Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty of 118 cases of childhood onset systemic lupus erythematosus collected in the Parisian area had an unfavorable outcome. Thirteen patients evolved to end-stage renal failure. Seven survived with renal substitution therapy, and 6 other patients subsequently died. Most had diffuse proliferative glomerulonephritis, the pattern of glomerular disease classically responsible for end-stage renal failure. Three patients had membranous nephropathy with segmental lesions, a form of glomerulonephritis whose severe prognosis should be emphasized. In another patient, end-stage renal failure was precipitated by thrombotic microangiopathy. Seventeen other patients died and in most, the causes of death were multiple. In 7, death could be attributed to complications secondary to an infection and in 4 other cases to SLE exacerbation with severe organ involvement. Two patients died suddenly, another showed cardiac failure and another had malignant hypertension. Of the remaining 2 patients, one suffered anticoagulant therapy complications after treatment for renal artery stenosis and the second, an urothelial carcinoma. Unfavorable evolutions were high among patients coming from French departments and territories, and among North African patients. One may speculate that poor outcome is associated with ethnic characteristics or with socioeconomic factors. However, the problem of compliance with treatment is clearly an extremely important factor in the prognosis. Both end-stage renal failure and death were in some of our cases precipitated by treatment interruption, indicating an insufficient understanding of the importance of treatment in this chronic disease.
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PMID:Unfavorable outcomes (end-stage renal failure/death) in childhood onset systemic lupus erythematosus. A multicenter study in Paris and its environs. 795 30

Wide albumin gradient (transudative) ascites is usually due to liver disease but may also result from many other disorders, including heart failure, hepatic infiltration by tumor, hepatic vein thrombosis, and veno-occlusive disease. It has not been linked with small bowel obstruction. Narrow albumin gradient (exudative) ascites, usually due to peritoneal carcinoma or inflammation, has been noted in cases of necrotic or perforated bowel, but simple small bowel obstruction has not previously been appreciated as a possible cause for ascites. We report a patient who developed wide albumin gradient ascites and secondary bacterial peritonitis in association with small bowel obstruction. The small bowel obstruction, ascites, and peritonitis resolved with lysis of a single abdominal adhesion.
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PMID:Ascites and secondary bacterial peritonitis associated with small bowel obstruction. 805 42

Calcitonin gene-related peptide (CGRP), a 37 amino acid peptide resulting from the specific maturation processes of calcitonin gene products, was discovered in 1982. Its messenger RNA was isolated from a calcitonin cancer in rats similar to the human thyroid medullary carcinoma. CGRP is closely related to calcitonin and amylin, and to a lesser extent, to the region coding for the alpha chains of relaxins, insulin and insulin growth factors. In thyroid C cells, calcitonin itself is the major gene product, but CGRP is predominant in the central and peripheral nervous system. CGRP is found in most all tissues and is considered to be a neuromediator of particular importance in the cardiovascular system. CGRP is a powerful endogenous vasodilator in man; plasma concentrations of 56 pmol/l (slightly above physiological levels) provoke flush, hypotension and secondary catecholamine release and subsequent tachycardia. Intravenous injections lead to systemic vasodilatation and redistribution of blood flow to the skin, the brain, and probably the splanchnic territory. It has been suggested that CGRP plays a role in blood pressure modulation in certain pathological conditions. CGRP level is decreased in hypertension and increased in septic shock. In patients with terminal renal failure, CGRP is correlated with excess volaemia. It could affect blood pressure by redistributing blood flow, interacting with the renin-angiotensin system or by inhibiting aldosterone secretion. CGRP may also play a role in modulating cutaneous vascular constriction in Raynaud's syndrome and cerebral vascularization in patients with migraine or meningeal hemorrhage subsequent to rupture of cerebral aneurisms. CGRP increases arterial flow in the cavernous body. Coronarian vascular tone and cardiac performance (positive chronotrope and inotrope effects) are improved. CGRP has also been studied in connection with glucose metabolism and may have other endocrine effects. Finally, CGRP increases electrolyte and water flow in the colon and its bronchoconstrictor effect could be implicated in asthma. The clinical significance of plasma CGRP is not yet known although it may be a marker of poor prognosis in thyroid medullary cancer. Recent studies suggest that CGRP could be a useful therapeutic agent in severe Raynaud syndrome, impotency, ischaemic neurological lesions due to ruptured aneurisms and in severe heart failure.
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PMID:[Calcitonin gene-related peptide (CGRP)]. 817 60

