Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe a case of Hemophilus parainfluenzae endocarditis in a previously healthy 26-year-old man, and review 21 cases from the literature. Although H parainfluenzae is considered to be part of the normal flora of the upper respiratory tract in man, it can cause serious disease. H parainfluenzae endocarditis is often difficult to diagnose. The patients generally had a history of recent infection of the upper respiratory tract, but a majority denied previous heart disease. Upon entry to the hospital, after an average of seven weeks of febrile illness, nearly one third of patients were found not to have a heart murmur. Furthermore, the organism was often difficult to grow from blood cultures, a problem possibly related to the need for accessory growth factors. The mortality with modern therapy was 12%, and the major complication was cerebral embolus. Antibiotic therapy of choice is ampicillin, generally used together with an aminoglycoside, though ampicillin alone may be sufficient.
 ...
PMID:Hemophilus parainfluenzae endocarditis. 44 62

Haemophilus parainfluenzae endocarditis is characterized by great variation in the acuteness of presentation, difficulty in isolation of the pathogen, a 50% to 60% incidence of major arterial emboli, and variability of response to therapy. Prosthetic valve endocarditis (PVE) due to H parainfluenzae biotype II occurred in a 14-year-old girl with congenital heart disease and a Starr-Edwards mitral valve prosthesis. Management was complicated by a prolonged culture-negative period (eight days), intermittent bacteremia (only five of 15 positive blood cultures), an embolus to the right femoral artery, progressive congestive heart failure, and urgent prosthestic valve replacement. Cure was achieved with 44 days of ampicillin sodium-gentamicin sulfate therapy monitored by serum bactericidal titers.
 ...
PMID:Prosthetic valve endocarditis due to Haemophilus parainfluenzae biotype II. 44 17

This study evaluated the effect of hormonal exposure before or during pregnancy on the risk of congenital heart disease to the child and assessed the cardiovascular teratogenicity of other drugs taken during early pregnancy. A total of 390 cases was ascertained from all infants with congenital heart disease born to Massachusetts women during the period of 1973-1975. 1254 randomly selected births were controls. A history of oral contraceptive (OC) use, hormonal pregnancy tests, prescribed hormones, and other drugs was obtained from both cases and controls. The proportion of mothers reporting any drug use during pregnancy was 54% for cases and 41% for controls. Among those reporting drugs, the mean number of drugs reported was 1.9 for cases and 1.8 for controls. Estimates of effects of specific drugs are provided tabularly. There was a small positive association with cardiac malformation for each of 3 categories of hormonal exposure (hormones prescribed during pregnancy, hormonal pregnancy tests, and OC use after conception). Combining the 3 types, the overall estimate for the rate ratio was 1.5; the overall exposure was compatible with no effect, the 90% confidence limit for the prevalence ratio ranging from 1-2.1. No association was evident between hormones and trunco-conal or any other class of defect among the cases, an observation which casts doubt on a causal relationship between hormones and cardiovascular malformations. Among the other drugs examined, insulin had the highest prevalence rate. Several other drugs were reported more frequently by mothers of cases, including: ampicillin, aspirin, a combined antinausea agent, chlordiazopoxide, codeine, diazepam, diphenylhydantoin, phenobarbital, phenothiazine, phenylephrine, and tetracycline.
 ...
PMID:Exogenous hormones and other drug exposures of children with congenital heart disease. 44 41

