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

The clinical and radiological features of pneumococcal pneumonia were studied in 94 hospitalized patients. Fifty-seven (61%) had a bronchopneumonic pattern on roentgenogram, and 37 (39%), a lobar pattern. Eighty-two (87%) of the patients in both roentgenographic classifications had one or more underlying disease states. There was no difference in the frequency of heart disease, diabetes, chronic pulmonary disease, or malignancy between the two categories. Sputum Gram's stains were also similar in both patterns. Twenty (54%) of the 37 patients with the lobar pattern were bacteremic compared with only five (9%) of the 57 patients with the bronchopneumonic pattern; all five patients with bronchopneumonia and bacteremia had an associated malignancy. Although a lobar pattern is usually emphasized in the diagnosis of pneumococcal pneumonia, this study showed that the majority of patients hospitalized with pneumococcal pneumonia had a roentgenographic bronchopneumonic pattern rather than the classic lobar pattern. Thus, patients with the bronchopneumonic pneumococcal pneumonia pattern may be underdiagnosed. The implications are important both for treatment and for epidemiologic data used in the selection of pneumococcal types for prophylactic vaccines.
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PMID:Pneumococcal pneumonia in hospitalized patients. Clinical and radiological presentations. 684 6

Children with acyanotic congenital heart disease frequently develop respiratory difficulties such as atelectasis, pneumonia, or infantile lobar emphysema. In some cases, the cause of the respiratory difficulty is compression of the tracheobronchial tree by hypertensive dilated pulmonary arteries, since this type of heart disease frequently demonstrates large left-to-right intracardiac shunts. Sites of predilection for compression include the left main bronchus, the left upper lobe bronchus, the junction of the right bronchus intermedius and right middle lobe bronchus, and the left side of the distal trachea. Cardiac anomalies which predispose to this type of compression include ventricular septal defect, patent ductus arteriosus, interruption of the aortic arch, and tetralogy of Fallot. Pulmonary arteriopexy may relieve the tracheobronchial compression.
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PMID:Tracheobronchial compression in acyanotic congenital heart disease. 688 45

This study examines a large number of demographic, hospital, patient volume, and medical factors that may influence in-hospital mortality due to trauma. The authors use data from the 1977 and 1978 National Hospital Discharge Survey to assemble a case-control data set of severe injuries (n = 336). Cases are defined as "deaths from trauma," and control subjects are "injured survivors." Control subjects are frequency-matched to cases on the basis of overall severity, site of the most severe anatomic injury, and age. The analysis estimates the relative risk of mortality associated with different levels of the risk factors by the odds ratio. The unadjusted results indicate a significant impact of the following variables: sex (with males at higher risk), average severity of hospital case mix, number of severe trauma patients treated at a hospital (with high-volume hospitals at increased risk), ischemic heart disease and other forms of heart disease, malignant neoplasms, influenza and pneumonia, and emergency tracheotomy or tracheostomy. After adjustment using multiple logistic regression, the single significant risk factor is the presence of ischemic heart disease and other forms of heart disease. The implication of this finding is that hospitals exhibit little difference in mortality from severe trauma after adjustment for patient mix characteristics. Possible explanations for this result are tendered.
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PMID:Mortality from traumatic injuries. A case-control study using data from the National Hospital Discharge Survey. 688 26

During a 6-year period 389 children and adolescents aged between 1 and 20 years died violently and 31 died suddenly, naturally, and unexpectedly in an area of southern Sweden. In about half of these 31 cases, death was caused by common infectious diseases--for example broncho-pneumonia, myocarditis, or acute epiglottiditis. In one group death was certainly sudden, but was caused by a known chronic disease--such as epilepsy or bronchial asthma. Three young men died from chronic heart disease, and one died from adrenal failure during or immediately after physical exertion. There were 4 cases of sudden, natural death for which the cause was unknown--that is 0.007 per 1000 live births. This figure is extremely low compared with the incidence of sudden unexplained infant death--that is deaths of infants aged between one week and one year.
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PMID:Sudden natural death in later childhood and adolescence. 711 76

