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)

A prospective study of 3509 consecutive patients examined by excretion urography has been conducted to assess the incidence and significance of the untoward effects of urographic contrast media. Four compounds were used in doses containing 160 to 500 mg iodine/kg body weight. Toxic effects, arm pain, and allegic reactions were assessed separately, while the remainder were classified according to the influence of each reaction on the investigation and the need for treatment. From the results and a review of the literature we conclude that when there is a clear clinical indication for excretion urography a dose of contrast medium containing up to 600 mg iodine/kg body weight should be injected rapidly. Prophylactic antihistamine treatment and pretesting should be abandoned. Special care is needed for small infants and the lederly and for patients with renal or hepatic failure, myeloma, heart disease, or a history of previous major reaction. Full resuscitation facilities must always be available.
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PMID:Acute reactions to urographic contrast media. 23 64

The efficacy of pneumococcal vaccine in groups of patients in the United States at high risk for pneumococcal disease was estimated by comparing distributions of serotypes of Streptococcus pneumoniae isolated from vaccinated and unvaccinated persons. Between May 1978 and March 1984, 187 blood isolates and 62 cerebrospinal fluid isolates from vaccinated patients, and 1447 blood isolates and 191 cerebrospinal fluid isolates from unvaccinated patients were serotyped at the Centers for Disease Control. The study did not include patients who were less than 2 years old or who had Hodgkin's disease, multiple myeloma, or immunoglobulin deficiency. In patients with bacteremic disease, the overall efficacy of pneumococcal vaccine was estimated at 64% (95% confidence limits, 47% to 76%); efficacy did not differ significantly with age. In persons over 65 years of age with diabetes mellitus, chronic heart disease, pulmonary disease, or no underlying illnesses, efficacy was 61% (95% confidence limits, 1% to 85%). These findings support the use of pneumococcal vaccine in selected populations in the United States.
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PMID:Pneumococcal vaccine efficacy in selected populations in the United States. 394 Apr 76

Clinically significant cardiovascular abnormalities may occur as secondary manifestations of noncardiac neoplasms. The principal cardiac effects of noncardiac tumors include the direct results of metastases to the heart or lungs, the indirect effects of circulating tumor products (causing nonbacterial thrombotic endocarditis, myeloma-associated amyloidosis, pheochromocytoma-associated cardiac hypertrophy and myofibrillar degeneration, and carcinoid heart disease), and the undesired cardiotoxicities of chemotherapy and radiotherapy.
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PMID:Cardiac effects of noncardiac neoplasms. 640 9

A patient with Bence-Jones myeloma and amyloidosis was treated with cytotoxic drugs and plasmapheresis, resulting in rapid improvement of myeloma-associated symptoms and signs. However, amyloidosis-associated symptoms, especially hypotension, grew worse. Echocardiographic examination demonstrated hypertrophy and a hyperrefractile appearance of the myocardium, thought to be pathognomonic of amyloid heart disease. A permanent pacemaker was inserted for treatment of Adams-Stokes attacks caused by sick sinus syndrome and atrioventricular conduction disturbances. Postmortem examination of the heart demonstrated abundant amyloid deposits corresponding to the altered acoustic qualities of the myocardium. Echocardiographic examination is a valuable non-invasive method for demonstration of amyloid deposits in the heart in multiple myeloma.
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PMID:Myeloma-associated cardiac amyloidosis. A case report. 670 98

AA-protein was identified by SDS-acrylamide electrophoresis in amyloid fibrils fixed in formalin after isolation from fresh-frozen tissues obtained from patients with familial Mediterranean fever (FMF) amyloidosis and idiopathic AA-amyloidosis and, following deparaffination, rehydration and homogenization of embedded formalin-fixed tissues of old autopsy cases of the hereditary amyloidosis of FMF and amyloidosis acquired in association with tuberculosis, bronchiectasis, and rheumatoid arthritis. That AA-protein is unaltered by formalin was firmly established by agar gel diffusion using specific rabbit anti-AA serum. By contrast, AL proteins could not be demonstrated either in formalin-fixed amyloid fibrils derived from fresh-frozen tissues of a patient with presumably AL-amyloidosis dominated by cardiomegaly and one with AL-kappa amyloidosis or in blocks of cases of familial neuropathic amyloidosis, multiple myeloma, and idiopathic amyloidosis with cardiopathy. AA-protein is not denatured by formalin and retains its typical electrophoretic, chromatographic, and immunologic characteristics even 30 years after fixation and paraffin-embedding.
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PMID:Demonstration of AA-protein in formalin-fixed, paraffin-embedded tissues. 706 12

