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)

Patients with bacteriuria are at risk for local and distant infectious complications at the time of urologic procedures. The American Heart Association recommends that penicillin and streptomycin be given prophylactically to patients with rheumatic or congenital heart disease without reference to the presence or absence of bacteriuria. A patient with unrecognized calcification of the mitral annulus who underwent cystoscopy for evaluation of urinary retention is reported. Although bacteriuria was present preoperatively antibiotics were not given. Subsequently, Serratia marcescens and possibly Proteus morgani mitral valve infection developed and the patient died. Calcification of the mitral valve annulus and an extensive urinary tract infection were identified at autopsy. This case suggests that calcification of the mitral annulus may be an endocarditis risk factor. The spectrum of prophylactic antibiotic coverage given at the time of urologic procedures to patients with congenital or aquired heart disease, including calcification of the mitral annulus, should include whatever organisms are present in the urine.
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PMID:Gram-negative endocarditis following cystoscopy. 34 Jul 13

A study of 200 pregnant women at the State Zenana Hospital, Jaipur, was conducted to analyse the effects of various maternal diseases on neonates. The maternal diseases were anemia, hypertension, urinary tract infection, heart disease, and tuberculosis. 200 healthy pregnant women were studied as controls. A high incidence (64.3%) of low birth weight babies were born to the unhealthy mothers. 80% of the tubercular mothered babies weighed less than 2.5 kg; 70% of the heart disease; 65% urinary tract infections; 60% hypertensive; and 64.3% anemia. The abnormal newborns showed a smaller average length and smaller head circumference (less than 33 cm.) than the normal group. There was also higher incidence of prematurity and poor neurological status among the abnormal group. Congenital malformations accounted for 2.15% in the abnormal cases, compared to .5% in the control group. The morbidity rate was 85%, compared to 46% in the controls. The causes were conjunctivitis, diarrhea, and cord sepsis.
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PMID:Effects of maternal medical diseases on the newborn. 72 Dec 25

This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situation. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, from Jan. 1, 1988, to May 31, 1990, Chung Ang Medical Center. Data were collected from June 25, 1990 to July 7, 1990. Data was analyzed by x2-test, F-test, Pearsons correction, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants (42.7%) were born to mothers with risk-scores greater than 7, and 753 infants (57.3%) were born to mothers risk-scores less than 7. 2. Maternal age, parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies (X2 = 20.88, 42.87, 15.60 P less than 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infant, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. (chi 2 = 175.96, 87.5, 16.28, 21.78, 9.46, 8.10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P less than 0.01). 4. Abnormal nutrition, anemia, UTI, other medical condition (pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 & 5 minute after birth and neonatal body weight. 6. Apgar score at 1 & 5 minute after birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 & 5 minute after birth, 3 group (0-3, 4-6, above 7), and neonatal body weight, 2 group (below 2.5 kg, the other group) (F = 104.65, 96.61, 284.92, P less than 0.01). 8. Apgar score at 1 & 5 minute after birth (below 7), and neonatal body weight (below 2.5 kg), were significant relation statistically with risk score. (chi 2 = 65.99, 60.88, 177.07, P less than 0.01) were 60.8%, 60%.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The identification of high-risk pregnancy, using a simplified antepartum risk-scoring system]. 192 Dec 77

A prospective study was undertaken to determine the prevalence of significant asymptomatic bacteriuria in adult women with diabetes mellitus attending endocrinology clinics at two tertiary-care university-affiliated teaching hospitals. In addition, host factors of the patients were correlated with bacteriuria. The overall prevalence of bacteriuria was 7.9% (85 cases per 1,072 women). Absolute urinary leukocyte (white blood cell) counts were > or = 10/mm3 in 77.6% (66) of the 85 bacteriuric women vs. 23.7% (234) of the 987 nonbacteriuric women (P < .001). Bacteriuric women were significantly more likely than nonbacteriuric women to have non-insulin-dependent diabetes mellitus, longer duration of diabetes, neuropathy, and heart disease. Aboriginals had bacteriuria at a significantly higher prevalence rate than that among nonaboriginals (19.7% [15 of 76] vs. 7.0% [70 of 996], respectively; P < .0001), were more likely to have occult upper urinary tract infection (antibody-coated bacteria positivity: 53% [8 of 15] vs. 20% [10 of 50], respectively; P = .016), and had significantly lower urinary leukocyte counts, whether they were bacteriuric or not (P < .05). Multivariate analysis identified duration of diabetes and aboriginal origin as independent risk factors for the presence of bacteriuria.
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PMID:Prevalence of asymptomatic bacteriuria and associated host factors in women with diabetes mellitus. The Manitoba Diabetic Urinary Infection Study Group. 856 38

