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)

We documented the pattern of medical illnesses in 613 elderly Nigerians (398 females and 215 males) resident in Idikan community in Ibadan city. Their ages ranged from 65 to 110 years with a mean of 76.2 years. Medical disorders diagnosed either singly or in combinations were diagnosed in 364 (59.4%) subjects and there was no gender association. Cardiovascular problems were the commonest and high blood pressure (27.8%) was the most frequent diagnosis. Only 5 of the hypertensive subjects were aware of that diagnosis and were on regular medications. The complications presented with included heart failure and stroke. Visual impairment (12.1%) mainly due to cataracts and osteoarthritis (6.7%) in that order were next in frequency. The most frequent neurological disorders were hearing impairment and movement disorders. The other conditions encountered were similar to the findings in previous studies in this environment, and the usual findings in studies focusing on this age-group in other countries. The presence of morbidity was significantly associated with increasing age and poor performance on screening. The latter increased the probability of being selected for clinical examination with detection of medical problems or could suggest associated cognitive impairment. The prevalence of systemic hypertension was not different from findings in other communities in people of similar age groups. This study emphasises the role of hypertension as a major cause of morbidity in this community and stresses the need for increased health awareness especially with regards to regular checking of blood pressure so as to avoid complications.
West Afr J Med
PMID:Morbidity pattern in a sample of elderly Nigerians resident in Idikan community, Ibadan. 1188 77

Three cases of dilated cardiomyopathy in patients with IIIV/AIDS are being reported. The three patients are of young age group and they presented with cardiac symptoms for the first time. They were all heterosexuals and not known was as intravenous drug abuser. There was no history of rheumatic fever or hypertension or diabetes mellitus and ischaemic heart disease. Examination confirmed cardiac failure and investigations including chest x-ray, echocardiograph and electrocardiograph confirmed dilated heart. All the patients tested positive to HIV-1 antibodies. They were managed with the usual anticardiac failure regimen. Two of the patients died on admission, one developed multi organ failure and the other had tonic-clonic seizure. In other parts of Africa reports have also emerged describing the cardiovascular involvement in HIV/AIDS.
West Afr J Med
PMID:Cardiovascular involvement in HIV/AIDS: report of 3 cases. 1188 84

Congestive cardiac failure is emerging as a significant public health problem around the world, including the Caribbean. Recent reports from developed countries suggest that 30 to 40% of patients with congestive cardiac failure have normal systolic function. This percentage may be even higher in non-Caucasian, non-male populations. This study was undertaken to determine the M-mode echocardiographic findings in a current, consecutive series of Afro-Caribbean patients referred for congestive cardiac failure. There were 165 patients, 51% male, mean and standard deviation (SD) age of 63 +/- 15 years, referred between May 1998 and June 2000. Echocardiographic findings included left atrial size (LA), left ventricular (LV) end systolic (ESD) and end diastolic dimension (EDD), LV posterior wall thickness (PWT) and ventricular septal thickness (VST). LV ejection fraction (EF) was derived. LA > 4 cm, PWT or VST > 13 mm and LVEF < 50% were considered abnormal. Increased LV wall thickness (LV hypertrophy) only was the most frequent finding, 68/165 (41%), consistent with possible diastolic dysfunction. If a less restrictive definition for abnormal LV wall thickness, 12 mm, is used, this finding increases to 79/165 (48%). Decreased LVEF (LV systolic dysfunction) was seen in 57/165, (35%) and was seen in significantly more men (42% versus 29%, p < 0.01). Valvular disease was seen in 13/165, 8%. Normal findings on echocardiography were found in 27/165 (16%), more commonly in women (19 versus 8, p < 0.05) and younger patients (54 years versus 65 years, p < 0.05) and in only 10% if 12 mm is used for LV wall limit. LV hypertrophy was seen in 42% of patients (61% if 12 mm is used for LV wall limit) with systolic dysfunction. Thus, congestive cardiac failure with LV hypertrophy is the most frequent finding in this Afro-Caribbean population, with LV systolic dysfunction in only 35% of patients. These findings are consistent with possible diastolic LV dysfunction due to hypertension as the primary cause of cardiac failure in the population.
West Indian Med J 2002 Jun
PMID:M-mode echocardiographic findings in a contemporary Afro-Caribbean population referred for evaluation of congestive cardiac failure. 1223 49

