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Query: UMLS:C0018801 (
heart failure
)
72,216
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients in the validation series, 19% were readmitted within 90 days. Twenty-six per cent of the readmissions occurred within ten days of discharge, and 57% within 30 days. Readmitted patients were older, had longer hospitalizations, and had greater hospital charges (p less than 0.01). The discharge diagnoses of AIDS, renal disease, and cancer were associated with increased risks of readmission regardless of patients' demographics or test results. The relative risks (95% confidence interval) associated with these diagnoses were: AIDS, 3.3 (1.4-7.8); renal disease, 2.3 (1.7-3.0); cancer, 2.8 (2.4-3.4). Other patients at increased risk were those with diabetes,
anemia
, and elevated creatinine (2.1; 1.6-2.8) and those with
heart failure
and elevated anion gaps (2.2; 1.7-2.8). For patients without one of these diagnoses, a normal albumin and no prior admission within 60 days identified patients at reduced risk for readmission (0.4; 0.3-0.4). Thus, commonly available clinical data identify patients at increased risk for emergency readmission. Risk factor profiles should alert physicians to these patients, as intensive intervention may be appropriate. Future studies should test the impacts of clinical interventions designed to reduce emergency readmissions.
...
PMID:Predicting emergency readmissions for patients discharged from the medical service of a teaching hospital. 369
Some particular features of the cardiomyopathies (CM) observed in the tropics, especially in Africa, are emphasized in this study. Chronic parietal endocarditis is excluded from the CM group. The author presents facts that justify the linking of that affection to endocardial diseases. Myocardiopathies are acute ailments presenting with congestive lesions, reversible under etiological therapy. Anemic and beri-beri myocardiopathies are not unusual in the tropics and present a hyperkinetic syndrome before the stage of advanced
cardiac insufficiency
. Infectious or parasitic myocarditis seem frequent in the tropics. The author recalls the characteristics of the myocarditis in the human african trypanosomiasis which he opposes, particularly, to the american trypanosomiasis. The reality of bilharzial myocarditis is more debatable while bilharzial pulmonary hypertension is well documented. Chronic congestive CM presents a few specific characteristics in the tropics. The features, well described in temperate regions, are found in the tropics with a particularly unfortunate prognosis. Some alcoholic myocardiopathies have been observed. The rare occurrence of hypertrophic CM in the tropics results, seemingly, from a lack of exploratory means. The author studies briefly a recent series of 31 cases in Abidjan. Post-partum myocardiopathy seems to be the clinical appearance of a latent myocardial insufficiency of the normal post-partum in women presenting with associated risks factors (
anemia
, malnutrition, overwork, excessive sodium intake, etc.). An early diagnosis enables a cure only by resting, but it is sometimes necessary to associate a medical treatment. Death by embolism or the passing to chronicity are however possible. Drepanocytic CM is debatable and in many cases, seems hardly differentiated from anemic myocardiopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Cardiomyopathies in tropical areas]. 377 21
Fever,
anemia
, pulmonary infiltrates and weight loss occurred in a 47-year-old man four weeks after a gastric operation. On echocardiography and cardiac catheterization an atrial myxoma was revealed. In removing the myxoma the tricuspid valve apparatus was destroyed, requiring insertion of a bio-prosthetic valve (Hancock). Signs of infection persisted post-operatively, together with complete A-V block and panuveitis. The Candida IGM titer was markedly increased and histological examination of the thrombus revealed massive fungal infection. Recurrent fever and massive vegetation on the prosthetic valve necessitated removal of the prosthetic valve under antimycotic treatment, which also cleared the pulmonary lesions. The patient's general condition improved. Right-
heart failure
was controllable by drugs.
...
PMID:[Unusual course of Candida endocarditis]. 382 21
Side effects and their relationship with the material used were analyzed in 748 plasma exchanges (PE) performed in 75 patients. The total incidence of acute and mild adverse effects (chills and/or fever, paraesthesias, allergic reactions, acute
anaemia
, vasovagal reactions, abdominal pain and hypotension) was 18.04%. Two patients developed an episode of left
cardiac insufficiency
. One patient in whom all PE were performed with fresh frozen plasma (FFP) developed metabolic alkalosis. Three patients developed sepsis during treatment with repeated PE and immunosuppressive drugs; in these three patients a permanent vascular inlet was used (shunt or catheter). All patients in whom only FFP was used as replacement solution developed non-A, non-B hepatitis. Neither haemorrhagic nor thrombotic episodes were observed in these patients. It is of the greatest importance to choose the most suitable material for each patient and to develop a careful technique in order to avoid these complications during treatment with PE.
...
