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)

To find out the causes of death with particular reference to venous thromboembolism all patients being operated on for hip fractures who were taking part in a trial of two methods of prophylaxis against thromboembolism were consecutively and prospectively registered. A total of 806 patients were included, 66 of whom died within three months (8%). The necropsy rate was 64%. The patients who died were significantly older than those who did not. Pulmonary emboli were diagnosed in 17 of the 42 necropsies: 3 fatal, 5 contributory, and 9 incidental. The patients with fatal and contributory emboli died a median of 31 days postoperatively. In the 24 patients who did not have necropsies the clinical cause of deaths were cardiac insufficiency (n = 11), pneumonia (n = 8), pulmonary embolism (n = 2), and myocardial infarction, cerebral infarction, and pancreatic cancer (n = 1 each). The incidence of fatal pulmonary embolism therefore varies between a minimum of 0.37% and a theoretical maximum of 3.3%. In conclusion, fatal pulmonary embolism after operations for fractured hips is low where routine thromboprophylaxis is used. Most patients who develop large pulmonary emboli are old but live independently. To study causes of death a high necropsy rate is essential.
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PMID:Pulmonary embolism and mortality in patients with fractured hips--a prospective consecutive series. 168 45

The mitomycins are antitumor antibiotics that are under investigation now for more than 30 years. Mitomycin C (MMC) is the best investigated subtype. It serves as a prototype for drugs with bioreductive alkylation, which is a unique feature of this class. MMC is mainly active under anaerobic circumstances. The pharmacokinetics are linear in a two-compartment model. The main toxicities of MMC are thrombocytopenia and leucocytopenia. Rare but severe side effects are a hemolytic uremic syndrome, pneumonitis and cardiac failure. MMC has a wide clinical antitumor spectrum with efficacy in various tumor types such as gastric cancer, pancreatic cancer, breast cancer, non-small cell lung cancer, cervical cancer, prostate cancer and bladder cancer. Still, the above mentioned side effects prevent a more widespread use. The most important features of the drug will be reviewed.
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PMID:Mitomycin C: mechanism of action, usefulness and limitations. 213 Oct 38

Five out of 15 homozygotes and 41 out of 527 heterozygotes of familial hypercholesterolemia (FH) died during the past 10 years. Sudden death or heart failure was the cause of death in each of the 5 deceased homozygotes. Twenty heterozygotes died of myocardial infarction, 9 of sudden death, and 1 died after AC bypass surgery. Thus, 30 heterozygotes (73.2%) died of coronary heart disease (CHD). The mean age of death was significantly younger in male heterozygotes (54 years) than in the females (68 years). Rate of death from CHD in heterozygotes was 11 times higher than in the general population in Japan. Rate of death from pancreas cancer in FH was significantly higher than in the general population. These results suggest that FH is highly associated with pancreas cancer as well as CHD.
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PMID:Causes of death in patients with familial hypercholesterolemia. 373 50

Gemcitabine (GEM) is currently considered a standard drug for advanced pancreatic cancer and widely used for patients with this carcinoma. We report on 2 patients with unresectable pancreatic cancer who were able to survive for more than 2 years after GEM treatments. Case 1 was a 82-year-old woman with invasion to celiac artery and who was inoperable. During GEM administration, she had no symptoms and the tumor did not progress. However, because of the toxicities of heart failure, GEM administration was stopped after she took a total of 16,800 mg. After GEM administration was stopped, symptoms appeared and the tumor progressed. Case 2 was a 39-year-old man with obstructive jaundice with liver and lymph node metastases. He was treated with metallic stent in order to reduce cholestasis. During GEM administration, he had no symptoms and the tumor did not progress. As an adverse event, rash occurred after he took a total of 51,800 mg. GEM administration was then stopped. This patient sometimes developed cholestasis due to tumor ingrowths and sludge and was treated successful by endoscopy. GEM has shown to improve survival and show a clinically beneficial response in patients with advanced pancreatic cancer. However, toxic events can be expected to occur with long term GEM administration. We consider that management of complications such as obstructive jaundice is very important in the treatment of pancreatic cancer.
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PMID:[Two cases of advanced pancreatic cancer responding to gemcitabine with long survival of 2 years]. 1522 20

