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)

Examined were 340 patients with closed thoracic trauma and posttraumatic pneumonia. Often, this complication was revealed in the elderly and senile. Chronic non-specific diseases of the lungs, pneumothorax predisposed to occurrence of posttraumatic pneumonia. The methods for treatment of a given complication have been developed. Diseases of the heart, vascular system in thoracic trauma can cause the aggravation of a patient's state up to lethal outcome.
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PMID:[Closed thoracic trauma and concomitant diseases]. 261 2

We report the features of 51 cases of hospital-acquired Legionella pneumophila pneumonia (HLP), diagnosed in our hospital during a period of about 5 years. Mean age was 64.6 years, and the male:female ratio 1.6. 29% of HLP involved patients who were not admitted to the hospital at the time of diagnosis. The monthly distribution showed a maximal incidence in July and August. Only 6% of cases involved patients without underlying diseases. The most common underlying diseases were chronic obstructive lung disease (COLD) (37%), heart disease (29%) and immunosuppressant therapy (29%). 21% of the patients with renal transplant had HLP. The only constant clinical feature was fever of 37.8 degrees C or higher. During the first 24-48 hours of illness, respiratory symptoms were not present in 41% of cases, and thoracic abnormalities in the physical examination were not present in 31%. The laboratory abnormalities were nonspecific and with incidence rates lower than 50%. In 41% of patients there was hypoxemia (60 mmHg or lower) with FiO2 of 0.21. The most common radiological finding was the initial unilateral and unilobar involvement. Pleural effusion and cavitation developed in 20% and 4%, respectively. Overall mortality rate was 12%. In the 43 patients treated early with intravenous erythromycin, mortality rate was 7%. We think that the relatively low incidence of severe underlying immunosuppression and the inclusion of hospital-acquired pneumonia in our institution influenced the low mortality rate of the present study, in contrast with other series of hospital-acquired legionellosis.
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PMID:[Nosocomial legionellosis: study of 51 cases]. 279 35

During the winter of 1986-1987, 64 children with respiratory syncytial virus (RSV) infection were admitted to our hospital. The diagnosis was made by direct immunofluorescent antibody technique. Twenty-three children (36%) needed intensive care treatment. Nearly 11 (52%) had a preexisting disease state, identified as a risk factor i.e., prematurity (n = 8), bronchopulmonary dysplasia (n = 2), congenital heart disease (n = 1). Twelve patients (50%) were intubated and ventilated. Conditions for intubation and ventilation were repetitive apnea with or without bradycardia (n = 4), clinical deterioration (n = 3) or hypercarbia (n = 5). Seventy-five percent of the patients who needed intensive care management were under three months of age compared to 34% of the children who were admitted to the clinical ward. The mean age for ventilated patients was 7.9 weeks. The mean duration of ventilation was 5.5 days. Volume controlled ventilation was initially applied to all patients. Pulmonary complications (atelectasis, pneumonia, pneumothorax or adult respiratory distress syndrome) were present in 15 (65%) IC patients. Nine (39%) of them also had symptoms of inappropriate antidiuretic hormone secretion (IADHS). Only two patients had symptoms of IADHS and two others had convulsions. Three children (5%) died as a result of respiratory insufficiency. Two of these infants belonged to the risk group.
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PMID:Respiratory syncytial virus infections in children admitted to the intensive care unit. 281 76

One hundred and eleven patients over 65 years of age underwent a major abdominal surgery between March 1986 and February 1987. The cardiorespiratory (CR) complications found were: cardiovascular (CV) failure 36%, post-operative myocardial infarction 5%, respiratory (R) failure 24%, pneumonia 11%. The overall mortality rate was 36%. The factors related with CV failure were: age over 75 years, ischemic cardiopathy, Goldman 3 and over, ASA III and over, cardiac failure, transoperatory hypotension and over 4 hours duration surgery. The ones related with myocardial infarction were: age over 75 years, Goldman 3 and over, ASA III and over, over 4 hours duration surgery and vital capacity (VC) less than 60%. For pneumonia the only related factor was VC less than 60%. For mortality, the factors found were Goldman 3 and over, ASA III and over and VC less than 60%. The mortality rate in patients without CR failure was 9%, with CV failure 35% (p less than 0.01), with R failure 33% and CR failure 90% (p less than 0.001).
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PMID:[Cardio-respiratory complications after major abdominal surgery in elderly patients. Risk factors and prognosis]. 281 95

