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)

This study carried out at a type "C" hospital, analyses the actual pathology of 1,052 patients attended to at the internal medicine department during a period of one year. The sex distribution did not show any differences. The median age (64 years) was significantly superior in women. The more frequent diseases were from group VII (cardiovascular: 512 cases) and group VIII (respiratory: 471 cases) according to the 9th edition of the who international diseases classification. The most frequent causes for admission were: respiratory infection (19.5%), cardiac insufficiency (13.8%) and CVA (10.6%). The most frequent baseline diseases were cardiomyopathy (20.4%), chronic obstructive airways syndrome (16%), malignant neoplasia (8.5%) and hepatopathy (7.6%). The risk factors and toxic habits observed were: Chronic bronchitis (19.6%), blood hypertension (15.5%), diabetes (13.5%) and high alcohol intake (10%).
 ...
PMID:[A morbidity study in a general internal medicine service in a third-level hospital]. 195 89

A 57-year-old female was admitted to our hospital with general lassitude, loss of appetite, nausea, upper abdominal pain, thirst, polydipsia and polyuria. On admission, she had an asymmetrical pear-shaped tumor in the right supraclavicular region and severe hypercalcemia. Plasma C-PTH was elevated to 22.72ng/ml. Plasma calcitonin was also elevated to 336 pg/ml. She died of respiratory and cardiac failure of two weeks after admission without any positive response to the treatment, including hemodialysis. Pathohistologically, the tumor was a parathyroid adenoma. The concentrations of C-PTH, intact PTH and calcitonin in the tumor tissue were markedly high: 4.56 micrograms/g wet, 13.9 ng/g wet and 50.7 ng/g wet, respectively. Immunohistologically, the tumor cells and the fibrous stroma were stained strongly positive to rabbit anti-human calcitonin antibody and rabbit anti-human N-PTH antibody by indirect immunoperoxidase staining. Calcitonin-producing tumors, except for medullary thyroid carcinoma are rarely reported. To our knowledge, this is the first report of such a calcitonin-producing parathyroid adenoma associated with primary hyperparathyroidism.
 ...
PMID:A case of calcitonin-producing parathyroid adenoma with primary hyperparathyroidism. 258 94

With two-dimensional echocardiography and Doppler ultrasound, we demonstrated high-output cardiac failure in three fetuses with large sacrococcygeal teratomas. All fetuses had normal cardiac structure, dilated ventricles maintaining a normal fractional shortening index, a dilated inferior vena cava reflecting the increased venous return from the lower body, pericardial and pleural effusions as a manifestation of fetal hydrops, and a markedly thickened placenta. When fetal hydrops was present, the combined ventricular output was very high (mean 1280 ml/min/kg; normal 553 +/- 153 (SD)). Descending aortic flow was also sharply increased (mean 930 ml/min/kg; normal 184 +/- 20), as was placental flow (mean 480 ml/min/kg, normal 110 +/- 26). High-velocity arterial flow signals were also found within the tumor. In one fetus studied serially, placental thickness and tumor diameter increased rapidly; placental flow as a percentage of descending aortic flow decreased, indicating a further increase of flow to the tumor. These abnormal hemodynamic changes were reversed after the fetus's teratoma was surgically removed. We conclude that the sacrococcygeal teratoma acts as a large arteriovenous fistula, which causes high-output cardiac failure. Surgical removal of the teratoma in a previable fetus with such hemodynamic findings may prove to be the most effective treatment.
 ...
PMID:High-output cardiac failure in fetuses with large sacrococcygeal teratoma: diagnosis by echocardiography and Doppler ultrasound. 265 57

