Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

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

Left ventricular function indices were measured by pulsed Doppler-echocardiography in 17 young patients (mean age: 25 +/- 5) with insulin-dependent diabetes and 17 controls (identical mean age: 25 +/- 5) free of heart disease. All subjects had normal left ventricular systolic function. Twenty three per cent of diabetics showed a left ventricular filling anomaly on the basis of at least two abnormal indices. Isovolumic relaxation time was significantly prolonged in diabetics as compared with normal individuals (83 +/- 7 v. 68 +/- 9 ms, p < 0.00015). Half-pressure time was also prolonged in the patients (46 +/- 9 v. 38 +/- 6 ms, p < 0.01), the same applying to rapid filling deceleration time (158 +/- 32 v. 136 +/- 29 ms, p < 0.05). Peak rapid filling rate, the proportion of total filling accounted for by rapid filling, peak atrial systole velocity and the atrial contribution to total filling did not differ between the diabetics and controls. Systolic blood pressure was significantly higher in diabetics as compared with controls (124 +/- 8 v. 114 +/- 10 mmHg, p = 0.007), although remaining within normal limits. This would not, however, explain the differences seen between the 2 groups regarding left ventricular profile. The filling anomalies reported here were not correlated with the duration of diabetes nor with other parameters such as glycosylated hemoglobin or 24-hour microalbuminuria. Our results suggest that approximately 20 p. cent of young diabetics have sub-clinical left ventricular anomalies.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Left ventricular filling in young insulin-dependent diabetics]. 812 48

We retrospectively examined the medical and autopsy records of seven previously unpublished cases of fatal pneumococcal septicemia in children with hemoglobin SC disease. The earliest death occurred in a 1-year-old child who had congenital heart disease with cyanosis; the other children were aged 3 1/2 to 15 years. Only one child had received pneumococcal vaccine or prophylactic penicillin therapy. All seven children had an acute febrile illness and rapid clinical deterioration despite parenterally administered antibiotic therapy and intensive medical support. Erythrocyte pit counts in two patients were 40.3% and 41.7%, respectively (normal, < or = 3.6%). Autopsy data from five cases showed marked splenic congestion without infarction in five, splenomegaly in four, and bilateral adrenal hemorrhage in three. These cases illustrate that functional asplenia predisposes some children with hemoglobin SC disease to the development of fatal septicemia after the age of 3 years. We conclude that pneumococcal vaccine should be administered to all children with hemoglobin SC disease and that acute febrile illnesses should be investigated promptly for the possibility of septicemia. The routine use of prophylactic penicillin therapy in infants and children with hemoglobin SC disease remains controversial.
...
PMID:Fatal pneumococcal septicemia in hemoglobin SC disease. 820 67

In a series of 416 women with congenital heart disease seen in the Royal Brompton National Heart and Lung Hospital, London, and the Hospital Giovanni Bosco, Torino, Italy, there were 822 pregnancies. The outcomes of 96 pregnancies in 44 patients with cyanotic congenital heart disease were studied. Patients with the Eisenmenger reaction were excluded. Patients were divided arbitrarily into groups according to the type of maternal congenital cardiac anomaly, and factors influencing maternal and fetal outcome were evaluated. The incidence of maternal cardiovascular complications was high (32%), with one death from endocarditis 2 months after delivery. Forty-one (43%) of 96 pregnancies resulted in a live birth; 15 (37%) were premature. Mean weight of full-term infants was 2575 g. Univariate analysis suggested that maternal disease, Ability Index, hemoglobin, and arterial oxygen saturation before the pregnancy were factors that discriminated between successful and unsuccessful fetal outcome, with hemoglobin and arterial oxygen saturation being the most important predictors. Women with cyanotic congenital heart disease can go through pregnancy with a low risk to themselves, with frequent treatable complications, but there is a high incidence of miscarriage, premature births, and low birth weights. An incidence of congenital heart disease in the fetus of 4.9% (2 of 41 live births) is higher than that found in the normal population.
...
PMID:Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. 820 80

