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

Some new predictors of postoperative psychosis in open-heart surgery have been identified in a multifactorial study of somatic and psychological factors: Somatic predictors are lower body weight, higher blood levels of urea nitrogen and creatinine, preoperative use of tranquilizers, especially in patients with double valve replacement or congenital heart disease and preoperative cerebral embolism in mitral valve disease. Bypass-time has not proved to be a valid predictor. Psychological predictors are distress provoked by severity and duration of illness, repeated delay of surgery as well as the manner of psychological coping with the illness.
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PMID:[Some somatic and psychological predictors of psychopathological disorders after cardiac surgery (author's transl)]. 108 27

Twenty outbreaks of Phalaris aquatica "sudden death" syndrome in sheep were investigated between 1981 and 1991. Four were confirmed and one was suspected, to be a cardiac disorder; 5 were confirmed and 3 were suspected, to be a polioencephalomalacic disorder; the aetiology of the remaining 7 outbreaks could not be determined. Potentially toxic levels of hydrocyanic acid (20 to 36 mg/100 g) were measured in the 3 toxic phalaris pastures tested. The measurement of potentially toxic levels of nitrate nitrogen (2920 micrograms/g) in toxic phalaris pastures by others, was noted. It is suggested that phalaris "sudden death" syndrome could have as many as 4 different underlying mechanisms, and that these might reflect the presence in the plant of a cardio-respiratory toxin, a thiaminase and amine co-substate, cyanogenic compounds, and nitrate compounds.
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PMID:Mechanisms underlying Phalaris aquatica "sudden death" syndrome in sheep. 144 81

Respiratory infections result from complex interactions between the infectious organism and the host, and exposure to environmental pollutants may alter host resistance. The atmospheric pollutants implicated in respiratory infections include acidic aerosols, particles, nitrogen dioxide, ozone, sulfur dioxide, and household allergens. An extensive epidemiological literature has been established linking environmental tobacco smoke to increased occurrence of lower respiratory tract infections in children; exposure to smoke from cooking and heating fires may also increase the risk of serious infections. Experimental evidence suggests that exposure to nitrogen dioxide and acidic aerosols may impair specific host defense mechanisms. Individuals with underlying lung or heart disease, as well as infants and the elderly, are among those most susceptible to the effects of environmental pollutants. Efforts should be directed toward reducing the exposure of children to environmental tobacco smoke and products of unvented combustion while investigations continue.
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PMID:Environmental factors and atmospheric pollutants. 180 97

The long-term results of pediatric heart transplantation were evaluated in 53 patients, aged 0.25 to 18.94 years, who received transplants at Stanford University Medical Center between 1974 and 1989. Indications for transplantation were idiopathic cardiomyopathy (68%), congenital heart disease (21%), endocardial fibroelastosis (8%), and doxorubicin cardiomyopathy (3%). Immunosuppression was achieved with combinations of cyclosporine, prednisone, and azathioprine. Thirty-seven of 42 recipients leaving the hospital after transplantation were alive and in New York Heart Association class I at study's end. Cumulative survival was 79% at 1 year, 76% at 3 years, and 69% at 5 years. Fourteen recipients have survived more than 5 years (5.1 to 12.4 years). Hospital readmission for illness has been infrequent, decreasing from 6.8 days to 0.9 days per year over 5 years. Eleven patients have required no rehospitalization. Posttransplant deaths were due to infection (19%), rejection (4%), pulmonary hypertension (4%), coronary artery disease (2%), and lymphoproliferative disease (2%). Retransplantation was required for intractable rejection in 4 patients and advanced coronary artery disease in 2. Hypertension and elevated blood urea nitrogen and creatinine levels were common in individuals receiving cyclosporine. Growth was often impaired in prepubertal children receiving daily prednisone. Based on this 15-year experience, it is concluded that heart transplantation represents a reasonable alternative for selected young patients with end-stage cardiac disease.
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PMID:Pediatric heart transplantation at Stanford: results of a 15-year experience. 186 16

