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

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

Paediatric cardiology is a dynamic field of progress for results. Those which have marked the year 1999 include the introduction of new techniques of cardiovascular imaging and interventional cardiology, and the new consequences of collaboration with workers in foetal cardiology and medical and molecular genetics. The advances in imaging are the result of those of microprocessors which enable three-dimensional reconstruction of ultrasonic, radiological or magnetic resonance images. This provides intracardiac or intravascular views which are very similar to those seen by the surgeon. This is a major tool for improving the diagnosis and treatment of congenital heart disease. Similarly, the introduction of programmes of tissue recognition enables fine ultrasonic analysis of the vascular wall and of endothelial function leading to the opening of a new chapter of preventive vascular medicine from the earliest age. Paediatric interventional cardiology has also progressed rapidly and the past year has been that of a consensus on the closure of a great number of atrial septal defects by new prostheses implanted and anchored in a simpler and safer manner. Prenatal diagnosis has become a crucial factor in the treatment and prognosis of congenital heart disease which is life-threatening in the first hours of life, explaining the benefit when this is applied to transposition of the great vessels or to coarctation of the aorta. Finally, advances in genetics have led to the identification of several genes of heart malformations and the correlations between interstitial microdeletions and syndromes often associated with heart disease: chromosome 22q11 and the Di George syndrome, chromosome 7q and the Williams syndrome. They have even allowed linking of myocardial and cerebellar abnormalities of a degenerative neuropathy (Friedreich's disease) to an abnormality of the mitochondrial respiratory chain, thus giving the opportunity of a real treatment.
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PMID:[The best of pediatric cardiology in 1999]. 1072 49

Loss of normal autonomic nervous system control of heart rate and rhythm is an important risk factor for adverse cardiovascular events. After myocardial infarction, reduction in beat-to-beat heart rate variability, a measure of cardiac autonomic innervation by the brain, is a strong predictor of death. With loss of vagal innervation, as is noted in patients with severe neuropathy and in heart transplant recipients, there is loss of heart rate variability. It is speculated that decreased parasympathetic innervation exposes the heart to unopposed stimulation by sympathetic nerves. Individuals with high hostility scores and patients with anxiety or depressive disorders have low heart rate variability and may be at increased risk for cardiovascular death associated with coronary heart disease and arrhythmias. After myocardial infarction, depressed patients exhibit higher mortality rates compared with nondepressed patients. Men with "phobic anxiety," a construct that appears to overlap substantially with panic disorder, also have higher rates of sudden cardiac death and coronary artery disease than control populations. The reduction in autonomic nervous system control to the heart may be one link between psychopathology and heart disease. Although tricyclic antidepressants reduce heart rate variability, at least one study has suggested that, in patients with panic disorder, treatment with the selective serotonin reuptake inhibitor paroxetine normalizes heart rate variability. Hence there is potential for the treatment of psychiatric disorders to affect positively the development and course of cardiovascular disease.
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PMID:Heart rate variability in depressive and anxiety disorders. 1101 52

Economic considerations in treating patients with type 2 diabetes mellitus are reviewed. Glycemic control, lipid profiles, and adherence to standards of care are less than optimal in many patients with type 2 diabetes mellitus. Diabetes has an enormous economic impact, and its related costs in the United States are expected to increase as the frequency of the disease increases. A substantial portion of diabetes-related health care expenditures is allotted to the treatment of cardiovascular disease, a major complication of diabetes. Significant health care resources are spent in a reactive manner (i.e., after complications have developed), with little emphasis on preventive care. One large study conducted in the United Kingdom demonstrated that providing intensive blood glucose control significantly reduced the risk of microvascular complications, such as retinopathy, nephropathy, and neuropathy, in patients with type 2 diabetes mellitus. Factors to consider in selecting pharmacotherapy for these patients include the magnitude of change in measures of glycemic control provided by the medication, other desired metabolic changes and outcomes (e.g., blood pressure and lipid changes), mechanism of action, adverse effects, contraindications, patient adherence, and cost. Early interventions, such as annual urinalysis and screening for microalbuminemia, annual comprehensive eye examination by an ophthalmologist or optometrist, and screening for neuropathy and foot problems are cost-effective ways of reducing diabetes-related complications. Interventions recommended for reducing the risk for cardiovascular complications in patients with type 2 diabetes mellitus include lipid control, blood pressure control, aspirin therapy, smoking cessation, and weight loss. Achieving and maintaining glycemic control in patients with type 2 diabetes mellitus improves quality of life and is cost-effective, especially among patients with comorbid heart disease, hypertension, or both.
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PMID:Economic considerations in treating patients with type 2 diabetes mellitus. 1248 82