In this report, a case is presented of a patient with advanced heart failure who had asymptomatic pancreatic gout, which masqueraded as metastatic pancreatic cancer. This unusual presentation of gout was important to recognize, as the presence of a pancreatic cancer would have precluded cardiac transplantation in an otherwise suitable candidate.
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PMID:Pancreatic gout masquerading as pancreatic cancer in a heart transplant candidate. 1978 97

An earlier review summarized evidence relating use of snus (Swedish-type moist snuff) to health and to initiation and cessation of smoking. This update considers the effect recent publications on snus use and health have on the overall evidence. The additional evidence extends the list of neoplastic conditions unassociated with snus use (oropharynx, oesophagus, stomach, lung) to include colorectal cancer and acoustic neuroma, and further undermines the weakly-based argument that snus use increases the risk of pancreatic cancer, although there is a report of poorer cancer survival in users. It remains undemonstrated that "snuff-dipper's lesion" increases risk of oral cancer, and recent publications add to the evidence that snus use has no effect on periodontitis or dental caries. Although onset of acute myocardial infarction is not adversely associated with snus use, there is some evidence of an association with reduced survival. Whether this is a direct effect of snus use or a result of confounding by socioeconomic status or other factors requires further investigation, as does a report of an increased risk of heart failure in snus users. Even if some adverse health effects of snus use do exist, it remains clear that they are far less than those of smoking.
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PMID:Epidemiological evidence relating snus to health--an updated review based on recent publications. 2431 26

A sensitive new plate-reader assay has been developed showing that adult mammalian blood serum contains circulating soluble sulfhydryl oxidase activity that can introduce disulfide bonds into reduced proteins with the reduction of oxygen to hydrogen peroxide. The activity was purified 5000-fold to >90% homogeneity from bovine serum and found by mass spectrometry to be consistent with the short isoform of quiescin-sulfhydryl oxidase 1 (QSOX1). This FAD-dependent enzyme is present at comparable activity levels in fetal and adult commercial bovine sera. Thus cell culture media that are routinely supplemented with either fetal or adult bovine sera will contain this facile catalyst of protein thiol oxidation. QSOX1 is present at approximately 25 nM in pooled normal adult human serum. Examination of the unusual kinetics of QSOX1 toward cysteine and glutathione at low micromolar concentrations suggests that circulating QSOX1 is unlikely to significantly contribute to the oxidation of these monothiols in plasma. However, the ability of QSOX1 to rapidly oxidize conformationally mobile protein thiols suggests a possible contribution to the redox status of exofacial and soluble proteins in blood plasma. Recent proteomic studies showing that plasma QSOX1 can be utilized in the diagnosis of pancreatic cancer and acute decompensated heart failure, together with the overexpression of this secreted enzyme in a number of solid tumors, suggest that the robust QSOX assay developed here may be useful in the quantitation of enzyme levels in a wide range of biological fluids.
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PMID:Disulfide bond generation in mammalian blood serum: detection and purification of quiescin-sulfhydryl oxidase. 2446 75

Incretin-based therapies either increase endogenous levels of glucagon-like peptide-1 by prolonging its half-life (DPP-4 inhibitors) or directly stimulate its receptor (glucagon-like peptide-1 analogues; GLP-1 RA). They are currently widely used for the treatment of patients with type 2 diabetes mellitus owing to good antidiabetic efficacy, low risk of hypoglycemia, and relatively few other side effects. They also offer potential additional benefits such as weight neutrality or weight loss, positive effects on blood pressure and lipid levels, and potential cardio- and neuroprotectivity. Some experimental and clinical studies have raised concerns with respect to potential cardiovascular and pancreatic side effects of these therapies such as increased risk of heart failure with DPP-4 inhibitors as well as acute pancreatitis and pancreatic cancer with both classes. The available data are at present not robust enough to enable firm conclusions regarding these potential associations. Nevertheless, some recent data suggest a possibility of slightly increased risk of acute pancreatitis with GLP-1 RAs while they do not indicate increased risk of pancreatic cancer. Ongoing cardiovascular outcome trials will shed more light on the possible cardioprotective effects of incretin-based therapies as well as on the possible interconnection of DPP-4 inhibitors and heart failure.
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PMID:Balancing benefits and risks in patients receiving incretin-based therapies: focus on cardiovascular and pancreatic side effects. 2539 58

