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)

A man, aged 63, had an illness which lasted 11 months from onset with pain under the left costal margin which radiated to the epigastrium, until his death from cardiac failure. His symptoms consisted principally of parasthesias and proximal weakness of both upper and lower extremities with atrophy of the shoulder and pelvic girdles. He developed pyramidal tract signs, became euphoric, emotionally unstable and mentally retarded. There was no clinical evidence of cerebellar dysfunction. Bronchogenic carcinoma was suspected from a tomograph of the thorax, but, in spite of extensive clinical and laboratory studies, the diagnosis was verified only postmortem. The CSF cell count was high at first but diminished as the disease progressed. Muscle biopsies revealed chronic generalized denervation without signs of myopathy. Neuropathologically, encephalomyeloradiculoneuritis concentrated on the spinal cord was combined with severe rarefaction of the ganglion cells of the anterior horns and with bilateral degeneration of the lateral pyramidal spinocerebellar and posterior tracts. A more diffuse process was obvious in the anterolateral tracts of the lumbar region. Polyneuropathy concentrated in the distal region was accompanied by slight inflammatory reaction in the sciatic nerve. Cerebellocortical degeneration which exceeded physiological age-related rarefaction was also present. The findings are discussed in relation to the literature.
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PMID:Carcinomatous encephalomyelopathy in conjunction with encephalomyeloradiculitis. 7 20

The cumulation of exogenic factors on the basis of an endogenic disposition and the addition of physiologic aging processes cause an increase of the "bronchitic syndrome" in old age. Heart insufficiency, tuberculosis, lung embolism and bronchial carcinoma are the important differential diagnostic aspects in these patients. The structural and functional changes of the lung in old people and the polypathy, resp. multimorbidity of the whole organism cause the complications and disadvantageous interferences. The prognostic important disturbances of the ventilation mechanics are early recognizable with new diagnostic tools, particularly with the whole body plethysmography.
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PMID:[Diagnosis of the bronchitic syndrome in the aged]. 86 63

Patients with idiopathic pulmonary fibrosis (IPF) inevitably experience declines in functional status that are most frequently due to progressive pulmonary fibrosis. However, the cause of the clinical deterioration is often uncertain, and disease progression is difficult to distinguish from disease-associated complications or adverse effects of therapy. In studies of the clinical course of IPF, mortality is most frequently due to respiratory failure (38.7%); other causes of death include heart failure (14.4%), bronchogenic carcinoma (10.4%), ischemic heart disease (9.5%), infection (6.5%), and pulmonary embolism (3.4%). Other, usually nonfatal, disease-associated complications include pneumothorax, corticosteroid-induced metabolic side effects and myopathy, and therapy-related immunosuppression. In evaluating clinical deterioration in patients with IPF, disease-associated complications and adverse effects of therapy should be distinguished from progressive pulmonary fibrosis. The cause of clinical deterioration will alter the therapeutic intervention required and will influence patient prognosis and duration of survival. This article examines the causes of clinical deterioration in patients with IPF and the diagnostic procedures for assessing disease-associated complications and staging IPF progression.
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PMID:Clinical deterioration in patients with idiopathic pulmonary fibrosis: causes and assessment. 218 1

The case histories of the 49 patients who died in a series of 165 patients admitted to the Medical Unit between 1958 and 1984 with polyarteritis nodosa (PAN) were reviewed. The causes of death of the 29 men and 20 women, mean age 51.44 +/- 7.4 years, were classified into 6 groups. Infection accounted for 26.5% (13/49) of deaths, the initial site of infection being pulmonary, complicated by septicaemia in 6 cases. Cardiovascular events were responsible for death in 24.4% (11/49): terminal cardiac failure (4 cases), myocardial infarction (1 case), ventricular tachycardia (1 case), stroke (1 case), pulmonary embolism (2 cases), fulminant hemoptysis (1 case). Gastrointestinal complications were the cause of death in 16.3% (8/49): ischemic necrosis (5 cases), acute pancreatitis (2 cases), oesophageal ulceration (1 case). Renal failure was observed in 10.2% (5/49), all occurring before 1972: acute renal failure (3 cases), chronic renal failure (2 cases). Cancer was the cause of death in 10.2% (5/49): primary bronchial carcinoma (2 cases), laryngeal carcinoma (1 case), carcinoma of the vulva (1 case), bone metastases (1 case). Finally, 14.2% (7/49) could not be classified in the preceding groups. Sudden death occurred in 3 patients, shock in 1 patient, multivisceral PAN in 2 patients and anaphylactic shock in 1 patient. Three of the 12 patients who had post-mortem studies had signs of progressive vasculitis. The results are compared with other reports in the literature and the pathogenic mechanisms are discussed. The infections and cardiovascular deaths occurred early or late and were not related to the state of the activity of the vasculitis. Immunosuppressive treatment seems to play an important role in their pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Causes of death in systemic vasculitis of polyarteritis nodosa. Analysis of a series of 165 patients]. 290 28

Two hundred and thirty patients, treated by resection for bronchial carcinoma, were analysed. The histological examination showed in 80% a squamous cell carcinoma, in 11.3% an adenocarcinoma, in 5.3% a large cell and in 3.4% a small cell carcinoma. There was a great difference between preoperative and postsurgical TNM-classification: 90% stage I preoperatively and only 68.3% after resection with mediastinal lymph node dissection. Twenty-four patients (10.4%) died during the first 30 days after operation. The main cause of death was cardiac failure or respiratory insufficiency. Forty-four patients (19.1%) had non-fatal complications. Atelectasis and pneumonia predominated. Survival without regard to stage and cell type was 27.6% at 5 years. As expected survival rate in T1N0M0 was best (40%). Therefore early detection of bronchial carcinoma is essential.
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PMID:Operated bronchial carcinoma: a review of 230 cases. 301 20