A mortality study of workers employed for at least one year between 1 January 1950 and 31 December 1975 at eight oil refineries in Britain has been carried out. Over 99% of the population were successfully traced to determine their vital status at 31 December 1975. The mortality observed in the study population was compared with that which would be expected from the mortality rates for the all male population of England and Wales, and Scotland, with adjustment for regional variation in mortality for the English and Welsh refineries. The overall mortality observed was considerably lower than that expected on this basis, as was the mortality from heart disease, stroke, bronchitis, and pneumonia. The observed number of deaths from all neoplasms was also very much less than expected, a result almost entirely due to a large deficit of observed deaths from lung cancer. Raised mortality patterns were found in several refineries for cancers of the oesophagus, stomach, intestines, and rectum, although no location was consistently high for all these causes of death. Different year-of-entry cohorts and job groups were also affected. In general, mortality from these causes increased as length of service and interval from starting work increased. There were also significantly more observed deaths than expected from cancer of the nasal cavities and sinus, and melanoma. Further work is required to ascertain whether these are due to an occupational factor and, if so, to identify the physical or chemical nature of the risk.
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PMID:An epidemiological survey of eight oil refineries in Britain. 727 34

Transthoracic diaphragmatic plication is a simple and effective means of treatment for phrenic nerve injury and resultant diaphragmatic paralysis, and should be undertaken as soon as the diagnosis of diaphragmatic paralysis is established in a child with substantial respiratory difficulty. Seven of more than 1,500 patients sustained phrenic nerve injury during operation for congenital heart disease at our institution over the past five years. All but 1 patient were less than 5 months old, and the average weight was 3.8 kg. Five of the 7 could not be weaned from the ventilator, and the other 2 had persistent postoperative tachypnea and stridor. Before 1980, 3 patients were intubated for an average of 16 days prior to diagnosis by fluoroscopy. Since then, 4 patients have been intubated for an average of 7.8 days before diagnosis. All 7 underwent transthoracic diaphragmatic plication and were extubated by 6 days after operation (mean, 3.7 days). Six patients survived and are doing well. The 1 death occurred in 1976 in a premature infant with multiple congenital cardiac lesions; diagnosis was delayed until the twenty-eighth day after intubation and transthoracic diaphragmatic plication, until the sixty-second day. This infant died of pneumonia one month after extubation. These data support our policy of establishing an early diagnosis of phrenic nerve injury and early treatment utilizing transthoracic diaphragmatic plication in symptomatic children.
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PMID:Aggressive treatment of acquired phrenic nerve paralysis in infants and small children. 728 17

A gram-negative, oxidase-negative, fermentative rod belonging to enteric group 15 of Enterobacteriaceae was isolated in mixed culture from two patients with pneumonia. Both were elderly patients with chronic heart disease.
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PMID:Enteric group 15 (Enterobacteriaceae) associated with pneumonia. 730 56

A 62-year-old woman died of a combination of pneumonia, empyema, emphysema, and severe heart disease. The pneumonia was due to Neisseria gonorrhoeae, a rarely if ever reported causative agent in pulmonary infection. Autopsy ruled out other sites from which the organism could have originated.
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PMID:Unilateral lobar pneumonia with empyema caused by Neisseria gonorrhoeae. 735 38

The combined cause-of-death category pneumonia and influenza (P&I) (International Classification of Diseases, Ninth Revision, codes 480-487) ranks as the sixth leading cause of death in the United States following heart disease, cancer, stroke, unintentional injuries, and chronic obstructive pulmonary disease. Changes in the epidemiology of Streptococcus pneumoniae and other recognized respiratory pathogens, the increasing occurrence of drug-resistant microorganisms, and the detection of new respiratory pathogens have heightened awareness of the public health importance of severe respiratory infections. To characterize the epidemiology of P&I deaths in the United States, CDC further analyzed underlying and multiple cause-of-death mortality files for 1979-1994. This report summarizes the results of this analysis.
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PMID:Pneumonia and influenza death rates--United States, 1979-1994. 760 29

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


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