Sildenafil citrate, an oral therapy for erectile dysfunction, is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), the predominant isozyme metabolizing cGMP in the corpus cavernosum. Chemically, it is a compound of the pyrazolo-pyrimidinyl-methylpiperazine class. Sildenafil has no direct relaxant effect on human corpus cavernosum but enhances the relaxant effect of nitric oxide (NO) on the corpus cavernosum by inhibiting PDE5, which is responsible for degradation of cGMP in this tissue. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil increases concentrations of cGMP in the corpus cavernosum, causing smooth muscle relaxation and blood flow into the penis, resulting in an erection. Sildenafil at recommended doses has no effect in the absence of sexual stimulation. The drug is rapidly absorbed after oral administration, with absolute bioavailability of 40%. Its pharmacokinetics are dose proportional over the recommended dosage range. Maximum plasma concentrations are reached within 30 to 120 minutes after oral dosing in the fasting state. Sildenafil is cleared predominantly by the hepatic microsomal isoenzymes CYP3A4 (major route) and CYP2C9 (minor route). Clinical studies assessed the effect of sildenafil on the ability of men with erectile dysfunction to engage in sexual activity and, specifically, to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Sildenafil was evaluated at doses of 25, 50, and 100 mg in randomized, double-masked, placebo-controlled clinical trials of up to 6 months' duration. The drug was administered to hundreds of patients aged 19 to 87 years having erectile dysfunction of various etiologies for a mean duration of 5 years. Sildenafil was associated with statistically significant improvement in erectile function compared with placebo. Adverse effects reported at a rate of >2% were headache, flushing, dyspepsia, nasal congestion, urinary tract infection, abnormal vision, diarrhea, dizziness, and rash. No cases of priapism were reported. The use of sildenafil is contraindicated in men who are taking organic nitrates, because of the potential for a precipitous decrease in blood pressure. Postmarketing reports and surveillance have revealed at least 39 deaths with sildenafil use in men having a history of heart disease, men taking nitrate medications, and men in poor physical health due to lack of exercise. Many of the men who experienced serious adverse effects or death had a variety of concomitant diseases and were taking multiple medications.
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PMID:Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction. 991 1

Of 93 blood cultures received with a suspicion of anaerobic bacteraemia over a period of two years, only 17 (18.3%) showed anaerobic growth. Twelve grew anaerobes alone while five had a polymicrobial flora. Seven of these patients (4.3%) had pre-existing heart disease while others had history of prior surgery, diabetes mellitus or urinary tract infection. Oropharynx was the commonest portal of entry, followed by gastrointestinal tract. The anaerobes isolated were anaerobic streptococci, Bacteroides fragilis group and Bilophila and Eubacterium species. Fifteen patients developed major complications such as congestive cardiac failure, systemic embolisation, and perforative peritonitis. The mortality rate among the cases with anaerobic bacteraemia was 23.5% in this study.
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PMID:Anaerobic bacteraemia: a review of 17 cases. 1070 73

PURPOSE: Various medical conditions, infectious agents, sexual, and hormonal factors have been investigated in relation to prostate cancer risk. Given inconsistent results these factors were examined in this study.METHODS: This population-based case-control study was conducted in northeastern Ontario from 1995 to 1999. Cases (n = 760), aged 45 to 84 at the time of diagnosis, were identified through the Ontario Cancer Registry and diagnosed between January 1995 and December 1998. Controls (n = 1,634) were age-frequency matched and were selected from the northeastern Ontario population using published telephone listings. Mail and telephone questionnaires were used for data collection. Logistic regression was used to investigate risk associated with: 1) particular medical conditions and 2) hormonal and sexual factors. Cases were subdivided into those with symptoms of prostate disease and those with few or no such symptoms.RESULTS: Symptomatic cases who reported a history of venereal disease (age-adjusted odds ratio (OR) = 2.11, 95% confidence interval (CI) 1.18-3.80) and vasectomy (age-adjusted OR = 1.49, 95% CI 1.14-1.95) were at significantly increased risk of prostate cancer. Asymptomatic cases who reported a check-up at least once a year were at increased risk (age-adjusted OR = 1.46, 95% CI 1.08-1.98). Asymptomatic and symptomatic cases who reported a history of prostate cancer in a first degree relative were at increased risk (age-adjusted OR = 2.41, 95% CI 1.64-3.54; age-adjusted OR = 3.18, 95% CI 2.28-4.45, respectively). Symptomatic cases with a history of urinary tract infection were at non-significantly increased risk (age-adjusted OR = 1.31, 95% CI 0.98-1.76). Heart disease, mumps, allergies, and height were generally not associated with prostate cancer.CONCLUSIONS: A history of venereal disease, family history of prostate cancer, and vasectomy were positively associated with prostate cancer. Further investigation of selected medical conditions, sexual, and hormonal factors in prostate cancer development is warranted.
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PMID:Prostate cancer risk. Medical history, sexual, and hormonal factors. 1101 99

