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 25-yr-old male captive walrus (Odobenus rosmarus divergens Illiger) died after suffering from periods of inactivity, anorexia, and weight loss for 8 wk. Necropsy revealed prominent, generalized atherosclerosis of cardiac arteries with widespread chronic myocardial infarction. Severe disseminated myocardial fibrosis most likely resulted in insidious cardiac failure that was ultimately the cause of death. Bouts of abdominal pain and disseminated cutaneous ulcers that had been observed 3 and 4 days before death, respectively, were attributed to circulatory failure and thrombosis. The cause of the vascular lesions remains unknown. When compared with humans, atherosclerosis is rare in animals and has not been described in a walrus.
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PMID:Atherosclerosis with multifocal myocardial infarction in a Pacific walrus (Odobenus rosmarus divergens Illiger). 1239 3

Hypertension is an important determinant of heart failure. Ventricular systolic and/or diastolic dysfunction can eventuate in an activation of the renin-angiotensin-aldosterone system (RAAS). Circulating RAAS effector hormones lead to: the appearance of the congestive heart failure syndrome; and a systemic illness that features oxi/nitrosative stress in various tissues, including blood, together with circulating pro-inflammatory cytokines, anorexia and, ultimately, cachexia. In addition to its well-known endocrine properties, expressed in epithelial cells of classic target tissues, aldosterone (ALDO) has an emerging portfolio of actions in nonclassic target tissues, such as circulating lymphocytes and monocytes (or peripheral blood mononuclear cells [PBMC]). This neuroendocrine-immune interface is based on Na(+)-dependent, ALDO-induced iterations in PBMC cytosolic free [Mg(2+)](i) and [Ca(2+)](i). Ca(2+) loading contributes to an induction of oxi/nitrosative stress and activation of PBMC transcriptome. This immunostimulatory state begets a pro-inflammatory/fibrogenic vascular phenotype involving the heart and systemic organs and can be prevented by either ALDO receptor antagonism or antioxidant. The established efficacy of ALDO receptor antagonism as an integral component of the overall management of symptomatic heart failure may include its immunomodulatory properties. This brief review traces studies that led to and then identified the neuroendocrine-immune interface that accompanies aldosteronism.
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PMID:A neuroendocrine-immune interface. The immunostimulatory state of aldosteronism. 1468 3

We report the case of a 58-year-old man who suffered from a generalized and intolerable itching one month after starting treatment with colchicine, amiodarone, perindopril, allopurinol and spironolactone. From the start of treatment he had progressively developed erythroderma, fever, anorexia and prostration, oedema of both hands and face, hypereosinophilia (42%; 5810 eosinophils/mm3), hepatic failure (including cholestatic jaundice, cytolysis, coagulation abnormalities and hypoproteinaemia), exocrine pancreatic failure (with severe steatorrhoea), renal failure, metabolic acidosis, aggravation of pre-existing cardiac insufficiency and oedema of the lower extremities. All medications were stopped and the condition improved slowly until complete remission was reached 4 months later. Patch-testing was performed, including the various drugs. All the tests (including components of the vehicles) were negative, except for spironolactone, which gave a strong positive reaction. Ten controls in healthy volunteers were negative. The diagnosis of drug rash with eosinophilia and systemic symptoms (DRESS) induced by spironolactone was made. This is the first report of DRESS due to spironolactone.
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PMID:Drug-induced eosinophilia and multisystemic failure with positive patch-test reaction to spironolactone: DRESS syndrome. 1504 Apr 82

Cachexia is a complex syndrome. The main components of this pathological state are anorexia and metabolic abnormalities such as glucose intolerance, fat depletion, and muscle protein catabolism among others. The aim of the present article is to review the different therapeutic approaches that have been designed to fight and counteract muscle wasting in different pathological states such as cancer, AIDS and chronic heart failure.
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PMID:The pharmacological treatment of cachexia. 1505 12

Dysphagia is most common in geriatric medicine. Aspirations may cause chronic inflammatory syndrome or acute pneumonia or heart failure. At-risk patients should be recognised: some risks are caused by an acute condition, some by chronic disease or handicap. Alzheimer's disease is the most common at-risk condition; it is causes a loss of the conscious part of mastication and early swallowing. Psychiatric disorders with anorexia should not be overlooked as a cause for dysphagia and malnutrition. Due to a longer life, elderly people are more likely to have multiple causes for dysphagia. Management of dysphagia in geriatric patients is sometimes curative but more often readaptative and palliative. It is not restricted to the time of the meals. It first starts with avoiding decubitus and maintaining a walking ability. Proper positioning in seats and bed involves an occupational therapist. The nutritionist selects tasty and appealing meals for each patient. Nurses detect acute confusion as opposed to, or in, dementia. The speech therapist takes charge in tutoring the staff in knowing what is the secure way to manage an assisted meal, and helps finding the best fitted texture for food and drink. Sometimes a proper rehabilitation will be feasible. Per endoscopic gastrostomies are mostly restricted to neuro-vascular patients and need discussed for their benefit/risk balance. The holistic approach needed to manage dysphagia in polypathology elderly patients calls for a "cultural" approach of the whole gerontologic team, never the less, accurate specialised diagnosis in mandatory.
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PMID:[Dysphagia, a geriatric point of view]. 1514 31

