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 14-year-old girl with acute promyelocytic leukemia (APL) developed cardiomyopathy following chemotherapy for remission induction and subsequent consolidation consisting of cumulative doses of 644 mg/m2 of daunorubicin and 31 mg/m2 of mitoxantrone. Six months after the first complete remission, when relapse of APL was recognized an allogeneic bone marrow transplantation (BMT) from her HLA-identical brother was performed. A preconditioning regimen, consisting of cytarabine (Ara-C, 2 g/m2/day x 3 days and 4 g/m2/day x 3 days), total body irradiation (TBI, 1200 cGy) and etoposide (VP-16, 50 mg/kg) caused moderate gastrointestinal symptoms and transient hemorrhagic cystitis, but did not worsen her cardiac function. Both continuous intravenous administration of heparin to control DIC and continuous low dose dopamine infusion to prevent cardiac failure achieved their purpose. The patient is leukemia-free and has no symptoms related to cardiomyopathy at the eight month after BMT. A preconditioning regimen (Ara-C, TBI and VP-16) appeared to be suitable for BMT to a patient with anthracycline-induced cardiomyopathy.
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PMID:[A successful allogeneic bone marrow transplantation for acute promyelocytic leukemia with anthracycline-induced cardiomyopathy at relapse]. 160 7

A 54-year-old man received insertion of an acupuncture needle into the region extending from the posterior neck to the back on two occasions for the treatment of shoulder stiffness. Two weeks after the second acupuncture, he developed fever, dysarthria and mictionary disturbance, finally reaching the condition of tetraplegia. He was immediately admitted to an emergency room in our hospital, and was diagnosed as sepsis with DIC, ARDS, heart failure, renal failure, liver failure, and myelitis. After one month, he recovered with transverse myelopathy as a residual deficit. Neurological findings showed transverse myelopathy below the level of Th2 at that time. Cervical CT revealed an irregular low density at the periphery of the cervical vertebra from the C2 to C4 level. Cervical MRI revealed an irregular swelling of his spinal cord from the C2 to C7 level. We explained the mechanism of transverse myelopathy in this case as follows. After the acupuncture, he suffered a focal infection of the region of needle insertion, and then the infection expanded to the cervical vertebra, thus causing osteomyelitis, sepsis, and finally cervical myelitis. Direct injury of the spinal cord and nerve roots as a complication of acupuncture was previously reported, but indirect injury of the spinal cord due to myelitis had not been reported except our present case. Careful attentions should be paid to the complications of acupuncture.
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PMID:[A case of transverse myelopathy caused by acupuncture]. 178 54

ARDS occurs in patients with no underlying pulmonary diseases, induced by stresses, such as lung injury, acute pancreatitis or infections. It is an acute respiratory disorder which manifests as acute dyspnea, hypoxemia and lowered pulmonary compliance. Greene et al, used balloon pulmonary angiogram (BOPA) as diagnostic tool to morphologically observe the pulmonary disorder. To study the dynamic pulmonary circulation and morphology of the peripheral pulmonary artery of ARDS, we performed this method for acute cardiac failure and ARDS patients. Pulmonary hemodynamic changes in ARDS revealed mild pulmonary hypertension and increased PVR, while C.I. and PCWP remained within a normal range. The findings of BOPA in ARDS showed that the frequency of PAFD correlated with the the presence of an elevated PVR and DIC, and pulmonary vasoconstriction was detected by measurement of PA diameter (B/A2).
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PMID:[ARDS: circulatory factors and their evaluation]. 203 88

