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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Geriatric patients are preferentially involved in ischemic bowel disease. The sudden occlusion of the large mesenteric arteries (a. mesenterica superior (more frequently) and inferior) is followed by intestinal gangrene and peritonitis with a poor prognosis and a high letality (greater than 90%). In chronic intestinal ischemia the leading clinical symptom is postprandial pain ('claudicatio intestinalis'). In some cases of acute mesenteric artery occlusion no embolus or thrombus will be found. In these cases the circulation in the arteriosclerotic vessels falls below a critical value due to cardiac insufficiency, shock, digitalis overdose and others. In less severe ischemia the mucosa is involved being most sensitive to O2 deprivation. It usually regenerates within a few days. This form is found more frequently in the colon than in other parts of the gut (about 40%): ischemic colitis. The therapy - if possible in acute, fulminant ischemia or if necessary in chronic intestinal ischemia - is surgical consisting in reconstructive procedures of the mesenteric circulation.
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PMID:[Ischemic bowel disease (author's transl)]. 1 31

A 91-year-old man had been treated for iron-deficiency anemia for four years before admission to the Geriatric Unit of the Hasharon Hospital because of cardiac insufficiency and epigastric pain. In the Unit, laboratory studies revealed, in addition to hypochromic anemia, a high level of plasma iron and a reduced iron-binding capacity. The low reticulocyte count in the peripheral blood despite hyperplasia in the bone-marrow erythrocyte series, the rapid disappearance of radioactive iron from the plasma, and the impaired erythrocytic uptake of iron were all indicative of the ineffective erythropoiesis. The findings suggested the possibility of sideroblastic anemia, and examination of bone-marrow aspirates stained for iron confirmed this diagnosis.
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PMID:Sideroblastic anemia in an elderly patient. 86 78

The authors investigated the effects of radiation therapy on the immune system by studying lymphocyte subsets and other parameters in 32 patients undergoing radiation therapy for solid cancer. With monoclonal antibody techniques, we studied both T- and B-lymphocytes; cell suspensions were analyzed by means of a Facs Spectrum III Ortho (Ortho-Diagnostic) unit. The first control was performed right after the beginning of radiotherapy, when the dose to the patients was 50 Gy or higher. The second control was performed at 40 Gy because all patients received this dose. 30% of the patients exhibited lymphopenia from the beginning of the study; at 40 Gy the number of T-lymphocytes was low and helper/suppressor ratio was altered. A variable response of B-cells was observed, although all patients exhibited restoration of normal values at 6 months. Four patients only suffered from side-effects: a patient with tongue cancer presented oral mycosis, and a woman--treated for breast cancer--presented vaginal mycosis. Two cases of cystitis were also observed, after 18 Gy, in patients with uterine carcinoma undergoing pelvic irradiation. Disease progression was observed in 2 patients with head and neck cancer, while 3 patients died from lung cancer progression. Another one, with head and neck cancer, died because of heart failure.
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PMID:[Influence of radiotherapy on lymphocyte subpopulations]. 202 47

Horses suffering from trauma, sepsis, and severe burns need 12% to 16% of protein (dry matter basis) in their diet. Since reduced appetite may be a problem, relatively energy dense (greater than 2 Mcal DE/kg) feeds should be offered. In hepatic failure, maintenance protein requirements (8% on a dry matter basis for adult horses) should be met with feeds that are high in short branched-chain amino acids and arginine but low in aromatic amino acids and tryptophan (for example, milo, corn, soybean, or linseed meal) in addition to grass hay. Vitamins A, C, and E should also be supplemented. In cases with renal failure, protein, calcium, and phosphorus should be restricted to maintenance or lower levels. Grass hay and corn are the best feeds for horses with reduced renal function. Do not offer free-choice salt to horses with dependent edema from uncompensated chronic heart failure. Following gastrointestinal resection, legume hay and grain mixtures are the feeds of choice. Horses with diarrhea should not be deprived or oral or enteral alimentation for prolonged periods of time. Liquid formulas may be used if bulk or gastrointestinal motility are a problem. Apple cider vinegar and a high grain diet may reduce the incidence of enteroliths in horses prone to this problem. Pelleted feeds will reduce fecal volume and produce softer feces for horses that have had rectovaginal lacerations or surgery. Horses with small intestinal dysfunction or resection should be offered low residue diets initially, but long-term maintenance requires diets that promote large intestinal digestion (alfalfa hay, vegetable oil, restricted grain). Geriatric horses (greater than 20 years old need diets similar to those recommended for horses 6 to 18 months old.
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PMID:Clinical nutrition of adult horses. 220 96

To study the problems of treatment which arise in intractable pneumonia in the elderly, randomly selected cases from recent cases of pneumonia aged over 65 (n = 657) in the Tokyo Metropolitan Geriatric hospital were annually retrospectively. Among factors which contributed to intractable pneumonia, malnutrition, aspiration, renal and cardiac failure as well as malignancy were considered statistically significant. The number of cases of the intractable pneumonia which were complicated with multiple organ failure (MOF) increased recently. Hypoxemia was one of the predisposing factor of pneumonia with MOF. It should be emphasized that well-designed supportive therapy as well as choice of appropriate antibiotics is important to determine the outcome of intractable pneumonia in the elderly. Problems concerning the pathogenesis of organizing pneumonia among intractable pneumonia cases which has recently increased in prevalence among the elderly was also discussed.
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PMID:[Treatment of intractable pneumonia in the elderly]. 261 83

