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)

Spontaneous arteriovenous fistulae of the vertebral artery are rare (only 41 cases in French and English-language literature). Auscultation regularly discloses a cervical bruit which was found by systematic examination in 30 p. 100 of the cases. Otherwise, the fistula was revealed by unilateral pulsatile tinnitus (30 p. 100) or by a transient vertebro-basilar ischaemic accident (20 p. 100). The main complications, which occurred in 40 p. 100 of the cases, were ischaemic accidents in the vertebro-basilar territory and, primarily in children, heart failure. Prognosis seems to be governed by the patient's age at the time of diagnosis: 6 out of 7 cardiac complications occurred before the age of 10, and only 2 beyond the age of 50; in contrast, the duration and complexity of the fistula do not appear to be prognostic factors. Doppler examination of the neck and head, based on clinical findings, confirms the diagnosis and provides information on a possible blood steal. Arteriography by the arterial route is mandatory before surgery, but it also represents a first therapeutic measure (embolization, or even spontaneous obliteration of the fistula during the procedure, as seen in 4 cases). Asymptomatic forms, for which embolization and surgery may be postponed, can be monitored by ultrasounds.
 ...
PMID:[Spontaneous arteriovenous fistulas of the vertebral artery. Apropos of a case--review of the literature]. 294 Jun 54

Dural arteriovenous malformation (AVM) is a rare clinical entity, presenting most commonly in adult patient with pulsatile tinnitus or haemorrhage. We report a case of a neonate with a massive dural arteriovenous malformation (AVM) with signs of cardiac failure soon after birth. The diagnosis was first suggested during angiocardiography when a hypertrophied left common carotid artery was detected. The AVM was supplied by branches from the left external carotid artery and the left veretebral artery and drained into the left transverse sinus near the torcula. This was excised in two stages. Post-operative angiography showed no residual malformation. The patient was well and developing normally 4 years after surgery. Review of the literature showed only 2 similar cases of dural AVM presenting in the neonatal period, both patients died, reflecting the high risks involved and the difficulties encountered in the management. Ligation of arterial supplies can be a useful temporary procedure in these high risk babies. Definitive excision should be performed later when the baby grows stronger.
 ...
PMID:Dural arteriovenous malformation presenting as cardiac failure in a neonate. 340 58

High dose furosemide is commonly used in renal failure to induce diuresis but rarely employed in cardiac failure. As furosemide elimination depends largely on renal excretion, drug accumulation with attendant side-effects would be expected to occur more commonly with renal failure than with cardiac failure. Response to a combination of thiazide diuretics and lower doses of furosemide is often unpredictable, ineffective and sometimes hazardous. High dose furosemide (greater than or equal to 0.5 g day-1) was administered for at least four weeks in 24 patients with severe cardiac failure refractory to a lower dose and to other conventional therapy. Mean maintenance dose of furosemide was 0.7 g day-1 and the maximum dose of furosemide averaged 1.3 g day-1. A peak dose of 8 g day-1 was used successfully in one patient. Improvement was observed in all patients when dosage was increased to and above 0.5 g day-1. There were no major side-effects although new-onset gout (4) and tinnitus (1) were reported; hypokalaemia was readily controlled with spironolactone or potassium supplements. Average duration of therapy was 12 months with a maximum of 33 months. High dose furosemide is logical and effective therapy (with other measures) for severe cardiac failure and relatively safe when administered cautiously. The maximum safe dose is probably no less than that used in renal failure.
 ...
PMID:High dose furosemide in refractory cardiac failure. 407 5

The authors share their results from the studies on the incidence and characteristic of hypertonic syndrome in 132 patients with chronic glomerulonephritis (ChGN). In that random group, 65.1 per cent had renoparenchymal hypertension (RPH), 34.8 per cent of the patients had RPH among the patients with normal renal function, and with various degrees of chronic renal insufficiency (ChRI) - 95.4 per cent. In 69 patients, the diagnosis was confirmed by puncture biopsy, with a predomination of membranous, membranous-proliferative, IgA and endoproliferative ChGN. With the exception of IgA nephritis, RPH in the rest is found relatively often even in the absence of ChRI. The symptomatics of RPH was relatively poor--most frequently the patients complained of headache--in 48 per cent but patients with ChGN without RPH also had the same complaints--26 per cent. Complaints as dizziness, tinnitus and insomnia were rare. The hypertension was with a short duration (according to anamnestic data)--in 2/3 less than three years and 40 per cent of the patients had hypertonic crises or/and acute left cardiac insufficiency in spite of the relatively little alterations in ECG and fundus of the eye. Those were mainly patients with advanced ChRI. The authors lay stress upon the necessity of complex treatment of renal insufficiency and of hypertension with a view to the improvement of the prognosis of those patients.
 ...
PMID:[Incidence and characteristics of the hypertension syndrome in chronic glomerulonephritis]. 716 7

