited and examined. All the death certificates were reviewed. The diagnosis was done by a neurologist, 35% had a CT scan. Survival was measured in days using lifetest procedure to generate survival curves, Cox's proportional hazards models in Stata 3.1 statistic package and logistic regression analysis. The mean age was 70.5 for the group of died and 62.3 years old for alive patients (p = 0.01). Infectious disease (p = 0.05), localization of stroke (p = 0.01) and rehabilitation (p = 0.005) were significant at univariate analysis. The cumulative probability of survival was 38 days, after one year and after five years, 48.1, 39.0 and 19.8%, respectively. The probability of survival by age, localization, heart disease and rehabilitation was statistically significant. Analysis of survival by sex, and previous stroke risk factors was not significant. Using Cox's proportional hazards regression we found that survival after 5 years depends on age (p = 0.03), rehabilitation (p = 0.008), infection (p = 0.05) and heart disease (p = 0.04). Stroke survival function is close to a decreasing exponential curve with high death probability at one month after the stroke. Survival is conditioned by stroke localization, age, heart disease and rehabilitation.
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PMID:[The study of patient survival in cerebral hemorrhagic and ischemic accident]. 947 Nov 62

The precipitating factors of repetitive exacerbation were investigated in 110 consecutive patients with chronic left heart failure admitted due to acute exacerbation more than twice to the medical emergency ward of National Cardiovascular Center from January, 1992 to December, 1996. The controls were 189 consecutive patients with chronic left heart failure admitted to the ward due to acute exacerbation only once during the same period. Excessive intake of water or sodium, overwork and infection were common precipitating factors in the first decompensation of left heart failure, but the former two factors became less common with repeated admission. Patient mistakes such as excessive intake of water or sodium, overwork and noncompliance with medications, and new onset arrhythmias were common precipitating factors in patients (n = 13) admitted to the ward more than four times. Infection was a common precipitating factor (63%) in patients with a time interval between readmission and the last discharge of longer than 2 years. Despite repeated admission, infection was a common precipitating factor in patients with valvular heart disease (n = 31), patient mistakes were common in heart disease with left ventricular hypertrophy (n = 20), and infection and new onset arrhythmias were common in dilated cardiomyopathy (n = 28) and old myocardial infarction (n = 31). Patient mistakes and new onset arrhythmias were the common factors that led to repetitive exacerbation of left heart failure, and precipitating factors were characterized by the etiology of left heart failure.
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PMID:[Precipitating factors in patients with repetitive exacerbation of chronic left heart failure]. 959 70

Cost-effectiveness analysis, an analytic tool that expresses as a ratio the cost of obtaining an additional unit of health outcome, can help decision makers achieve more health protection for the same or less cost. We characterize the state of the cost-effectiveness analysis literature by reviewing how this technique is applied to various clinical and public health interventions. We describe the results of cost-effectiveness analyses for over 40 interventions to reduce cancer, heart disease, trauma, and infectious disease. The cost-effectiveness ratios for these interventions vary enormously, from interventions that save money to those that cost more than $1 million per year of life gained. The methods used to derive the cost-effectiveness ratios also vary considerably, and we summarize this variation within each health area. Greater uniformity of analytical practice will be necessary if cost-effectiveness analysis is to become a more influential tool in debates about resource allocation.
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PMID:Evaluating the cost-effectiveness of clinical and public health measures. 961 15

The incidence of cardiovascular events during travel is rising with the age of the population and number of traveling seniors. Cardiovascular events are the second most frequent reason for medical evacuation and the cause of 50% of deaths recorded during commercial air travel. In most cases the underlying disorder is coronary artery disease which is readily destabilized by stress and fatigue associated with travel. Inflight conditions that can cause problems include altitude-related hypoxia, pressurization, and cramped seating in most sections of the plane. Upon arrival the traveler is exposed to a variety of climatic, food, and environmental factors that can trigger manifestations of latent heart disease. Prophylactic drugs for tropical infectious disease (especially antimalarials of the quinidine group) should be used with caution due to possible adverse interaction with medications used to treat heart disease. A pre-travel examination is necessary to ascertain cardiovascular status and define simple preventive precautions.
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PMID:[Cardiovascular risk for the traveler]. 961 52

The number of dental patients who have medical illnesses is increasing at the hospital of the Faculty of Dentistry, Tokyo Medical and Dental University. Although prosthodontic treatments are considered less invasive in all dental treatments, invasive procedures such as tooth extraction may be required occasionally. Therefore, it is necessary to treat patients in consideration of their condition. Under this situation, a clinical survey was conducted by health questionnaires answered by the patients who visited our clinic between October 1992 and March 1997. The number of patients whose illness was heart disease, hypertension, diabetes, nephritic disease, hepatitis, tuberculosis, hemodyscrasia, asthma, epilepsy, and so on during dental treatment was higher than the national average according to the Ministry of Health and Welfare. Dental psychosomatic diseases such as TMD and dental phobia were increased every year. These data reflect the contemporary disease structure in Japan characterized by the spreading of life-style related diseases and increase of neuropsychological and infectious diseases.
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PMID:[A survey on condition of outpatients at prosthodontics II, University Hospital, Faculty of Dentistry, Tokyo Medical and Dental University]. 971 Oct 43

The greatest cause of death throughout the world today is noncommunicable disease. In Western societies, coronary artery disease is a principal cause of death. In developing countries, the incidence of coronary disease is rising as well. Heart disease often occurs in younger persons in developing societies, resulting in a disproportionately greater number of years of life lost. The reason for this change in global patterns of mortality is that deaths from infectious diseases are declining, resulting in greater life expectancy and changing lifestyles.
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PMID:The global problem of cardiovascular disease. 992 39

Chlamydia infections are epidemiologically linked to human heart disease. A peptide from the murine heart muscle-specific alpha myosin heavy chain that has sequence homology to the 60-kilodalton cysteine-rich outer membrane proteins of Chlamydia pneumoniae, C. psittaci, and C. trachomatis was shown to induce autoimmune inflammatory heart disease in mice. Injection of the homologous Chlamydia peptides into mice also induced perivascular inflammation, fibrotic changes, and blood vessel occlusion in the heart, as well as triggering T and B cell reactivity to the homologous endogenous heart muscle-specific peptide. Chlamydia DNA functioned as an adjuvant in the triggering of peptide-induced inflammatory heart disease. Infection with C. trachomatis led to the production of autoantibodies to heart muscle-specific epitopes. Thus, Chlamydia-mediated heart disease is induced by antigenic mimicry of a heart muscle-specific protein.
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PMID:Chlamydia infections and heart disease linked through antigenic mimicry. 1250 37


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