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)

The prevalence of chronic respiratory symptoms and of abnormalities in pulmonary function was determined by a survey of persons, aged 25 to 74, residing during May and June 1963 in a rural town, Chilliwack, B.C. Morning phlegm was reported by 26% of men and 13% of women. Chronic bronchitis was considered present in 21.5% of men and 11.3% of women. More serious obstructive lung disease, not related to heart disease, was found in 12.6% of men and 8.7% of women. These prevalences were higher than those found by the authors at Berlin, New Hampshire, U.S.A., in 1961. Demographic factors, such as birthplace, occupational class and measures of social stability, were not related to the prevalence of respiratory disease at Chilliwack. Some observer variation was found after analysis to be the result of non-randomization of respondents among the observers. An incidental observation was a high prevalence at Chilliwack of heart disease and hypertension under treatment.
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PMID:THE CHILLIWACK RESPIRATORY SURVEY, 1963: 3. THE PREVALENCE OF RESPIRATORY DISEASE IN A RURAL CANADIAN TOWN. 1428 55

Influenza virus infection accounts for significant morbidity, mortality, and healthcare expenditures among persons worldwide. Approximately 20,000 to 40,000 people in the US die each year as a result of influenza. Individuals most susceptible to adverse outcomes include the elderly and those with asthma, chronic obstructive pulmonary disease (COPD), heart disease, renal failure, malignancy, or immunosuppression. Prior to the AIDS epidemic, underlying respiratory disease was the greatest risk factor for influenza-related hospitalization ranking third to heart disease and malignancy for risk of mortality. Although the influenza vaccine can help prevent pneumonia and hospitalization, it is limited by less than ideal immunization rates and the possibility of viral antigenic shifts that render the vaccine ineffective. Pharmacologic interventions play an important role in the management of influenza virus infection by shortening the duration of symptoms. The advent of the neuraminidase inhibitors (NAIs) zanamivir and oseltamivir has significantly affected the treatment of influenza. Unlike NAIs, the older therapeutic options amantadine and rimantadine may cause significant central nervous system adverse effects. In addition, amantadine and rimantadine are not active against influenza B viruses, whereas NAIs are active against both influenza A and B. Post-marketing surveillance of the NAIs has revealed that bronchospasm may occur in patients with underlying respiratory disease treated with the NAI zanamivir. Recent data suggest zanamivir is effective in patients with underlying respiratory disease, but the data are insufficient to elucidate the true risk of bronchospasm. Based on post-marketing reports, zanamivir should be used with caution in patients with asthma or COPD. Although oseltamivir has not been associated with any significant respiratory adverse effects, no data exist on the safety and efficacy of this NAI in patients with underlying respiratory disease.
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PMID:Neuraminidase inhibitors in patients with underlying airways disease. 1472 62

Smoke-free indoor air ordinances protect employees and customers from secondhand smoke exposure, which is associated with increased risks for heart disease and lung cancer in adults and respiratory disease in children. As of January 2004, five states (California, Connecticut, Delaware, Maine, and New York) and 72 municipalities in the United States had passed laws that prohibit smoking in almost all workplaces, restaurants, and bars. On January 2, 2002, El Paso, Texas (2000 population: 563,662), implemented an ordinance banning smoking in all public places and workplaces, including restaurants and bars. The El Paso smoking ban is the strongest smoke-free indoor air ordinance in Texas and includes stipulations for enforcement of the ban by firefighting and law enforcement agencies, with fines of up to $500 for ordinance violations. To assess whether the El Paso smoking ban affected restaurant and bar revenues, the Texas Department of Health (TDH) and CDC analyzed sales tax and mixed-beverage tax data during the 12 years preceding and 1 year after the smoking ban was implemented. This report summarizes the results of that analysis, which determined that no statistically significant changes in restaurant and bar revenues occurred after the smoking ban took effect. These findings are consistent with those from studies of smoking bans in other U.S. cities. Local public health officials can use these data to support implementation of smokefree environments as recommended by the Task Force on Community Preventive Services.
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PMID:Impact of a smoking ban on restaurant and bar revenues--El Paso, Texas, 2002. 1498 52

