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

Sixty-four severe infections in hospitalized patients were treated with intravenous Timentin. Most patients (mean age: 50.5 years, range 18-85) had serious underlying conditions such as agranulocytosis, heart failure, cancer, diabetes mellitus, chronic alcoholism or other functional or anatomical abnormalities. Forty-three episodes were bacteriologically proved, and bacteraemia was diagnosed in 18. The sites of infection were: lower respiratory tract (10), upper respiratory tract (10), soft tissues (9), urinary tract (7), bones (6), peritoneal cavity (3), meninges (1) and pelvis (1). In addition, 13 episodes of fever and four of septicaemia in patients with agranulocytosis were treated with Timentin plus amikacin. Overall, 59% of the episodes were cured, 14% improved and 17% failed to respond. In 9% of cases the efficacy of the Timentin was unassessable mainly because of concurrent administration of other antimicrobials. Failure appeared to be more frequent in soft tissue and intra-abdominal infections, in patients infected with bacteria susceptible to Timentin but resistant to ticarcillin and in patients superinfected with Timentin-resistant strains. Major side effects were haemorrhagic diathesis with platelet dysfunction (1), severe water sodium overload (1), and possibly pancreatitis (1). Other side effects were mild: catheter-related phlebitis, and abnormal but clinically insignificant laboratory test results. Timentin appears to be an effective and safe broad-spectrum combination which compares favourably with third-generation cephalosporins in the treatment of severe hospital infections. More experience is needed to decide whether the somewhat lower response rate in patients infected with ticarcillin-resistant strains is significant.
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PMID:Clinical experience with Timentin in severe hospital infections. 363 28

Fanconi's anaemia (FA) is a hereditary disease transmitted in a recessive manner, characterized by congenital malformations and bone marrow aplasia. A high rate of chromosome breakage is observed in mitoses of cultured blood cells, but the caryotypes are normal. Forty-four patients (27 boys and 17 girls) were followed in the same department between 1962 and 1976. Most were treated with androgens, sometimes combined with corticosteroids. Nine patients died of acute granuloblastic leukaemia, with more than 25% bone marrow blasts; in three of these, cytogenetic examination showed clonal anomalies. Five patients were in preleukaemic state with non-blastic bone marrow; 4 showed clonal anomalies and 2 of these died of aplasia; the 5th patient had gross liver and spleen enlargement and died of haemorrhage. Among the 30 remaining patients 12 are still alive and 18 died of cerebral haemorrhage (7), hepatic failure (3), cardiac failure (1), pancreatitis (1), septicaemia (2) or graft-versus-host reaction after bone marrow transplantation. One patient transplanted 4 years ago has complete chimerism and is still alive without treatment. The incidence of leukaemic or preleukaemic state in this series was 30%, while no case of leukaemia was observed in 200 patients with acquired aplastic anaemia. Neither parents norsibship had leukaemia. Androgen treatment apparently did not increase the risk of leukaemia which developed within 1 to 13 years (mean = 5 years) of the diagnosis, was preceded by a 2 1/2 year long preleukaemic state with clonal chromosomal anamolies and invariably was of the granulocytic type. None of the patients developed cancer. The median survival in this series was 4 1/2 years.
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PMID:[Fanconi's anemia. Incidence of its development into leukemia]. 622 98

200 patients with pancreatitis were examined for various concomitant and previous diseases, and socioeconomic factors, in a retrospective study. This pancreatitis group (PG) was compared with a control group (CG) of 250 patients. Most frequent amongst the etiological factors, were biliary diseases, especially a state after cholecystectomy. Second in rank, was chronic alcoholism. For women, the incidence was highest in the 7th decade; for men, there was a double peak in the 4th and 6th decade, respectively. The incidence was about equal for both sexes. The following factors were found to play no essential role in the PG: type of profession, cigarette consumption, gastric and/or duodenal ulcers, partial gastric resection, renal and cardiac insufficiency, viral hepatitis, liver cirrhosis of hypertriglyceridemia. There is a significant accumulation of mumps in the history of the PG, which had gone along without any clinically detectable affection of the pancreas in childhood, in practically all cases.
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PMID:[Social profile and accompanying diseases in acute and chronic pancreatitis (author's transl)]. 700 47

Myocardial depression (measured by ventricular function curves on response to a fluid load) has been shown in 10 patients with acute hemorrhagic pancreatitis. Significant inadequate responses were found on evaluation of both the left and right heart. The increased pulmonary vascular resistance associated with adult respiratory distress syndrome (ARDS) of this disease was shown to correlate inversely with pulmonary wedge pressure, thereby excluding myocardial failure and pulmonary edema as mechanisms for the production of the ARDS.
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PMID:The myocardial depressant factor (MDF) in acute hemorrhagic pancreatitis. 724 73