In the U.S., the Centers for Medicare and Medicaid Services uses 30-day readmission, following hospitalization, as a proxy outcome to monitor quality of care. These efforts generally focus on treatable health conditions, such as pneumonia and heart failure. Expanding quality of care systems to monitor conditions for which treatment options are limited or non-existent, such as pancreatic cancer, is challenging because of the non-trivial force of mortality; 30-day mortality for pancreatic cancer is approximately 30%. In the statistical literature, data that arise when the observation of the time to some non-terminal event is subject to some terminal event are referred to as 'semi-competing risks data'. Given such data, scientific interest may lie in at least one of three areas: (i) estimation/inference for regression parameters, (ii) characterization of dependence between the two events, and (iii) prediction given a covariate profile. Existing statistical methods focus almost exclusively on the first of these; methods are sparse or non-existent, however, when interest lies with understanding dependence and performing prediction. In this paper we propose a Bayesian semi-parametric regression framework for analyzing semi-competing risks data that permits the simultaneous investigation of all three of the aforementioned scientific goals. Characterization of the induced posterior and posterior predictive distributions is achieved via an efficient Metropolis-Hastings-Green algorithm, which has been implemented in an R package. The proposed framework is applied to data on 16,051 individuals diagnosed with pancreatic cancer between 2005-2008, obtained from Medicare Part A. We found that increased risk for readmission is associated with a high comorbidity index, a long hospital stay at initial hospitalization, non-white race, male, and discharge to home care.
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PMID:Bayesian Semi-parametric Analysis of Semi-competing Risks Data: Investigating Hospital Readmission after a Pancreatic Cancer Diagnosis. 2597 92

Metformin alone is the glucose-lowering drug of first choice for patients with type 2 diabetes. None of the other glucose-lowering drugs available in 2014 have any proven efficacy in preventing diabetes complications. How important are adverse effects in the choice of glucose-lowering alternatives to metformin for patients with type 2 diabetes? What about their effects on HbA1c levels? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. Sulphonylureas have been in use for many years. These drugs lower HbA1c levels by an average of 1.5% when used alone, and by 0.8% to 1% when added to metformin. All sulphonylureas can cause dose-related hypoglycaemia. Available data do not rule out a tangible increase or decrease in cardiovascular mortality among patients treated with sulphonylureas. Comparative data suggest that the combination of metformin + sulphonylurea increases overall mortality. Human insulins have also been in use for many years. A daily injection of long-acting insulin, added to on-going oral glucose-lowering therapy, lowers HbA1c by 0.7% to 2.5% on average but causes weight gain and increases the risk of hypoglycaemia. It cannot be ruled out that insulin may increase the risk of certain cancers. Alpha-glucosidase inhibitors have a weak glucose-lowering effect. The average decline in HbA1c is about 0.7%, which is not sufficient to offset the gastrointestinal disorders caused by these drugs. The glucose-lowering effect of repaglinide is similar to that of sulphonylureas. Repaglinide can cause hypoglycaemia, particularly when co-administered with inhibitors of some cytochrome P450 isoenzymes. Glitazones have a clearly unfavourable harm-benefit balance, potentially causing fractures, heart failure, other cardiovascular events, bladder cancer. Gliptins lower HbA1c by 0.7% on average but can provoke anaphylactic reactions, Stevens-Johnson syndrome, and infections. Saxagliptin may increase the risk of fractures and heart failure. The long-term adverse effects of gliptins are poorly documented and may include an increased risk of pancreatic cancer. These risks are not offset by any proven clinical efficacy; patients should therefore not be exposed to these drugs. When they are combined with metformin, two injectable GLP-1 analogues, exenatide and liraglutide, have a glucose-lowering potency similar to one or two daily insulin injections. They have the advantage of inducing weight loss, without increasing the risk of hypoglycaemia. Gastrointestinal adverse effects such as nausea are frequent at the beginning of treatment. A possible increase in the risk of pancreatitis, pancreatic cancer and thyroid cancer has not been ruled out. Gliflozins reduce HbA1c by 0.6-0.7% on average. These drugs are already known to have a burdensome adverse effect profile despite their relatively recent market introduction. There are also safety signals concerning serious long-term adverse effects. Patients should not be exposed to these risks.
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PMID:Glucose-lowering treatment of type 2 diabetes. Part II--Glucose-lowering drugs after metformin: a choice based largely on adverse effects. 2603 6


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