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)

Geriatric patients are preferentially involved in ischemic bowel disease. The sudden occlusion of the large mesenteric arteries (a. mesenterica superior (more frequently) and inferior) is followed by intestinal gangrene and peritonitis with a poor prognosis and a high letality (greater than 90%). In chronic intestinal ischemia the leading clinical symptom is postprandial pain ('claudicatio intestinalis'). In some cases of acute mesenteric artery occlusion no embolus or thrombus will be found. In these cases the circulation in the arteriosclerotic vessels falls below a critical value due to cardiac insufficiency, shock, digitalis overdose and others. In less severe ischemia the mucosa is involved being most sensitive to O2 deprivation. It usually regenerates within a few days. This form is found more frequently in the colon than in other parts of the gut (about 40%): ischemic colitis. The therapy - if possible in acute, fulminant ischemia or if necessary in chronic intestinal ischemia - is surgical consisting in reconstructive procedures of the mesenteric circulation.
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PMID:[Ischemic bowel disease (author's transl)]. 1 31

The oral use of enteric-coated potassium chloride (and apparently of its slow-release form too) to compensate potassium loss during thiazide diuretic treatment may engender ischemic enteropathy. This iatrogenic condition is linked to the vaso-active properties of KCl, which act on blood vessels often damaged by hypertension or chronic heart failure. Four observations are presented involving stenosing ulceration or perforation of the small bowel following oral KCl treatment. The main clinical, pathological and therapeutic aspects are discussed.
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PMID:[4 cases of potassium enteropathy]. 91 79

Plasma, blood cell, and total body potassium levels were measured serially in 21 patients receiving long-term diuretics for the treatment of cardiac oedema and the results compared with similar measurements in 10 control subjects. Initially, all diuretic recipients received potassium chloride supplements. However, in 17 of the 21 subjects these were discontinued and measurements of potassium status were repeated regularly thereafter. No significant fall in the measured indicators of potassium status were observed in the patients in whom potassium was withdrawn; however, in one subject with persistent cardiac failure who presented with hypokalaemia this was not corrected even after intensive potassium supplementation. It is concluded that for those taking a normal diet who are free of any major gastro-intestinal disorder, routine potassium supplementation is unnecessary, and might indeed occasionally prove harmful.
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PMID:Potassium supplements in patients receiving long-term diuretics for oedema. 94 47

Intestinal infarction in the absence of organic vascular occlusion received increasing attention in recent years. The clinical picture is discussed based on results in 9 cases, an attempt to suggest a possible pathophysiological mechanism is made. Prophylactic digitalisation especially in the elderly patient in the absence of severe heart failure and in cases with already low mesenteric perfusion may lead to a further vasoconstriction and to hemorrhagic enteropathy. Therapeutic possibilities are discussed.
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PMID:[Hemorrhagic enteropathy]. 108 16

A case of hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE) in an 84-year-old woman with cardiac failure is presented. The autopsy showed hepatic infarction, THNE, fibrous endocarditis, generalized arteriosclerosis, myocardial hypertrophy, liver congestion, and other findings as described. Both rare infarctions (hepatic and intestinal) seemed to have originated not only as a result of impaired systemic circulation due to cardiac failure, but also from liver congestion due to peripheral circulatory deficiency through the portal vein. The circulatory correlation between these infarcts of the liver and intestine is discussed.
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PMID:Hepatic infarction associated with terminal hemorrhagic necrotizing enteropathy (THNE): case report. 117 51

Variable degrees of injury of the pancreatic islets of Langerhans, with sparing of the acinar pancreas, were observed in three infants (age range, 1 day to 3 months) who died of profound shock. The duration of shock varied from 19 to 48 hours. In two of the infants, the shock stemmed from hypovolemia; in the remaining infant, the shock followed blood loss, sepsis, and heart failure. The islet lesions were devoid of cellular infiltrates, hemorrhage, and fibrin thrombi. Tissue manifestations of shock included acute renal tubular necrosis, massive hepatic centrilobular necrosis, ischemic enteropathy, and "shock" lung. Study of pancreatic sections from 30 children (age range, 13 hours to 15 years) with clinical and/or morphologic evidence of shock showed no additional instances of islet injury. These findings suggest that pancreatic islets in the young may be vulnerable to shock-induced ischemia. Studies are in progress in an animal model to test this hypothesis.
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PMID:Shock-related injury of pancreatic islets of Langerhans in newborn and young infants. 390 77

The urophysis, a neurosecretory organ in fish, contains a number of putative hormones, collectively called urotensins. One of these, urotensin I--a straight chain peptide of 38 amino acids--produces a sustained hypotensive action in all mammalian species examined. In the anesthetized dog, the hypotensive action of native urotensin I is due to specific dilatation of the mesenteric vascular bed, the peptide having no significant actions on other vascular beds. Recent work has established that urotensin I is similar in structure to sauvagine and ovine corticotropin-releasing factor (CRF). Synthetic urotensin I and synthetic sauvagine both share the ability of synthetic ovine CRF to release adrenocorticotropin from cultured pituitary cells. All these synthetic peptides appear to lower blood pressure in the dog by the mechanism established for native urotensin I: selective mesenteric vasodilatation. The selectivity of the mesenteric vascular response suggests that a similar endogenous peptide might be the physiological regulator of gut blood flow. These peptides, or analogs, may also prove to be of value in ischemic bowel disease or anastomotic gastrointestinal surgery, or in reduction of afterload in heart failure.
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PMID:Mammalian pharmacology of the fish neuropeptide urotensin I. 684 83

