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

Poor weight and length gain of infants with congenital heart disease is generally considered to be related to inadequate nutritional intake, but no longitudinal data on growth and nutritional intake of such infants are available. We compared weight, length, subscapular and triceps skinfold thickness, energy and protein intake (24-h dietary intake records) as well as serum prealbumin and albumin of infants with cyanotic heart disease (n = 8) or isolated left-to-right shunt (n = 8) with those of healthy infants aged (n = 8) 45-365 days. Weight, length, and combined (subscapular and triceps) skinfold thickness of the two groups with congenital heart disease (CHD) were significantly less from 183 through 365 days of age. However, energy and protein intake was similar to that of the control group from 45 through 365 days of age. Normal serum prealbumin and albumin in the infants with CHD ruled out protein-calorie malnutrition. It is concluded that a low level of food intake was not the main cause of inadequate growth and of small subcutaneous fat stores in these two small, but homogeneous, groups of infants with CHD.
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PMID:Growth and nutritional intake of infants with congenital heart disease. 249 25

This is a study of Lesotho's proposal to United Nations agencies for financial assistance to build a medical school and a 600- bed referral teaching hospital. To qualify for such assistance, a feasibility study was prepared that included data from Lesotho's Ministries of Planning, Finance and Health on the following: 1) demography, including fertility; 2) health status and major health problems; 3) health facilities and health service utilization; 4) health manpower; and 5) health service organization, financing and cost. Lesotho's population was 1.37 million in 1981 growing at 2.3% per year. 13% of the population was urban, living in Maseru, the capital. Infant and child mortality rates are 116/1000 and 15.6/1000 while maternal mortality rates are 3.7/1000. The leading causes of death for children are malnutrition, acute respiratory and infectious diseases, gastrointestinal diseases and congenital anomalies. While adults are dying from tuberculosis, heart disease, injuries, burns and digestive diseases. Even though Lesotho's climate and high altitude insulate it from many diseases, there is concern over the high incidence of pulmonary tuberculosis, sexually transmitted diseases (STD's) and respiratory infections. In 1980 1/3 of the population has access to hospital care. Maseru had 40% of the hospital beds, yet only 4.4% of the population. In 1982 there were 1536 health workers employed by the Ministry of Health, of these 41 were doctors, 175 nurses and 132 nursing assistants. Instead of building a new medical school, Lesotho accepted renovating the existing general hospital, converting it into a national referral center, while introducing more specialties at 20% of the $US60 estimated for a new medical school. Recommendations to the government also included: 1) special programs aimed at reducing and controlling tuberculosis and STD's; 2) establishing and strengthening primary health care programs; and 3) decreasing long hospital stays. (author's modified).
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PMID:Getting the best value for money in health care. 261 Aug 47

A case of necrotizing amebic pancolitis in a 6-year-old boy with asplenia, partial situs inversus, and cyanotic congenital heart disease is reported and the literature is reviewed briefly. Our patient was managed successfully by prompt colectomy, ileostomy, a Stamm gastrostomy, and extensive drainage of the peritoneal cavity with administration of metronidazole postoperatively and prolonged jugular vein Broviac catheter hyperalimentation. This child may be the first survivor of total colonic amebic necrosis in childhood. Necrotizing amebic colitis appears to be more hazardous in infancy and childhood than in adult years. Malnutrition and additional illnesses and malformations may produce greater immunocompromise in the very young, placing them at greater risk for the ultimate of amebic intestinal complications, total colonic necrosis and disintegration.
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PMID:Colectomy for necrotizing amebic pancolitis in early childhood with survival. 268 61

Diagnosis of significant disease is a major stressor that may interfere with a patient's quality of life. This case study reports the nursing care of a 29-year-old female marathon runner diagnosed with congenital heart disease. The nursing diagnoses, Alteration in Family Process, Disturbance in Self-Esteem, and Knowledge Deficit are addressed in care plan format.
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PMID:Congenital heart diseases in adults. Nursing grand rounds. 291 97

In this Fourth Ruth Langton Memorial Lecture, the author highlights some of the major health problems in children, mentally and physically handicapped people, and in the growing numbers of elderly people in society. Nurses' roles are discussed. He identifies many major areas of concern and points out that many of the afflictions affecting people throughout the world, such as infectious diseases, blindness and malnutrition, could so easily be prevented. The author also focuses on the diseases caused by unhealthy lifestyles, in particular heart disease, cancers, drug addiction and obesity. He argues that a redirection of resources spent on arms and defense could do much to alleviate disease and suffering throughout the world. He also questions the present effectiveness of nursing education programmes and community care programmes. The paper concludes with a challenge to all nurses to explode the myth that society is becoming healthier, to face the reality of the urgent need for more primary health care and health education programmes, and to heal the dichotomy between present nursing and health care provision and the actual health needs of society.
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PMID:Nursing and health care in the twentieth century: myth, reality and dichotomy. 294 Feb 78

Twelve of 13 patients with congenital heart disease given continuous enteral nutrition displayed normal growth; cardiac function remained stable or improved in 10 in spite of the water load (146 +/- 22 ml/kg/day). This is safe treatment for malnutrition in congenital heart disease.
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PMID:Nutritional treatment of congenital heart disease. 309 Sep 48