At our institution, the TAH has been identified as a valuable support to a select subgroup of individuals with end-stage heart disease as a bridge to transplantation. Length of implantation has varied from 1 to 48 days in the PUH series. Management of the care of the TAH-implanted patient requires a collaborative effort by nurses, physicians, and biomedical engineers. Nurses caring for the patient must have extensive knowledge of postoperative care of the high-risk cardiac surgical patient that is supplemented by the specialized knowledge of TAH function and monitoring. We have identified specialized components to the nursing care of the patient following TAH implantation. Monitoring for hemorrhage is important in the immediate postoperative period; anticoagulation and assessment of possible embolic events are later considerations. Knowledge of the relationship between TAH function and changing preload and afterload enhances the nurses' interpretation of COMDU and hemodynamic monitoring parameters, and is essential when applied to other nursing interventions, such as patient positioning and mobilization. Nursing-care measures to prevent atelectasis or consolidation are essential to prevention of pneumonia. Prevention of infection is crucial to facilitate transplantation. Practice of aseptic technique with particular care to drive-line insertion sites is necessary. Pain management, as well as nutritional and psychologic support, are important to promote patient well-being (a nursing-care plan is outlined in Table 1). The goals of all nursing-care measures are an improved perfusion state as offered by the TAH, prevention of possible complications associated with TAH implantation, and prevention of possible complications of critical illness and immobility. The desired outcome is a patient with a stabilized or improving condition prior to cardiac transplantation. It has been exciting to participate in the development of nursing-care guidelines for a patient population that has little precedent. The TAH creates a symbiotic relationship between man and machine, and nursing-care responsibilities have grown to encompass the mechanical aspects of this relationship. Satisfaction has increased as well, as the nurse is able to provide a specialized service in the provision of a life-saving therapy and be a vital element in the successful implementation of an artificial-heart program. As advances are made in the development of mechanical devices that assist or replace the human heart, ongoing evaluation and refinement of nursing care guidelines are essential.
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PMID:Nursing considerations for the patient with a total artificial heart. 281 89

A girl aged 2 years and 10 months repeatedly suffered viral (thrice) and bacterial (colitis, salmonellosis, pneumonia 6 times) infections. At an age of 2 years primary pulmonary hypertension was diagnosed. Diagnostic catheterization was performed to exclude a congenital heart disease. The death occurred during the catheterization. An increase of beta-lymphocytes and plasma cells, a reduction of the T-lymphocyte zone were detected in the immunocompetent system during postmortem histological examination. The pathology diagnosis: primary immunodeficiency with a predominant suppression of cell-mediated immunity; hyperplasia of the lymph nodes with their plasmacytization; pneumosclerosis of all lobes of both lungs (a syndrome of primary pulmonary hypertension clinically); hypertrophy of the muscles of both atria and right ventricle, dilation of the heart cavities; acute heart insufficiency.
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PMID:[Primary immunodeficiency state in a child with the pulmonary hypertension syndrome]. 293 90

Gastrointestinal (GI) abnormalities are frequent in patients with Down's syndrome. In a 12-year retrospective review, we identified 187 patients with Down's syndrome admitted to the Columbia-Presbyterian Medical Center. Twenty-seven had major GI disorders, the most common being duodenal stenosis (DS, nine), gastroesophageal reflux (GER, five), imperforate anus (five), and Hirschsprung's disease (four). The mortality for the whole group was 11% (20 patients). The mortality in the small group of patients with duodenal stenosis was particularly high (five out of nine, or 56%). Associated congenital heart disease, especially endocardial cushion defects, and the frequent occurrence of pneumonia contributed to this high mortality rate.
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PMID:Down's syndrome and the gastrointestinal tract. 294 89

The first analysis of multiple cause-of-death data for Huntington's disease in the United States was performed, using data from the National Center for Health Statistics for the period 1971 and 1973 through 1978. The overall mortality rate was 2.27 per million population per year, approximately 80% higher than the corresponding rate for deaths in which Huntington's disease was listed as the underlying cause of death. Age-specific mortality rates peaked around age 60. Rates were similar for both sexes, and higher in whites than nonwhites. Age-adjusted rates were similar for United States whites and reported values from the Scandinavian countries. The leading causes of death were pneumonia and heart disease. Other common causes of death were nutritional deficiencies; mental disorders; cerebrovascular disorders; and accidents, poisonings, and violence. Suicide was rarely reported.
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PMID:Huntington's disease mortality in the United States. 296 5

Since November 1985, 14 neonates and young infants have undergone orthotopic heart transplantation at Loma Linda University Medical Center (LLUMC) as therapy for hypoplastic aortic tract complex. Eleven (78%) survived surgery and are living and well today. Three perioperative deaths resulted: one due to perforated peptic ulcer, one due to necrotizing pneumonitis, and one due to graft failure unrelated to rejection. No late deaths occurred in the 1-29 months of follow-up, during which time noninvasive surveillance techniques were used. Immunosuppression was accomplished using cyclosporine and azathioprine. Steroids and antithymocyte globulin were used for identified rejection episodes only. Ordinary childhood infections were tolerated well. All survivors were normotensive. There was no late renal dysfunction. Although inadequate donor resources remain a significant limiting factor for transplantation therapy during early life, these results suggest that cardiac transplantation is effective therapy for selected neonates and young infants with incurable congenital heart disease.
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PMID:Orthotopic transplantation during early infancy as therapy for incurable congenital heart disease. 304 15

RSV is now understood to be the most significant viral respiratory pathogen of infants and is capable of causing both bronchiolitis and pneumonia. It is a particular risk to hospitalized infants as the virus is easily spread through close contact. The most vulnerable infants are those who suffer with either congenital heart disease or bronchopulmonary dysplasia who easily fall prey to pulmonary complications of infection. Strict environmental control and the use of protective clothing and eyewear should be implemented to decrease the nosocomial spread of RSV. Available diagnostic studies include viral isolation, fluorescent antibody stains, and enzyme immunoassays. Treatment of the disease is usually supportive but hospitalized patients frequently benefit from aerosolized ribavirin therapy. Hopefully, current vaccine trials will be successful and this pathogen will not only be treatable but will also be preventable.
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PMID:Respiratory syncytial virus. 306 24


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