Mitochondriopathies (MCPs) are either due to sporadic or inherited mutations in nuclear or mitochondrial DNA located genes (primary MCPs), or due to exogenous factors (secondary MCPs). MCPs usually show a chronic, slowly progressive course and present with multiorgan involvement with varying onset between birth and late adulthood. Although several proteins with signalling, assembling, transport, enzymatic function can be impaired in MCP, most frequently the activity of the respiratory chain (RC) protein complexes is primarily or secondarily affected, leading to impaired oxygen utilization and reduced energy production. MCPs represent a diagnostic challenge because of their wide variation in presentation and course. Systems frequently affected in MCP are the peripheral nervous system (myopathy, polyneuropathy, lactacidosis), brain (leucencephalopathy, calcifications, stroke-like episodes, atrophy with dementia, epilepsy, upper motor neuron signs, ataxia, extrapyramidal manifestations, fatigue), endocrinium (short stature, hyperhidrosis, diabetes, hyperlipidaemia, hypogonadism, amenorrhoea, delayed puberty), heart (impulse generation or conduction defects, cardiomyopathy, left ventricular non-compaction heart failure), eyes (cataract, glaucoma, pigmentary retinopathy, optic atrophy), ears (deafness, tinnitus, peripheral vertigo), guts (dysphagia, vomiting, diarrhoea, hepatopathy, pseudo-obstruction, pancreatitis, pancreas insufficiency), kidney (renal failure, cysts) and bone marrow (sideroblastic anaemia). Apart from well-recognized syndromes, MCP should be considered in any patient with unexplained progressive multisystem disorder. Although there is actually no specific therapy and cure for MCP, many secondary problems require specific treatment. The rapidly increasing understanding of the pathophysiological background of MCPs may further facilitate the diagnostic approach and open perspectives to future, possibly causative therapies.
 ...
PMID:Mitochondriopathies. 1500 63

In previous studies the possibility of a mechanism of hemodynamic imbalance consequent to a sharp decrease in blood pressure causing a more or less transient inner ear impairment was evaluated and to some extent demonstrated. In this scenario, tinnitus is very frequently present as a debilitating symptom associated to cochlear impairment. On the other hand, a possible cause of a sharp decrease in blood pressure is represented by major cardiovascular disorders, requiring an early assessment in order to avoid fatal consequences. In this paper, the hypothesis of resorting to tinnitus as a simple warning method for self detecting a possibly incoming cardiovascular imbalance in patients with heart failure (HF) is advanced.
 ...
PMID:Is tinnitus useful in early detection of incoming heart decompensation? 1662 99

Following trauma to her right frontal region, a 68-year-old woman suffered bilateral, benign, paroxysmal, positional vertigo and a left-sided, longitudinal petrosal bone fracture, with secondary facial palsy and ossicular luxation. From the onset, the patient complained of pulsatile, left-sided tinnitus. After eight weeks, she developed left-sided ocular symptoms, progressing from conjunctival hyperaemia and orbital oedema to an abducens nerve palsy, and ultimately to heart failure. The case and the final diagnosis of carotico-cavernous fistula are discussed. Guidelines are proposed for a diagnostic approach to pulsatile tinnitus and for the optimal management of patients presenting with pulsatile tinnitus associated with ocular symptoms.
 ...
PMID:Post-traumatic pulsatile tinnitus: the hallmark of a direct carotico-cavernous fistula. 1729 36

