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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred elderly patients who had an intertrochanteric femoral fracture were randomized to treatment with a compression hip-screw with a plate (fifty patients) or a new intramedullary device, the intramedullary hip-screw (fifty patients). All patients were followed prospectively for one year or until death. A detailed assessment of the functional status and the plain radiographs of the hip was performed one, three, six, and twelve months postoperatively. The two treatment groups were strictly comparable. The operative time needed to insert the intramedullary hip-screw was significantly greater than that needed to insert the compression hip-screw with the plate (p = 0.02), but use of the intramedullary hip-screw was associated with less estimated intraoperative blood loss (p = 0.011). The prevalence of perioperative complications, such as bronchopneumonia, cardiac failure, and urinary tract infection, was comparable in the two treatment groups. There were one intraoperative fracture of the femoral shaft and two intraoperative fractures of the greater trochanter in the group managed with the intramedullary hip-screw. One patient had pulling-out of the compression hip-screw on the seventh postoperative day. Four patients had a trochanteric wound hematoma, without infection, after insertion of an intramedullary hip-screw. All but one of the fractures healed. The one non-union, which was in a patient who had a compression hip-screw, was treated with a hemiarthroplasty. The mortality rate was similar in the two treatment groups. The patients who had an intramedullary hip-screw had, on the average, significantly better mobility at one (p < 0.0001) and three months (p = 0.0013) postoperatively. This difference was no longer seen at six and twelve months, although the patients who had an intramedullary hip-screw still had significantly better walking ability outside the home at those time-periods (p = 0.05). The compression hip-screw was removed from two patients because of pain in the mid-portion of the thigh, which had begun after consolidation of the fracture. Fourteen patients who had an intramedullary hip-screw had cortical hypertrophy at the level of the tip of the nail at twelve months postoperatively. Cortical hypertrophy was significantly related to the use of two interlocking screws (p = 0.02). Six of these patients also had pain in the mid-portion of the thigh, and the nail had been locked with two screws in five of them. Three of the six patients had the hardware removed because of the pain, and the symptoms resolved. A seventh patient had pain without cortical hypertrophy. The intramedullary hip-screw device was associated with significantly less sliding of the lag-screw and subsequent shortening of the limb in the region of the thigh (p = 0.012 and 0.019, respectively); these differences were more pronounced when the unstable fractures in the two treatment groups were compared (p < 0.001).
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PMID:Use of an intramedullary hip-screw compared with a compression hip-screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one hundred patients. 1053

Out of 938 parasitologically confirmed patients with visceral leishmaniasis treated with amphotericin B (1 mg/kg bodyweight daily infused in 2 h for 20 days), 935 were cured clinically, 933 parasitologically and 931 ultimately (no relapse within 6 months). Two parasitologically 'not cured' and 4 relapsed patients were cured with 25 infusions, and 1 with double relapse with 30 infusions. The treatment was started only when serum haemoglobin reached 5 g/dL, serum electrolyte imbalance was corrected and sodium stibogluconate-induced myocardial damage stabilized after 10 days' rest. Bronchopneumonia, cardiac failure and acute renal failure caused the death of 1 patient each. Nightblindness, angular stomatitis, neuritis, and petechial haemorrhages improved with appropriate treatment; 2 patients were given blood transfusion for post-treatment anaemia. Nausea and anorexia, and changes in serum creatinine and potassium, became normal in 2 weeks. Immediate withdrawal of the drug and restart after 10 days cured 2 patients who developed acute renal failure. Infusion-related toxicities--shivering, rigor and fever--were minimized but not eliminated by prior administration of hydrocortisone. Tuberculosis and visceral leishmaniasis were treated concurrently. Four pregnant patients were successfully treated without harmful effects on mother and child. It was concluded that the dosage of amphotericin B used was an effective and well-tolerated regimen and achieved 99% cure. Toxicity could be minimized with some precautions. All unresponsive and relapsed patients responded to more amphotericin and no resistance to the drug was seen.
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PMID:Amphotericin B deoxycholate treatment of visceral leishmaniasis with newer modes of administration and precautions: a study of 938 cases. 1049 70

