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

The widespread use of ethyl alcohol suggests its potential importance in clinical medicine. There is no proven therapeutic effect in cardiac patients and its role as an etiologic factor in heart disease has been disputed over the years and attributed to coexistent malnutrition. The latter factor, however, has been dissociated from ethanol use in many patients with the cardiomyopathic form of heart failure. Major support for the role of ethanol as a toxic agent when used in large amounts for a prolonged period has been obtained in various species of animals, including the subhuman primate. Abnormalities include depression of ventricular function, and metabolic and morphologic changes that parallel the changes in humans with preclinical malfunction of the heart. While the mechanism of progression to heart failure or arrhythmias is not known, several factors may be associated. These include, particularly in males, the cumulative effects of ethanol alone or after intensified drinking episodes, simultaneous exposure to trace metals in excess, and occasional specific nutritional deficiency or superimposed infection. The low prevalence of clinical nutritional deficiency in patients with alcoholic cardiomyopathy and the infrequency of heart disease in patients with cirrhosis or neuropathy supports the view that the cardiac abnormality is commonly not dependent on malnutrition. Clinical data indicate that the cessation of alcohol intake may reverse the disease or interrupt its progression in many patients. However, the pathogenic process may continue unabated in some patients who become abstinent.
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PMID:The role of ethanol in cardiac disease. 32 69

Serum somatomedin activity was found to be very low in cases of growth retardation and malnutrition due to congenital heart disease and to malabsorption, respectively. Growth hormone levels in these cases were slightly elevated. The possible role of low somatomedin activity in the origin of growth retardation due to organic diseases is discussed.
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PMID:[Somatomedin and growth hormone in patients with retarded growth and atrophy due to congenital heart disease or malabsorption (author's transl)]. 90 38

Sixteen children with anomalies of the auricle and/or middle ear who presented malformations of the face, mouth, upper airway, spine, limbs, heart, gastrointestinal (GI), and/or genitourinary (GU) systems, were described. While clusters of anomalies suggested syndromes such as the oculo-auriculo-vertebral syndrome of Goldenhar, hamifacial microsomia, mandibulo-facial dysostosis (Treacher Collins syndrome), Pierre Robin, Klippel-Feil, Moebius, Duane, and/or VATER syndromes, many children did not fit what are usually considered even minimal criteria for these syndromes. Several children had malformations which fit the description of more than one syndrome. The importance of investigating the children for unsuspected anomalies, especially of the GU system, was emphasized. Life threatening problems in this group consisted of airway problems, congenital heart disease, and major anomalies of the GI and GU systems. Better management of sucking, swallowing and airway problems might have decreased the early morbidity and mortality (3/16) in this group. Children with multiple defacing anomalies may not be mentally retarded so that aggressive management of their visceral anomalies and hearing problems, and early educational intervention are mandatory. Delay in development may be due to hearing loss, vestibular impairment, ataxia, the consequences of early malnutrition, and multiple hospitalizations rather than to mental retardation. A pessimistic attitude in infancy is unwarranted since it is impossible to predict which children will end up competitive individuals.
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PMID:Patterns of anomalies in children with malformed ears. 96 14

The effect of congestive cardiac failure, hypoxia and hypoglycaemia on glucose tolerance and insulin secretion were studied in selected groups of infants with congenital heart disease. Fasting blood glucose level was significantly decreased in patients with congestive heart failure and in cyanotic infants without congestive heart failure. In the former it seemed to be correlated with the degree of malnutrition, while in cyanotic infants it was independent of the nutritional state. Plasma insulin levels were reduced in infants, with congestive cardiac failure, although their glucose tolerance test and free fatty acid concentrations were normal. It is suggested that the decreased plasma insulin concentration was a consequence of adaptation to reduced requirements. Glucose tolerance and insulin secretion were not affected by hypoxia or hypoglycaemia.
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PMID:Plasma glucose, insulin and free fatty acids in infants with congenital heart disease. 124 3

Between 1980 and 1988, 32 infants under three years of age with left to right shunt congenital heart disease underwent cardiac catheterizations, and their glucose tolerance and insulin secretion were investigated. These patients were divided into three groups by weight and compared. Group I consisted of 11 patients whose weights were 80% or more of the ideal body weight (IBW) for their age. Group II consisted of 10 patients whose weights were between 70% and 80% of the IBW. Group III consisted of 11 patients whose weights were less than 70% of the IBW. The CTR and biochemical blood studies showed no difference. By cardiac catheterization, Group III showed higher pulmonary/systemic vascular pressure ratio (Pp/Ps) than Group I. The mixed venous O2 saturation (SvO2) were 69.5 +/- 6.41% in Group I, 64.8 +/- 5.78% in Group II, 57.2 +/- 3.59% in Group III. Group III showed the lowest SvO2 of the three. Group III also showed the lowest arterial O2 saturation (SaO2). This indicates that the patients of Group III had the most serious congestive heart failure. In the 0.5 g/kg intravenous glucose tolerance tests, the K values (glucose disappearance rates) were as follows: Group I: 3.30 +/- 0.597, Group II: 2.91 +/- 0.624, Group III: 2.48 +/- 0.417. Group III showed the lowest values of the three. This indicates the deterioration of glucose tolerance in Group III. In the examination of serum insulin secretion, Group III showed the lowest serum insulin levels: 26.6 +/- 18.3 mmu/ml at 3-minute intervals, 22.8 +/- 14.3 mmu/ml at 5-minute intervals. After cardiac catheterization, corrective operations were performed on 17 patients out of 32. Fifteen patients survived, though 2 patients of Group III died early postoperatively. The results of glucose tolerance test and serum insulin levels before and after operation in 12 survivors were compared. Although the K values had been 2.8 +/- 0.41 before operation, it rose up to 3.81 +/- 0.81 three to four weeks after operation. The serum insulin levels at 3, 5, 10 and 15-minute intervals also rose after operation. This indicates the improvement of glucose tolerance and insulin secretion due to the improved circulation. It is suggested that the adequate nutritional management before and after operation on infants with serious congestive heart failure, because they tend to have malnutrition before operation. Aggressive and careful nutritional management is advisable.
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PMID:[Glucose tolerance and insulin secretion in infants with the left to right shunt congenital heart disease]. 140 84

