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)

This study explored perceptions toward physical activity and sport in the lives of youth with congenital heart disease. Thirteen cardiac participants were interviewed in the presence of their parents, and a process of inductive analysis was conducted. Sport was not considered a valued pursuit despite the belief that it is essential for the attainment of good health. Low-self efficacy and fatigue were influenced by covert fears and exclusion and further decreased the value ascribed to sport and physical activity. Nontraditional activities, support from others, and perceptions of mastery played a crucial role in enabling participation and facilitated the journey toward recovery. Findings are discussed within the context of self-efficacy theory and may inform the design of safe and enjoyable physical activity opportunities for this population.
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PMID:Physical activity and sport participation in youth with congenital heart disease: perceptions of children and parents. 1820 44

The results of many studies and recent meta-analyses strongly suggest that depression is a risk factor for total and cardiovascular mortality, both in the general population and in patients with known heart disease. By contrast, the association between depression and sudden death or cardiac arrest has received little attention. This issue has been investigated in three recent studies; two were carried out in the general population and showed depression to be a independent risk factor for sudden death. The other study was carried out in patients with acute myocardial infarction (AMI); the adjusted relative risk (RR) of sudden death was significantly increased in depressed patients but, after adjustment for dyspnea/fatigue (a common symptom for heart disease and depression), the RR was no longer statistically significant. However, when the cognitive-affective depressive symptoms were examined separately from the somatic ones (dyspnea/fatigue, etc.), there was a clear trend for an association between cognitive-affective symptoms and sudden death. Because a risk factor can be defined as 'independent' only in a multivariate analysis in which variables are dichotomized, the presence of common symptoms between heart disease and depression represents a very difficult problem. However, taken together, the results of studies carried out in the general population and in patients with AMI strongly suggest that depression is a significant risk factor for sudden death.
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PMID:Is there an association between depression and cardiovascular mortality or sudden death? 1833 89

Physical inactivity is a modifiable risk factor for heart disease. With heart disease as the leading cause of death in women, barriers to physical activity require exploration. Low-income women are the least likely to be physically active. The purpose of this study was to explore perceived barriers to physical activity in low-income women. Focus group methodology and content analysis were used to identify 16 perceived barriers in 14 participants of the study. The top barriers were: fatigue, culture, health problems, absence of child care, and lack of encouragement. These findings have implications for physical activity interventions with low-income women.
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PMID:Low-income women's perceived barriers to physical activity: focus group results. 1845 44