To evaluate the early and late results of mitral valve replacement and reconstruction for mitral insufficiency due to ruptured chordae tendineae respectively, 74 consecutive cases were analyzed. Fifty-five (74.3%) of the patients were men, and the mean age was 48 +/- 12 years old (range 16 to 76). The causes of the mitral disease were idiopathic in 50 (67.6%), rheumatic in 7 (9.4%) and infective endocarditis in 11 (14.9%) patients. In idiopathic 50 cases, 24 had mitral valve prolapse and 16 had both mitral valve prolapse and hypertension. Forty-one (55.4%) of the patients were in NYHA functional class III or IV preoperatively. Thirty (40.5%) cases underwent surgery within one year after their initial symptoms of heart failure onsets including six emergency operation cases due to uncontrollable acute lung edema. Chordae to anterior mitral leaflet were ruptured in 31 (a5, m16, p10)[41%] patients, to the posterior mitral leaflet in 45 (a4, m23, p18)[59%], and to both leaflets in one patient. Mitral valve replacement was performed in 68 patients (91.9%) and 6 patients (8.1%) underwent mitral valve repairs. Twenty cases underwent associated procedures that included tricuspid valve annuloplasty in 8, aortic valve replacement in 5 and myocardial revascularization in 4 cases. There were two operative deaths (2.4%); both occurred after replacement, left ventricular rupture in one and DIC in one. Mean follow-up period was 4.5 years (range 1 to 17) in 67 cases. There were four late deaths; all occurred after replacement. However five patients sustained mild mitral insufficiency after mitral valve repair including one that became worse of regurgitation three years after isolated Kay's annuloplasty, there were no cases that had needed reoperation and no late death after reconstruction. Left ventricular function and pulmonary arterial pressure were almost normalized in more than 90% cases postoperatively. Our data indicated that mitral valve reconstruction (McGoon's plus Kay's method as standardized maneuver) was the procedure of choice for selected patients with mitral insufficiency owing to ruptured chordae tendineae to the posterior mitral leaflet, including more limited patients with ruptured chordae to the anterior mitral leaflet.
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PMID:[Mitral insufficiency due to ruptured chordae tendineae--clinical features, early and late results of valve replacement and repair]. 273 33

One-hundred-fourteen evaluable patients with metastatic soft tissue or bony sarcoma with measurable disease were treated with Adriamycin (doxorubicin) administered intravenously at a dose of 60 mg/M2 on day 1, followed by DTIC (dacarbazine) at a dose of 750 mg/M2; courses were administered at 3-week intervals. Ten complete remissions and 17 partial remissions were observed. The most responsive cell type was malignant fibrous histiocytoma with a response rate of 54%. This treatment schedule was very well tolerated, with only moderate myelosuppression and moderate nausea and vomiting. Cardiac toxicity was identified in three patients, with two patients demonstrating electrocardiogram (EKG) changes and arrhythmias and only one patient developing heart failure. The 24% overall response rate suggests no compromise in activity on this schedule, with a significant reduction in toxicity.
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PMID:A useful high-dose intermittent schedule of adriamycin and DTIC in the treatment of advanced sarcomas. 375 66

The concentration of antithrombin III (AT) was determined with a chromogenic method in plasma samples from 1,302 patients referred for evaluation of the haemostatic system. A clearly subnormal AT level (below 60%) was found in 129 patients. In ten cases, this was explained by known (8 cases) or suspected (2 newborns) hereditary deficiency. Only in 5% of the 600 cases referred with definite or suspected thrombosis, AT was below 60%. These cases had a lethality of about 20%. In about 30% of the cases with liver disease, AT was below 60%. In a group of 72 patients with either severe infection, cardiac insufficiency, malignancy or suspected DIC for other reasons, AT was below 60%. Also in this group lethality was about 50% despite lack of a clear DIC blood profile in 67 of the 72 patients. The results indicate that an AT value below 60% of normal, unexplained by hereditary deficiency, carries a grave prognosis.
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PMID:On the clinical significance of acquired antithrombin deficiency. 608 56