Malnutrition is a condition of increased risk for surgical patients, yet incompletely understood. Its role in the prognosis of neoplastic, gastrointestinal and infective disease undergoing surgery is now better underlined; unfortunately the same attention is still lacking for the majority of cardiac diseases. Nowadays many methods are at hand for evaluation of nutritional status, and it is possible to restore the correct condition before surgery by various techniques of artificial nutrition. Here the authors consider the possibility of discovery and evaluation of various hidden conditions of malnutrition in patients suffering of valvular heart disease--depending or not from the cardiopathy itself--and their complex pathogenesis, to correct at the end such condition and offer the patients an optimal prognosis with therapeutical procedures.
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PMID:[Nutritional status and heart valve surgery: response to surgical aggression]. 150 72

This article reports survey results to Ghanaian nursing students' perceptions of public health issues. Their views were ascertained through a questionnaire designed to capture ratings of educational curriculum concerns and perceptions of the importance of public health factors. Both frequency data and chi-square analysis were used to assess the ordinal position of health factors and gender differences, respectively. Chi-square analysis was also done to assess differences by age. Differences between men and women respondents existed on six of 15 health factors (p less than .05) including malaria, heart disease, measles, cancer, malnutrition and car accidents, while differences between age groups were found on two of the 15 factors (violence and cancer). Based on the ascertained student perceptions, current efforts in Ghana suggest that preventive health is an emerging concern to public health officials. As such, Ghanaian nursing students hold perceptions not dissimilar to those of U.S. health professions students.
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PMID:Nursing student perceptions of public health issues in Ghana. 155 72

To determine an effective nutritional regimen for management of growth failure in infants with congenital heart disease and congestive heart failure, the authors studied 19 infants with cardiac anomalies who were not candidates for early corrective surgery. Patients were randomly assigned to one of three feeding groups: group 1 (n = 7) received continuous, 24-hour nasogastric alimentation; group 2 (n = 5) received overnight, 12-hour nasogastric infusions plus daytime oral feedings as tolerated; and group 3 (n = 7) received oral feedings alone. For all patients, commercial infant formula (cow's milk or soy protein) was supplemented to a calorie density of approximately 1 kcal/mL. During a 5.25 +/- 0.45 month study period, only group 1 infants achieved intakes greater than 140 kcal/kg per day (mean = 147 kcal). Serial anthropometric measurements demonstrated that only 24-hour infusions (group 1) were associated with significantly improved nutritional status, when assessed by z scores for weight (P less than .01) and length (P less than .05). Group 1 infants also showed marked increases in midarm muscle circumference and triceps and subscapular skinfold thicknesses (P less than .01, compared with groups 2 and 3). These data suggest that infants with congenital cardiac defects complicated by malnutrition manifest increased nutrient requirements for growth and weight gain. Continuous, 24-hour, nasogastric alimentation is a safe and effective method for achieving both increased nutrient intake and improved overall nutritional status in these infants.
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PMID:Enteral nutrition in infants with congenital heart disease and growth failure. 211 41

Protein-energy malnutrition is commonly observed in infants with congenital heart disease (CHD). The effect of a hypercaloric formula on nutritional recovery was evaluated in malnourished infants with congenital heart diseases. We retrospectively studied 30 infants (mean age 9 months, range 2 to 21) with CHD along 60 to 90 days in a closed nutritional recovery center. All patients were fed a hypercaloric whole cow's milk formula with sucrose, butter oil and corn starch (1.29 kcal.ml). Mean daily energy intake was 220 +/- 19.8 kcal.kg body weight.day. Mean weight gain was 2.7 g.kg.day. No effect of cyanosis, cardiac failure, degree of malnutrition or number of illness-free days was observed on nutritional recovery. Patients older than 9 months had significantly greater weight gain than younger infants. Those infants with worse CHD and severe intercurrent illnesses had the worst nutritional recovery. We suggest that a hypercaloric formula induces good nutritional weight gain infants with severe congenital heart disease.
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PMID:[Nutritional recovery in infants with congenital heart disease and severe malnutrition using a hypercaloric diet]. 215 13

Congenital microgastria is a rare anomaly. Only 22 cases have been reported in the literature. Its clinical manifestations depend on the stage at which the embryologic development of the stomach is arrested. The outcome of most patients with severe microgastria previously reported has either been death or extreme malnutrition. Since 1978, four patients with congenital microgastria have been managed at The Children's Hospital of Philadelphia. All patients had severe feeding intolerance and associated congenital malformations. Three patients were treated with a double lumen Roux-en-Y jejunal reservoir (Hunt-Lawrence pouch). This treatment improved the nutritional management of these patients. On follow-up two patients are at the 50th percentile for height and weight, and one is at the 25th percentile. One patient with associated severe congenital heart disease was treated nonoperatively. Her nutritional management was difficult, and she ultimately died of congestive heart failure at 3 years of age. In patients with the most severe forms of microgastria, early operative treatment improves nutritional management and facilitates the achievement of normal growth and development.
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PMID:Management of congenital microgastria. 230 88


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