Most sacrococcygeal teratomas diagnosed before birth can be managed by planned delivery and postnatal surgery. However, large tumors early in gestation may result in placentomegaly, hydrops, and fetal death and a preeclampsia-like syndrome in the mother. This chain of events may result from high output cardiac failure in the fetus caused by arteriovenous shunting through the tumor. We recently encountered this situation in a fetus at 21 weeks' gestation and performed fetal surgery in an attempt to reverse the process. Excision of the teratoma resulted in reversal of hydrops, diminution of descending aortic flow on Doppler echocardiography, and decrease in placental thickness. Despite these changes, uterine irritability after hysterotomy resulted in labor and delivery of a nonviable premature infant. This case demonstrates that when fetal sacrococcygeal teratoma becomes very large early in gestation, high output cardiac failure can endanger both fetus and mother. In the future, use of Doppler echocardiography may allow appropriate selection of high-risk fetuses. Intervention to prevent arteriovenous shunting through the tumor may offer these fetuses an improved chance for survival.
 ...
PMID:Fetal hydrops and death from sacrococcygeal teratoma: rationale for fetal surgery. 238 65

The fundamental principles of pheochromocytoma management are reviewed. These are a high index of clinical suspicion; biochemical confirmation of the diagnosis; preoperative localization and pharmacologic treatment with alpha-adrenergic blockers (and occasionally with beta-adrenergic blockers and/or alpha-methylparatyrosine); meticulous anesthesia and intraoperative cardiovascular monitoring; and attention to the surgical principles of wide exposure, careful dissection and complete exploration, early interruption of tumor vasculature, and delivery of the tumor with the capsule intact. For malignant lesions, the roles of pharmacologic management (alpha- and beta-adrenergic blockade, alpha-methylparatyrosine, and drugs for heart failure, diabetes, and pain), teleradiotherapy, radiopharmaceutical treatment with I-131 MIBG and chemotherapy (with cyclophosphamide, vincristine, and dacarbazine) are discussed.
 ...
PMID:Management of pheochromocytoma. 266 82

The patient was a 70-year-old male with complaint of macrohematuria at the first visit to our clinic on June 10, 1986. At that time, cystoscopy revealed a thumb sized papillary tumor and a rice sized non papillary tumor, and the biopsy specimen was pathologically diagnosed as undifferentiated carcinoma. But, he refused admission. On January 30, 1987, he came back to our clinic with complaints of dyspnea, general fatigue and weight loss. Moderate lt. gynecomastia was found and the level of serum hCG-beta was detected as high as 101 ng/ml. Excretory urogram and enhanced CT revealed a large mass in the bladder. In the seventeenth day after admission, he died of lung edema and heart failure. The findings of autopsy showed a large light greenish to light brownish tumor of 10 X 10 X 3 cm in the bladder. Distant metastases were observed in internal, common iliac and paraaortic lymph nodes, but without other distant metastasis. In histological and immunohistochemical studies, the final diagnosis is choriocarcinoma of the bladder, containing syncytiotrophoblastic giant cells with hCG-beta granules as an undifferentiated carcinoma. To our knowledge this case is the eighth described in Japan. Herein we report a new case of primary choriocarcinoma of the bladder and make a brief review of the literatures.
 ...
PMID:[Primary choriocarcinoma of the bladder: a case report of autopsy]. 267 66

A 62-year-old man developed symptoms of heart failure. Echocardiography showed a dense mass arising from the free wall of the right ventricle and occupying about 75% of the right ventricular cavity. Selective coronary angiography demonstrated intense neovascularization of a cardiac neoplasm arising in the distribution of the right coronary artery. Under cardiopulmonary bypass the tumor was resected completely and the defect of the ventricular wall was repaired with Gore-tex (EPTFE) patch (area 7.5 X 5.0 cm). The size of the resected tumor was 10.0 X 9.5 X 3.4 cm and weighed 170 g. Histological examination of the tumor disclosed cavernous hemangioma. The post operative course was uneventful and the patient has remained asymptomatic after the surgery. To our knowledge, only 23 cases of intramyocardial or intracavital hemangioma were reported in the world literature and this may be the first report in Japan.
 ...
PMID:[Intramyocardial hemangioma of the right ventricle with successful resection--report of a case and review of the literature]. 268 49