One patient with a large inoperable malignant hemangiopericytoma and three patients with local recurrence and/or metastases were treated with combination adriamycin, 50 mg/m2, and DTIC, 600-700 mg/m2, intravenously every 4 weeks. Two achieved palliation, one with measureable shrinkage of tumor, and the other with loss of incapacitating lower limb edema secondary to vascular and lymphatic obstruction. The third patient objectively had a less than partial response. The fourth patient did not respond to adriamycin and DTIC or to a subsequent trial of cis-platinum, 60 mg/m2, intravenously every 3 weeks. However, radiotherapy produced an objective response at the site of the local recurrence and relief of painful bone metastases. Two patients died of progressive disease; the third patient has stable disease and is continuing chemotherapy; and the fourth patient died, probably from adriamycin-induced cardiac failure in the presence of rapidly advancing intraabdominal metastases. The combination of adriamycin and DTIC is active in malignant hemangiopericytoma, and palliation of advanced disease can be achieved. However, prolonged survival is uncommon in the presence of a large tumor burden.
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PMID:Treatment of advanced malignant hemangiopericytoma with combination adriamycin and DTIC: a report of four cases. 668 61

22 patients with severe preeclampsia-eclampsia were treated in our Intensive Care Unit from 1972 to 1978. Control of convulsions was achieved by diazepam, diphenylhydantoin and phenobarbital. In 11 comatose patients brain monitoring was carried out by frequent neurological examination and use of computerized x-ray tomography; aspiration of gastric contents was prevented by nasotracheal intubation. Brain oedema therapy included controlled hyperventilation, steroids and mannitol (7 patients). 10 patients with respiratory failure (due to pulmonary oedema, "shock lung" or aspiration pneumonitis) were treated by mechanical ventilation. Diastolic blood pressure above 100 mm Hg was reduced by hydralazine. Diuresis was induced by normalization of hypovolaemia with albumin and plasma expanders. Six patients died (27%); main causes of death included intracerebral haemorrhage, brain oedema, heart failure, acute pulmonary thromboembolism and bleeding from DIC.
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PMID:[Intensive care of severe preeclampsia-eclampsia. A report on 22 cases (author's transl)]. 742 60

A 25 year-old woman diagnosed as acute myelocytic leukemia (M0) suffered a fourth relapse in February 1992 at which time she already had anthracycline-induced cardiac dysfunction. Although remission was induced by low dose cytosine arabinoside and etoposide combined with pirarubicin, she developed acute heart failure followed by extreme elevation of transaminases level and DIC. Abdominal echography and CT revealed small round lesions in the liver. We diagnosed this episode as ischemic hepatitis because of the following clinical findings; serological markers of virus hepatitis were negative, hypotension and reduced blood flow to the liver were seen, and both transaminases and LDH were markedly elevated. Dobutamin and oxygen inhalation were started, her liver function returned to almost normal levels 8 days later.
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PMID:[Ischemic hepatitis due to anthracycline-induced cardiac insufficiency in a patient with acute myelocytic leukemia (M0)]. 771 77

48 patients with heart failure were supported by intra-aortic balloon pumping (IABP) from 1985 to 1993. The disease included rheumatic (39 patients), congenital (7) and coronary hearts (2). The average time of supporting with IABP was 27 hours, 23 patients (48%) survied inclading 19 patients with postoperative lower cardiac output syndrome. Hemodynamics was improved. IABP increased cardiac output syndrome, and hemodynamics was improved. IABP increased cardiac output (50%), cardiac index (60%), stroke volume (50%), stroke volume index (60%) and decreased left atrial pressure or pulmonary wedge pressure. The mortality was 25 patients (52%). The death causes were as follows: arrhythmia (4), renal failure (6), lung failure (2), DIC (1), and the other (12). The main complication of IABP was lower limb ischemia particularly in surgical cut-down method to establish IABP. The analysis indicated that the temporary pacing maker with IABP could prevent some arrhythmia such as frequent premature ventricular beats. Lower limb ischemia and renal failure should receive much attention because they are easy to be confused with shock symptom when IABP.
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PMID:[Intra-aortic balloon pumping in 48 patients with heart failure]. 870 69


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