Meconium aspiration syndrome (MAS) is a common severe respiratory disease in full-term infants. To investigate the risk factors for mortality of MAS, a retrospective chart-review study of MAS was conducted from 1995 to 2001. All cases of MAS were included except cases of cyanotic congenital heart disease or congenital fetal anomaly. Prenatal, perinatal and postnatal risk factors of mortality were recorded. The risk factors were compared between surviving and deceased cases. There were 314 cases of MAS during the seven years. Total mortality rate was 4.8% (15/314); this did not change significantly during these years. Risk factors of mortality by univariate analysis were: outborn babies, resuscitation before admission, first born baby, low pH, high oxygen index (OI), high alveolar-arterial oxygen tension gradient (AaDO2) at admission, high OI and AaDO2 at 2 hours after admission, shock, pneumothorax, asphyxia, pulmonary hemorrhage, persistent pulmonary hypertension of newborn (PPHN), and renal failure. Logistic regression analysis showed asphyxia, pneumothorax and PPHN are the most important risk factors of mortality in MAS. How to diminish these events is the key point for reducing the mortality rate of MAS.
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PMID:Risk factors of mortality in meconium aspiration syndrome: review of 314 cases. 1526 3

This study compared health-related outcomes, during a 1-year period, for two groups of frail elders-one that received care coordination via distance monitoring (home-telehealth) and one that received no intervention. A case-control design was employed. The home telehealth intervention group was made up of 111 male veterans who were enrolled in a Veterans Health Administration project. The control group consisted of 115 men who were referred from either senior service agencies or hospital rehabilitation programs, but did not receive home-telehealth. Subjects in both groups had primary diagnoses of hypertension, diabetes, respiratory disease, or heart disease. The two groups were similar in terms of age, race, marital status, and independence in instrumental activities of daily living (IADL) at baseline. A paired t-test was used to study the before-after (baseline to 12-month follow-up) improvements in the outcome measures within each group. Regression models were used to compare the outcome improvements between the two groups. Over 1 year, the intervention group improved 2.2 points more in IADL, 14.4 points more in FIM motor scores, and 2.7 points more in FIM cognitive scores than the control group (p < 0.0001). This evidence supports the use of a specific home-telehealth strategy for care coordination to improve functional independence in non-institutionalized veterans with chronic disease. A randomized controlled trial should be employed to confirm these findings.
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PMID:The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men. 1531 42

Forms were sent to members of the Obstetric Anaesthetists' Association requesting information on cardiorespiratory disease in pregnancy. Reports of 274 pregnancies in 259 women were received over four years (1997-2000). There were 83 valve lesions, 52 complex congenital heart disease, 112 miscellaneous heart disease and 27 respiratory disease. Half the mothers were classified as New York Heart Association grade I, 29% grade II, 14% grade III, 5% grade IV and six unknown. Thirty-nine mothers were seen by an anaesthetist only just before delivery. Regional analgesia for labour was more likely to be planned for severe (82%) than for mild symptoms (55%; P=0.039), but severity of symptoms did not affect choice of anaesthesia for caesarean section. Eighty-one women were delivered by elective caesarean section, 59 by emergency caesarean section, 82 had spontaneous and 49 assisted vaginal delivery. Three women suffered miscarriages. Regional analgesia was used in 73% of vaginal deliveries, Entonox or pethidine in 15% and no analgesia in 12%. Spinal anaesthesia was used in 21% of caesarean sections, an incremental regional technique (incremental epidural or combined spinal-epidural) in 40% and general anaesthesia in 39%. Forty-three women were admitted to intensive care units electively and 10 unplanned. Ninety-five per cent survived pregnancy in the same state as antepartum, 2% deteriorated and seven died. Ninety-four per cent of babies (258 babies) were delivered in good condition, nine in poor condition and seven died. Despite lack of denominator data and potential biases among the reported cases, the Registry provides a valuable snapshot of current practice in the UK.
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PMID:UK registry of high-risk obstetric anaesthesia: report on cardiorespiratory disease. 1532 83

How do the concentrations of indoor air pollutants known to increase risk of respiratory disease, cancer, heart disease, and stroke change after a smoke-free workplace law? Real-time measurements were made of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in a casino, six bars, and a pool hall before and after a smoking ban. Secondhand smoke contributed 90% to 95% of the RSP air pollution during smoking, and 85% to 95% of the carcinogenic PPAH, greatly exceeding levels of these contaminants encountered on major truck highways and polluted city streets. This air-quality survey demonstrates conclusively that the health of hospitality workers and patrons is endangered by tobacco smoke pollution. Smoke-free workplace laws eliminate that hazard and provide health protection impossible to achieve through ventilation or air cleaning.
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PMID:Respirable particles and carcinogens in the air of delaware hospitality venues before and after a smoking ban. 1535 53

