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

Fibrosing mediastinitis, also known as sclerosing mediastinitis and mediastinal fibrosis, is an uncommon disease characterized by the proliferation of a dense fibrous tissue in the mediastinum. This article describes a patient who presented to the ED with atypical signs and symptoms that initially seemed like heart failure but were eventually diagnosed as fibrosing mediastinitis.
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PMID:Fibrosing mediastinitis mimicking postpartum heart failure. 2541 62

Spontaneous esophageal perforation is relatively uncommon, but carries a high mortality rate if diagnosis or treatment is delayed. We report the case of a 68-year-old man with spontaneous esophageal perforation who was successfully treated over 96 h after onset by thoracic drainage and jejunostomy for enteral nutrition. He vomited after drinking alcohol, soon followed by epigastralgia. Heart failure was suspected on admission to another hospital. Spontaneous esophageal perforation was diagnosed 48 h after admission. Chest tube drainage was performed, but his general condition deteriorated and he was transferred to our hospital. Emergent surgery was performed and esophageal perforation combined with pyothorax and mediastinitis was identified on the left side of the lower esophagus. The left thoracic cavity was rinsed and thoracic drainage was performed. Feeding jejunostomy was performed for postoperative enteral nutrition. Effective drainage and sufficient nutrition management appear extremely valuable in treating spontaneous esophageal perforation.
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PMID:Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition. 2556 34

Multifocal fibrosclerosis is a rare syndrome of unknown cause that is characterized by fibrosis involving multiple organ systems. Definitive diagnosis can only be made based on biopsy findings. In this case, the biopsy specimen of the patient demonstrates pulmonary hyalinated granuloma or sclerosing mediastinitis. There are few reports of multiple fibrosclerosis with heart failure. Here, we reported a case of retroperitoneal fibrosis with massive mediastinal involvement extending to pleura and pericardium causing pleuro- pericardial effusion with dilated cardiomyopathy. Systolic dysfunction was improved and pericardial effusion disappeared with methylprednisolone treatment.
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PMID:Improvement of dilated cardiomyopathy with methylprednisolone in a patient with multiple fibrosclerosis. 2561 63

The aim of this study was to determine the association between preoperative medium-term (60-90 days) glycemic control, as reflected by glycosylated hemoglobin levels (HbA1c), and the incidence of major complications (mediastinitis, perioperative infarction, heart failure, stroke and kidney failure dialysis) and mortality in diabetic patients undergoing elective coronary artery by-pass graft surgery (CABG). This study suggests that aggressive glycemic control three months before surgery, achieving HbA1c=7% improvement results with less postoperative morbidity and mortality.
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PMID:Medium-term glycemic control in diabetics before coronary bypass surgery. 2650 61

Vacuum-assisted closure(VAC) therapy is mainly used for tissue defects. VAC therapy can remove exudate that could impair the healing process. We applied VAC therapy in patients considered at high risk of surgical site infection who underwent cardiovascular surgery via standard median sternotomy. Risk factors included advanced heart failure, obesity, diabetes mellitus, steroid administration, immunosuppressant administration, and chronic renal failure, etc. VAC therapy was used in 134 patients. Only 3 of these patients (2.2%) developed surgical site infection caused by Staphylococcus epidermidis;2 patients fully recovered after prolonged VAC therapy for 2 weeks, and the other required an additional sternal fixation after the sternal wires were removed for wound infection control. No patient developed infective mediastinitis. Prophylactic VAC therapy can reduce postoperative wound infection in high risk patients undergoing open heart surgery via full sternotomy.
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PMID:[Prophylactic Effectiveness of Vacuum-assisted Closure for High-risk Patients Undergoing Cardiovascular Surgery through Median Sternotomy]. 2879 Feb 37

Cardiac resychronization therapy (CRT) was performed via transvenous approach in a 2-year-old boy with a tetralogy of Fallot and postoperative severe heart failure, and complete atrioventricular block treated with a dual-chamber pacemaker. Epicardial leads were unavailable because of mediastinitis and the presence of severe bilateral pleural effusions requiring continuous drainage. There were no procedural complications. Biventricular pacing was significantly effective and both mediastinitis and pleural effusions recurred. The transvenous CRT was exchanged for an epicardial CRT after 4 months because of the possibility of a venous obstruction.
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PMID:Cardiac resynchronization therapy via transvenous approach in a 2-year-old boy with a complete atrioventricular block after a tetralogy of Fallot repair. 2925 19


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