After separation of pediatric patients from cardiopulmonary bypass (CPB), the authors salvaged red blood cells (RBCs) from the extracorporeal circuit by ultrafiltration and reinfused them to the patients. The purposes of this study were to determine 1) the effects of infusion of hemoconcentrated RBCs on hemoglobin, plasma free hemoglobin, and activated clotting time, and 2) the incidence of perioperative homologous RBC transfusion. Data were collected prospectively from 200 consecutive infants and children undergoing CPB during correction of congenital heart defects. The patients' hemoglobin, plasma free hemoglobin, and activated clotting time were measured both before and after infusion of 10 mL/kg of hemoconcentrate. Guidelines for intraoperative and postoperative transfusion of homologous RBCs were followed, and such transfusions were recorded. Significant increases in hemoglobin concentrations occurred when the hemoconcentrate was infused, as did statistically significant, but clinically manageable, increases in plasma free hemoglobin and activated clotting time. Perioperative homologous RBC transfusion was performed in 67% of patients (56% received intraoperative transfusion). Intraoperative transfusion was more frequent in small infants who were more hemodiluted by the clear CPB priming solution. Postoperative transfusion was more frequent in patients who had operation for cyanotic heart disease. Hemoconcentration by ultrafiltration after CPB is an effective and safe means of salvaging RBCs and reducing homologous RBC transfusion.
...
PMID:Blood conservation during pediatric cardiac surgery: ultrafiltration of the extracorporeal circuit volume after cardiopulmonary bypass. 821 52

It is well known that the incidence of cardiac arrhythmia is particularly high in patients with chronic respiratory insufficiency (CRI). This study examines the prevalence, incidence and prognostic clinical importance of arrhythmia occurring during the course of CRI on the basis of data taken from the literature and the authors' personal experience using dynamic electrocardiographic diagnosis (24-hour Holter monitoring). The majority of arrhythmias observed in these patients appeared to take the form of premature ventricular and/or supraventricular beats and less frequently of atrial fibrillation and/or attacks of supraventricular paroxysmal tachycardia. Cardiac rhythm alterations were observed using Holter monitoring in 70-90% of patients. No cardiac rhythm disorder is specific to this pathological condition. The aim of this study was to formulate, as far as was possible, a rational therapeutic approach which took account of the electrogenesis of arrhythmic phenomena, variations in the type of arrhythmia and the hemodynamic conditions under which they occur. The etiopathogenesis of arrhythmias within the framework of CRI is relatively complex and probably multifactorial since there are a number of concomitant pathological conditions able to trigger off arrhythmogenic processes both inducing the onset of reflux circuits and enhancing cardiac automatism centres. Many studies correlate the presence of arrhythmia with hypoxemia, hypercapnia and both respiratory and metabolic alkalosis. Even the combined effect of hypoxia with respiratory acidosis and the integrity or otherwise of cardiac function (chronic pulmonary heart, right ventricular hypertrophy, ischemic cardiopathy) have a notable pro-arrhythmic effect. Hypokalemia induced by both respiratory alkalosis and by drugs used during the course of CRI (eg diuretics and/or steroids) may induce a marked dispersion of refractory periods of the various fibrocells thus encouraging the onset of arrhythmia. With regard to drugs, it has been observed that both digitalis and theophylline and beta-2 stimulants if frequently used during the course of CRI may possibly induce arrhythmia. It is therefore important to underline that they should be used with particular caution. As far as concerns the use of beta-2 adrenergic compounds, it is advised that they be administered using an aerosol rather than systemic route. Digitalis has limited indications; the molecules of the methylxanthine classes require careful pharmacological dose monitoring. Arrhythmic therapy should also be seen in terms of prophylaxis and the correction of predisposing and decisive factors such as hypoxemia, hypercapnia, hemoglobin and electrolyte levels, and alterations in blood pH following the obstruction of small airways.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:[Respiratory insufficiency and cardiac arrhythmia: the rationale of treatment]. 833 38

