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)

Diabetic individuals have a significantly increased likelihood of developing cardiovascular disease. Whilst part of this association is explained by the presence of concomitant risk factors, large epidemiological studies have consistently reported diabetes as a strong risk factor for the development of heart failure after adjusting for such covariates. This has resulted in the notion that there is a distinct cardiomyopathy specific to diabetes, termed 'diabetic cardiomyopathy'. The natural history is characterized by a latent subclinical period, during which there is evidence of diastolic dysfunction and left ventricular hypertrophy, before overt clinical deterioration and systolic failure ensue. These clinical findings have been supported by a growing body of experimental data which support the notion that diabetes inflicts a direct insult to the myocardium, with cellular, structural and functional changes manifest as the diabetic myocardial phenotype. Several of these mechanisms appear to work in unison, forming complicated reciprocal pathways of disease. Reactive oxygen species and alterations in intracellular calcium homeostasis appear to play significant roles in many of these mechanisms. Determining the hierarchy of this cascade of disease will allow identification of the pathological trigger most responsible for disease. Translational research in this field is currently hindered by a lack of clinical studies and intervention trials specifically in patients with diabetic cardiomyopathy. Future clinical and experimental studies of accurate models of diabetic cardiomyopathy should help to define the true aetiology and lead to the development of specific pharmacotherapies for this condition, ultimately reducing the increased cardiovascular morbidity and mortality in diabetic patients.
Best Pract Res Clin Endocrinol Metab 2009 Jun
PMID:Diabetic cardiomyopathy--a distinct disease? 1952 Mar 8

Pregnancy still constitutes a major challenge for women with systemic lupus erythematosus. Coordinated medical/obstetric care is essential to maximise the chance of success. Pregnancy should be planned in advance, following a pre-conceptional visit in which the specific risk for complications can be assessed. Previous complicated pregnancies, renal disease, irreversible damage, anti-phospholipid antibodies and treatment with high-dose steroids are adverse features. Pregnancy should be discouraged in women with symptomatic pulmonary hypertension, heart failure, severe restrictive pulmonary disease, severe chronic renal failure and recent serious lupus activity. Treatment is based on hydroxychloroquine, low-dose steroids, azathioprine and in patients with anti-phospholipid antibodies, low-dose aspirin+/-low molecular weight heparin. Close surveillance, with monitoring of blood pressure, proteinuria and placental blood flow by Doppler studies helps the early diagnosis and treatment of complications such as pre-eclampsia and foetal distress. Post-partum follow-up is also essential.
Best Pract Res Clin Rheumatol 2009 Aug
PMID:Managing lupus patients during pregnancy. 1959 86

A culture of quality improvement (QI) is needed to bridge the gap between possible STEEEP (safe, timely, effective, efficient, equitable, and patient-centered) care and actual usual care. Baylor Health Care System (BHCS) developed Accelerating Best Care at Baylor (ABC Baylor), an innovative educational program that teaches health care leaders the theory and techniques of rapid-cycle QI. Course participants learn general principles of continuous QI, as well as health care-specific QI techniques, and finish the course by designing and implementing their own QI project. ABC Baylor has been employed in a variety of settings and has spread its success to other organizations, especially small and rural hospitals. These hospitals, like BHCS, have demonstrated sustained improvements that are due in part to the use of ABC Baylor and its reliance on specific modules that focus on health care safety, service, equity, and chronic disease management. The role of ABC Baylor training and consulting is part of the overall culture and infrastructure that have allowed BHCS to achieve success in its improvement journey, including the receipt of several national awards and the achievement of high reliability in compliance with Centers for Medicare and Medicaid Services core measures of processes of care related to heart failure, acute myocardial infarction, community-acquired pneumonia, and surgical care. The culture of rapid-cycle QI facilitated by ABC Baylor serves to link BHCS's vision and goals to practical execution.
 ...
PMID:Accelerating best care at baylor dallas. 1986

Our heart failure team was part of the Accelerating Best Care in Pennsylvania program through a grant by our State Representative, Todd Eachus. Our team met weekly and identified high leverage points that needed to be addressed-one being that of discharge instructions. We also identified the need for standing order sets for heart failure admissions. We implemented standing order sets in July of 2005, making them mandatory for use in 2006. We also placed a "yellow" heart failure form on the front of all heart failure patients to alert nursing staff to the fact that this was a heart failure admission. We also asked the pharmacy to printout patient profiles to compare meds at discharge for these patients, and a memo was sent to our medical staff reminding them of their responsibility of filling out disease-specific "Heart Failure Discharge Instructions" and writing out the meds. The disease-specific heart failure discharge instruction form was a newly developed form strictly for use with heart failure patients.
 ...
PMID:Heart failure tools. 1995 51

Because growth hormone and IGF-1 both have regulatory roles in the cardiovascular system, patients with acromegaly often present with abnormalities of heart structure and function and the vascular system, which if left unmanaged can reduce life expectancy. Early symptoms of acromegalic cardiomyopathy (hyperkinetic syndrome) can be characterized by cardiac hypertrophy, increased heart rate, and increased systolic output. When left untreated, more pronounced hypertrophy, signs of diastolic dysfunction and insufficient systolic function on exertion arise, and can lead to systolic dysfunction at rest, and eventually heart failure with signs of dilative cardiomyopathy. Increasingly, evidence suggests that early diagnosis and treatment of acromegaly (before the age of 40 years) can help prevent the progression of cardiovascular disease, improve quality of life, and reduce the risk of premature mortality. This review focuses on management strategies for newly diagnosed patients with acromegaly and evidence of cardiovascular disease. The roles of surgery and medical treatment are discussed in the context of using optimal treatment strategies to help reverse cardiac hypertrophy and normalize other cardiac risk factors.
Best Pract Res Clin Endocrinol Metab 2009 Dec
PMID:5 Long-term acromegaly and associated cardiovascular complications: a case-based review. 2012 92