All newborn infants have limited pulmonary reserve compared with older children. This puts them at increased risk of respiratory complications, such as those associated with infection by the respiratory syncytial virus. Young children with congenital cardiac disease are particularly likely to suffer severe disease related to infection by the virus. In these children, the extreme vulnerability of the lung to pulmonary oedema is compounded by the additional burden caused by the respiratory syncytial virus. In addition to the well-documented acute pulmonary effects of infection with the respiratory syncytial virus, there may also be consequent long-term respiratory morbidity. Clinical studies have shown that infection by the virus in infancy is associated with a higher risk of developing subsequent bronchial obstructive disease. Much debate surrounds the mechanisms underlying this association. It is thought that a combined immunological and neurogenic response mechanism is likely. Prevention of severe respiratory disease in infants and young children with congenital heart disease due to infection by the virus may, therefore, offer both immediate and long-term benefits. Indeed, an increasing body of evidence supports this hypothesis, indicating a clinical rationale for prophylaxis against the virus in infancy, in order to reduce the chance of developing reactive airways disease and asthma in later life.
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PMID:Acute and long-term effects of infection by the respiratory syncytial virus in children with congenital cardiac malformations. 1586 28

A set of dicephalous parapagus twins was born at 36 wk gestational age. Twin A had complex congenital heart disease in the form of a single ventricle that would be fatal without surgical intervention. Twin B had normal intracardiac anatomy. The twins were deemed surgically inseparable and the parents requested palliative open-heart surgery on Twin A. The twins shared a common circulatory system to the lower half of the body so that physiological manipulations in one twin adversely affected the other's hemodynamic condition. Twin A underwent successful single ventricle palliation; however, after a prolonged hospitalization, the infants died secondary to severe respiratory disease in Twin B.
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PMID:Anesthetic management of conjoined twins presenting for palliative open-heart surgery. 1597 4

The aim of this study was to determine the rate, risk factors and outcomes of catheter-related bloodstream infections (CRBSIs) in patients in a paediatric intensive care unit (PICU). A prospective cohort study was performed in King Abdulaziz Medical City, Riyadh, Saudi Arabia; a 650-bed academic/tertiary care centre with a combined 10-bed medical and surgical PICU. All patients admitted to the PICU from July 2000 to February 2003 who had a central line placed were monitored for the development of bloodstream infection (BSI) from insertion until 48 h after removal. Four hundred and forty-six patients with 2493 central-line-days were documented; 273 (55%) were male and the mean age was 2.6 years. Of the 446 patients, 278 (56%) had congenital heart disease, 108 (22%) had genetic disorders and/or congenital malformations, 55 (11%) had respiratory disease, and 42 (8%) had trauma. There were 50 episodes of CRBSI in 46 patients with a rate of 20.06 per 1,000 central-line-days and a device-utilization rate of 57%. Of these 50 episodes, 24 (48%) were polymicrobial, 16 (32%) were due to Gram-negative organisms, five (10%) were due to Gram-positive organisms, and five (10%) were fungal. The most common organisms isolated were Klebsiella pneumoniae (N=12, 16%), coagulase-negative staphylococci (N=10, 14%) and Pseudomonas aeruginosa (N=8, 11%). The mean duration of line insertion was 11.8 days for CRBSI patients and 4.22 days for non-BSI patients (P<0.0001). The mean PICU stay was 30.20 days for CRBSI patients and 6.35 days for non-BSI patients (P<0.0001). BSI occurred more often in catheters inserted in the PICU compared with the operating room, and in the femoral site compared with jugular or subclavian sites (P<0.001). In multiple logistic regression analysis of the risk factors, CRBSI patients were more likely to have multiple central lines [odds ratio (OR) 9.19; 95% confidence intervals (CI): 3.76-22.43), the line was more likely to be used for total parenteral nutrition (OR: 8.69; 95% CI: 3.5-21.4), and guidewire exchange was more likely to be performed on the line. CRBSI was not associated with a higher mortality rate. The CRBSI rate in our hospital is high compared with that reported by the National Nosocomial Infection Surveillance system. This study has established a benchmark for future comparisons. Additional studies from Saudi Arabia are necessary for national comparison and development of preventive measures.
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PMID:Rate, risk factors and outcomes of catheter-related bloodstream infection in a paediatric intensive care unit in Saudi Arabia. 1630 22


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