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 report two patients with solitary thalamic abscesses, occurring among 91 consecutive patients (2.2%) with computed tomography (CT)-diagnosed and surgically-verified brain abscess experienced in our college during 1975 to 1991. A 9-year-old girl with congenital heart disease experienced frequent vomiting followed by left hemiparesis and deterioration of consciousness. CT demonstrated a right thalamic ring-enhanced lesion. Purulent material was aspirated via a burr hole. She died of heart failure on the 5th postoperative day. Autopsy disclosed diffuse brain swelling and an encapsulated abscess in the right thalamus, which had ruptured into the third ventricle. A 30-year-old female experienced headache, nausea, and vomiting, which progressed to somnolence and right hemiparesis. CT demonstrated a left thalamic ring-enhanced lesion. Purulent material was aspirated by stereotactic procedures. All symptoms had resolved by the end of the 2nd postoperative week.
 ...
PMID:Solitary pyogenic thalamic abscess--two case reports. 750 3

Acute respiratory infection (ARI) is responsible for many childhood deaths in developing countries, particularly deaths of children less than six months old. A major risk factor for death in children with ARI is hypoxia, which is oxygen saturation of 90% in the blood, but administration of oxygen is rare and, when it is administered, clinicians tend to use it when the children become so severely ill that their outcome is poor. Oxygen is not readily available in developing countries. Administration of oxygen earlier in the course of ARI may improve outcome and prevent deterioration. In Papua New Guinea, standard treatment manuals list indications for oxygen use as cardiac failure, grunting, drowsiness, and apneic episodes, in addition to cyanosis and restlessness. Indications that significantly increase diagnosis of hypoxemia and therefore the need for oxygen, although they are not clear cut, include either cyanosis or grunting together with an increased respiratory rate. Use of pulse oximeters would facilitate decisions to use oxygen, but they are cost-prohibitive for developing countries, except in a few well-equipped health facilities. A pragmatic approach to making a decision on what child receives oxygen is administration of a test dose and monitoring the child's response after 24 hours of oxygen therapy. If the child's condition improves, oxygen treatment should continue. Rational criteria are needed to facilitate the decision to stop giving oxygen to a child who does not respond, however. Oxygen concentrators may improve management of childhood pneumonia in developing countries and would be more cost-effective than conventional bottled oxygen. Yet, oxygen concentrators depend on a reliable electricity source. Providers should use an intranasal catheter to administer oxygen to children with pneumonia, since it is less wasteful (50% oxygen concentration at low rate of 0.5 l/min) and safer should the tube disconnect.
 ...
PMID:Hypoxia in childhood pneumonia: better detection and more oxygen needed in developing countries. 829 86

Obstructive sleep apnoea syndrome is due to pharyngeal obstruction of inspiratory airflow with preservation of thoraco-abdominal respiratory movements. This disease has been described for about thirty years, but is now the subject of growing interest. According to the increasingly abundant literature on this subject, OSAS is associated with essentially cardiovascular morbidity and mortality (systemic hypertension, pulmonary hypertension, heart failure, coronary heart disease, arrhythmias, cerebral vascular accidents and sudden death). The pathophysiology of its underlying mechanisms and its complications is complex and multifactorial. The diagnosis of this syndrome should be suspected on clinical interview (snoring, excessive daytime drowsiness, and apnoea during sleep) and is confirmed by polysomnography. Nasal continuous positive pressure with elimination of aggravating factors is the reference treatment in 1994. The diagnosis and management of this syndrome requires a multidisciplinary approach with collaboration between general practitioners, neurologists, maxillofacial/ENT surgeons, cardiologists and respiratory physicians.
 ...
PMID:[Obstructive sleep apnea syndrome and cardiovascular diseases]. 874 61

