Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65-year-old woman, known to have peptic ulcers, developed nausea and retching. Clinical examination demonstrated pain on pressure in the epigastrium with otherwise normative findings for age. Two gastric ulcers and gastritis with erosions were seen at endoscopy. The patient, who was being treated with digitoxin for heart failure, reported having taken up to four digitoxin tablets (0.07 mg each) daily because she had insomnia. The plasma digitoxin level was between 150 and 160 nmol/l (therapeutic range 17-33 nmol/l), while the ECG showed no signs of digitalis intoxication. Initially the platelet count was 40,000/microliter: there had been no history of thrombocytopenia or symptoms of abnormal haemostasis. Other laboratory tests were within normal limits. After digitoxin had been discontinued, the platelet count rose without further treatment to 373,000/microliter 3 weeks after hospital admission by which time the digitoxin level had fallen to 48.9 nmol/l. The gastrointestinal symptoms regressed completely on treatment with omeprazole (40 mg three times daily for 8 days) and ranitidine (150 mg twice daily).
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PMID:[Reversible thrombocytopenia due to digitoxin overdose]. 800 65

Fenoldopam, a selective DA1-receptor agonist, infused intravenously for 24 hours (0.6 +/- 0.3 microgram/kg/min, range 0.1-1.5) in 25 patients with NYHA functional class III or IV heart failure, produced a prompt and sustained hemodynamic response. Cardiac index rose from an average preinfusion baseline value of 1.8 to 2.6/l min. Stroke volume index increased from 19 to 26 ml/m2 and stroke work index increased from 18 to 25 g M/m2. These changes were accompanied by a reduction in systemic vascular resistance from an average of 2400 to 1500 dynes sec/cm5. There was no change in the heart rate or right atrial pressure. There was a transient reduction in the left ventricular filling pressure from 25 to 20 mmHg. Urinary sodium excretion did not change significantly. Transient asymptomatic thrombocytopenia developed in four patients. The drug was well tolerated by all patients. These results suggest that continuous intravenous infusion of fenoldopam is safe and produces favorable hemodynamic responses in severe heart failure. However, unlike its effects in patients with hypertension, it failed to produce sustained natriuresis in these patients.
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PMID:Intravenous fenoldopam infusion in severe heart failure. 809 27

The authors report two cases of thrombosis occurring after partial interruption of the inferior vena cava. They presented as collapse and anuria with fatal outcome. Heparin induced thrombocytopenia was present in two cases and distal migration of filter in one case. Thrombo-embolic complications can follow heparin induced thrombocytopenia and justify first treatment with low molecular weight heparin and/or early treatment with oral anti-coagulant. Thrombosis, recurrent embolism or thrombosis of renal vena may occur after vena cava filter. Renal vena thrombosis especially follow filter movement and present as collapse and cardiac failure often with fatal outcome.
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PMID:[Heparin-induced thrombocytopenia and vena cava filter. Difficulties of treatment]. 812 Apr 65

A 82-year-old woman was admitted to hospital because of heart failure, vomiting, and pain in the right upper abdomen. During the past three months she had received treatment with 0.07 mg digitoxin twice daily. The ECG showed sinus bradycardia with intermittent complete sinoatrial block. On the basis of the history, clinical presentation and ECG findings digitalis intoxication was suspected. Digitoxin level was 65.23 ng/ml--far beyond the therapeutic range. Laboratory examinations revealed a marked thrombocytopenia (25,000/microliters). The patient was placed on cholestyramine (4g three times daily) to accelerate intestinal excretion of digitoxin. As there were no life-threatening complications there was no indication for treatment with digitalis-specific antibodies. On the 6th day after discontinuation of digitoxin treatment the platelet count showed a marked rise and returned to normal values as from the 12th day.
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PMID:[Digitoxin-induced thrombocytopenia]. 821 11

The so-called percutaneous dilatational tracheostomy-essentially a minimally invasive puncture method-inserting the tracheal cannula by a modified Seldinger-technique is an alternative method to the conventional operative tracheostomy. The percutaneous dilatational tracheostomy was evaluated in a prospective trial (June 92-January 93) on 50 consecutive surgical (n = 36), medical (n = 10), and neurological-neurosurgical (n = 4) critically ill patients (29 m, 21 f; age 14-87 years) with need for prolonged mechanical ventilation. After an average duration of endotracheal intubation of 6 (0-22) days, the procedure was endoscopically guided and controlled via the endotracheal tube. An 8 mm cannula was inserted in each case. Eight patients had severe thrombocytopenia (< or = 50,000 Plt./microL). The percutaneous tracheostomy was always performed with success. The average procedure duration was 8 (5-15) minutes. The perioperative complications were: one patient died of acute cardiac failure independent from the method of tracheostomy, one sustained a temporary subcutaneous emphysema and one a minor bleeding. During a mean duration of cannulation of 21 (0-113) days only one bleeding from the skin margin was observed postoperatively. Infection of stoma site, misplacement of cannula, rupture of the tube cuff, and pneumothorax were not noticed. On 13 decannulated patients stenosis of the trachea was not found in a period of 6-8 weeks following the tracheostomy. As a bedside procedure the percutaneous dilatational tracheostomy is safe and quick and should therefore be the method of choice for critically ill patients who require a tracheostomy.
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PMID:[Puncture tracheostomy in intensive care patients. Technique and results of a minimally invasive method]. 837 22