The study was performed on 612 routine cultures of material obtained from root canals of teeth at the time of filling (r-cultures) by students at the Department of Endodontics during a continuous period of one year. Twenty-nine isolates from 27 (29.3%) of the 92 positive cultures filled the criteria of enterococci (Sherman, 1937) and had demonstrable group D-antigen. With a set of tests these isolates were identified as follows: Strep. faecalis subsp. faecalis (10), Strep. faecalis subsp. zymogenes (3), Strep. faecalis subsp. liquefaciens (8), atypical variants of Strep. faecalis (6), Strep. faecium var. faecium (1) and Strep. faecium var. durans (1). Five tests in the present study clearly differentiated Strep. faecalis from Strep. faecium i.e. fermentation of sorbitol, glycerol (anaerobic) and melezitose, tolerance to potassium tellurite (0.1%) (positive for Strep. faecalis) and production of hydrogen peroxide (positive for Strep. faecium). In the inocula 10(3) or more colony forming units of enterococci were found more often of other identified microorganisms. This means that enterococci are of special interest in studies on the influence of infection at the time of filling of root canals on the prognosis of root canal therapy. The isolates were also tested for susceptibility to azidocillin, ampicillin, penicillin-G, penicillin-V and erythromycin with the paper disc method. All the isolates were susceptible to azidocillin and ampicillin (sensitivity group I), while the majority of the isolates showed a lower susceptibility to the other three antibiotics (sensitivity group II). The significance of these findings in the choice of prophylactic antibiotic to prevent bacterial endocarditis in patients with a history of rheumatic or congenital heart disease are discussed, when bacteremia from dental procedures may be expected.
 ...
PMID:Streptococcus faecalis and Streptococcus faecium in infected dental root canals at filling and their susceptibility to azidocillin and some comparable antibiotics. 81 Jul 53

We have evaluated three patients with Haemophilus parainfluenzae endocarditis. Two of the three had underlying heart disease. All presented with fever, chills and malaise of less than two weeks' duration. Mitral valve involvement led to congestive heart failure in two of three cases. Treatment proved difficult, despite normally adequate dosages of antibiotics to which the pathogens were sensitive in vitro (ampicillin, 12-20 gm/dag; gentamicin, 3-5 mg/kg/day). Two patients were cured; one died. There was a suggestion of an inverse correlation between vegetation mass and favorable clinical response. Review of the English literature disclosed 22 documented cases of H parainfluenzae endocarditis, including 12 in the antibiotic era.
 ...
PMID:Bacterial endocarditis due to Haemophilus parainfluenzae. 83 83

Transient, usually asymptomatic bacteremia occurs in a wide variety of procedures and manipulations, particularly those associated with mucous membrane trauma. It may also occur with such daily functions as tooth brushing and bowel movements. These brief bacteremias are especially common in tooth extraction and other dental procedures. Although numerical risk is uncertain, these bacteremias can occasionally give rise to infective endocarditis in the susceptible patient. While no proof exists that antibiotics given prior to procedures causing bacteremia prevent endocarditis in humans, experimental evidence in rabbits supports their use. Therefore, in situations where bacteremia is highly predictable, it would seem wise to administer prophylactic antimicrobials. Procedures in the susceptible host where prophylactic antibiotics seem prudent include dental manipulations and urinary tract instrumentation. Whether patients with acquired valvular or congenital heart disease who are to undergo abdominal surgical procedures should routinely receive prophylactic antibiotics is unclear. However, until the incidence of transient bacteremia associated with various abdominal procedures is further defined, endocarditis-prone patients should probably receive prophylaxis. Furthermore, patients with prosthetic valves who are subjected to upper gastrointestinal endoscopy, sigmoidoscopy, liver biopsy, or barium enema should also probably have antibiotic pretreatment. For dental procedures and for upper gastrointestinal endoscopy in patients with prosthetic valves, a combination of penicillin and streptomycin or vancomycin alone is recommended. For urinary tract instrumentation in all patients and for sigmoidoscopy, liver biopsy, or barium enema in patients with prosthetic valves, prophylaxis should be with ampicillin and gentamicin or vancomycin and gentamicin.
 ...
PMID:Transient bacteremia and endocarditis prophylaxis. A review. 83 37

Seven young to middle-aged patients with Haemophilus parainfluenzae endocarditis are reported. Three patients had underlying heart disease and three patients had recent events predisposing for endocarditis. The clinical presentation was subacute or acute and new pathologic murmurs were uncommon. Diagnosis was prolonged because of difficulties in isolating the organism. Routine subculturing of blood cultures to chocolate agar with incubation in CO2 is recommended. A prominent complication, occurring in six patients, was major arterial occlusion secondary to emboli. Antibiotic control of infection was difficult and best achieved by the concomitant administration of ampicillin and gentamicin. Killing curves proved useful in assessing antibiotic efficacy. There were two medical failures and one death in the series. It appears H. parainfluenzae endocarditis is characterized by distinctive clinical features, difficult in vitro isolation of the organism, and the necessity for combination antibiotic therapy.
 ...
PMID:Haemophilus parainfluenzae infective endocarditis. 84 91