A cat was presented with acute-onset exfoliative erythroderma and gross and histopathological lesions of erythema multiforme. Marked cardiovascular abnormalities including heart failure occurred concurrently and a dermatogenic enteropathy was also seen. Medical treatment resolved the dermatopathy and enteropathy but the heart failure progressed. A drug reaction was initially suspected to be the underlying cause with no neoplasia being detected, but repeat radiographs subsequently revealed a thymoma which had not been visible on the initial radiographs. The dermatopathy may have been a paraneoplastic disease associated with thymoma and, possibly, exacerbated by a drug reaction to imidacloprid. The cardiovascular and gastroenterological diseases were thought to be systemic effects associated with the exfoliative erythroderma. The thymoma was surgically removed but the cat subsequently died from heart failure.
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PMID:Dermatosis and associated systemic signs in a cat with thymoma and recently treated with an imidacloprid preparation. 1044 53

It is sometimes necessary for the practitioner to transfuse the ruminant with whole blood or plasma. These techniques are often difficult to perform in practice, are time-consuming, expensive, and stressful to the animal. Acute loss of 20% to 25% of the blood volume will result in marked clinical signs of anemia, including tachycardia and maniacal behavior. The PCV is only a useful tool with which to monitor acute blood loss after intravascular equilibration with other fluid compartments has occurred. An acutely developing PCV of 15% or less may require transfusion. Chronic anemia with PCV of 7% to 12% can be tolerated without transfusion if the animal is not stressed and no further decline in erythrocyte mass occurs. Seventy-five percent of transfused bovine erythrocytes are destroyed within 48 hours of transfusion. A transfusion rate of 10 to 20 mL/kg recipient weight is necessary to result in any appreciable increase in PCV. A nonpregnant donor can contribute 10 to 15 mL of blood/kg body weight at 2- to 4-week intervals. Sodium citrate is an effective anticoagulant, but acid citrate dextrose should be used if blood is to be stored for more than a few hours. Blood should not be stored more than 2 weeks prior to administration. Heparin is an unsuitable anticoagulant because the quantity of heparin required for clot-free blood collection will lead to coagulation defects in the recipient. Blood cross-matching is only rarely performed in the ruminant. In field situations, it is advisable to inject 200 mL of donor blood into the adult recipient and wait 10 minutes. If no reaction occurs, the rest of the blood can probably be safely administered as long as volume overload problems do not develop. Adverse reactions are most commonly seen in very young animals or pregnant cattle. Signs of blood or plasma transfusion reaction include hiccoughing, tachycardia, tachypnea, sweating, muscle tremors, pruritus, salivation, cough, dyspnea, fever, lacrimation, hematuria, hemoglobinuria, collapse, apnea, and opisthotonos. Intravenous epinephrine HCl 1:1000 can be administered (0.2 to 0.5 mL) intravenously or (4 to 5 mL) intramuscularly (preferable) if clinical signs are severe. Pretreatment with antipyretics and slowing the administration rate may decrease the febrile response. Blood or plasma administered too rapidly will also result in signs of cardiovascular overload, acute heart failure, and pulmonary hypertension and edema. Furosemide and slower administration of blood or plasma should alleviate this problem. Administration rates have been suggested starting from 10 mL/kg/hr; faster rates may be necessary in peracute hemorrhage. Plasma should be administered when failure of absorption of passive maternal antibody has occurred or when protein-loosing enteropathy or nephropathy results in a total protein of less than 3 g/dL or less than 1.5 g albumin/dL. Plasma can be stored at household freezer temperatures (-15 to -20 degrees C) for a year; coagulation factors will be destroyed after 2 to 4 months when stored in this manner. To maintain viability of coagulation factors, plasma must be stored at -80 degrees C for less than 12 months. When administering plasma, a blood donor set with a built-in filter should always be used. When bovine plasma is thawed, precipitants form in the plasma and infusion of these microaggregates may result in fatal reactions in the recipient.
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PMID:Use of blood and blood products. 1057 16

The high case-fatality of severe malnutrition is due to infections, dehydration, electrolyte disturbances and heart failure. We focus on the evidence about managing these complications of severe malnutrition. Signs of circulatory collapse in severely malnourished children should be treated with intravenous or bone marrow infusion of Ringer's lactate with additional dextrose and potassium at a rate 20-40 mL/kg fast with close monitoring of vital signs. Recommendations for slow or restricted fluids in the face of shock are unsafe, and hypotonic or maintenance solutions must be avoided to prevent hyponatraemia. However, the evidence that severely malnourished children do not tolerate excessive fluid administration is good, so caution must be exercised with regards to fluids in the initial phase of treatment. There is also good evidence that wide spectrum antibiotics need to be given empirically for severe malnutrition to prevent the otherwise unavoidable early mortality. There is a need for improved protocols for tuberculosis diagnosis, HIV management and treatment of infants under 6 months with severe malnutrition. The contribution of environmental enteropathy to poor growth and nutrition during the weaning period means that there should be more priority on improving environmental health, particularly better hygiene and less overcrowding. A T-cell mediated enteropathy contributes to growth failure and malnutrition, and it is related to environmental contamination of enteric organisms in the weaning period rather than allergic responses.
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PMID:Critical appraisal of the management of severe malnutrition: 3. Complications. 1697 63


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