One hundred consecutive admissions of children with a diagnosis of congestive cardiac failure to the paediatric department of the University College Hospital, Ibadan were evaluated during a 10-month period. They were aged 8 days to 12 years. They constituted 5.8% of the total paediatric admissions during the study period. The most frequent underlying causes of heart failure were acute lower respiratory tract infections (36%), intrinsic heart disease (31%) and severe anaemia (28%). Other less common causes of heart failure were renal disorders (3%) and septiceamia (2%). Heart failure remains a common problem encountered in emergency paediatric practice in Nigeria, with the majority of cases resulting from preventable causes.
West Afr J Med
PMID:Childhood heart failure in Ibadan. 1276 6

The majority of patients seen at the renal clinic of the University Hospital of the West Indies (UHWI) are of African descent. The case notes of patients with systemic lupus erythematosus (SLE) with class 4 nephritis and who were given standard pulse intravenous cyclophosphamide therapy during the period 1990-2000 were retrospectively reviewed. Primary outcomes were doubling of serum creatinine and development of end stage renal disease (ESRD). Secondary outcomes were return of proteinuria to normal and renal remission. A total of 117 patients had a renal biopsy for SLE nephritis at the UHWI between 1990 and 2000. Of the patients, 34 (29%) had diffuse proliferative glomerulonephritis (WHO class 4), of which 29 were reviewed. Twenty-two patients of 24 in whom it was measured (92%) had significant proteinuria at presentation. The 24-hour proteinuria was measured at final review in 16 patients and in 10 patients it went into complete remission. At the beginning of therapy, 24 patients (83%) had renal impairment. Of the 18 who had final creatinine values, the renal function returned to normal in eight patients (44%) and an additional six patients showed a significant improvement in renal function at final review. Six patients developed end stage renal disease (ESRD). The risk (95% confidence interval) of developing ESRD at one year was 16.2% (CI, 6.4-37.6) and at two years was 23.2% (CI, 10.0-48.5). There were three deaths, two from sepsis and one from heart failure. The one-year mortality (95% CI) was 8% (CI, 2.0-28.5), the two-year mortality was 15.6% (CI, 4.9-43.5) and the five-year mortality was also 15.6% (CI, 4.9-43.5). Intravenous pulse cyclophosphamide for Jamaican patients with SLE and diffuse proliferative glomerulonephritis is an ineffective form of treatment.
 ...
PMID:Severity of systemic lupus erythematosus with diffuse proliferative glomerulonephritis and the ineffectiveness of standard pulse intravenous cyclophosphamide therapy in Jamaican patients. 1294 26

The efficacy of beta blockers in managing patients with post-acute myocardial infarction (AMI) was established based on randomized controlled trials predating the era of modern therapy in Western populations. We compared the effects of beta blockers on cardiovascular events with those of calcium antagonists in Japanese post-AMI patients on modern reperfusion therapy by performing a multicenter, prospective, randomized, open-blind end point study. Five hundred forty-five patients were assigned to the beta-blocker group and 545 patients to the calcium antagonist group. The mean follow-up period was 455 days. There was no significant difference in the incidence of cardiovascular death (1.7% vs 1.1%), reinfarction (0.9% vs 1.3%), uncontrolled unstable angina (11.0% vs 10.6%), and nonfatal stroke (0.7% vs 0.2%) between the 2 groups. However, the incidences of heart failure and coronary spasm were significantly higher in the beta-blocker group than in the calcium antagonist group (4.2% vs 1.1%, p = 0.001; 1.2% vs 0.2%, p = 0.027, respectively). We conclude that the cardiovascular event rate is substantially lower in Japanese post-AMI patients receiving modern therapy than in those reported in the West, and that there are no significant differences in the cardiovascular event rate between the beta-blocker and calcium antagonist groups.
 ...
PMID:Comparison of the effects of beta blockers and calcium antagonists on cardiovascular events after acute myocardial infarction in Japanese subjects. 1508 37

Heart failure (HF) affects more than one million older Americans. As the population ages, the incidence of HF will increase. The purpose of this study was to identify variables that profile elders hospitalized with HF who are at high risk for poor postdischarge outcomes. A total of 103 patients were enrolled in the study. A low serum sodium and a fair or poor self-reported health status predicted all-cause readmission. A low serum sodium predicted HF-related readmissions. Four or more HF symptoms and index admission to an urban hospital predicted physician office visits. Admission to a community hospital predicted emergency department visits, and the number of coexisting medical conditions indicated an increased risk for an emergency department visit. The findings indicate that it is possible to profile hospitalized elders with HF who are at risk for poor postdischarge outcomes.
West J Nurs Res 2004 Aug
PMID:Variables predictive of poor postdischarge outcomes for hospitalized elders in heart failure. 1535 56