Clinical observation of a population of patients with chronic heart failure suggested that some patients adapt to their disease more effectively than others. This difference in response appeared to be more related to psychosocial variables, including a positive future orientation, than to variation in severity of disease. The purpose of this study was to investigate the relationship among the psychosocial variables of hope and morale, the level of function of the individual, and the physiological status of that individual. The sample for this descriptive study was patients who met inclusion criteria and who attended the Heart Failure Clinic at St Joseph's Hospital, Hamilton, Ontario, Canada (n = 23). Data were collected at one point in time. Population characteristics were obtained by chart extraction and patient interview. The Beck Hopelessness Scale, the Philadelphia Geriatric Centre Morale Scale, and an adapted version of the McMaster Health Status Index were administered. Physiological status was determined by clinical signs and symptoms in accordance with a scale devised by Lee. Patients who scored higher on the scales assessing hope and morale also scored higher on social function. There was very little relationship between these psychosocial variables and the physical variables of physiological status and physical function. These findings suggest that patients who are more hopeful maintain their involvement in life regardless of physical limitations imposed by their heart failure. Nursing interventions must continue to include the enhancement of hope for the future and active participation with others.
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PMID:Hope, morale and adaptation in patients with chronic heart failure. 363 18

A newly developed human immunoglobulin preparation for intravenous use, SM-4300, has been studied in Nagoyashi-Koseiin Geriatric Hospital on the effects of 14 cases of the various severe infections in the combined use with antibiotics. The following results were obtained: The patients had many kinds of underlying diseases. Cerebral vascular disease was the most frequent underlying disease, and found in 70% of 14 patients, followed by heart failure. Among them 8 cases were chosen for the clinical evaluation by doctors in charge. SM-4300 effected good in 1 case, fairly 3 and poorly 4. The efficacy rate was summarized as 12.5%. In all cases, there were no significant side effects regarding symptoms, hematological analysis, renal and live functions. Based on these results, SM-4300 may be safe and a drug worth to try in treatment of severe infections.
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PMID:[Clinical effects of SM-4300 in severe infectious patients]. 407 17

Comparative studies of the differences in elderly patients with and without cardiovascular disorders were made in regard to complications occurring during and after operation. The subjects included 38 patients (6 men and 32 women) aged 70 to 99 years (mean: 84 years) at Nagoya City Kouseiin Geriatric Hospital who had orthopedic surgery under general anesthesia, between March 1990 and October 1992. Diseases identified in these subjects were sequelae of cerebrovascular disease (38 subjects), heart disease (22 subjects), hypertension (9 subjects), senile dementia (6 subjects), Parkinson's disease (5 subjects), malignant disease (3 subjects) and diabetes mellitus (2 subjects). They were initially divided into 2 groups according to ultrasonic cardiography: a normal group comprising 20 patients without cardiovascular abnormalities, and a disorder group comprising 18 patients with reduction of left ventricule function, left ventricular hypertrophy and/or valvular disease (more than moderate). All subjects were examined with regard to age, weight, the nutrition index proposed by Onodera, activity of daily living (ADL), cardiac output, left ventricular ejection fraction, serum level of BUN and albumin etc. Moreover, the disorder group subjects were divided into 2 groups according to the presence or absence of heart failure occurring after surgery. In addition to the above-mentioned, we also studied the duration of surgery and anesthesia, and water balance during and after surgery. Results showed that the ADL and nutrition index in the disorder group were lower compared to the normal group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Comparative studies on complications occurring during and after surgery in elderly patients with and without cardiovascular disorders]. 829 52

During 1996, 585 patients, aged 55 to 96, were admitted into hospital at the Geriatric Department of Ospedale Maggiore (Turin). Acute confusion was seen in 22.2% of these patients who tended to have more serious clinical condition, were more likely to have chronic cognitive impairment, were treated with a greater number of drugs and suffered more from immobility with pressure ulcer. The confusional state, manifested at admission to Geriatric department, was mostly related with the patient's clinical severity, while the one which developed during hospital stay was linked to situations of physical frailty, as pressure ulcer and low albumin values. The most frequent causes of acute confusional state were acute infectious diseases, heart failure, gastro-intestinal bleeding with secondary anaemia, stroke and dehydration. In many cases the very cause of the acute confusional state could not be identified. Falls, more than 31 days length of stay in hospital and death were more frequent in patients suffering from confusional state. Chronic cognitive impairment, functional dependence, clinical severity and treatment involving a great number of drugs, are the main contributing factors in this syndrome. Thus, a multi-dimensional evaluation which takes into account both clinical-functional and socio-economical aspects, is useful for a correct preventive and diagnostic approach of acute confusional state.
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PMID:[Acute confusion in the geriatric patient]. 967 28

Several studies have reported the prevalence of medical conditions or investigated the relationships between the oral health status and general health conditions in the elderly. However, the relationship between medical conditions and oral health among the elderly is not well-described. Previous studies have not clearly identified a consistent association between medical conditions and oral health, specifically edentulism and tooth loss. The purpose of this study was to investigate the relationships between medical conditions and oral health, as assessed by edentulism and missing teeth, in an institutionalized elderly population. A systematic sample (n = 175), stratified by age and sex, was drawn from nursing home patients treated by the University of low' as Geriatric Mobile Unit (GMU) team. Data were extracted from GMU dental records, regarding history of medical conditions, medications, dental history, dentate status, and tooth-by-tooth conditions. Mean numbers of missing teeth were significantly higher among those who had a history of atherosclerotic vascular disease, heart failure, ischemic heart disease, and joint disease. Subjects who had a history of atherosclerotic vascular disease, heart failure, ischemic heart disease, and joint disease were more likely to be edentulous than subjects who did not have a history of those diseases. The biological basis for these relationships between dentate status and systemic medical conditions is unclear and warrants further study.
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PMID:Medical conditions associated with missing teeth and edentulism in the institutionalized elderly. 968 Sep 23


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