We evaluated retrospectively the presenting clinical features, response to treatment and clinical course of 19 patients with LCDD, 11 of whom had multiple myeloma. At presentation, renal insufficiency was present in 18 patients and proteinuria in 16. Renal biopsy revealed typical LCDD in 16 patients, while in the remaining three LCDD was associated with other abnormal tissue deposits. Extrarenal signs were observed in 12 patients (63%), with the liver, heart and peripheral nerves being the most frequently involved organs. After diagnosis, 18 patients underwent therapy: 2 received steroids alone and 16 were treated with steroids and cytotoxic drugs; 7 patients also underwent plasma exchange. At the end of the first month of treatment renal function improved in 5 patients, worsened in 5 and remained unchanged in 8. All but 3 of the patients continued treatment beyond the first month: 7 patients developed end-stage renal disease, 5 an improvement and 4 a worsening in renal function. No effect on proteinuria was observed. Extrarenal symptoms developed in 4 previously unaffected patients and in 3 others they extended to more organs. Sixteen patients died: 12 during the first year of the follow-up, and 4 at 21st, 34th, 37th and 82nd month of observation. Five patients died from neoplastic cachexia, 4 from hypokinetic cardiopathy, 3 from hemorrhagic complications, 2 from pneumonia and one from unknown cause. Mean patient survival after presentation was 18.1 +/- 20.7 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal disease and patient survival in light chain deposition disease. 763 43

As a result of the content of benzene in various streams of refinery products, including gasoline, it is not surprising that over the years studies and case reports have linked gasoline exposure to lymphopoietic cancers (LPC), particularly leukemia and multiple myeloma (MM). Of three recently conducted studies of gasoline-exposed workers, one shows strong associations with leukemia and MM, a second suggests some association with leukemia and did not analyze data for MM, and the third study is not possible to evaluate because of a major problem with study design. Other diseases of particular interest in relation to gasoline exposure are kidney cancer, malignant melanoma, and heart disease. One study suggests an association with kidney cancer, but the second study did not. There appears to be no association between employment in refineries or gasoline exposure and heart disease. However, evaluation of risk of kidney cancer and heart disease is somewhat difficult because investigators did not control for cigarette smoking, even though it is related to these diseases. This is of particular concern when studying gasoline-exposed workers, who because of the explosive nature of gasoline probably smoke less than the general population used for comparison of mortality. Some studies of refinery workers and gasoline-exposed workers in particular show an excess risk of death from malignant melanoma. Whether this latter association is the result of benzene/gasoline exposure, sunlight exposure, or a combination of the two cannot be determined with the data currently available.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:State of the science on the carcinogenicity of gasoline with particular reference to cohort mortality study results. 802 Apr 33