We know a great deal about the receptors and signaling pathways in cardiomyocytes that contribute to hypertrophic growth. Although drugs that target them have proven effective in substantially reducing left ventricular hypertrophy and associated mortality, cardiovascular disease remains the leading cause of death in the West. Another approach may rest with exploiting naturally occurring regulators of maladaptive cardiac hypertrophy that have been identified in the past few years. These endogenous negative regulators can be grouped, for the most part, into those constitutively active but whose activity is decreased by hypertrophic stimulation, and those with little or no baseline activity that are activated by hypertrophic stimulation. Spanning both groups are 4 systems that converge on cyclic guanosine 3', 5'-monophosphate (cGMP) generation, namely natriuretic peptides (ANP and BNP), kinins, nitric oxide (NO), and the angiotensin II type 2 receptor (AT2). Although holding promise as a means for restricting hypertrophy, each of these signaling molecules has certain limitations that need to be overcome. What follows is an overview of research over the past 2 years, much of it published in Hypertension, which has dealt with the antihypertrophic action of this particular group of endogenous signaling molecules. Understanding the function and regulation of the antihypertrophic NO-cGMP system offers the promise of novel therapeutic strategies for treating cardiac hypertrophy and heart failure.
 ...
PMID:Putting the brakes on cardiac hypertrophy: exploiting the NO-cGMP counter-regulatory system. 1571 Jul 77

Cardiovascular disease represents the main cause of death among adults in the Caribbean. Primary and secondary care facilities are efficiently managed. Cardiac surgical and interventional facilities, however, exist only in a small number of territories and are mainly privately funded and are only accessible to few patients. Patients with end-stage heart failure (ESHF) are given few options apart from palliative care or to seek treatment outside of the region. Transplantation remains the 'gold standard' therapy for ESHF. Establishing a Caribbean cardiac transplantation programme would require legislative and infrastructure changes. Tissue rejection poses a problem and expensive immunosuppressants are needed. Mechanical assist devices are costly and associated with complications such as haemorrhage, thrombosis and infections. Both forms of therapy require significant technical and financial investment and do not appear to be economically viable for the Caribbean. The use of the patient's own skeletal muscle to perform biological cardiac assistance is potentially the ideal alternative. The skeletal muscle is conditioned by electrical stimulation to become fatigue resistant. It is then transposed and harnessed as an auxilliary circulatory pump. The required muscle stimulators are relatively inexpensive and the surgical techniques and postoperative care are not overly demanding. We discuss the financial and research implications of treating patients from the Caribbean who have end-stage heart failure.
West Indian Med J 2005 Jan
PMID:Use what you have--biological assistance for the treatment of heart failure in the Caribbean. 1589 93

A 64-year-old woman was transferred to the intensive care unit with dyspnea and palpitation on effort. Chest x-ray film showed cardiomegaly and pulmonary congestion. We carefully examined for sarcoidosis as a differential diagnosis of heart failure. Serum lysozyme was mildly high, but human atrial natriuretic peptide (HANP) and brain natriuretic peptide (BNP) were strikingly high. Angiotensin converting enzyme was within normal limit. Chest roentgenogram did not reveal bilateral hilar lymphadenopathy. Atrioventricular conduction block was not observed on electrocardiogram. Echocardiographic examination showed left ventricular global hypokinesis with septal thinning and enlargement. Mitral valve regurgitation was recognized by Doppler evaluation. Coronary arteriography showed normal coronary arteries. Endomyocardial biopsy revealed noncaseous epithelioid granulomas containing, Langhans type giant cell accompanied by fibrosis and lymphocyte infiltration. From these data cardiac sarcoidosis was diagnosed. Gallium scintigraphy showed diffuse uptake only in the heart. Treatment with oral prednisolone 20 mg/day was started. Her symptoms improved by several weeks after the medical treatment. In addition, both the value of HANP and BNP were markedly decreased and echocardiogram showed improvement of cardiac systolic function. In Japan, there is a higher incidence of cardiac sarcoidosis than in the West. The prognosis of this condition associated with cardiac dysfunction is reported to be very poor. When progressive heart failure in older patients is seen, cardiac sarcoidosis should also be kept in mind. Endomyocardial biopsy play an important role as the only accurate technique for the diagnosis of cardiac sarcoidosis.
 ...
PMID:[A case of sarcoidosis in which sarocoid granulomas were observed only in the heart]. 1598 67


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