A large proportion of patients with congenital heart disease (CHD), in particular those with relevant systemic-to-pulmonary shunts, will develop pulmonary arterial hypertension (PAH) if left untreated. Persistent exposure of the pulmonary vasculature to increased blood flow, as well as increased pressure, may result in pulmonary obstructive arteriopathy, which leads to increased pulmonary vascular resistance that, if it approaches or exceeds systemic resistance, will result in shunt reversal. Eisenmenger's syndrome, the most advanced form of PAH associated with CHD, is defined as CHD with an initial large systemic-to-pulmonary shunt that induces severe pulmonary vascular disease and PAH, with resultant reversal of the shunt and central cyanosis. The histopathological and pathobiological changes seen in patients with PAH associated with congenital systemic-to-pulmonary shunts, such as endothelial dysfunction of the pulmonary vasculature, are considered similar to those observed in idiopathic or other associated forms of PAH. A pathological and pathophysiological classification of CHD with systemic-to-pulmonary shunt leading to PAH has been developed that includes specific characteristics, such as the type, dimensions and direction of the shunt, extracardiac abnormalities and repair status. A clinically oriented classification has also been proposed. The prevalence of PAH associated with congenital systemic-to-pulmonary shunts in Western countries has been estimated to range between 1.6 and 12.5 cases per million adults, with 25-50% of this population affected by Eisenmenger's syndrome. Clinically, Eisenmenger's syndrome presents with multiple organ involvement, with progressive deterioration of function over time. The signs and symptoms of Eisenmenger's syndrome in the advanced stages include central cyanosis, dyspnoea, fatigue, haemoptysis, syncope and right-sided heart failure. Survival of patients with Eisenmenger's syndrome is clearly less than that of the general population, but appears to be better than that of patients with idiopathic PAH in a comparable functional class. The treatment strategy for patients with PAH associated with congenital systemic-to-pulmonary shunts and, in particular, those with Eisenmenger's syndrome is based mainly on clinical experience rather than being evidence based. General measures include recommendations for physical activity, pregnancy, infections, air travel, exposure to high altitudes and elective surgery, and that psychological assistance be provided as necessary. Phlebotomies are required only when hyperviscosity of the blood is evident, usually when the haematocrit is >65%. The use of supplemental oxygen therapy is controversial and it should be used only in patients in whom it produces a consistent increase in arterial oxygen saturation. Oral anticoagulant treatment with warfarin can be initiated in patients with pulmonary artery thrombosis and absent, or only mild, haemoptysis. The following three classes of drugs targeting the correction of abnormalities in endothelial dysfunction have been approved recently for the treatment of PAH: (i) prostanoids; (ii) endothelin receptor antagonists; and (iii) phosphodiesterase-5 inhibitors. The efficacy and safety of these compounds have been confirmed in uncontrolled studies in patients with PAH associated with corrected and uncorrected congenital systemic-to-pulmonary shunts, as well as in patients with Eisenmenger's syndrome. One randomized controlled trial reported favourable short- and long-term outcomes of treatment with the orally active dual endothelin receptor antagonist bosentan in patients with Eisenmenger's syndrome. Lung transplantation with repair of the cardiac defect or combined heart-lung transplantation are options for Eisenmenger's syndrome patients with a poor prognosis. A treatment algorithm based on the one used in the treatment of PAH patients is proposed for patients with PAH associated with corrected and uncorrected congenital systemic-to-pulmonary shunts and Eisenmenger's syndrome.
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PMID:Management of pulmonary arterial hypertension associated with congenital systemic-to-pulmonary shunts and Eisenmenger's syndrome. 1848 98

Alfred Nobel never spoke publicly about his problems of ill health, but a detailed, subjective record has recently been published in the form of 216 letters written to his mistress during an 18-year period. His descriptions of constant pain, debilitating migraine, and "paralyzing" fatigue permit a hypothesis that he might have had a long struggle with fibromyalgia. This does not preclude his having suffered other illnesses as well. He thought he had heart disease, which his physicians denied until his final years, when he was diagnosed with angina pectoris. He died of a cerebral hemorrhage in 1896 at the age of 63. His letters describe a 30-year search for diagnosis from the best physicians in Europe. He was ridiculed by many people as a hypochondriac, and he never received a diagnosis for "the pain that will not go away." This may well have contributed to the bitterness and depression of his final years. Increasing worldwide interest and research in this elusive syndrome will hopefully prevent a repetition of the Nobel story of a century ago.
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PMID:Alfred nobel. 1907 79

A 53-year-old woman with severe erythrocytosis (hemoglobin concentration 19.5 g/dl and hematocrit 0.59) was admitted to our hospital because of fatigue and headache. The serum erythropoietin (Epo) concentration was 68.6 U/l (reference range; 3.7-31.5). Further investigations excluded polycythemia vera or any lung or heart disease. Radiological examination showed a tumor in the left hepatic lobe. Needle biopsies were performed and the histopathological diagnosis was hepatocellular adenoma. Immunohistochemistry demonstrated erythropoietin expression in the adenomatous cells. Liver adenoma is a rare cause of erythrocytosis. For the first time, we report erythropoietin-positive immunoreactivity in liver adenomatous cells in a patient with erythrocytosis.
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PMID:Erythropoietin production by a hepatic adenoma in a patient with severe erythrocytosis. 1933 71