Hepatic hemangiomas are benign vascular tumors that represent 5-15% of all liver tumors. They occur more often in females than in males (relation 2:1). They may produce cardiac failure, because of high output; less frequently hemolytic anemia, thrombocytopenia or bleeding are observed. We present a case of a newborn premature child with a gestation age of 34 weeks and weight of 1359 g who presents a palpable abdominal tumor in the right hypochondrium without additional symptoms. The diagnosis was confirmed by ultrasound with Doppler system any by means of the magnetic resonance imaging (MRI) both methods were able localize the hemangioma in the posterior segment of the right hepatic lobulus. MRI is a diagnostic tool which can provide finer anatomic details than ultrasound or axial computed tomography in hepatic hemangiomas. MRI has a sensitivity of 90% and specificity of 92%; the treatment depends of the complications which the patient presents.
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PMID:[Hepatic hemangioma in a premature newborn. The magnetic resonance images]. 844 69

We gave the "optimal" dose of doxorubicin (75 mg/m2) with ifosfamide (5 g/m2), the two most active agents against metastatic soft-tissue sarcomas, in an attempt to determine the feasibility of administration of these doses in combination. To offset complications arising from the myelosuppression associated with this regimen, recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF, 250 micrograms/m2 daily) was given by subcutaneous injection during the intervals between courses of chemotherapy. In all, 111 patients with progressive metastatic soft-tissue sarcoma were entered, 104 of whom were eligible for preliminary analysis. Use of rhGM-CSF allowed full doses of chemotherapy to be given to the majority of patients, although cumulative thrombocytopenia became a dose-limiting toxicity during subsequent courses. Two treatment-related deaths occurred, one from presumed septicemia while the patient was at home and one as a result of cardiac failure. An overall response rate of 45% was achieved. The activity of this high-dose combination (with rhGM-CSF) will be compared with that of standard treatment doses in a future phase III randomized trial.
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PMID:The use of recombinant human granulocyte-macrophage colony-stimulating factor with combination chemotherapy in the treatment of advanced adult soft-tissue sarcomas: early results from the EORTC Soft-Tissue and Bone Sarcoma Group. 845 7

A 29-year-old woman, with a slightly elevated temperature for 3 weeks, increasing dyspnoea at rest, markedly reduced general condition and in heart failure, was found to have a leucocytosis of 100,000/microliters, anaemia (haemoglobin 6.3 g/dl) and thrombocytopenia (41,000/microliters). There were 62% plasma cells in the blood smear. Immunoelectrophoresis of serum and urine revealed kappa-light chains and immunocytology demonstrated IgG-kappa. There was no radiological evidence of osteolysis, while ultrasound examination showed multiple abdominal lymphomas and marked hepatosplenomegaly. Bone marrow smear showed a 90% infiltration of plasma cells. High-dosage melphalan treatment (single intravenous injection of 140 mg/m2) resulted in complete remission after myelodepression over several weeks. Two extramedullary recurrences 5 and 12 months after the diagnosis had been made were successfully treated with high-dosage melphalan, but it was associated with severe and long-lasting myelodepression. Septicaemia with renal and hepatic failure developed and the patient died 6 weeks after the third course of high-dosage melphalan, 14 months after the diagnosis.
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PMID:[Acute plasma cell leukemia. Clinical course during high-dose melphalan therapy]. 846 34

A 27-year-old male with acute lymphoblastic leukemia (L2) received allogeneic bone marrow transplantation on June, 7 1990. He was conditioned with cyclophosphamide, Ara-C and total body irradiation. GVHD prophylaxis consisted of cyclosporin and short term methotrexate. He was diagnosed as having hemolytic uremic syndrome (HUS) on the basis of microangiopathic hemolytic anemia, thrombocytopenia and renal dysfunction on day 224. Cyclosporin was discontinued and FFP was transfused and plasma exchange was performed. He died of heart failure and sepsis on day 582. Autopsy confirmed the findings of HUS.
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PMID:[An autopsy case report of hemolytic uremic syndrome after allogeneic bone marrow transplantation]. 849 23

The role of platelet-activating factor in mediating the cardiovascular and peripheral cellular responses to large-colon ischemia and reperfusion, was explored in anesthetized ponies. A specific platelet-activating factor (PAF) antagonist (WEB 2086) was administered to a group of 6 ponies, and another 6 ponies (controls) were given an equivalent volume of saline solution, prior to 1 hour of large-colon torsion. After correction of the torsion, ponies were monitored during the reperfusion period. Significant (P < 0.05) hypotension and metabolic acidosis developed in all ponies after correction of colonic torsion, cardiac index increased initially, but then decreased significantly (P < 0.05) over the study period. Mean times between correction of torsion and onset of cardiac failure and death were not different between groups. Significant (P < 0.05) thrombocytopenia developed during the reperfusion period in control ponies, but not in WEB-treated ponies. Blood leukocyte concentration in control ponies was more variable and significantly (P < 0.05) decreased immediately upon reperfusion, compared with that in WEB-treated ponies. We conclude that although the cardiovascular responses to colonic ischemia and reperfusion are not prevented by use of a specific PAF-antagonist, specific peripheral cellular responses are mediated by PAF.
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PMID:Effect of a specific platelet-activating factor antagonist on cardiovascular and peripheral cellular responses to colonic ischemia and reperfusion in anesthetized ponies. 849 51


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