To find reliable indicators of digoxin clearance (CLdig) in the neonatal period, we investigated the linear correlation of CLdig and the reciprocal of CLdig (1/CLdig) with serum beta 2-microglobulin (S beta 2-MG), serum creatinine, blood urea nitrogen, age, and weight on 25 occasions in 21 neonates with congenital heart disease. The S beta 2-MG value showed a significantly closer correlation to 1/CLdig (r = 0.84, p less than 0.0001) than to the other values. The regression equation was (1/CLdig) = 0.15 X (s beta 2-MG) + 0.08. Creatinine and blood urea nitrogen values correlated less closely with 1/CLdig (r = 0.67 and 0.71, respectively). Age and weight had no significant linear correlation with CLdig and 1/CLdig. Determination of s beta 2-MG values allowed an estimate of CLdig by means of the regression equation between s beta 2-MG and 1/CLdig, and permitted a prediction of the required maintenance dose of digoxin. We conclude that s beta 2-MG is a good indicator of CLdig in neonates, and that the determination of s beta 2-MG values may facilitate the advance individualization of digoxin therapy in the neonatal period.
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PMID:Digoxin clearance and serum beta-2-microglobulin in neonates. 267 32

Although prostaglandin E1 is used to dilate the constricted ductus arteriosus in infants with cyanotic heart disease, the mechanism is unknown. To test the hypothesis that the cyclic nucleotides adenosine 3',5'-monophosphate (cAMP) and guanosine 3',5'-monophosphate (cGMP) play a role in relaxation, isolated rings of the ductus arteriosus of fetal lambs were studied. Tension of isometric contraction was measured by force displacement transducers. After contraction with oxygen, a control group was compared with rings in which the stimulus for relaxation was either nitrogen gas, prostaglandin E1 (PGE1), nitroglycerin (NTG), or nitroprusside (NPS). During relaxation, tissue was frozen at 30 seconds and at 1, 2, and 5 minutes and analyzed for cAMP and cGMP. PGE1 (10(-6) mol/L) decreased tension by 33% compared with 70% for nitrogen gas, 81% for NTG (10(-5) mol/L), and 92% for NPS (10(-5) mol/L). The maximal relaxation induced by PGE1 was associated with an 11-fold increase in cAMP; PGE1 had no significant effect on cGMP tissue levels. Nitrogen gas, NTG, and NPS produced similar increases in cAMP, and eight-, 25-, and nine-fold increases in cGMP, respectively. These results suggest that the patency of the ductus arteriosus is dependent on activation of both guanylate cyclase and adenylate cyclase and that the nitrovasodilators may be clinically useful in maintaining patency of the ductus arteriosus.
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PMID:Role of cyclic nucleotides in relaxation of fetal lamb ductus arteriosus. 303 77

Nutritional modulation is one approach to successful aging. In animals, dietary restriction increases life span. Alterations in the macronutrient and micronutrient constituent of the diet can modulate gene expression. Anorexia is common in elderly persons. The results of studies in animals suggest that aging is associated with a decrease in the opioid feeding drive and an increase in the satiating effect of cholecystokinin. Unrecognized depression is a common, treatable cause of anorexia and weight loss in elderly persons. Protein synthesis decreases in elderly persons; nevertheless, nitrogen balance can be maintained in patients with fairly low intakes of protein. Carbohydrate intolerance is common and may be modulated by nutritional intervention and physical activity. The role of cholesterol in the development of heart disease in very old persons is controversial. Homebound and institutionalized elderly persons often do not expose their skin to sunlight; because the skin of older persons has a decreased ability to form vitamin D, the vitamin D status in these persons is precarious and they are at risk for osteopenia. Vitamins are often abused by elderly persons. Drug administration alters the vitamin requirements of persons. Borderline zinc state has been associated with deteriorating immune function, especially in persons who have diabetes mellitus or who abuse alcohol. Zinc administration appears to protect against the deteriorating vision associated with age-related macular degeneration. Selenium deficiency seems to be associated with an increased prevalence of cancer.
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PMID:Nutrition in the elderly. 305 65