Double outlet right ventricle (DORV) is a complex group of abnormal ventriculoarterial connections where both the aorta and pulmonary artery rise from the right ventricle morphologically. It is a rare condition affecting 1-1.5% of patients with congenital heart disease. The patient's cardiac measurements were taken by two-dimensional echocardiography. The pathological findings of the defined case are illustrated in the figures. A 20-year-old male patient with palpitations, tachypnea, and tiredness with weak exercise capacity and back pain was diagnosed with heart murmur in different degrees; slight cyanosis, cachexia, and developmental retardation were found clinically. Echocardiography showed: DORV, perimembranous ventricular septal defect, pulmonary stenosis, dilatated right ventricle, and dilatated left atrium. However, the left ventricle was normal. In addition, the septum interatriale filled the left atrium like an aneurysm. DORV is an important and rare congenital cardiac malformation. This complex condition may result in different clinical findings and require different therapeutic approaches.
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PMID:The double outlet right ventricle with additional cardiac malformations: an anatomic and echocardiographic study. 1944 98

Major industrialised countries, like the United States, Canada, Australia and countries of the European Union (EU) have Hours-of-Service (HoS) regulations for truck drivers that stipulate duration of continuous driving and rest periods. The purported aim is the improvement of road safety by reducing fatigue and drowsiness, but the regulations can also have a strong impact on the working conditions for drivers. Better working conditions for truck drivers is one of the aims of the EU HoS regulations, but they do not seem to fully produce the desired benefits. Truck drivers continue to have a high prevalence of back disorders, which have been linked with the time spent driving. They also have a high incidence of heart disease, which might be due to stress factors at work. Stress levels can be affected by HoS regulations, that leave the driver little job control and lead to social isolation. HoS regulations could contribute more to the improvement of working conditions of truck drivers through counteracting irregular work schedules, night driving and social isolation. Moving the focus from simple control of time spent driving or not driving to fatigue management could improve job control and working conditions for truck drivers without loss of traffic safety.
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PMID:Truck drivers hours-of-service regulations and occupational health. 1975 35

The disease management (DM) model for the treatment of chronic conditions has been around for many years and has been found to be effective for diseases of high prevalence and high cost (eg, diabetes, asthma, heart disease). With an increasing number of people living with cancer and the continual escalation of treatment costs, DM vendors have begun to implement DM concepts into cancer care. However, the multitude of cancer types, treatment options, and adverse effects have all presented barriers to oncology DM, and data reflecting the effectiveness of oncology DM have remained scarce. Oncology costs, the lack of congruence between provider and patient expectations of treatment, the lack of prevention and early detection for many cancers, and, most importantly, the inability of people to adhere to healthy lifestyles are additional obstacles that must be overcome. Moreover, when designing an oncology DM program, it is imperative to look at cancers individually as the etiology, treatment, and impact of cancer can be markedly different from one patient to the next. An effective oncology DM program is one that acts to decrease fatigue, reduces nosocomial infections, deals with dehydration and pain, manages anemia, identifies and treats skin infections, recognizes and treats depression and other psychological distress, provides patients access to palliative care services, facilitates informed decision making and end-of-life transitions, and promotes communication between patients and their providers as well as between physicians. Moving forward, DM vendors and health insurance companies capable of incorporating DM with medical management will be in the best position to provide optimal cancer care.
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PMID:Is disease management right for oncology? 2003 60

A lay-led, community-based intervention, the Chronic Disease Self-Management Course (CDSMC) is effective for a range of long-term health conditions (e.g. arthritis, heart disease). However, the perceived value and experience of the CDSMC for people with Multiple Sclerosis (MS) has not been examined. The present qualitative study addressed this omission. Ten participants with MS (7 female; age range 35 to 60 years; disease duration 4 to 19 years) were interviewed before attending the CDSMC and at 4-month follow-up. Data were analysed using Framework Analysis. Some participants learned new self-management techniques and reported enhanced confidence (self-efficacy), whereas other participants were already confident in their self-management ability and found the CDSMC acted as a reminder of techniques previously used. Relaxation, pacing, and goal setting were particularly valuable for managing fatigue. Goal setting helped some participants to build confidence. Participants valued meeting similar others including those with different conditions. The CDSMC was an opportunity for social comparison and inspirational role modelling. Improvements to the CDSMC were suggested, including the addition of specific MS information. Overall, the CDSMC was viewed as a valuable source of new skills and a reminder of previously learned self-management skills, particularly in the context of managing fatigue. Gender differences emerged.
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PMID:The experience of attending a lay-led, chronic disease self-management programme from the perspective of participants with multiple sclerosis. 2020 86


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