The present study was carried out in 33 cases of cyanotic congenital heart disease (CCHD) to determine the prevalence of iron deficiency anemia (IDA) and its correlation to hyperviscosity symptoms in terms of hematocrit levels. Furthermore, the study was aimed at assessing the response to low dose iron therapy (60 mg of elemental iron once daily) in relieving symptoms of hyperviscosity. All these cases were evaluated for presence of symptoms of hyperviscosity and later subjected to various hematological & biochemical parameters of iron deficiency anemia including hemoglobin (Hb), pack cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), serum iron, total iron binding capacity respectively. Results showed presence of IDA in 6/33 cases (18.2%) and hyperviscosity symptoms in 10/33 cases (30.3%). Amongst the group with symptoms of hyperviscosity, in the subset having IDA these symptoms were observed at PCV levels of 0.52 L/L to 0.58 L/L in contrast to the subset not deficient in iron where the symptoms occurred at a PCV 0.68 L/L. Relief of symptoms of hyperviscosity was evident with a minimal rise of mean hemoglobin by 2.1 gm/dl. It was concluded that IDA was not an uncommon finding in CCHD cases and that it leads to symptoms of hyperviscosity at a level of PCV much lower than those known to produce these symptoms. Finally low dose iron therapy was found effective in relieving the symptoms of hyperviscosity.
...
PMID:A clinico-hematological study of iron deficiency anemia and its correlation with hyperviscosity symptoms in cyanotic congenital heart disease. 836 42

A pulse oximeter sensor is used to monitor changes in arterial hemoglobin oxygen saturation (SpO2) in anesthetized pediatric patients. The authors compared the kinetics of desaturation and resaturation measured by sensors placed over central (tongue, cheek) and peripheral (finger, toe) vascular beds in children with congenital heart disease. Desaturation time was defined as the time which elapsed between the onset of apnea and a 4% decrease in SpO2 from baseline. The desaturation times averaged 24 +/- 12 s, 56 +/- 34 s, and 58 +/- 28 s for the cheek, finger, and toe, respectively (n = 40; P < 0.0001 for cheek versus finger or toe). Resaturation time was defined as the interval between the resumption of ventilation and a 4% increase in SpO2 above the nadir. Resaturation times averaged 12 +/- 8 s for the cheek, 40 +/- 36 s for the finger, and 47 +/- 25 s for the toe (n = 40; P < 0.0001 for cheek versus finger or toe). A comparison of the kinetics at two central sensor sites, cheek and tongue, respectively, revealed no significant differences in desaturation times (20 +/- 10 s vs 21 +/- 9 s) or resaturation times (10 +/- 6 s vs 7 +/- 3 s) (n = 13). The authors conclude that both desaturation and resaturation are detected earlier by centrally placed sensors.
...
PMID:Influence of sensor site location on pulse oximetry kinetics in children. 846 11

Of 320 children with cyanotic congenital heart malformations who had previously undergone cavopulmonary shunt operations, 11 had increasing cyanosis and exercise intolerance and were considered unsuitable for definitive repair, a Fontan procedure, or other palliation. Eight had a previous Glenn shunt and three had a previous bidirectional cavopulmonary connection. To augment pulmonary blood flow, 10 patients underwent creation of an ipsilateral axillary arteriovenous fistula. Mean oxygen saturations were 80% +/- 2% before operation, 85% +/- 2% immediately after operation, and 84% +/- 3% at a mean follow-up interval of 7.4 years (range 0.1 to 15.5 years). Mean hemoglobin values were 202 +/- 10 gm/L before operation, 177 +/- 10 gm/L after operation, and 191 +/- 14 gm/L at latest review. The only complication was mild swelling of the arm distal to the fistula in one patient. All patients reported improvement in exercise tolerance. Eight patients have continued evidence of fistula patency. Development of ipsilateral pulmonary arteriovenous fistulas has not been observed in any patient. Creation of an axillary arteriovenous fistula to augment pulmonary blood flow after a cavopulmonary shunt provides useful palliation for complex cyanotic heart disease when other options are limited. Such additional sources of pulmonary blood flow may influence the development of pulmonary arteriovenous fistulas.
...
PMID:Augmentation of pulmonary blood flow with an axillary arteriovenous fistula after a cavopulmonary shunt. 855 63