The mortality experience of firefighters has been an active topic of investigation. Collateral toxicological evidence suggests that certain causes of death are likely to be associated with firefighting: lung cancer, heart disease, and obstructive pulmonary disease. To date there has not been a clear and consistent demonstration of excess risk due to occupational exposure for these outcomes, but certain other cancers, including genitourinary, colon and rectum, and leukemias, lymphomas, and myeloma, appear to be consistently elevated. A major unproven hypothesis is that risk increased following the introduction, in the 1950s of combustible plastic furnishing and building materials known to generate toxic combustion products. Mortality by cause of death was examined for two cohorts totalling 3,328 firefighters active from 1927 to 1987 in Edmonton and Calgary, the two major urban centers in the province of Alberta, Canada, examining associations with cohort (before and after the 1950s) and years of service weighted by exposure opportunity. The study attained 96% follow-up of vital status and over 64,983 person-years of observation, yielding 370 deaths. Mortality from all causes was close to the expected standardized mortality ratio (96; 95% confidence limits (CL) 87, 107) as was that for heart disease (110; 95% CL 92, 131), and neither was statistically significant at the p < 0.05 level (N.S.). Excesses were observed for all malignant neoplasms (127; 95% CL 102, 155, p < 0.05) and for cancer of lung (142; 95% CL 91, 211, N.S.), bladder (315; 95% CL 86, 808, N.S.), kidney and ureter (414; 95% CL 166, 853, p < 0.05), colon and rectum (161; 95% CL 88, 271, N.S.), pancreas (155; 95% CL 50, 362, N.S.) and leukemia, lymphoma, and myeloma (127; 95% CL 61, 233, N.S.); obstructive pulmonary diseases (157; 95% CL 79, 281, N.S.). Fire-related causes showed a marked excess (486; 95% CL 233, 895, p < 0.01), but external causes overall showed a significant deficit (66; 95% CL 49, 87, p < 0.05). The lung cancer excess was confined to Edmonton; there was no consistent association with duration of employment, exposure opportunity, or cohort of entry (before or after the 1950s) except that the highest risk was observed among Edmonton firefighters with over 35 weighted years. The excess of cancers of the urinary tract was observed mostly among firefighters entering service after 1950, appeared to increase with length of service and exposure opportunity, and was observed in both cities. An occupational association with heart disease and chronic pulmonary disease is not supported in this study on this population.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Mortality of urban firefighters in Alberta, 1927-1987. 832 77

In June 1992, we started a dose-escalated cytotoxic therapy with peripheral blood progenitor cell (PBPC) transplantation in patients with chemosensitive multiple myeloma (MM). At the time of best response to conventional treatment, 70 patients received high-dose cyclophosphamide (HD-CY) or, in case of pre-existing heart disease, dose-escalated ifosfamide/mitoxantrone followed by filgrastim (R-metHuG-CSF, 300 micrograms/day). PBPC collection was commenced when CD34+ cells were detectable using direct immunofluorescence analysis. Fifty-four out of 70 patients were successfully harvested (> or = 2.5 x 10(6) CD34+ cells/kg body weight [BW]) after the first cycle of HD chemotherapy. Conditioning therapy consisted of 140 mg/m2 melphalan plus TBI (14.4 Gy hyper-fractionated) or 200 mg/m2 melphalan in patients not eligible for TBI because of previous radiotherapy. To date, 56 patients have been transplanted. Autografts contained a median of 3.4 x 10(6) CD34+ cells/kg BW. Following reinfusion of PBPC, rapid engraftment was achieved in 54 out of 56 patients with a median of 14 days (range 9-23) to reach 0.5 x 10(9)/l neutrophils and 10 days (range 5-22) for an unsubstituted platelet count of > 20 x 10(9)/l. One patient died of transplantation-related complications. Sequential HD treatment improved the remission status (European Bone Marrow Transplantation criteria) in 19 out of 46 patients (9 patients too early). Of note, in 11 patients the immunofixation became negative and a polyclonal immunoglobulin reconstitution was achieved. Our protocol provides an effective treatment strategy for patients with advanced MM combined with low treatment-related toxicity.
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PMID:Sequential high-dose treatment with peripheral blood progenitor cell transplantation in patients with multiple myeloma. 874 87

Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, affects 18 million people in Latin America and is an important cause of heart disease. Although transmission has been reduced, an effective therapy for the infected population is lacking. New nitroimidazoles were designed and synthesized aimed at the development of a trypanocidal drug. The coupling of nitroimidazoles with heterocyclic N-trifluoromethyltriazolyl and pyrazolyl groups, 5-[N-(3-(5-trifluoromethyl)-1H-1,2,4-triazolyl)]amino-1-methyl-4-nitroimidazole (compound 4) and 5-N-(1-pyrazolyl)-1-methyl-4-nitroimidazole (compound 5). The in vitro trypanocidal effects of compounds 4 and 5 were evaluated. The results demonstrated that compound 5 was the most active compound, killing about 100% and 64% of the parasites in 0.3 mg/ml and 0.003 mg/ml concentrations, respectively. Interestingly, compound 4 also inhibited myeloma cell growth in a dose-dependent manner.
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PMID:Novel nitroimidazoles with trypanocidal and cell growth inhibition activities. 1139 74


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