We present a case of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA)-associated vasculitis that demonstrated a systemic granulomatous lesion at autopsy. The patient initially showed anorexia, general malaise and anemia. Colon fiber was examined to detect the bleeding site, which revealed ischemic mucosal damage associated with venous fibrin thrombus. Because a high titer of MPO-ANCA was found, ANCA-associated vasculitis was suspected and the patient was started on steroid pulse therapy. However, anemia, renal failure and respiratory failure worsened and the patient died of sudden cardiac failure 2 days after the start of the therapy. An autopsy revealed systemic arteritis in multiple organs including the kidneys, liver, spleen, gastrointestinal system and genital organs that indicated fibrinoid necrosis accompanied by granulomatous reaction with multinucleated giant cells; the granulomatous reaction further extended along the splenic capsule. Glomerulonephritis and diffuse pulmonary damage, which are common in MPO-ANCA-associated vasculitis, were almost absent but parapleural fibrosis was present. The direct cause of death was presumed to be hemorrhagic shock due to rupture of an aneurysm in the gastric subserosa. As far as we know, this is the first case of a systemic granulomatous reaction in MPO-ANCA-positive vasculitis, although the cause of the granulomatous lesion is unknown.
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PMID:Systemic granulomatous necrotizing vasculitis in a MPO-ANCA-positive patient. 1526 Aug 56

A 4-year-old German Shepherd was evaluated for progressive depression, lethargy, anorexia, and dyspnea. Despite treatment with diuretics and antibiotics, the dog died. Based on clinical, radiographic, and pathologic findings, the diagnosis was heart failure resulting from aortic valvular endocarditis.
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PMID:Aortic valvular endocarditis in a dog. 1536 43

We present a rare surgical case of aorto-right atrial fistula caused by type A aortic dissection in an 85-year-old man. Complaints included progressive general fatigue and anorexia caused by right side heart failure. However, there were no symptoms attributable to onset of the aortic dissection. A diagnosis of aorto-right atrial fistula was made from intraoperative transesophageal echocardiography. Total aortic arch replacement concomitant with direct closure of the fistula was performed successfully.
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PMID:Aorto-right atrial fistula caused by type A aortic dissection. 1556 Oct 67

An 86-year-old woman was admitted to our hospital because of vomiting and anorexia. Although serum cardiac markers, an electrocardiogram, and echocardiography suggested acute myocardial infarction, emergency cardiac catheterization revealed akinesis of the left ventricular apex without significant coronary artery stenosis. She was diagnosed as having takotsubo cardiomyopathy. The left ventricular dysfunction was considered transient and reversible but did not improve at all, contrary to our expectations. She died of worsening heart failure on day 14. We discuss this serious clinical course of a very elderly patient with takotsubo cardiomyopathy.
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PMID:A serious clinical course of a very elderly patient with takotsubo cardiomyopathy. 1577 83

The clinical manifestations of thyroid diseases in the elderly are often atypical and can easily be attributed to other medical conditions or 'normal aging'. Two nursing home patients with hyperthyroidism are described. Due to the atypical presentation of the thyroid disease their complaints were attributed to other conditions. In both patients there was a significant delay in diagnosis and treatment of hyperthyroidism. In elder patients signs and symptoms of thyreotoxicosis are frequently related to cardiovascular, gastrointestinal and neuropsychiatric disorders. Most often occur atrial fibrillation, worsening of cardiac failure and angina pectoris, weight loss, anorexia, constipation, cognitive impairment and delirium. Delay of diagnosis and treatment of hyperthyroidism may be potentially harmful to the patient. Untreated thyreotoxicosis may lead to serious cardiovasculair complications (particularly cardiac failure and cerebrovascular accidents), mental deterioration and osteoporosis. In elder people with unexplained and vague signs and symptoms thyroid function should always be checked. The TSH assay is a very accurate diagnostic test for screening thyroid function. A normal TSH indicates euthyroidism with an accuracy of almost 100%. The medical treatment for hyperthyreoidism in the elderly are antithyroid drugs. When an euthyroid state is rendered, suppletion with L-thyroxine may be nessecary. Radioactive iodine treatment is preferred in some cases though there may be practical difficulties with the application of this treatment in nursing home patients because temporary isolation is necessary.
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PMID:[Hyperthyroidism in the elderly: aspecific signs may cause a delay in diagnosis]. 1594 73


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