Many patients die shortly after surgery for proximal femoral fracture. These patients are subjected to painful operative procedures that do not improve their outcome. We attempted to identify such patients with a case-controlled study of variables associated with death in hospital after proximal femoral fracture. Bronchopneumonia, ASA grade 4, heart failure and malnutrition were significantly associated with death but the latter two variables alone were insufficiently specific to justify withholding surgical treatment. However, 90% of patients with bronchopneumonia and those deemed unfit for anaesthesia died shortly after admission and their condition was not improved by active intervention. We suggest that it is kinder to withhold early surgery in this population.
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PMID:Refining the indications for surgery after proximal femoral fracture. 1132 65

Twenty-seven infants with ventricular septal defects and in cardiac failure were followed regularly under medical treatment for an average period of 17 months. The diagnosis was proved in all cases by cardiac catheterization.At the end of the follow-up period, the patients could be classified as follows: Sixteen patients showed no change in their cardiovascular status, and six had signs of pulmonary infundibular stenosis. One child had died from bronchopneumonia. Another was classified as having probable functional closure of the defect. Finally, three other children, because of failure of medical treatment, underwent banding of the pulmonary artery. One died during the operation.It is concluded that the great majority of patients with ventricular septal defects and cardiac failure can be carried successfully under medical management until the age at which corrective surgery is feasible. Palliative procedures which in themselves carry a fairly high mortality risk should be used only as a last resort.
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PMID:[INTERVENTRICULAR COMMUNICATION WITH HEART FAILURE IN NEWBORN AND OLDER INFANTS: EVALUATION OF MEDICAL TREATMENT]. 1420 Dec 62

Cardiac involvement by sarcoidosis and concomitant deposition of AL amyloid is an uncommon association. We describe the case of a 53-year-old African-American man with a 7-year history of dilated nonischemic cardiomyopathy and severe cardiac failure who underwent orthotopic heart transplantation. His prior cardiac biopsies had only mild myocyte hypertrophy and minimal interstitial fibrosis. After surgery, numerous sarcoid granulomas and amyloid deposition were identified in the native heart. Six days after the transplant the patient died due to aspiration bronchopneumonia and acute renal failure. At autopsy, both sarcoidosis and immunoglobulin (Ig) lambda light-chain amyloidosis were present in the native atria, lungs, thyroid, liver, spleen, and kidneys. Sarcoid granulomas alone were present in the parathyroids, lymph nodes, and bone marrow. Amyloid deposition alone was present in the aorta, stomach, large bowel, and urinary bladder. There was no evidence of plasma cell dyscrasia, or underlying gammopathy. This unusual association was described in only two other cases in the medical literature. However, this is the first case of sarcoidosis and AL amyloidosis with successful sequencing and identification of Ig lambda light-chain amyloid, and in which there was no evidence of plasma cell dyscrasia.
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PMID:Sarcoidosis and immunoglobulin lambda II light-chain amyloidosis diagnosed after orthotopic heart transplantation: a case report and review of the literature. 1571 64

Measles remains one of the leading causes of childhood mortality in the world, despite the availability of a safe, effective, relatively inexpensive vaccine. It is also one of the leading causes of childhood blindness in the developing world. We reviewed the records of cases of measles admitted into Oni Memorial Children's Hospital, Ibadan over a 5-year period, January 2000 to December 2004; to evaluate any changes in the pattern of the disease. A total of 666 cases of measles were admitted comprising of 347 males and 319 females, giving a male to female ratio of 1.1:1. The yearly incidence of measles remained fairly the same from January 2000 to December 2002. There was a marked increase in yearly incidence in the year 2003. The majority of the affected children (74.1%) were 2 years and below. One hundred and thirty-six (20.4%) cases developed measles before the age of 9 months, the recommended age for measles vaccination in Nigeria. The peak incidence occurred in the months February and March. The commonest complication was bronchopneumonia, seen in 45.2% of cases. Other complications include protein-energy malnutrition, tuberculosis, croup, keratopathy, otitis media, heart failure and tension pneumothorax. Fifty-six patients died giving a case fatality rate of 8.4%. Factors associated with increased mortality were young age (<2years) and malnutrition. Measles remains a major threat to the health of the Nigerian child. A significant number of children developed measles before receiving the required vaccination at the recommended age of 9 months. There is a need to review the current immunisation policy, strengthen immunisation practices and improve the living standards in order to make the eradication of measles a reality.
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PMID:Measles in Ibadan: a continuous scourge. 1675 70