The incidence rate of chest wall invasion in bronchogenic carcinoma is difficult to estimate, but is possibly as high as 5%. These cancers can be locally extensive without systemic dissemination. From 1973 to 1982, 9 patients in our hospital underwent en bloc pulmonary and partial chest wall resection for bronchogenic carcinoma with local invasion of the thoracic wall. All the patients were male, their ages ranging from 49 to 67 years. Pain was the most prominent symptom. Bronchoscopy examination revealed no tumors in 7 of the 9 patients, in one a tumor was seen in the apex of the right lower lobe and in another in the apex of the right upper lobe. Seven lobectomies and 2 pneumonectomies were performed. The macroscopic size of the tumour ranged from 3 to 17 cm, the number of partially resected ribs ranged from 1 to 4. In 8 cases squamous cell carcinoma was found, in one adenocarcinoma. After operation 7 patients were classified as T3N0M0 and 2 as T3N1M0. One T3N0M0 patient died shortly after operation due to a lung embolism. Two out of the 6 patients with T3N0M0 neoplasm survived more than 5 years, none of the patients with T3N1M0 neoplasm survived more than 3 months. Late deaths were due to recurrent carcinoma in the chest wall (2 cases), cerebral metastasis (1 case), cardiac failure (1 case) and unknown causes (2 cases). In cases where the lymph nodes are not involved, the survival rate is not unfavorably influenced by chest wall invasion. In the literature the mean operative mortality rate is 12%, the median survival time approximately one year and the mean 5-year survival rate 18%; resection is also of great importance in relieving pain.
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PMID:Chest wall resection for bronchogenic carcinoma. 620 97

A 50-year-old man was admitted to hospital because of vertigo for 3 weeks. He was found to have severe hyponatraemia (107 mmol/l), which was rectified with sodium chloride infusions. Two weeks later he became agitated with confusion and hallucinations. Within a few hours he went into coma. At that time the serum sodium concentration had again fallen from 132 to 105 mmol/l. Repeated measurement revealed urinary osmolality (558 mosm/l) to be above that of serum (252 mosm/l), pointing to the syndrome of inadequate antidiuretic hormone secretion (SIADH) as the diagnosis. Lung tomography, performed because the patient had two bouts of pneumonia in quick succession, demonstrated enlarged hilar lymph nodes. Bronchoscopy revealed a tumour of about 1.0 cm diameter in the left main bronchus which histologically proved to be a small-cell bronchial carcinoma. Despite chemotherapy the tumour progressed and the SIADH also persisted. The patient died 9 months later of heart failure.
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PMID:[Hyponatremic coma as the first symptom of a small cell bronchial carcinoma]. 807 Mar 40

For reasons unknown, metastatic squamous-cell carcinoma is a rare cause of pleural effusions and is even less common in pericardial effusions. A review of all pericardial effusions examined in the Cytology Service at Montefiore Medical Center over a 15-year (1980-1994) period was undertaken (N = 251). Four cases with metastatic squamous-cell carcinoma were identified among 39 malignant effusions. Two patients with metastatic squamous-cell carcinoma presented with cardiac tamponade, and the other two cases had progressive cardiac failure. The diagnostic cells on cytology evaluation were scant in all four cases but exhibited classical features of metastatic squamous carcinoma, such as cytoplasmic keratinization, intercellular bridges, and occasional "pearl" formation. Pericardial biopsies available in three patients, two with cardiac failure and one with cardiac tamponade, were negative. In all four cases the primary tumor was a bronchogenic carcinoma. Metastatic squamous-cell carcinoma is an uncommon cause of pericardial effusion and usually indicates the presence of a bronchogenic carcinoma with a rapidly fatal outcome. Cytologic examination of pericardial fluid is essential in the evaluation of such patients.
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PMID:Metastatic squamous-cell carcinoma in pericardial effusion: report of four cases, two with cardiac tamponade. 962 14

The risk of thoracic cancer surgery in patients of advanced age, i.e. 75 years or older, was analysed by reviewing 119 consecutive patients from August 1986 to May 1998 with bronchial carcinoma (n = 87), pulmonary metastases (n = 22), mesothelioma and pleural carcinosis (n = 7) and mediastinal or chest wall tumours (n = 3). Repeated surgery in one case of bronchial carcinoma and in another of metastases gave a total of 124 operations. Of the patients, 22 were 80 years or older (21%) and 32% were female. The median age was 77 years (range 75-87 years). Six fatalities occurred within 30 days or during hospitalization. This corresponds to a 4.8% mortality for the whole series and 6.8% for the subgroup of bronchial carcinoma. The causes of death were surgical complications in two patients, one died from heart failure after simultaneous combined coronary artery bypass grafting and left lower lobectomy 2 hours after the operation from heart failure refractory to resuscitation. With this exception all these patients had stage II (n = 2) or stage III A (n = 3) bronchial carcinoma. It is concluded that cancer surgery in the elderly is safe provided appropriate selection is observed. Indications should be very restrictive for advanced cancer and for pneumonectomy.
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PMID:Thoracic cancer surgery in the elderly. 980 Sep 68

A case is reported in which an undiagnosed bronchogenic carcinoma presented clinically with sudden onset shortness of breath and cardiac failure due to the development of an acute bronchopericardial fistula.
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PMID:Bronchogenic carcinoma presenting as a bronchopericardial fistula. 1034 53


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