Newer, minimally invasive catheter-based endovascular technology utilizing stent grafts are currently being evaluated for abdominal aortic aneurysm (AAA) repair. A retrospective review of all (3 years) consecutive, non-ruptured elective AAA repairs was undertaken to document the results of AAA surgical repair in a modern cohort of patients to allow a contemporary comparison with the evolving endoluminal data. One hundred twenty-one AAAs were identified in a male veteran population. Mean age was 68.5 +/-7.7 years. Medical history review showed hypertension in 55%, heart disease in 73.5%, peripheral vascular disease in 21%, stroke and transient ischemic attacks in 22%, diabetes mellitus in 7%, renal insufficiency in 10%, and smoking history in 80%. The AAA size was documented with ultrasound (5.2 +/-1.3 cm, n=40) and computed tomography (5.6 +/-1.3 cm, n=100). Fifty-nine percent had angiography. Intraoperative end points included an operative time of 165 +/-6.3 minutes from incision to dressing placement. A Dacron tube graft was used in 78%, the remaining were Dacron bifurcated grafts. A suprarenal clamp was used in 8% for proximal aortic control with juxtarenal aneurysms. A pulmonary-artery catheter was placed in 69%. A transverse incision was used in 69% of patients and a midline incision was used in the rest. Estimated blood loss was 1505 +/-103 mL; cell saver blood returned 754 +/-53 mL; crystalloid/Hespan 4771 +/-176 mL; banked packed red blood cells 0.75 +/-0.11 U. Time to extubation was, in the operating room (78.5%), on the day of the operation (5.0%), postoperative day (POD) 1 (12.4%), POD2 (1.7%), POD3 (0.8%), and one case was performed with epidural anesthesia only. Postoperative end points included a 30-day mortality rate of 1.6% (two patients). Postoperative morbidity included wound dehiscence 0.8%; sepsis, urinary tract infection, wound infection, leg ischemia, ischemic colitis, and stroke each had an incidence of 1.6%; myocardial infarction, congestive heart failure, pneumonia, re-operation for suspected bleeding, and ileus or bowel obstruction occurred with an incidence of 3.3%. No significant increase in serum creatinine levels was noted. Time to enteral fluids/nutrition was 3.5 +/-0.08 days. Patients were out of bed to a chair or walking by 1.3 +/-0.06 days postoperatively. The length of stay in the intensive care unit (ICU) was 2.0 +/-0.12 days and postoperative hospital stay was 6.6 +/- 0.33 days. Transfusion requirement for the hospital stay was 1.6 +/-0.2 U per patient. This review highlights a cohort of male veteran patients with significant cardiac co-morbidity who have undergone repair with a conventional open technique and low mortality and morbidity rates. This group had rapid extubation, time to oral intake, and ambulation. In addition, ICU and hospital stays were relatively short.
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PMID:Abdominal aortic aneurysm repair. 1156 37

Urolithiasis is a common clinical disorder. Its frequency has risen with the development of humanity and varies wirl the country, geographic area, etc. It poses health problems in most countries. The urolithiasis has some potential risk factors such as intrinsic and extrinsic epidemiological, metabolic, physic-chemistry of the urine, mechanics and urinary infection. Our objective in this epidemiological study in a general population was to know the frequency, the potential risk factors, the morbidity, and social and economical impact of the urolithiasis in our subtropical Caribbean country. The prevalence was 4.64% and the annual incidence was 0.1%. Both are with in the estimated range of urolithiasis frequency in the world. It mainly started between 20 and 29 years in both genders. The white (5.2%) and the male (6.36%) patients were the most affected. 40% of all patients had a family history of urolithiasis. It was highly associated with diabetes mellitus, ischaemic cardiopathy, urinary tract infection and arterial hypertension. Stone formation was related to the warmer season. High calcium, protein-purine, carbohydrates and oxalic acid intake together with low fluid intake were closely associated with this disorder. 85% of patients had suffered renal colic and 75% of them more than once. Stone recurrence affected 33.8% of patients and 54.5% of them had more than one recurrence. Procedures for stone removal were needed in 33.8% of subjects. 40% of all patients were admitted to hospital due to urolithiasis morbidity. Non-specific medical treatment had been taken by 49.2% of the patients and specific treatment by none. Urolithiasis in this population was the some as has been reported in others studies. It has shown high frequency, increasing incidence, the same risks factors, high morbidity, and high social and economical impact. The low cost treatment is only taken by half of the patients.
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PMID:[Clinico-epidemiologic study of urolithiasis in a Caribbean urban area]. 1212 23

Described here are seven new cases of infective endocarditis due to Escherichia coli, including four involving prosthetic valves, followed by a review of similar cases in the literature. The review identified cases according to the modified Duke's criteria and revealed 16 cases reported before 1960, 5 between 1960 and 1980, and 11 after 1980. Currently, patients diagnosed with E. coli endocarditis are older than the patients diagnosed before 1960 (p<0.05), and they are often diabetic with underlying heart disease. Prosthetic valves are frequently involved (p<0.05), and the principal source of infection is the urinary tract. Surgery is often necessary. The mortality rate associated with this type of infection has decreased since 1960, but it remains high, with 17% calculated for the present series of seven new cases. The data presented here suggest that elderly patients with prior valve disease or prosthetic valve and E. coli urinary tract infection should be examined for endocarditis.
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PMID:Escherichia coli endocarditis: seven new cases in adults and review of the literature. 1613 8


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