The data on 130 children with brain abscesses treated over 21 years (1970-1990) were analyzed retrospectively. The whole group included four infants. Chronic ear infection and cyanotic congenital heart disease were the most common predisposing factors. In infants, meningitis and/or ventriculitis were dominant in the etiopathogenesis. Cases were evaluated according to the treatment received and also according to time periods. More than half of the patients (n = 74) in this series were treated by primary or secondary excision. Computed tomography (CT) facilitated the diagnosis and helped the planning of treatment. Aspiration gained increasing credit after the advent of CT. Microorganisms could be identified in 54% of the cultured specimens. Staphylococci, streptococci and Proteus were the dominating microorganisms. Penicillin and chloramphenicol have long been the mainstay of antimicrobial therapy but have recently been replaced by third-generation cephalosporins and sulbactam-ampicillin combinations. Overall mortality was 15.5% but showed a decline from 30% in the pre-CT era to 6% in the last 5 years and to zero in the last three. Neither the location nor associated heart disease contributed to the mortality, but mortality among infants was as high as 50%.
 ...
PMID:Management of brain abscess in children: review of 130 cases over a period of 21 years. 145 99

Branhamella catarrhalis is an aerobic Gram-negative diplococcus. It has been traditionally regarded as an oropharyngeal commensal and until recently was only identified as a pathogen in cases of bronchopulmonary infections. The aim of this study was to analyse the characteristics of the respiratory infections caused by B. catarrhalis and to know the antibiotic susceptibility of this microorganism. We retrospectively studied 32 lower respiratory tract infections, caused by B. catarrhalis (20 cases of bronchial infection and 12 cases of pneumonia), diagnosed between 1988-1989 in our hospital. All patients had an underlying disease; chronic obstructive pulmonary disease (COPD) and chronic heart disease being the most frequent. The aetiological diagnostic procedures were: sputum culture in 28 cases (15 in pure culture and 13 mixed), protected specimen brush (PSB) in three cases and transthoracic needle aspiration (TNA) in one case. Twenty B. catarrhalis isolates were penicillin and ampicillin-resistant, 11 in the pneumonia group and 9 in the bronchial infection group. All isolates were sensitive to amoxycillin-clavulanic acid and second generation cephalosporin. In our group four patients died. We conclude that B. catarrhalis is a not infrequent cause of respiratory infection, particularly in COPD patients, and that the high incidence of antibiotic resistance to penicillin and ampicillin should be taken into account before considering an empirical antibiotic treatment.
 ...
PMID:Branhamella catarrhalis respiratory infections. 162 25

Thirty-two patients with native valve infective endocarditis who presented over a 10-year period at our hospital were analyzed retrospectively. The presenting symptom was a persistent fever in 22 patients. In 30 patients, the New York Heart Association functional class was less than II before the development of endocarditis. Blood cultures were positive on all occasions in 24 out of 29 culture-positive patients. All of the viridans streptococci, accounting for 79% of the isolated pathogens, were highly susceptible to ampicillin. Treatment consisted of a 6 week course of antibiotics, usually ampicillin, at a dose of 12 grams/day. In 9 cases, we had to change or stop the antibiotics because of severe side effects. The longer the period before making a diagnosis, the more severe were the symptoms of congestive heart failure and the more frequent was the incidence of cerebral hemorrhage. To initiate treatment as early as possible, in order to minimize valve destruction and to reduce the risk of cerebral hemorrhage, serial blood cultures are recommended in patients with valvular heart disease or congenital heart disease and a persistent fever, with minimal cardiac symptoms.
 ...
PMID:Native valve infective endocarditis in adults--analysis of 32 consecutive cases over a ten-year period from 1980 to 1989. 182 92


1 2 3 Next >>