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

During a pertussis epidemic, the majority of children admitted with respiratory disease were under one year old and had pneumonia, with or without pertussis syndrome; heart failure was common. A greater proportion of those with 'pneumonia alone' were slightly older, were malnourished, were admitted earlier and recovered slightly faster than those who had 'pertussis with pneumonia'. Differential white cell count was of little help in diagnosis and chest X-ray findings seldom altered management. Eight percent of the pertussis and 3 percent of the pneumonia groups died: all had pneumonia and additional complications, and 71 percent of those who died were under one year of age. Results suggest that two or more infections of triple antigen may protect some children from an attack of pertussis so severe that hospital care would be needed.
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PMID:Childhood pertussis and pneumonia admissions in the highlands of Papua New Guinea. 27 31

Patients with chronic obstructive lung disease often present with a combination of respiratory and circulatory insufficiency. In secondary erythrocytosis (polycythemia) blood viscosity rises and further impairs peripheral oxygenation. Against this background, a patient with acute exacerbation of a chronic respiratory disease with secondary erythrocytosis was treated with isovolemic hemodilution during two periods of hospitalization. During each of these two periods, hemodilution was achieved by removing 1 700 and 1750 ml blood, respectively, and replacing this simultaneously by infusing equal volumes of dextran 70 (Maacrodex). The patient's general condition improved, her dependence on supplementary oxygen drastically decreased and the blood gas values improved after hemodilution. The progress of the disease in this case suggests that the raised hematocrit rather than hypervolemia contributed to the patient's poor condition. It also illustrates that too intensive diuretic therapy in cardiac insufficiency with concomitant erythrocytosis can lead to hemoconcentration and thereby add to the strain on an already overloaded circulation.
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PMID:Isovolemic hemodilution in erythrocytosis secondary to chronic obstructive lung disease. 50 7

Thirty-two consecutive preterm infants with birth weights under 1,500 grams and with respiratory distress syndrome (RDS) complicated by a patent ductus arteriosus (PDA) underwent ligation of PDA. The indications for operation were massive left-to-right shunting associated with heart failure (cardiomegaly and pulmonary edema) unresponsive to medical treatment. The clinical manifestations of heart failure were related to the severity of RDS. Infants with mild-to-moderate RDS (21) often recovered and later developed typical findings of PDA (bounding pulses, hyperactive precordium, and murmur). They are now operated upon as soon as respiratory support is required. Infants with severe RDS (11) develop cardiomegaly earlier, and retrograde aortography may show massive left-to-right shunting before the presence of a murmur. Ligation is indicated when blood-gas values deteriorate despite medical treatment. Nineteen (59 per cent) of these extremely preterm infants survived to be discharged and 16 (50 per cent) are developing normally. Three have neurologic impariment. None of the survivors has clinical respiratory disease, and their radiologic findings of bronchopulmonary dysplasia are improving.
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PMID:Improving the results of ligation of patent ductus arteriosus in small preterm infants. 124 41

Respiratory events are between the most frequent postoperative complications. The preoperative conditions associated with postoperative respiratory failure were evaluated in a prospective study of 1182 patients from six Italian Surgical Units. Multiple regression logistic analysis was employed for statistical evaluation and a predictive prognostic score was derived. Only the presence of the following conditions was significant in affecting postoperative respiratory outcomes: preoperative respiratory and cardiac failure, hypotransferrinemia, prolonged surgical procedures (above the 2 hours) and peroperative bacterial contamination. Advanced age did not appear as a major risk factor. Studies on the predetermination of the pulmonary complications have been widely published. Historical risk factors include the presence of respiratory disease, smoking habits, obesity and thoracic or upper abdominal surgical procedures. Although the results of the present study need a prospective confirmation, the predictive scoring system proves to be a usefull tool that can be employed in most of the General Surgery Units.
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PMID:[Multifactorial surgical risk index of the development of respiratory complications]. 146 55

Two patients are presented in whom percutaneous radiofrequency spinal rhizotomy was complicated by contralateral paresis. Both patients were elderly and suffered from cardiac failure, chronic obstructive respiratory disease, and generalized vascular disease. Investigation of the paresis indicated a contralateral ischaemic cord lesion. It is suggested that local haemodynamic changes induced by heat-mediated rhizotomy may compromise oxygen delivery to the adjacent cord, especially in the presence of pre-existent cardiovascular disease.
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PMID:Ischaemic spinal cord lesion following percutaneous radiofrequency spinal rhizotomy. 1193 79