Intravenous leiomyomatosis (IVL) is a rare neoplastic disease which is defined as the extension into venous channels of histologically benign smooth muscle tumors arising either from a uterine myoma or from the walls of a uterine vessel. We report a case of IVL originating from the uterus, growing up in the inferior vena cava, and extending into the right pulmonary artery. The patient was a 42-year-old woman, who was admitted to our hospital with clinical signs of right-side heart failure and syncope in December 1987. Her medical history included a total hysterectomy in August 1986. On examination, two dimensional echocardiography showed a freely floating tumor in the right atrium and right ventricle, which protruded via the inferior vena cava. Cavography confirmed the above findings. Because of the clinical disability caused by the tumor localized in the right heart, emergency operation was performed, extracorporeal circulation was instituted through the femoral vein, the superior vena cava, and the femoral artery. Opening the right atrium confirmed that a white sausage-like mass quite free from the wall extended into the right ventricle, and the head of the tumor was adherent to the right pulmonary artery. After detaching the head of the tumor from the right pulmonary artery, the remaining tumor in the inferior vena cava was also successfully pulled out. The operative specimen was measured 55 cm in length, but the basal end of the tumor was supposed to be left in place. Two months later, the second-stage operation for the remaining tumor was carried out through a median laparotomy.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[A case report of intravenous leiomyomatosis of the uterus with extension into the right pulmonary artery]. 269 64

Anthracyclines are drugs with widespread applications on the chemotherapy of cancer. Cardiotoxicity is an important side effect of these drugs, well known for doxorubicin, the most representative of this group of drugs. Dysrhythmias and heart failure are the most important among the toxic effects of anthracyclines and are dependent on cumulative doses reason why WHO established maximal doses for the different anthracyclines. Pathogenic hypothesis about the mechanism of the myocardial lesion induced by anthracyclines include the production of free oxygen radicals, alterations of energetic metabolism and disturbances of calcium and sodium exchange at membrane level. Early detection of the toxicity of these drugs is of utmost importance. Electrocardiography has low sensitivity and specificity. Echocardiography gives specific information about previous cardiac pathology and enables the detection of complication of the basic neoplastic disease. However, detection of early changes of left ventricular function is not accomplished so well, as it is with equilibrium radionuclide angiography. Left ventricular ejection fraction is the method of choice in the early detection of cardiotoxicity of these drugs, and its frequent evaluation enables to individualize the doses in each patient, and so, a most accurate use of the therapeutic potential of the anthracyclines. Radionuclide angiography has some important indications on the selection of patients for treatment with anthracyclines, namely: to identify patients that must be excluded from the treatment; select patients at risk of congestive heart failure; to decide the appropriate moment to stop the drugs; change the therapeutic schema, etc.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Anthracycline cardiotoxicity. Review of the literature and presentation of a study protocol]. 269 92

PGE1 has a beneficial effect on cardiac failure with mitral valve regurgitation by decreasing the "after load". An 82-year-old female had a total cystectomy of a bladder tumor. The preoperative standard 12 lead electrocardiogram showed atrial fibrillation and incomplete right bundle branch block. The preoperative echocardiogram showed regurgitation of both mitral valve and tricuspid valve. Under heavy premedication, we intubated with fentanyl and pancuronium bromide, maintained anesthesia with enflurane. After incision, both pulmonary artery pressure and pulmonary capillary wedge pressure increased, and cardiac index decreased. Continuous injection of 100ng.kg-1.min-1 PGE1 made pulmonary artery pressure and pulmonary capillary wedge pressure to decrease, and cardiac index to increase. PaO2, however, decreased apparently. PGE1 was effective for cardiac failure with mitral valve regurgitation associated with pulmonary hypertension. But attention must be given to the decrease in PaO2.
 ...
PMID:[The use of PGE1 in an elderly patient with mitral valve regurgitation during general anesthesia]. 270 14


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