Congestive cardiac failure (CCF) is a common paediatric emergency with diverse aetiologies. The objective of this study is to define the current prevalence rate and common causes of CCF among children hospitalized in a Nigerian Tertiary Hospital. The study was prospectively done over a 1-year period in the Paediatric Wards of the hospital. Consecutive children aged 0-14 years, who fulfilled the standard diagnostic criteria for CCF were recruited. Data obtained from them included the age, sex, duration of illness and the socioeconomic status of the parents. Each subject was given a specific diagnosis based on the clinical, laboratory and radiological features. Out of a total of 1552 admissions, 109 had CCF giving the prevalence of 7.02%. The mean age of children with CCF was mean of 2 +/- 3.1 years (range: 1 day to 14 years). Ninety-five (91%) of them were concentrated in the lower socioeconomic classes III-V. The aetiologies of CCF identified in this study were as follows: severe anaemia occurring alone (48; 46%), lower respiratory tract infections (LRTI) (30; 29%), anaemia with LRTI (12; 11.5%), congenital heart diseases (CHD) (11; 10.5%), rheumatic heart disease (1; 1%), myocarditis (1; 1%) and chronic renal disease (1; 1%). Malaria was the commonest cause of anaemia while bronchopneumonia was the commonest form of LRTI in the subjects. Measles infection was associated with LRTI in 10 (23.8%) children. Three children had HIV-related anaemia. Infants formed the bulk of the subjects with CCF due to anaemia, LRTI and CHD. Ventricular septal defect was the commonest CHD identified. The prevalence obtained from this study was higher than rates obtained from some previous studies in the country. Severe anaemia is the commonest cause of CCF probably from the effects of severe malaria and increasing poverty. Stringent attention to poverty alleviation and malaria control may reduce the burden of CCF among Nigerian children.
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PMID:Current trends in the prevalence and aetiology of childhood congestive cardiac failure in Sagamu. 1716 31

Hemangiomas are rare benign tumours of the heart, generally asymptomatic and usually diagnosed in male young or full-grown adults. We report here a case of a symptomatic right atrial hemangioma in a 75-year-old woman with a clinical history of hypertension. The tumour was diagnosed after an episode of acute bronchopneumonia precipiting the patient's cardiac failure initially referred to the hypertensive condition.
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PMID:Right atrial hemangioma: clinicopathological considerations of a case. 1766 83

Case report of young woman presents involvement of dilated cardiomyopathy and rhythm disturbances in 18 months after infection of tick, with direct assessment of spirochetes in myocardial tissue. Cardial decompensation occured after asthma exacerbation, complicated by bronchopneumonia. Rhythm disturbances and heart failure gradually subside after parenteral antibiotic treatment and peroral treatment of heart failure. Nevertheless there is a long-lasting persistence of dilated cardiomyopathy with significant systolic dysfunction, which is supposedly last consequence of Borrelia infection. Resynchronic therapy combinated with cardioverter-defibrilator primary considering was postponed for improvement clinical condition and myocardial electric stability. There is demonstrating complicated serologic diagnostics of Lyme disease in discussion. Lyme carditis would be part of differential diagnosis in rhythm disturbances and cardiomyopathy of unknown etiology, including serious or fatal events.
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PMID:[Lyme carditis--rare cause of dilated cardiomyopathy and rhythm disturbances]. 1863 Jun 24

To elucidate the epidemic status, clinical profile, and current diagnostic issues of scrub typhus in Shandong Province, we analyzed the surveillance data of scrub typhus from 2006 to 2011 and conducted a hospital-based disease survey in 2010. Scrub typhus was clustered in mountainous and coastal areas in Shandong Province, with an epidemic period from September to November. The most common manifestations were fever (100%), eschar or skin ulcer (86.3%), fatigue (71.6%), anorexia (71.6%), and rash (68.6%). Predominant complications included bronchopneumonia, toxic hepatitis, and acute cholecystitis in 21.6%, 3.9%, and 2.9% of the cases, respectively. Severe complications including toxic myocarditis, heart failure, pneumonedema, pleural effusion, and emphysema were first reported in Shandong. Missed and delayed diagnosis of scrub typhus was common in local medical institutions. Alarm should be raised for changes of clinical features and current diagnostic issues of scrub typhus in newly developed endemic areas.
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PMID:Scrub typhus: surveillance, clinical profile and diagnostic issues in Shandong, China. 2309 Nov 93


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