In order to find out any possible cause of an alteration of the vasomotor reactivity which can be responsible for a more or less severe sufferance of the inner ear, announced by the onset or the enhancement of sensorineural hearing loss, tinnitus, and some kind of dizziness and vertigo, a multidisciplinary approach should be considered. The possibility of an influence of hemodynamic imbalance due to hypotensive changes followed by vasomotor changes affecting the microcirculation of the inner ear has already been widely discussed; moreover, an increase in prevalence of tinnitus (which in many cases can be considered as a symptom of sufferance of the inner ear) has been found in subjects submitted to an "aggressive" antihypertensive therapy as well as in patients with severe heart failure, thus demonstrating a relationship between hemodynamic changes and inner ear dysfunction. For the same reason, the research for this mechanism of imbalance could concern other conditions possibly activating an abnormal response of the autonomic nervous system, which could in turn lead to a circulatory impairment of the labyrinth: among these, affections concerning central nervous system, endocrine system, metabolism, renal apparatus and even gastroenteric diseases with a functional component and any other factor which could interfere with vasomotor regulation should be considered. Thus, the absence of reliable causes for a sufferance of the inner ear should not lead to catalogue it as a disorder of "idiopathic" nature, but should represent a reason for a multidisciplinary investigation on all the possible causes of hemodynamic imbalance and/or autonomic dysregulation.
 ...
PMID:Inner ear dysfunction of uncertain origin: a multidisciplinary approach could give something more. 1902 43

MoM hip bearings are being scrutinized due to high early failure rates and concerns that the results of the revision surgeries will be poor. However, orthopedic surgeons and the general medical community are unaware that patients with MoM bearings are also at risk for cobaltism. Medical providers need to know that hip arthroplasty implantees that present with symptom complexes that include tinnitus, deafness, vertigo, visual changes, rashes, hypothyroidism, tremor, dyspnea on exertion, mood disorders, dementia, heart failure, and peripheral neuropathy may be presenting arthroprosthetic cobaltism. These patients need to be asked if they have had a hip replacement and if so what type. For those patients implanted with a MoM bearing or those with a history of hip revision for a failed ceramic bearing obtaining a [Co] is indicated. MoM implantees with renal failure are a particularly high risk for cobaltism. A [Co] can be measured by many reference laboratories from royal blue top trace elements tube of venous blood. Venipuncture with a standard needle is adequate as long as a red stoppered tube is drawn first. The radiographic appearance of a MoM bearing is readily apparent to an orthopedic surgeon. The patient's operative report will usually specify the bearing type. Given that the publicity of the recent ASR bearing recall medical providers will be contacted by worried patients concerned about their hip implants. Most patients with hip replacements will not know the brand or material of their bearings. Providing patients with copies of their hip implant inventory might avoid worry by the majority of patients with hip arthroplasties that are not at risk. Patients with a cobalt levels of greater than 7 mcg/l bear observation of neurologic and cardiac function. Those patients with levels greater than 20 should be advised to have revision of their hip arthroplasty to a bearing that eliminates cobalt. Most patients implanted with MoM bearing have cobalt levels greater than those allowed in industry and cobalt exposed workers may have an increased incidence of subclinical cognitive and cardiac impairments. This association merits further study. Table 1 is a summation of the previously referenced data of this paper that might assist the clinician in interpreting a [Co].
 ...
PMID:Arthroprosthetic cobaltism: identification of the at-risk patient. 2106 26

Vagus is Latin for wandering, and the vagus nerve fully deserves this name due to its extensive distribution through the body. Indeed, one of the lines of the song that accompanied the 2012 G. L. Brown Prize Lecture exaggerates this diversity, 'My function's almost anythin', and vagus is my name'. Alteration of vagal activity was first investigated in the 1880s as a treatment for epilepsy, and vagus nerve stimulation is now an approved treatment for refractory epilepsy and depression in the USA, despite an incomplete understanding of the mechanisms involved. Vagus nerve stimulation could be beneficial in many other conditions, including heart failure, tinnitus, chronic hiccups, Alzheimer's disease and inflammatory diseases. Inhibition of vagal activity could also be beneficial in some conditions, e.g. reducing activation of vagal respiratory afferents to treat chronic cough. This review discusses evidence underlying some current and potential therapeutic applications of vagal modulation, illustrating the wonders of the Wanderer.
 ...
PMID:The wonders of the Wanderer. 2284 84


1 2 Next >>