Infected pancreatic necrosis is the most lethal form of pancreatic infections. We have compared our results of open packing and closed catheter drainage after surgical debridement in 20 patients between 1978 and 1993. There were 18 men and 2 women, ages 18 to 72 (mean 54 years). Pancreatitis was attributed to alcohol in eight patients, gallstones in four, surgery in four, hyperlipidemia in one, and was unknown in one. The most common infectious organisms were Strep. viridans, E. coli, Staph aureus, and Candida albicans. Surgical debridement and closed catheter drainage without lavage was the initial treatment in nine patients. Seven of 9 (78%) required reoperation for recurrent abscess and necrosis. Procedure related morbidity was 70 per cent and overall mortality was 44 per cent. Sepsis was the cause of death in three patients and multi-system organ failure in one patient. Surgical debridement and open packing was performed in 11 patients. Each patient had scheduled reoperations for repeat debridement and packing an average of 10 times over 21 days. Procedure-related morbidity was 73 per cent and overall mortality was 18 per cent. One patient died of cardiac failure and one of multisystem organ failure. Retroperitoneal hemorrhage and recurrent abscesses were more frequent after closed drainage, whereas gastric fistula and incisional hernia were more frequent after open packing. Ventilator dependence, pancreatic and intestinal fistula, and organ failure occurred at the same rate. In conclusion, surgical debridement and open packing, with planned redebridement and packing, is more effective in controlling the septic process than is closed catheter drainage of infected pancreatic necrosis.
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PMID:Closed drainage versus open packing of infected pancreatic necrosis. 779 43

Laparoscopic exploration of the common bile duct is now technically possible. This prospective study evaluates the feasibility of the different techniques and their complications. From January 1990 to March 1995, 140 patients, aged from 22 to 92, underwent laparoscopic treatment for choledocholithiasis. A transcystic approach was attempted in 70 patients and was successful in 46 (65.7%). The failures were treated by 19 laparoscopic choledochotomies and 5 postoperative endoscopic sphincterotomies. A choledochotomy was performed in 89 cases and was successful in 85 (94.4%). The failures were treated by 3 laparotomies and 2 postoperative endoscopic sphincterotomy. The total success rate was 92.8% (130/140). The 5 local complications were pain (1), liver injury (1), and wound abscess (2), bleeding from a trocar site. Heart failure (medical treatment) (2), gastrointestinal haemorrhage from intestinal angiomas, severe pancreatitis after transcystic failure and psychiatric disorders were the 5 general complications. The total morbidity rate was 7.1%. There were 2 residual common bile duct stones. The mortality rate was 0. Mean hospital stay was 7.8 days. Laparoscopic exploration of the common bile duct appears to be safe and effective and should be included in the management protocol of choledocholithiasis.
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PMID:[Laparoscopic treatment of common bile duct calculi]. 855 70

Eighty-four patients of severe pancreatitis were divided by different line of age and the mortality of patients with severe pancreatitis above and below the line was comared. The results showed that the 60-year of age was the age with the lowest mortality. The analysis of 35 patients with severe pancreatitis who were older than 60 years of age indicated that multiple gallstones was the most common cause initiating the disease. The common severe concurrent diseases were hypertension, coronary disease, cerebrovascular disease, and respiratory disease. Common organ failures were ARDS, shock and heart failure. The number of failed organs in elderly patients in the fifth and seventh day after admission was obviously more than that in young patients.
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PMID:[Influence of age on severe pancreatitis]. 873 73

Results of surgical treatment of acute pancreatitis combined with concrements of biliferous tract in 197 patients (108 females and 89 men) at the age of 25-78 years are analysed. In all cases there was calculous cholecystitis, that was in 126 (64%) cases combined with choledocholithiasis. In 141 (71,6%) patients there was edematic pancreatitis, in 56 (28,4%)-destructive pancreatitis. 29 patients had fatty pancreonecrosis, 12 patients-hemorrhagic pancreonecrosis, 15 patients-mixed forms of pancreonecrosis. All the patients were operated on. Urgent surgery have been done in 62 (31,5%) patients, planned-in 135 (68,5%). The mortality rate after the urgent surgery was 16 (25,8%), after planned-5 (3,7%). The total postoperative mortality rate is 10,6%. The causes of mortality were: liver and kidney insufficiency (5), heart failure (5) infection (14).
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PMID:[Surgical treatment of acute pancreatitis associated with biliary calculi]. 875 90

Cardiac-related death of HIV-positive patients is not rare. The etiology of AIDS-associated dilated cardiomyopathies often remains unknown, even at autopsy. We report an observation associated to a severe deficit in selenium. The patient had been diagnosed as HIV-positive 2 years before. He presented Pneumocystis carinii pneumonia then Cryptococcus meningitis. Two months later he was hospitalized for pancreatitis and cachexia. He presented global heart failure that lead to death. No microorganism was found in myocardium at autopsy but plasma selenium was dramatically decreased (24 micrograms/L). The deficit in selenium has been associated to a dilated cardiomyopathy in non-AIDS patients. HIV-positive patients have an early decrease in plasma selenium, this concentration is dramatically decreased in malnourished patients. Selenium deficit might be the cause of some of the AIDS-related dilated cardiomyopathies and selenium supplementation might be useful in these patients.
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PMID:[Dilated cardiomyopathy and selenium deficiency in AIDS. Apropos of a case]. 936 39

Infections are thought to be important in the pathogenesis of many heart diseases. Coxsackievirus B3 (CVB3) has been linked to chronic dilated cardiomyopathy, a common cause of progressive heart disease, heart failure and sudden death. We show here that the sarcoma (Src) family kinase Lck (p56lck) is required for efficient CVB3 replication in T-cell lines and for viral replication and persistence in vivo. Whereas infection of wild-type mice with human pathogenic CVB3 caused acute and very severe myocarditis, meningitis, hepatitis, pancreatitis and dilated cardiomyopathy, mice lacking the p56lck gene were completely protected from CVB3-induced acute pathogenicity and chronic heart disease. These data identify a previously unknown function of Src family kinases and indicate that p56lck is the essential host factor that controls the replication and pathogenicity of CVB3.
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PMID:The tyrosine kinase p56lck is essential in coxsackievirus B3-mediated heart disease. 1074 50


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