Three years after heart transplantation and immunosuppressive therapy, a 66-year-old man suffered from dyspnea and showed symptoms mainly due to right heart failure. Malignant tumor cells were discovered within extensive pleural effusion. Computed tomography revealed two lesions of the liver suspicious of metastases, and recurrent blood in the stools was evident. The patient deteriorated rapidly and died 3 weeks after admission. Autopsy findings included an adenocarcinoma of the cecum (grade II) with metastases to the liver. High-grade immunoblastic non-Hodgkin's lymphoma of plasmoblastic differentiation was diagnosed, located within the mediastinal soft tissues and infiltrating the peri- and myocardium. Mesenteric lymph nodes were enlarged with histological verification of malignant lymphoma. The lymphatic tumor masses had caused considerable compression of the heart and vessels, leading to the signs of cardiac failure. The development of metastasizing colonic carcinoma and high-grade immunoblastic non-Hodgkin's lymphoma 3 years after heart transplantation and immunosuppressive therapy must be considered an unusual combination. Malignent lymphomas following heart transplantation have been described several times.
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PMID:[Malignant lymphoma and colon carcinoma 3 years after heart transplantation and immunosuppression]. 819 70

From 1981 to 1994, intra-operative radiotherapy after subtotal cystectomy was performed on 22 patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition. All the patients received 25 to 30 Gy of radiotherapy focused on trigonum and internal urethral orifice after subtotal cystectomy with uretero-cutaneostomy. Of 22 patients, 15 patients died. Five patients died of bladder cancer, one died of gastric cancer, one died of rectal cancer and the others died of pneumonia, heart failure, sepsis and senility. The five-year survival rate was 41% and the cause-specific five-year survival rate was 75%. Local recurrence was seen only in one patients, who received second intra-operative radiotherapy and recovered well in complete remission. We believe that intra-operative radiotherapy after subtotal cystectomy is useful for patients with invasive bladder carcinoma on whom radical cystectomy could not be recommended because of old age or condition.
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PMID:[Clinical evaluation of intra-operative radiotherapy combined with subtotal cystectomy for invasive bladder carcinoma]. 861 87

From 1980 to 1990, a total of 54 patients with prostatic carcinoma were treated with external radiation therapy at the Kumamoto National Hospital. Ten patients were classified as Stage B, 22 as Stage C, and another 22 as Stage D according to the American Urological Association Clinical Staging System. The 5-year survival for all 54 patients was 30%. The 5-year disease-specific survival was 67% for Stage B, 47% for Stage C, and 26% for Stage D. The 5-year survival was 43% for patients in whom radiation therapy was initiated immediately after the first diagnosis or with less than one year of hormonal therapy, while it was 0% for patients in whom radiation therapy was initiated after more than one year of hormonal therapy (p = 0.01). The cause of intercurrent death was acute myocardial infarction in four patients and acute cardiac failure in one. Four of these patients received hormonal therapy for more than one year. The incidence of radiation-induced proctitis was not severe. This study suggests that long-term hormonal therapy prior to radiation therapy worsens the prognosis of patients with prostatic carcinoma.
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PMID:External radiation therapy of prostatic carcinoma and its relationship to hormonal therapy. 885 Mar 71

The tall-cell variant of papillary thyroid carcinoma (TCV) has been described as an aggressive tumor with a significantly higher incidence of recurrence and mortality than other forms of papillary carcinoma. In some series it has accounted for up to 10%, whereas in other series it has not been reported at all, indicating that there are difficulties identifying it. In a series of 162 consecutively treated patients with papillary thyroid carcinoma treated by total thyroidectomy according to a highly standardized procedure, all specimens were specifically examined by an international group of pathologists to establish the occurrence of TCV. All patients with TCV were studied with regard to local aggressiveness, the presence of metastases, iodine uptake, DNA pattern, thyroglobulin production, treatment (surgical and adjuvant), and outcome (follow-up 3-17 years, median 10 years). At primary histopathologic evaluation by the local pathologist, three patients were recorded as having TCV. At special evaluation by the expert group, eight more cases were found, giving a total of 11 patients in this series (7%). Five of them had extracapsular growth, and four were multifocal. Three had metastases at the time of admission. Seven tumors were diploid, one tetraploid, and three aneuploid. Of the three patients with primary distant metastases two died (8 and 24 months after operation), and one is still alive after 10 years. Four other patients developed recurrences, one of whom died from cardiac failure, but the others have so far been treated successfully. Two of these recurrences had no radioiodine uptake, and one had no rise in thyroglobulin concentrations; the other two had rising values that correlated with recurrence. The other four patients are alive without recurrence. It was concluded that identification of the TCV requires examination by an experienced pathologist. Moreover, it may have a higher incidence than is generally recognized. No reliable criteria for prognostic classification were identified. The results suggest that early identification and active treatment can lead to an outcome more favorable than has previously been described.
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PMID:Tall-cell variant of papillary thyroid cancer: disregarded entity? 894 72