Patients with neuromuscular disease may suffer from nocturnal respiratory failure despite normal daytime respiratory function. The physiological reduction in muscle tone during sleep may be life-threatening in a patient with impaired muscle strength. Nocturnal respiratory failure may occur in patients with the postpolio syndrome, amyotrophic lateral sclerosis, myasthenia gravis, myotonic dystrophy, and muscular dystrophy. Diagnosis of obstructive, central and mixed apneas, hypopneas, and hypoventilation is best made using polysomnography. Therapeutic options include noninvasive ventilation such as continuous positive airway pressure, bilevel positive airway pressure, intermittent positive pressure ventilation and, rarely, tracheostomy, oxygen, or protriptyline. Evaluation by a sleep specialist should be initiated in any neuromuscular patient with nocturnal symptoms such as air hunger, intermittent snoring or breathing, orthopnea, cyanosis, restlessness, and insomnia. Daytime symptoms may include morning drowsiness, headaches and excessive daytime sleepiness. Polycythemia, hypertension, and signs of heart failure may also be seen. Effective treatment is available, and may improve the quality of life, and possibly increase survival.
 ...
PMID:Nocturnal respiratory failure as an indication of noninvasive ventilation in the patient with neuromuscular disease. 967 Mar 10

This overview discusses pathogenesis, clinical presentation, prognostic implications and therapy of central sleep apnea with special reference to Cheyne-Stokes-Respiration or periodic breathing. In contrast to obstructive sleep apnea due to upper airway collapse during sleep, central sleep apnea (CSA) is mainly due to an instability of the breathing control system. Causes of central sleep apnea include alveolar hypoventilation disorders, heart failure, neurologic and autonomic disorders and idiopathic forms of CSA. Patients with idiopathic CSA often complain of insomnia and awakening during sleep but may also suffer from daytime sleepiness. Cheyne-Stokes-Respiration or peridic breathing is often associated with heart failure and neurological disorders especially those involving the brainstem. In heart failure periodic breathing has enormous prognostic implications. Treatment options for central sleep apnea are oxygen supplementation, medical therapy (i.e. acetazolamide) and CPAP. For patients with central sleep apnoea associated with alveolar hypoventilation nasal ventilation is treatment of choice. Newer nasal ventilation techniques (BiPAP, AutoSetCS) are under investigation for heart failure patients with Cheyne-Stokes-Respiration.
 ...
PMID:[Central sleep apnea syndrome and Cheyne-Stokes respiration]. 1095 54

Signs of exsiccation are to be found in almost every fourth acutely ill patient admitted to the geriatric department. The major clinical signs are those associated with reduced general condition, together with somnolence, possibly agitation, oliguria, dry skin, orthostatic hypotension, and a tendency to be bedridden. In such cases, subcutaneous infusion is a simple-to-apply and for the patient stress-free, largely pain-free possibility for fluid replacement. Properly applied and with account being taken of the contraindications--in particular emergency situations, decompensated cardiac insufficiency and severe coagulation disturbances--the risks of s.c. infusion are negligible.
 ...
PMID:[Dehydration in geriatric patients. Fluid substitution--also subcutaneous!]. 1110 4

Ageing is often associated with a decrease in the quality of sleep. In older subjects, sleep-related breathing disorders (SRBD) are increasingly recognized as being responsible for alterations in the quality of sleep. The prevalence of obstructive sleep apnea (OSA) increases with ageing; despite sometimes major disturbances in sleep structure, clinical symptoms are often subtle in this age group. Central apnea and periodic breathing, also more frequent in older subjects, most often occur in patients suffering either from neurological problems (such as tumors, brain infarcts, sequelae of infection, diffuse encephalopathies) or moderate to severe heart failure. In fact, patients suffering from cerebro-vascular diseases (such as brain infarcts or transient ischemic attacks) have a higher prevalence of SRBD than a control age-matched population. In these patients, SRBD are associated with a poorer prognosis in terms of functional recovery and survival. The clinical impact of SRBD on cognitive function appears to be modest in patients without dementia, albeit for a slight increase in daytime somnolence. However, in patients suffering from Alzheimer's disease, SRBD occur more frequently than in non-demented subjects, and indexes of severity of SRBD have been correlated with the importance of cognitive impairment. The hypothesis of a causal relationship between SRBD and the degree neuropsychological impairment in either Alzheimer's disease or multi-infarct dementia remains a matter of controversy. SRBD should be considered as a possible cause of "reversible dementia" and sought for in the presence of daytime somnolence, delirium, or unexplained right-sided heart failure in older patients.
 ...
PMID:[Respiratory sleep disorders in the elderly]. 1114 Mar 5