PMID:Adverse effects secondary to the treatment with plasma exchange. 403 Jan 33
In a survey of people of 75 years and over in a general practice situated in the north-west of England a total of 297 patients was examined. Among the many previously unreported medical conditions and social needs were seven unknown malignant conditions, 28 patients with
heart failure
, five with diabetes, and one with myxoedema. A high incidence of nutritional
anaemia
was also found. It is concluded that such a survey can detect much hidden illness and disability and that general practice is the right setting for it.
...
PMID:Sociomedical study of patients over 75 in general practice. 503 60
The chest X-rays of 15 hypoglycaemic small-for-gestational-age infants showed cardiomegaly in 10 infants, 4 had
heart failure
. None of the infants had respiratory distress syndrome, congenital heart disease, septicaemia,
anaemia
or polycythaemia; infants of diabetic mothers were excluded. Cardiomegaly disappeared with the normalization of blood glucose in most of the cases. The cause of the cardiomegaly and
heart failure
might be related to insufficient cardiac energy substrates in small-for-gestational-age infants. This condition should also be considered in the differential diagnosis of cardiomegaly and
heart failure
.
...
PMID:Cardiomegaly in hypoglycaemic small-for-gestational-age infants. 621 92
Trophoblastic embolism is subclinical in normal pregnancy, pronounced in eclampsia, and massive in hydatidiform mole. Self-limited acute respiratory distress arises in 3% to 10% of molar pregnancies at the time of uterine evacuation. Infrequently death occurs; the principal findings are trophoblastic emboli in the pulmonary arterioles, edema of the lungs, and dilatation of the right side of the heart. Hyperthyroidism may develop, and fibrin may line the alveolar walls. Pathogenetic mechanisms include
heart failure
, hyperthyroidism, dilutional
anemia
, and pulmonary arteriolar blockage. Infusions of fluid and whole blood tend to cause pulmonary overload, which may precipitate right-sided
heart failure
. Preferred therapy consists of diuresis and ventilatory support, especially with oxygen under positive end-expiratory pressure.
...
PMID:Trophoblastic pulmonary embolism. 626 19
A 20-year-old woman presented with malignant hypertension, pulmonary edema,
anemia
, and azotemia. Blood pressure was adequately controlled only after progressively more intensive drug regimens, finally including minoxidil, nadolol, and furosemide. On these drugs, the patient developed progressive left and right heart failure, anasarca, and malnutrition. The control of hypertension,
heart failure
, and fluid retention, was accomplished by administration of captopril and furosemide. Captopril is a logical alternative to vasodilators in refractory hypertension complicated by congestive heart failure.
...
PMID:Efficacy of captopril in relieving congestive heart failure developing during management of hypertension. Case report. 634 Dec 22
In acutely uremic animals, the contractile force of the heart is consistently increased; such an increase can be dissociated from changes of afterload or catecholaminergic drive. It is associated with diminished sarcolemmal Na,K-ATPase activity in the heart which, in turn, may be related to increased levels of endogenous digitalis-like substances (endigens) that have been postulated to represent a natriuretic factor. In patients with chronic uremia, myocardial contractility is usually normal, but occasionally there may be
heart failure
unrelated to pre-existing hypertension, coronary heart disease,
anemia
, fluid overload, or other recognizable factors. So far, the experimental basis for this clinical observation is uncertain. Possible causes for the clinical syndrome include an excess of parathyroid hormone or cardiodepressor substances. There is experimental evidence of impaired cardiac response to beta adrenergic agonists, e.g., decreased isoproterenol-dependent calcium uptake, diminished inotropic and chronotropic responses. In acutely uremic rats, cardiac cyclic AMP levels are high but can be reversed by beta blockers. Heart calcium content is variable and heart weight is constantly increased in acutely uremic rats, despite decreased skeletal muscle mass. The change in heart weight is not related to
anemia
, to an excess of parathyroid hormone, or to sympathetic activity; its cause remains unknown. Experimental studies to date have shown a variety of abnormalities, but do not provide a uniform concept of the mechanisms or an explanation for the cardiac dysfunction so often observed in patients with uremia.
...
PMID:Cardiac function in experimental uremia. 636 51
A four - month old boy with Salmonella Typhimurium meningitis is presented. This patient was admitted to the hospital with a diagnosis of staphylococcal pneumonia, pyo-pneumothorax,
cardiac failure
and
anemia
. He has been treated for 18 days and he was discharged in good condition. Two days after discharge patient was readmitted with a fever, vomiting and feeding problem. In physical examination, stiff neck and bulging of the fontanel were remarkable. Examination of cerebrospinal fluid (CSF) has revealed meningitis and cultures of blood and CSF specimens were positive for S. typhimurium. It was sensitive only to trimethoprim sulphamethoxazole and netilmicin. Trimethoprim sulphamethoxazole (IM) and netilmicin (IV) were given. At the fifth day of this treatment patient expired. Postmortem examination has revealed the same agent in both meninges tissue and CSF cultures.
...
PMID:[Salmonella meningitis]. 636 87
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