Peripartum heart disease is reviewed in the light of reports in the literature and personal experience from the University College Hospital, Ibadan. It is concluded that it is worldwide in distribution but appears most commonly in multiparous black women with a low socioeconomic background. The clinical features are the same as those of dilated cardiomyopathy, with the exception of cases from Zaria, northern Nigeria, where heart failure may be induced by high salt and fluid intake. The possible causes of peripartum heart disease are reviewed. Glomerulonephritis, toxemia of pregnancy, and malnutrition have not been shown convincingly to be causal, and infection, hypertension, and alcoholism have been suggested. Hypertensive heart failure and toxemia of pregnancy can induce peripartum heart disease. It is concluded that the myocardial disorder in peripartum heart disease is probably the same condition as dilated cardiomyopathy, and that infection may be an important element. However, diverse other factors may also play a part.
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PMID:Peripartum heart disease. 384 85

Since many patients with cardiomyopathy have a history of chronic ethanolism often associated with malnutrition, we have evaluated left ventricular (LV) function in alcoholics with fatty liver, who had no clinical evidence of cardiac or nutritional disease. During an afterload test of LV function the pressor response to angiotensin evoked a threefold rise of enddiastolic pressure in the alcoholic group which was substantially greater than the 4 mm Hg rise in control subjects. The stroke volume and stroke work response in the noncardiac alcoholic was significantly less than in controls. Diminished LV function was corroborated in the noncardiac alcoholic at rest, using a contractility index. To evaluate the dose-response relationship of ethanol in the production of cardiac malfunction, two groups of noncardiac alcoholic subjects were studied acutely at low and moderate dose levels. After 6 oz, ventricular function, myocardial blood flow, and metabolism were not significantly affected. After 12 oz, there was a progressive rise of end-diastolic pressure and decrease of stroke output at a mean blood alcohol level of 150 mg/100 ml, reverting toward control by 4 hr. The coronary effluent transiently evidenced leakage of cell constituents, despite an increase of coronary blood flow, suggesting a direct but reversible cardiac injury. Myocardial extraction of triglyceride was enhanced, whereas FFA uptake was reduced. A possible role of myocardial triglyceride accumulation in heart muscle was considered in pathogenesis. Chronic ingestion of 16 oz of Scotch daily by an alcoholic subject while on a normal diet produced, after 12 wk, a progressive increase of heart rate and size, circulation time, and venous pressure, and a ventricular diastolic gallop. Normal values were restored within 7 wk after interrupting alcohol. These several studies suggest that the cumulative effects of repeated ingestion of ethanol in intoxicating doses can produce diminished LV function before clinical evidence of cardiac abnormality, or heart disease not necessarily related to malnutrition.
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PMID:Ventricular function in noncardiacs with alcoholic fatty liver: role of ethanol in the production of cardiomyopathy. 430 60

Familial hypercholesterolaemia (FH) is a dominantly inherited error of metabolism characterised by a raised plasma low-density lipoprotein (LDL) concentration, xanthomas of skin and tendons, and a tendency to premature heart disease due to atherosclerosis of the coronary arteries. The clinical and biochemical abnormalities are more marked in homozygotes than in heterozygotes. Other biochemical changes include an increased concentration of very-low-density lipoprotein (VLDL) remnants and of a minor subfraction of high-density lipoproteins. Measurement of plasma lipoprotein turnover shows reduced fractional rates of catabolism of LDL and VLDL remnants, and increased production of LDL. Similar abnormalities are found in Watanabe rabbits, an inbred strain carrying a mutation similar to that responsible for FH. Cultured cells from human and animal tissues express surface receptors with high binding affinity for LDL. Binding of LDL to LDL receptors is followed by endocytosis and lysosomal digestion of the lipoprotein. Cultured cells from FH heterozygotes express only half the normal number of LDL receptors; those from homozygotes have little or no receptor activity and are therefore unable to degrade significant amounts of LDL by the LDL-receptor pathway. The LDL receptor has been isolated from cell membranes; it has a molecular weight of about 160 kd. Several different mutant forms of the receptor have been identified in the cells of FH homozygotes. The LDL-receptor pathway for the catabolism of LDL accounts for at least 1/3 of the total LDL catabolised by normal human subjects in vivo and almost none of that catabolised by FH homozygotes. Deficiency of LDL receptors accounts for the increased plasma concentrations of LDL and VLDL remnants in FH. The increased plasma concentration in these lipoproteins is the cause of deposition of lipid in xanthomas and arterial wall, but the mechanism by which lipoprotein enters the cells in which lipid accumulates is not yet understood.
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PMID:The metabolic basis of familial hypercholesterolemia. 630 34

Many patients with end-stage renal disease have now been maintained for 5 years or more with continuous ambulatory peritoneal dialysis (CAPD). Viewed initially as an experimental alternative to be used only when hemodialysis was not feasible, CAPD is now seen as the treatment of choice in an increasing number of situations. CAPD is suitable for self-care. The main concern in the early years--peritonitis--is now less frightening and less frequent (one episode occurring every 18 patient-months as compared with every 8 initially), and this has allowed chronic complications of CAPD, such as malnutrition and loss of the peritoneum's capacity for ultrafiltration, to come to light. As would be expected, among patients of advanced age and those who have heart disease or diabetes, survival rates tend to be lower than among other CAPD patients. However, hypertension seems to be more easily controlled, pre-existing anemia can be significantly ameliorated, and young children grow more normally than they do with hemodialysis. Diabetes-related changes in vision stabilize in most CAPD patients, and control of the blood glucose level is good; insulin is administered intraperitoneally. CAPD is thus showing itself to be a feasible form of long-term treatment for end-stage renal disease.
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PMID:Continuous ambulatory peritoneal dialysis: no longer experimental. 669 77


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