IL-6, soluble IL-6 receptor (sIL-6R) and soluble gp130 (sgp130) levels were measured in sera and pleural effusions from 42 patients with metastatic carcinoma, non-Hodgkin's lymphoma, tuberculosis, cardiac failure and miscellaneous diseases. Pleural IL-6 levels measured by ELISA were very high in all patient groups (mean 34.8 +/- 15.3 ng/ml) without significant difference according to diseases. IL-6 was shown to be biologically active in a proliferative assay. Serum IL-6 levels were low (0.049 +/- 0.014 ng/ml) and did not correlate with pleural fluid levels. Pleural IL-6 levels correlated with the number of polymorphonuclear cells in pleural fluid (P < 0.03). Pleural sIL-6R levels (76 +/- 8 ng/ml) were always lower than serum levels (196 +/- 12 ng/ml; P < 0.0001) but correlated with them (P < 0.01). Pleural sIL-6R and albumin levels correlated (P < 0.01), suggesting a transudation of sIL-6R from the serum. Pleural sgp130 levels (10.9 +/- 1.0 ng/ml) were lower than serum levels (24.6 +/- 2.8 ng/ml; P < 0.002). After gel filtration of pleural fluid, the bulk of IL-6 (> 90%) was recovered in a 15,000-30,000 fraction, corresponding to the expected mol. wt of free IL-6. These results suggest a production and a sequestration of IL-6 in the pleural cavity in all studied conditions.
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PMID:IL-6 and soluble IL-6 receptors (sIL-6R and sgp130) in human pleural effusions: massive IL-6 production independently of underlying diseases. 901 Feb 74

A 42-year-old man presented with cough, chest pain and dyspnea. The chest roentgenogram revealed a large mass shadow in the right upper and middle lobes with atelectasis and pleural effusion. Massive polypoid tumor extending into the left atrium was diagnosed by computed tomography and two dimensional echocardiography. In order to prevent sudden death and cardiac failure, surgery was performed. At first, the polypoid tumor in the left atrium was removed with a partial resection of the left atrial wall under cardiac arrest using cardiopulmonary bypass. Then, a right pneumonectomy was performed. Episodes of embolism were not observed during surgery. His postoperative course was almost favorable. The size of the tumor in the right lung was 18 x 15 x 8 cm and the one in the left atrium was 6.5 x 4.5 x 3 cm, respectively. Pathological examination of the resected specimen revealed the evidences of large cell carcinoma extending into the left atrium. Local recurrence with S9 metastasis of the left lung were detected 6 months after surgery, and he died 6 months later. It is emphasized that the extended surgery using cardiopulmonary bypass was useful for both prevention of embolism and improvement of quality of life.
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PMID:[A successful removal of T4 lung cancer with its left atrial extension using cardiopulmonary bypass]. 902 67

A multicenter nonrandomized study was designed to assess the efficacy (response rate and duration of relapse-free survival) and safety of the combination of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) 200 mg/m2 given as a 3-hour intravenous infusion with premedication every 3 weeks, followed by mitoxantrone 12 mg/m2, given as an intravenous push every 3 weeks, in patients with metastatic breast carcinoma. So far, 30 patients have entered the study and 27 are evaluable for response. All patients had advanced metastatic breast cancer and have been extensively pretreated with chemotherapy (28 patients), radiotherapy (13 patients), and hormonotherapy (24 patients). Fourteen patients (46.7%) have been previously treated with anthracyclines, and disease progressed in seven (23.3%) during anthracycline treatment. One patient had a complete remission and 14 a partial remission for a total remission rate of 55.6%. One of the 15 patients entering remission developed heart failure and was withdrawn from the protocol after 4 months in remission. She then relapsed and died 9 months after entering protocol. The remaining 14 patients continue to respond and their remission durations range from 4+ to 12+ months (mean, 9 months; 95% confidence interval [CI] 7.96 to 10.04). Eleven patients (40.7%) developed minor responses or disease stabilization lasting from 1.5 to 11.4+ (mean, 3.5 months; 95% CI, 1.9 to 6.0) and one of them had disease progression after 3.5 months and is still alive whereas another one who had disease progression died at 1.5 months. Four patients failed to respond and their disease progressed during protocol treatment; two of them died at 6.7 months while the other two are alive at 3.4 and 9.8 months. Overall survival ranged from 1.5 to 13+ months (mean, 6.7 months; 95% CI, 5.5 to 7.9). In the group of 14 anthracycline-pretreated patients, seven showed a partial remission, six a minor response or disease stabilization, and one had disease progression. Response duration ranged from 1.5 to 12+ months (mean, 6.1 months; 95% CI, 4.2 to 8.0); the three patients whose disease progressed died at 1.5, 6.7, and 8.8 months. Bone marrow toxicity was dose-limiting and caused treatment delays as well as dose de-escalation of both drugs in eight patients.
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PMID:Treatment of advanced and relapsing breast cancer with a combination of paclitaxel and mitoxantrone. South-Central Hellenic Oncology Group. 907 35


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