Familial amyloidotic polyneuropathy (FAP) is an autosomal dominant disorder caused by mutation in the transthyretin gene. The most common mutation is substitution of valine for methionine at position 30 (MET30). Liver transplantation (LT) is the preferred treatment. After LT, although many patients show stabilization or improvement in the disease, adverse outcomes have been reported in those who have malnutrition, long-standing disease, and non-MET (NMET) mutations at position 30. Our aim is to compare survival and outcome of symptoms associated with FAP after LT in patients with MET30 and NMET30 mutations. Medical records of all patients who underwent LT for amyloidosis at our institution were reviewed to obtain demographic information and clinical features, such as severity of neuropathy, diarrhea, orthostatic hypotension, and posterior wall or ventricle septal thickness before and after LT. Fifteen patients underwent LT for amyloidosis at our institution between 1990 and 2000 (MET30, n = 5; NMET30, n = 7; hereditary amyloidosis, n = 2; primary amyloidosis, AL type, n = 1). Patients with hereditary and primary amyloidosis were excluded from analysis. One- and 3-year survival rates after LT in MET30 patients were 100%. Before LT, five of five patients had sensorimotor neuropathy; five of five patients had diarrhea, and four of five patients had orthostatic hypotension. After LT, improvement or stabilization of neuropathy was seen in two of five patients; of diarrheal symptoms, in three of five patients; and of orthostatic hypotension, in three of four patients. One- and 3-year survival rates after LT in NMET30 patients were 100% and 85.7%, respectively. Before LT, six of seven patients had sensorimotor neuropathy, six of seven patients had diarrhea, and five of seven patients had orthostatic hypotension. After LT in this group, improvement or stabilization of neuropathy was seen in two of six patients; of diarrhea, in six of six patients; and of orthostatic hypotension, in five of five patients. Before LT, posterior wall and/or ventricle septal thickness was increased in two of five MET patients and seven of seven NMET patients. Five of seven NMET30 patients (71.4%) who received a combined liver and heart transplant had stabilization, and two patients in the NMET group and one patient in the MET group had progression of heart disease. Outcomes for LT for patients with FAP with MET or NMET mutations were similar. Earlier LT for patients with FAP with MET30 or NMET30 mutation would improve outcomes after LT.
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PMID:Outcome of liver transplantation for familial amyloidotic polyneuropathy. 1462 27

Diabetes mellitus is one of the most widespread metabolic diseases in Western industrial countries with increasing prevalence due to a progressively aging population that is also characterized by increasing obesity and a sedentary life style. Cardiovascular conditions are the major prognostic complications of diabetes. Cardiologically, diabetic cardiopathy may become manifest on different structural and functional levels of the heart. Disorders may involve the micro- and macrocirculation (angiopathy), ventricular function (cardiomyopathy) and the intracardial nervous system (autonomous neuropathy). The following survey summarizes the cardiovascular risk with particular attention to the pathogenesis, diagnostics and therapy of diabetes mellitus related coronary disease and diabetic cardiomyopathy.
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PMID:[Diabetic cardiopathy: pathogenesis, diagnosis and therapy]. 1463 77

Anaemia is a frequent complication of diabetic nephropathy. It has only recently been recognised that in diabetic patients anaemia is seen not only in preterminal renal failure, but also frequently in patients with only minor derangement of renal function. At any level of glomerular filtration rate (GFR) anaemia is more frequent and severe in diabetic compared to nondiabetic patients. A major cause of anaemia is an inappropriate response of erythropoietin to anaemia. Additional factors are iron deficiency and iatrogenic factors, e.g. ACE inhibitor treatment. When serum creatinine is still normal, the erythropoietin concentration is predictive of more rapid loss of glomerular function. When serum creatinine is elevated, the haemoglobin values are predictive of the rate of progression. It is currently under investigation whether reversal of anaemia attenuates the rate of progression. Because most of the late complications of diabetes (retinopathy, neuropathy, heart disease, peripheral arterial disease) involve ischaemic tissue damage, it would be intuitively plausible that treatment with human recombinant erythropoietin should be beneficial, but definite evidence for this hypothesis is currently not available.
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PMID:Diabetic nephropathy and anaemia. 1628 61

Anderson-Fabry disease is an X-linked disorder that is caused by deficiency of the lysosomal enzyme alpha-galactosidase A. Symptoms include chronic progressive painful small-fibre neuropathy, cornea verticillata, renal failure and heart disease. Interestingly, female heterozygous patients may also show severe symptoms. After clinical suspicion, usually the determination of alpha-galactosidase activity in leukocytes is requested first. Alternatively, an enzymatic assay using dried blood specimens has been described. Dried blood samples require less material and are substantially more stable (several months at room temperature) than whole-blood specimens. To validate the new method and to asses its usefulness for diagnosis of female patients, enzyme activities of alpha-galactosidase, beta-galactosidase and beta-glucuronidase from 78 known Fabry patients were compared (29 males, 47 females) between both materials. In summary, the determination of alpha-galactosidase activity using dried blood and leukocytes as well as the ratio of alpha-galactosidase to beta-glucuronidase in dried blood can improve the diagnostic specificity in cases of female patients who are difficult to identify when only leukocyte enzyme activities are considered.
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PMID:Direct comparison of enzyme measurements from dried blood and leukocytes from male and female Fabry disease patients. 1769 54

In the last years the occurrence of type 2 diabetes mellitus has rapidly increased. The presence of cardiovascular complications, retinopathy, nephropathy and neuropathy are the results of delayed diagnosis. In the year 2004, in the Internal Diseases Depertment in Dabrowa Tarnowska, type 2 diabetes mellitus was diagnosed for the first time in 62 patients. In this group the majority of patient suffered from I-III degree hypertension, 27% had ishaemic heart disease, and 11% were hospitalized because of heart infarction. Heart failure was present in 20% and paroxysmal atrial fibrillation in 21% of them. The other diabetic complications diagnosed in this group were: microalbuminuria (43%), proteinuria (27%), simple retinopathy (64%), proliferative retinopathy (21%), and peripheral neuropathy in 40 of patients.
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PMID:[Organ complications in patients with diabetes mellitus type 2 diagnosed during hospitalization due to other diseases in the year 2004]. 1778 45

Amiodarone is recommended for the cardioversion of atrial fibrillation and prevention of paroxysmal atrial fibrillation in patients with structural heart disease, coronary artery disease or left ventricular dysfunction. It has well-recognised side-effects on the skin, lungs, liver, thyroid and eyes. Neurological side-effects, including ataxia and neuropathy, also occur, and may be more prevalent in older patients. These side-effects are reversible after cessation of amiodarone. Monitoring of amiodarone therapy should include assessment of the central and peripheral nervous system especially in older patients.
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PMID:Ataxia caused by amiodarone in older people. 1838 85


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