Some cardiovascular (heart rate and mean arterial pressure), and renal (glomerular filtration rate-GFR; renal plasma flow-RPF; filtration fraction-FF; blood urea nitrogen-BUN and albuminuria) parameters, coupled with morphologic examination, was undertaken in early (2 months) and late (6 months) stage of streptozotocin-induced diabetes mellitus in rats. The results showed a temporally (early) bradycardia and gradually increase of blood pressure with morphologic changes typical for diabetic cardiopathy. The increased GFR (by 92%), associated with significantly decreased RPF (by 37%), increased FF (by 133%), increased kidney weight/body weight ratio (by 88%), increased BUN (by 52%) and distinct albuminuria (13.53 +/- 2.08 mg/24 h/100 g b. w.), together with typical morphologic changes, suggested the development of diabetic nephropathy which was progressive with the duration of the disease.
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PMID:Pathogenesis of cardiovascular disorders in streptozotocin-induced diabetes in rat. I. Cardiovascular, renal and morphologic changes in different stages of diabetes. 306 11

In certain forms of congenital heart disease, patency of the ductus arteriosus is critical for survival. Since the administration of prostaglandin is associated with adverse side effects, this study was undertaken to evaluate the effects of nitroglycerin and nitroprusside on ductal blood flow during oxygen-induced ductal closure. Fifteen near-term fetal lambs were instrumented acutely. Ductal blood flow and pre- and post-ductal pressures were monitored continuously. After obtaining control data, intravenous bolus injections of nitroglycerin (250 micrograms), nitroprusside (250 micrograms), or prostaglandin E1 (5 micrograms) were administered during ventilation with either 100% nitrogen or 100% oxygen. All three agents significantly increased ductal blood flow during nitrogen ventilation (PO2 = 15 +/- 1 mm Hg). When the lambs were ventilated with 100% oxygen, the arterial PO2 increased to 107 +/- 14 mm Hg, and this was associated with a marked decrease in ductal blood flow from 275 +/- 44 to 83 +/- 11 ml/min (P less than 0.05). When nitroglycerin was administered during oxygen-stimulated ductal closure, ductal blood flow increased 184%, from 79 +/- 18 to 225 +/- 18 ml/min (P less than 0.05); nitroprusside increased ductal blood flow 126%, from 86 +/- 20 to 195 +/- 25 ml/min (P less than 0.05); prostaglandin E1 increased ductal blood flow 110%, from 84 +/- 18 to 178 +/- 17 ml/min (P less than 0.05). These data demonstrate that both nitroglycerin and nitroprusside are potent vasodilators of the ductus arteriosus and, like prostaglandin E1, can markedly attenuate the oxygen-induced ductal vasoconstriction. These results imply that nitroglycerin and nitroprusside may be useful clinically in maintaining ductal patency.
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PMID:Response of lamb ductus arteriosus to nitroglycerin and nitroprusside. 312 17

The hemodynamic response to 50% nitrous oxide was studied in 12 sedated but responsive infants in the intensive care unit following repair of their congenital heart disease. One-half of the infants studied had an elevated pulmonary vascular resistance index (PVRI greater than 3.5 Wood units). During mechanical ventilation with a fractional inspired O2 concentration (FIO2) of 0.5, hemodynamic parameters were measured after equilibration with 50% nitrogen and then after 50% nitrous oxide. The sequence was repeated once to assure reproducibility of the responses. Average heart rate decreased by 9%, mean arterial blood pressure decreased by 12%, and cardiac index decreased by 13% in both the elevated and normal PVRI groups each time nitrous oxide was given. Although statistically significant, these changes would not generally be clinically important except in infants with severely compromised cardiovascular reserve. In contrast, pulmonary artery pressure and PVRI were not significantly changed by administration of 50% nitrous oxide in either the group with normal PVRI or the group with preexisting elevated PVRI. We conclude that while these mild depressant effects of nitrous oxide on systemic hemodynamics in infants are similar to those previously reported in adults, in infants nitrous oxide does not produce the elevations in pulmonary artery pressure and pulmonary vascular resistance seen in adults.
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PMID:Pulmonary and systemic hemodynamic effects of nitrous oxide in infants with normal and elevated pulmonary vascular resistance. 376 34


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