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

The usefulness of photomotographic determination of the duration of the ankle reflex in the diagnosis of thyroid dysfunction was studied. Diagnoses by photomotography and I(131) uptake were in accord in 28 normals (260-380 milliseconds), 14 hypothyroid (390-600) and 21 hyperthyroid patients (160-250). Euthyroid reflex duration did not vary in 141 healthy persons when considered in terms of race, sex, age and pregnancy. In 172 patients, psychiatric or neuromuscular illness, heart failure, fever or several drugs had no effect. Hyperthyroidism was erroneously diagnosed in seven euthyroid subjects; there were no false hypothyroid values. Photomotography is helpful in the diagnosis of thyroid dysfunction, especially hypothyroidism.
 ...
PMID:RAPID ESTIMATION OF THYROID FUNCTION BY PHOTOMOTOGRAPHY. 1417 25

Patients with hyperthyroidism usually present with symptoms of hypermetabolism with or without goitre and/or eye signs. Occasionally, however, the chief complaints are not immediately suggestive of hyperthyroidism. Patients with hyperthyroidism are described who presented with such atypical manifestations as periodic muscular paralysis, myasthenia, myopathy, encephalopathy, psychosis, angina pectoris, atrial fibrillation, heart failure without underlying heart disease, skeletal demineralization, pretibial myxedema, unilateral eye signs, and pitting edema of the ankles.
 ...
PMID:ATYPICAL MANIFESTATIONS OF HYPERTHYROIDISM. 1417 5

Mutations of the TSH receptor leading to constitutive activation of the cAMP cascade are responsible for the development of hot nodules, if arising in a somatic cell, and nonautoimmune hyperthyroidism, when occurring in a germinal cell. An animal model of constitutive activation of the thyroid cAMP cascade has been obtained by generating transgenic mice expressing the adenosine receptor (Tg-A2aR) under the control of the thyroglobulin promoter. These mice develop huge goiters and die prematurely due to hyperthyroidism induced cardiac failure. To identify new genes involved in the tumorigenic pathway of the thyroid, we designed a protocol using microarray technology to study the differential expression, between normal and transgenic thyroid, of +/-13,000 genes. A total of 360 genes or expressed sequence tags showed a strong modulation with background corrected values of fluorescence superior to 2-fold change. The modulated genes were classified according to their proposed gene ontology functions. Approximately half of them were up-regulated. The function of the majority of these genes in thyroid physiology is still to be determined. Some of them, like IGF-I or IGF binding protein 3 or 5, may play an important role in the development of thyroid nodules through paracrine mechanisms. This study demonstrates the feasibility of sequentially following the cascade of events leading to the formation of benign tumors such as hot thyroid nodule or hyperfunctional goiter.
 ...
PMID:Gene expression profile in thyroid of transgenic mice overexpressing the adenosine receptor 2a. 1456 36

Amiodarone is an antiarhytmic drug used in many clinical situations for its probed effect; it is also preferred in particular groups of patients (heart failure, post-ischemical) for its safe and its prognostic benefits. However, a substantial proportion of amiodarone treated patients develop either hypothyroidism or thyrotoxicosis. Both abnormalities may occur in apparently normal glands or in glandes with pre-existed abnormalities. It may be difficult to recognize the dysfunction because of the many changes in thyroid function test results that occur in euthyroid patients who are receiving amiodarone. Hypothyroidism is a well defined clinical situation managable thanks to common guidelines. The occurrence of hypothyroidism does not necessitate withdrawing amiodarone while instituting L-T4 replacement therapy, although many cases are transient and will spontaneously remit after amiodarone withdrawal. At the opposite, hyperthyroidism needs more attention to be diagnosed and to be treated, in fact there is a "personal" clinical-therapeutical behave towards it, caused by the lack of big trials made on this clinical situation. Effective strategies exist for the management of thyroid dysfunction, these should be tailored to the needs of the individual patient.
 ...
PMID:[Amiodarone and thyroid dysfunction: a pending problem]. 1465 Aug 17

Besides the typical and in this case severe signs of hyperthyroidism the thyrotoxic crisis is characterized by additional signs and symptoms such as fever, cardiac involvement (tachycardia, arrhythmia, heart failure) and central nervous impairment eventually leading to coma. Additional diseases and comorbidities impair the diagnostic process and may mask the symptoms of thyrotoxicosis. If undiagnosed, this situation harbors a mortality of approximately 90%. The precise knowledge of typical (and atypical) symptoms is mandatory in order to rapidly recognize this situation and to initiate pharmacological treatment and/or surgery. An experienced endocrinologist should always be involved in this decision process.
 ...
PMID:[Thyrotoxic crisis]. 1468 83

A case of neonatal thyrotoxicosis secondary to maternal autoimmune hyperthyroidism is reported in an infant born at 34 weeks gestation who presented with tachycardia, jitteriness, diarrhea, and a small goiter. Propranolol and oxygen were used to treat high-output cardiac failure and transient persistent pulmonary hypertension. The infant's response to propylthiouracil therapy, gradual resolution of cardiac and systemic symptoms, and normaliziation of thyroid studies are described. Thyroid physiology and function and the special considerations in a premature infant are reviewed. An overview of maternal autoimmune hyperthyroidism and the implications for the developing fetus and neonate are presented. The risk factors for, and clinical presentation of, hyperthyroidism are outlined and treatment strategies highlighted. The nursing care of infants with hyperthyroidism is carefully described with an emphasis on the surveillance for and management of multisystem manifestations.
 ...
PMID:A case report of neonatal thyrotoxicosis due to maternal autoimmune hyperthyroidism. 1469 99