Sleep disordered breathing (SDB), i.e., obstructive, central or mixed sleep apneas, has been recognized as a common occurrence in the elderly. Aging is per se associated with a decrease in the quality of sleep; SDB may further disrupt the sleep architecture in older subjects. The prevalence of obstructive sleep apnea (OSA) increases with aging; available studies report prevalence rates of 11-62%. Furthermore, OSA has been associated with increased mortality in older adults. Central apneas and periodic breathing occur with increased frequency either in subjects with neurological disorders such as infarction, tumor, sequelae of infection, diffuse encephalopathies, or in chronic heart failure. Patients with cerebrovascular disease (stroke, or transient ischemic attacks) have a markedly high prevalence of SDB, mainly OSA. In these patients, SDB is associated with a poorer functional prognosis at 3 and 12 months after the acute event, and a higher mortality. The clinical impact of SDB on cognitive function appears to be modest in patients without dementia, although there is a moderate increase in daytime sleepiness. In Alzheimer's disease (AD) however, SDB occurs more frequently than in non-demented older subjects, and its severity is correlated with the degree of cognitive impairment. The hypothesis of a causal relationship between AD and SDB remains a subject of controversy. The possibility of SDB should be considered in the elderly in the differential diagnosis of "reversible dementias", increased daytime sleepiness, or unexplained right-sided heart failure.
 ...
PMID:Sleep disordered breathing in the elderly. 1121 51

The objectives of treating hypertension are to achieve adequate control of blood pressure (BP) and maintain it under tight control. Maintenance of tight control of BP will most likely prevent stroke, heart attack, and heart failure, cause regression of left ventricular hypertrophy, and quite possibly preserve or improve renal function. The last two salutary effects combined will further reduce the morbidity and mortality in the treated hypertensive subjects. Choice of antihypertensive drugs is of significant importance so that our efforts to control hypertension do not grossly alter the quality of life. The cost of therapy is also an important consideration. Thus, thiazide diuretics, beta-blockers, and central inhibitors that are relatively inexpensive and adequately lower BP should be a common choice. However, if drowsiness interferes with work, or impotence becomes a threat for the marital partner or significant other, adjustment has to be made. The metabolic abnormalities consisting mainly of impaired glucose tolerance, hypercholesterolemia, and insulin resistance often induced by these relatively inexpensive drugs have put calcium channel blocker and ACE inhibitor group of drugs on the top of the list for antihypertensive therapy. They are far more expensive, yet offer no greater antihypertensive advantage than a diuretic or central inhibitor, except in special circumstances.
 ...
PMID:Profiling Antihypertensive Therapy. 1185 Jul

The uses, pharmacology, clinical efficacy, dosage and administration, adverse effects, and drug interactions of hawthorn are discussed. Hawthorn (Crataegus oxyacantha) is a fruit-bearing shrub with a long history as a medicinal substance. Uses have included the treatment of digestive ailments, dyspnea, kidney stones, and cardiovascular disorders. Today, hawthorn is used primarily for various cardiovascular conditions. The cardiovascular effects are believed to be the result of positive inotropic activity, ability to increase the integrity of the blood vessel wall and improve coronary blood flow, and positive effects on oxygen utilization. Flavonoids are postulated to account for these effects. Hawthorn has shown promise in the treatment of New York Heart Association (NYHA) functional class II congestive heart failure (CHF) in both uncontrolled and controlled clinical trials. There are also suggestions of a beneficial effect on blood lipids. Trials to establish an antiarrhythmic effect in humans have not been conducted. The recommended daily dose of hawthorn is 160-900 mg of a native water-ethanol extract of the leaves or flowers (equivalent to 30-169 mg of epicatechin or 3.5-19.8 mg of flavonoids) administered in two or three doses. At therapeutic dosages, hawthorn may cause a mild rash, headache, sweating, dizziness, palpitations, sleepiness, agitation, and gastrointestinal symptoms. Hawthorn may interact with vasodilating medications and may potentiate or inhibit the actions of drugs used for heart failure, hypertension, angina, and arrhythmias. The limited data about hawthorn suggest that it may be useful in the treatment of NYHA functional class II CHF.
 ...
PMID:Hawthorn: pharmacology and therapeutic uses. 1188 7


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