In the last decade, biologic agents, in particular anti-TNF agents such as infliximab, adalimumab, and certolizumab have substantially extended the therapeutic armamentarium of inflammatory bowel disease (IBD). Additional approaches include biologicals, such as natalizumab, that block leucocyte adhesion; those that target cytokines, such as interleukin-12/23 antibodies; or those that inhibit T-cell signaling, such as interleukin-6 receptor antibodies. However, these drugs have a number of contraindications and side effects, especially when used in combination with classical immunosuppressive agents or corticosteroids. Areas of concern include opportunistic infections, malignancies, and miscellaneous complications such as injection/infusion reactions and autoimmunity and contraindications, such as heart failure and acute infectious diseases. In this review, the indications of biologicals in IBD treatment are briefly reported, and the potential disadvantages of a more active therapeutic approach in IBD are discussed. We have learned in the last decade that anti-TNF-alpha therapy is an effective and relatively safe treatment option for selected patients that changes the natural course of severe IBD. However, despite these changed therapeutic paradigms and goals in IBD, clinicians should be aware that the powerful immunosuppressive capacity of biologicals necessitates a rigorous long-term safety follow-up.
Best Pract Res Clin Gastroenterol 2010 Apr
PMID:Adverse effects of biologics used for treating IBD. 2022 30

Pulmonary hypertension presenting in the neonatal period can be due to congenital heart malformations (most commonly associated with obstruction to pulmonary venous drainage), high output cardiac failure from large arteriovenous malformations and persistent pulmonary hypertension of the newborn (PPHN). Of these, the most common cause is PPHN. PPHN develops when pulmonary vascular resistance (PVR) remains elevated after birth, resulting in right-to-left shunting of blood through foetal circulatory pathways. The PVR may remain elevated due to pulmonary hypoplasia, like that seen with congenital diaphragmatic hernia; maldevelopment of the pulmonary arteries, seen in meconium aspiration syndrome; and maladaption of the pulmonary vascular bed as occurs with perinatal asphyxia. These newborn patients typically require mechanical ventilatory support and those with underlying lung disease may benefit from high-frequency oscillatory ventilation or extra-corporeal membrane oxygenation (ECMO). Direct pulmonary vasodilators, such as inhaled nitric oxide, have been shown to improve the outcome and reduce the need for ECMO. However, there is very limited experience with other pulmonary vasodilators. The goals for anaesthetic management are (1) to provide an adequate depth of anaesthesia to ablate the rise in PVR associated with surgical stimuli; (2) to maintain adequate ventilation and oxygenation; and (3) to be prepared to treat a pulmonary hypertensive crisis--an acute rise in PVR with associated cardiovascular collapse.
Best Pract Res Clin Anaesthesiol 2010 Sep
PMID:Pulmonary hypertension of the newborn. 2103 14

The prevalence of peritoneal dialysis in France remains one of the lowest in Europe in spite of official recommendations in 2008. Progress in peritoneal catheter placement and a good knowledge of the management of catheter complications are essential. A more frequent use of biocompatible solutions should achieve a better preservation of the peritoneal membrane. Such physiological peritoneal fluids seem to decrease morbidity and mortality. Best peritoneal dialysis indications are mainly young patients waiting for a kidney transplantation, old patients without malnutrition and patients with cardiac insufficiency. Objective and complete information dedicated to both peritoneal dialysis and hemodialysis is necessary, even for patients seen in emergency or unplanned or late referral patients. A pre-end-stage renal disease education program has to be mandatory. Non-medical obstacles, mainly financial, are still common so that economic incitations are necessary for the development of peritoneal dialysis. A university formation of nephrologists is now available.
 ...
PMID:[Why and how to promote peritoneal dialysis?]. 2192 62

Thalassaemia is the most common monogenetic disease worldwide. Antenatal screening is effective and simple, and accurate genetic prenatal diagnosis can be achieved in early gestation. Less invasive methods are feasible with ultrasound fetal assessment for alpha-thalassaemia, analysis of circulating fetal nucleic acid in maternal plasma, and pre-implantation genetic diagnosis. Women with thalassaemia major and intermedia are at risk of various maternal complications, such as cardiac failure, alloimmunisation, viral infection, thrombosis, endocrine and bone disturbances. Therefore, it is prudent to adhere to a standard management plan in this group of pregnant women. Close monitoring of the maternal and fetal condition during pregnancy is essential, and various treatments, such as blood transfusion or postpartum prophylaxis for thromboembolism, may be indicated. After birth, resumption of iron chelation and bisphosphonates treatment is needed, and counselling on breast feeding and contraception should be given.
Best Pract Res Clin Obstet Gynaecol 2012 Feb
PMID:Thalassaemia in pregnancy. 2207 88

Genetic haemochromatosis is a hereditary disease characterised by tissue iron overload. In Caucasians it is most often due to homozygous C282Y HFE gene mutation, but other genes may be involved. Without treatment by venesections, patients can develop life-threatening visceral damage such as liver cirrhosis and carcinoma, diabetes or heart failure. This treatment has been remarkably successful in preventing these complications, but patients survive with other symptoms of the disease susceptible to impair, sometimes seriously, their quality of life. This is the case of arthropathy and osteoporosis complicating haemochromatosis. In this chapter, focus has been placed on the rheumatological complications of genetic haemochromatosis.
Best Pract Res Clin Rheumatol 2011 Oct
PMID:Miscellaneous non-inflammatory musculoskeletal conditions. Haemochromatosis: the bone and the joint. 2214 45


<< Previous 1 2 3 4 5 6 7 Next >>