Atrial fibrillation (AF), the most widespread arrhythmia, is a source of disability and death in the elderly, in particular because of the functional heart failure entailed and the considerable frequency of thromboembolic complications. Today, overt hyperthyroidism (oHT) is generally believed to be the most important extracardiogenic predisposition factor for AF. There exists no widespread acceptance so far that subclinical hyperthroidism (sHT) influences the occurrence of AF. Furthermore, there are no clear recommendations for treatment of sHT to prevent AF. Recent data confirm AF prevalence to be 5-6 times higher not only in cases of oHT but also in sHT patients compared with a reference group with normal thyroid function. Subclinical hyperthyroidism increases the prevalence of AF approximately to the same extent as oHT and has to be included in diagnostical considerations in patients with AF.
 ...
PMID:[Subclinical hyperthyroidism and atrial fibrillation]. 1471 Apr 78

Subacute motor neuropathy involving bulbar nerves is an unusual complication of hyperthyroidism. Clinical and neurophysiologic follow-up of such patients has been rarely reported. We describe a 41-year-old Colombian patient who developed respiratory failure associated with motor neuropathy and severe weight loss. The major clinical features included diffuse amyotrophy, bilateral facial paresis, and fasciculations, suggesting motor neuropathy. Electromyography confirmed the presence of axonal neuropathy, with predominant motor involvement. Goiter with hypervascularization was noticed, associated with pure T3 hyperthyroidism (T3l=26 pg/ml; N<3.8). The patient was given carbimazole which induced a severe skin vasculitis 10 days later. Carbimazole was stopped and replaced by propylthiouracile, which also induced vasculitis with secondary cardiac failure. Total thyroidectomy was then performed. General status improved rapidly as well as motor deficit, amyotrophy and pyramidal syndrome. Electromyographic abnormalities improved significantly within 3 months. This observation demonstrates that hyperthyroidism can produce motor axonal neuropathy, curable with radical surgery.
 ...
PMID:[Subacute motor neuropathy induced by T3 hyperthyroidism]. 1473 39

The aim of this study is to clarify the specificities of atrial fibrillation in hyperthyroidism. It's a retrospective study of 6 years, about 14 patients hospitalized for hyperthyroidism with atrial fibrillation. There were 9 Women and 5 men, 55.7 +/- 11.5 years old. Arryhthmia was discovered especially with palpitation and dyspnea. Cardiac echography diagnosed valvular disease in 83.3% of cases. Cardiovascular complications concerned 5 patients and consisted in cardiac insufficiency and cardiomyopathy in one case. Treatment of hyperthyroid consisted in radio-iodine administered to 7 patients at the dose of 9.8 +/- 3.9 mCi. Two patients had total thyroidectomy. Arryhthmia was treated with propranolol, 98.3 +/- 70 mg daily and anticoagulant treatment was given. From the group of nine hyperthyroid recovered patients, arryhthmia was reduced in 3 cases. In this group, age was higher and arryhthmia history was longer. We conclude that chances to treat arryhthmia associated to hyperthyroid are higher when euthyroidism or even hypothyroidism is rapidly obtained, during of atrial evolution is short and some factors aren't present, like aging, existence of valvular disease or left auricular dilatation.
 ...
PMID:[Therapeutic specifics in atrial fibrillation in hyperthyroidism. Study of 14 cases]. 1498 28

AF remains the most common and most challenging arrhythmia. Although several new treatment modalities are available to restore and maintain sinus rhythm, the long-term success of such a strategy remains disappointing, often making rate control a good alternative. Factors associated with failures to restore and maintain sinus rhythm thereafter are a longer duration of AF, older patient age, atrial dilatation, poor functional class or heart failure, and hypertension. Recent trials comparing rate and rhythm control (see Box 1) could not show superiority of rhythm control and even gave some evidence that rhythm control may even be worse than rate control (more hospitalizations, more adverse drug effects). In general, however, these trials in general included older patients with persistent AF, and, most importantly the success of rhythm control was poor, stressing the fact that attempts to maintain rhythm control cannot be construed as being the same as actual maintenance of sinus rhythm. As mentioned previously, at least 37% to 74% of all patients in these trials were in AF and did not benefit from the possible advantages of sinus rhythm while they were exposed to the possible adverse effects of cardioversions and antiarrhythmic drugs. The decision to choose rhythm or rate control strategies should be individualized and depends on the expected benefit of restoring sinus rhythm, chance on failure to maintain sinus rhythm in the long-term, and the likelihood of adverse drug effects (Fig. 1). In all patients with AF, treatment should focus on underlying heart disease, anticoagulation, and control of ventricular rate during AF. In the authors' opinion, rhythm control remains first choice for patients with a first episode or highly symptomatic episodes of AF and for patients who have AF caused by a reversible cause (eg, hyperthyroidism, postcardiac surgery) or who have a high chance of remaining in long-term sinus rhythm (young patients, no hypertension, normal left atrium size, short preceding AF duration). Also patients with symptomatic AF who are suitable for ablation therapy (eg, focal AF, class IC flutter ), restoration and maintenance of sinus rhythm would be first choice. Rate control, however, will be a good option in asymptomatic patients and in patients in which rhythm control has failed or is very likely to fail. Also, if rhythm control does not improve symptoms or causes unwanted adverse effects (eg, frequent cardioversions, sinus node disease needing pacemaker implantation, or proarrhythmia), it should be abandoned. The present decision to opt for rhythm or rate control is determined mainly by the fact that in general, there is no single treatment that is highly effective and does not cause any adverse effects. If a 100% effective, 100% safe, and inexpensive drug or other treatment becomes available to restore and maintain sinus rhythm, it is more likely that the benefits of maintaining sinus rhythm could be proven, and one likely would opt for rhythm control in most patients.
 ...
PMID:Rate versus rhythm control in atrial fibrillation. 1499 48


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