The Nippon-Zeon (NZ) ventricular assist device is a sac type, air driven, heterotopic, external pump. Its performance has been evaluated in Japan as a bridge to myocardial recovery. Few data are available on the device as a bridge to heart transplantation. Since 1991, 10 patients (9 men) were bridged to heart transplantation with NZ, all in biventricular support. The mean age was 39 +/- 13 years (range, 21-60 years), mean body weight was 75 +/- 13 kg (range, 51-95 kg). Five patients had a dilated cardiopathy, and five were ischemic (three acute myocardial infarctions). Despite maximal inotropic support, including enoximone in seven, epinephrine in three, and intraaortic balloon pumping in one, eight patients were anuric, three were in acute hepatic failure, and three were intubated. Preoperative hemodynamic and biologic values were: cardiac index, 1.57 +/- 0.4 l/min/m2; pulmonary capillary wedge pressure, 34 +/- 5 mmHg; creatinine, 200 +/- 80 mumol/l; blood urea nitrogen, 17.5 +/- 8 mmol/l; total bilirubin 36 +/- 6 mumol/l; aspartate aminotransferase, 1,000 +/- 2,000 IU/l. In all patients, a biventricular assist device was implanted without the use of cardiopulmonary bypass. Improvement occurred immediately in all but one. Mean left ventricular flow was 4.5 +/- 0.8 l/min. Anticoagulation was maintained with intravenous heparin. Recently for bleeding was required in one case (10%), and two patients had positive blood cultures that were successfully treated. There was no mechanical failure. Hemolysis was not significant (lactate dehydrogenase, 378 +/- 50 IU/l; plasma-free hemoglobin below 10 mg/dl). Each device was free of thrombi and deposits at time of explantation. One patient died while on assist. Nine patients (90%) were transplanted after 11 +/- 8 days (range, 1-32 days). Three died early after transplantation, one of graft failure, two of sepsis. Six patients (66%) could be discharged. The follow-up ranges from 7 to 28 months. NZ is a simple, reliable, pneumatic device driven by a light, silent console; it can be rapidly implanted without cardiopulmonary bypass in patients in desperate condition who are awaiting cardiac transplantation. The difficulty of patient rehabilitation while using this device should limit the duration of support to weeks to allow the patient to be in optimal condition for heart transplantation.
...
PMID:Use of the Nippon-Zeon pneumatic ventricular assist device as a bridge to cardiac transplantation. 855 33

To test the hypothesis that physical inactivity is associated with increased stroke risk in women and men, the authors analyzed data from a longitudinal cohort study with three follow-up data collection waves. In the Nation Health and Nutrition Examination Survey I (NHANES I) Epidemiologic Follow-up Study, 7,895 white persons and black persons aged 45-74 years were examined in 1971-1975 as part of NHANES I. Included in this analysis were 5,852 persons without a history of stroke (fatal and nonfatal) or missing data. The average follow-up was 11.6 years (maximum, 16.4 years). Incident stroke (fatal or nonfatal) was the main outcome measure. Events were ascertained from cause of death information coded from death certificates and from discharge diagnoses coded from hospital and nursing home records during the follow-up period (1971 through 1987). Participants were asked to characterize their level of habitual physical activity as low, moderate, of high. The relative risk for stroke was estimated by Cox proportional hazards regression analysis, comparing persons reporting low with those reporting high physical activity at baseline and persons in the upper with those in the lower tertile of resting pulse rate. There were 249 incident cases of stroke identified in white women, 270 in white men, and 104 in blacks. In white women aged 65-74 years, low nonrecreational activity was associated with an increased risk of stroke (relative risk = 1.82,95% confidence interval 1.10-3.02) after adjusting for the baseline risk factors of age, smoking, history of diabetes, history of heart disease, education, systolic blood pressure, serum total cholesterol, body mass index, and hemoglobin concentration. Similar associations were seen for men and for blacks and for low recreational activity in women. A higher resting pulse rate was associated with an increased risk of stroke in blacks but not in whites. A consistent association of reported low physical activity with an increased risk of stroke was observed in white women. Regular physical activity may be of benefit in preventing stroke in women as well as men.
...
PMID:Physical activity and stroke incidence in women and men. The NHANES I Epidemiologic Follow-up Study. 861 Jun 99


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>

---