ARDS occurs in patients with no underlying pulmonary diseases, induced by stresses, such as lung injury, acute pancreatitis or infections. It is an acute respiratory disorder which manifests as acute dyspnea, hypoxemia and lowered pulmonary compliance. Greene et al, used balloon pulmonary angiogram (BOPA) as diagnostic tool to morphologically observe the pulmonary disorder. To study the dynamic pulmonary circulation and morphology of the peripheral pulmonary artery of ARDS, we performed this method for acute cardiac failure and ARDS patients. Pulmonary hemodynamic changes in ARDS revealed mild pulmonary hypertension and increased PVR, while C.I. and PCWP remained within a normal range. The findings of BOPA in ARDS showed that the frequency of PAFD correlated with the the presence of an elevated PVR and DIC, and pulmonary vasoconstriction was detected by measurement of PA diameter (B/A2).
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PMID:[ARDS: circulatory factors and their evaluation]. 203 88

We studied 17 severely obese subjects (age range 26 to 42 years), without hypertension, diabetes mellitus, angina, or clinical signs of heart failure or respiratory disease, and 16 age-matched control subjects. X-teleroentgenographic findings (transverse cardiac diameter and cardiothoracic ratio), blood pressure, and mechanocardiographic parameters were analyzed in both groups. By means of conventional simultaneous recordings of ECG, phonocardiogram, and carotid pulse (100 mm/sec), systolic time intervals were calculated as mean values from 10 beats in the morning. The following comparisons were made by means of analysis of variance: heart rate, preejection period (PEP), rate-corrected PEPI (PEPI), left ventricular ejection time (LVET), and QS2 interval (QS2); the latter two were both corrected for heart rate, respectively, as LVETI and QS2I and the PEP/LVET ratio. Abnormal x-ray data were shown in the obese group along with higher values for heart rate, PEP, PEPI, and PEP/LVET and a shorter LVETI; there were no differences in QS2I or blood pressure. There was a correlation between the amount of overweight and, respectively, transverse cardiac diameter (r = 0.84), heart rate (r = 0.69), PEP (r = 0.49), PEPI (r = 0.59), LVETI (r = -0.61), and PEP/LVET ratio (r = 0.72). A correlation was also found between transverse cardiac diameter and PEP/LVET (r = 0.67). We conclude, therefore, that abnormalities in the mechanocardiographic parameters are related to cardiac enlargement, suggesting a preclinical cardiac dysfunction secondary to chronic cardiocirculatory overload in severe obesity. Thus systolic time intervals appear to be affected by preclinical abnormalities of cardiac performance in these subjects.
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PMID:Abnormal systolic time intervals in obesity and their relationship with the amount of overweight. 294 49

All adult patients (978) admitted in 1983 to a multidisciplinary intensive care unit (ICU) were studied prospectively. 9.6% died in the unit. The cumulative mortality was 26.5% 1 year after admission. Of the patients who were 65 years and older, 43.1% had died after 1 year compared to 10.6% in the youngest age group (15-44 years). Using multiple logistic regression analyses, prognostic factors for mortality were identified. All the factors were known at the time of admission. Risk factors for death in the ICU included age, admission for disorders in several organ systems, cardiopulmonary arrest and acute respiratory disorder. In addition to age and acute conditions at the time of admission, cumulative mortality after 1 year was also influenced by chronic conditions such as diabetes mellitus, chronic heart failure and cancer. These data document the importance of taking age and chronic illness into account when making a prognosis for intensive care patients.
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PMID:Survival of intensive care patients. I: Prognostic factors from the patient's medical history. 334 79

Respiratory disease on Tristan da Cunha has been observed since the islanders returned in 1962. An epidemic of unprecedented severity occurred in the winter of 1971 and involved 273 (96%) of 284 islanders, 92 of whom had two attacks.The epidemic was apparently introduced by the Tristania.The illness of both first and second attacks ranged from mild to severe but there were some differences. There were two deaths, both in elderly persons with chronic chest disease and heart failure. Serological evidence suggests that this was due to influenza A2 of the Hong Kong serotype H(3)N(2).
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PMID:An epidemic of influenza on Tristan da Cunha. 451 51

Alpha 1-acid glycoprotein (AAG) concentrations and propranolol binding were investigated in the serum of elderly hospitalized patients with acute illness, and healthy elderly and young subjects. Significantly greater AAG concentrations and reduced unbound propranolol fraction were observed in the elderly with acute disease compared to the elderly controls. The greatest changes (up to five-fold) occurred with cancer, with lesser changes associated with myocardial infarction and ischaemic heart disease, acute infection, heart failure, chronic obstructive respiratory disease, and cerebrovascular accident. Various miscellaneous conditions were also associated with high AAG concentrations and enhanced propranolol binding. The healthy elderly had higher AAG concentrations and lower unbound propranolol fractions than the healthy young group. Overall there was a highly significant correlation between the propranolol binding ratio (bound/free) and the serum AAG concentration. These results suggest that the elderly population may be particularly susceptible to changes in AAG concentrations, and that during acute illness interpretation of serum concentrations of drugs which bind mainly to AAG, may require knowledge of their free fractions.
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PMID:Alpha 1-acid glycoprotein concentrations and propranolol binding in elderly patients with acute illness. 650 90


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