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)

I report five cases of occlusion of the superior mesenteric artery from one general practice; four of these occurred in one year.THE COMMON CLINICAL FEATURES WERE: acute diarrhoea and vomiting in elderly persons (all over 70) with abdominal pain and distension and shock. All had a previous history of auricular fibrillation and cardiac failure and past episodes of clinical arterial occlusive disorders had been experienced by four. Each diagnosis was confirmed at operation and all five patients died. It is important for general practitioners to recognize this syndrome.
J R Coll Gen Pract 1979 Sep
PMID:Acute superior mesenteric artery occlusion: problems of pre-operative diagnosis. 52 38

There is little recent information on the prevalence of heart failure in the United Kingdom. Assuming that patients with heart failure would be taking diuretic drugs all such patients were identified in three general practices in north west London. The practice records of these patients were examined to determine which patients had heart failure. Of the 30,204 patients served by the practices, 117 had heart failure, a prevalence of 3.9 per 1000 patients. The mean age of these patients was 74 years. The prevalence of heart failure among patients under 65 years of age was 0.6 per 1000 patients rising to 27.7 per 1000 among those aged 65 years and over. The aetiology of heart failure was considered to be coronary heart disease for 32% of patients, valve disease for 19%, hypertension for 6%, cor pulmonale for 4% and congenital heart disease for 2%. The aetiology for the remaining 37% of patients was unknown. Most patients were referred to hospital and only 20% had been treated solely by the general practitioner. An electrocardiogram and chest radiograph had been obtained for over 80% of patients but only 28% had an echocardiogram. Heart failure occurs primarily in elderly patients, and coronary heart disease is the dominant aetiological factor.
Br J Gen Pract 1992 Jul
PMID:Prevalence of heart failure in three general practices in north west London. 141 62

A 63-year-old married man with idiopathic terminal cardiomyopathy was admitted to the medical service for treatment of advanced heart failure. A psychiatric consultation was requested to assist the medical treatment team in dealing with the patient's abusive behavior. The case is presented and discussed within the context of understanding the borderline personality in the medical setting.
Gen Hosp Psychiatry 1992 Jul
PMID:Terminal cardiomyopathy, splitting, and borderline personality organization. 150 50

Circular dichroism (CD) spectra of myocardial G-actin significantly differ from those of F-actin, and the spectra of G- and F-actins differ from those of myocardial tropomyosin, native tropomyosin and alpha-actinin. In heart failure in man and experimental animals, characterized by a significantly decreased ability of the contractile protein system to generate force, considerable changes in the tertiary structure of Straub G-actin are observed. During polymerization a monomer of this actin is included in F-actin as a promoter without corresponding conformational changes of a part of G-actin globule; G-actin from the failing myocardium loses its conformational mobility. According to CD data the secondary protein structure is not altered. CD spectra analysis with regard to the regions of aromatic amino acid residue localization in active sites of actin suggests that the sites of actin-myosin and actin-actin interactions do not assume the conformation necessary for normal functioning of thin filaments.
Gen Physiol Biophys 1990 Apr
PMID:Conformational state of thin myofilament proteins in normal and chronically failing heart. 235 86

The authors developed a new measure of subjective health status for patients with heart failure. Eighty-eight patients with heart failure were asked about the impact of their condition on 123 items related to physical and emotional function. The most frequently chosen and important items were included in a 16-item Chronic Heart Failure Questionnaire (CHQ) that examines dyspnea during daily activities, fatigue, and emotional function. The CHQ was tested in a controlled trial of digoxin in heart failure patients in sinus rhythm. When administered serially to 25 patients in the run-in phase of the trial, the CHQ proved reproducible. Subsequently, CHQ results distinguished those who reported improvement or deterioration from those who did not. The CHQ showed moderate correlations with patient global ratings, walk test scores, and clinical assessments of heart failure. The authors conclude that the CHQ may be useful for measuring health status in clinical trials in heart failure.
J Gen Intern Med
PMID:Development and testing of a new measure of health status for clinical trials in heart failure. 270 67

Decisions about when to perform cardiopulmonary resuscitation (CPR) are frequently made without knowing the wishes of the patient. To evaluate the feasibility of outpatient discussions about CPR, the authors surveyed 22 male and 53 female, mentally competent, ambulatory patients 65 years of age and older. Only 7% of those interviewed had an accurate understanding of what CPR meant before hearing a standardized description. Eighty-seven per cent thought discussions about CPR should take place routinely, but only 3% had previously discussed this issue with their physicians. Seventy per cent felt such discussions should take place during periods of health, and 84% felt their views should be part of the medical record. When asked about three terminal illnesses, a minority of patients wanted CPR: 25% felt CPR was indicated in the presence of irreversible coma, 28% for terminal cancer, and 41% for irreversible heart failure. More patients felt they would request CPR if they had irreversible heart failure than if in a coma (p less than 0.002) or for terminal cancer (p = 0.002). The majority of elderly outpatients have clearly defined opinions about the application of CPR and wish to discuss them with their physicians.
J Gen Intern Med
PMID:Discussing cardiopulmonary resuscitation: a study of elderly outpatients. 340 92

Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients in the validation series, 19% were readmitted within 90 days. Twenty-six per cent of the readmissions occurred within ten days of discharge, and 57% within 30 days. Readmitted patients were older, had longer hospitalizations, and had greater hospital charges (p less than 0.01). The discharge diagnoses of AIDS, renal disease, and cancer were associated with increased risks of readmission regardless of patients' demographics or test results. The relative risks (95% confidence interval) associated with these diagnoses were: AIDS, 3.3 (1.4-7.8); renal disease, 2.3 (1.7-3.0); cancer, 2.8 (2.4-3.4). Other patients at increased risk were those with diabetes, anemia, and elevated creatinine (2.1; 1.6-2.8) and those with heart failure and elevated anion gaps (2.2; 1.7-2.8). For patients without one of these diagnoses, a normal albumin and no prior admission within 60 days identified patients at reduced risk for readmission (0.4; 0.3-0.4). Thus, commonly available clinical data identify patients at increased risk for emergency readmission. Risk factor profiles should alert physicians to these patients, as intensive intervention may be appropriate. Future studies should test the impacts of clinical interventions designed to reduce emergency readmissions.
J Gen Intern Med
PMID:Predicting emergency readmissions for patients discharged from the medical service of a teaching hospital. 369

Superprecipitation (SP) of artificial actomyosin, obtained by hybridization of Straub actin from the human myocardium with myosin of normal animal hearts was studied. Actin was prepared from the myocardium of persons who died of congestive heart failure and various non-cardiac diseases, as well as of infants whose death resulted from toxic pneumonia complicated or not with heart failure. It was shown that, in the control hybrid actomyosin, the substitution of normal Straub actin by that from the failing heart resulted in decrease of both the rate and extent of SP. The conclusion was made that both changes in myosin properties and Straub actin underlie the reduced contractility of the myofibrillar protein system in acute and congestive heart failure.
Gen Physiol Biophys 1985 Aug
PMID:Superprecipitation of hybrid actomyosin containing pathologic actin from failing hearts of adults and infants. 402 5

This paper describes how the quality of medical care provided by general practitioners for patients suffering from cardiac failure was assessed. A peer group of general practitioners provided the criteria of adequate process and outcome of care. The impact of a flow sheet design of medical record on the quality of care was tested in a controlled study. Although there were significant improvements in the process measures as a result of the new medical record, there was no measurable benefit in terms of outcome. The particular problems of defining criteria of care in general practice are described and the usefulness of methods of measuring quality whose validity is in doubt is questioned.
J R Coll Gen Pract 1981 Mar
PMID:Medical audit in general practice - fact or fantasy? 727 90

1. Prolonged existence of hypertension is known to induce a compensatory increase in cardiac weight, later followed by a loss of functional responsiveness to biological stimuli. 2. It was the aim of the present study to investigate the functional responses of hypertrophied hearts to rising levels of intracellular calcium. The experiments were performed using two different degrees of cardiac hypertrophy, the first as obtained in spontaneously hypertensive rats (SHR) of 18-20 weeks old, the second by using rats, 32-34 weeks old, with a surgically induced stenosis of the thoracic aorta (ASR). The ASR, which showed signs of overt heart failure, may be presented as a model for hypertension-induced end-stage cardiac hypertrophy. Age-matched normotensive Wistar-Kyoto rats (WKY) and sham-operated Wistar rats served as respective controls. 3. Different methods were employed such as increasing the extracellular Ca2+ concentration, stimulation of calcium influx by means of the calcium entry promoter Bay K 8644, or altering the sodium-calcium exchange by means of the sodium ionophore monensin. 4. The inotropic responses induced by increasing the extracellular Ca2+ concentration or provoked by the calcium entry promoter Bay K 8644 proved more pronounced in hearts taken from SHR of 18 weeks old than in those from normotensive control rats, whereas the response to monensin was found to be the same in both types of hearts. In the hearts of ASR, however, the inotropic responses to Ca2+, Bay K 8644 and monensin were strongly impaired. 5. These data demonstrate that in functional experiments the sensitivity to Ca2+, which represents the main pathway in establishing a contraction, is strongly reduced in advanced cardiac hypertrophy.
Gen Pharmacol 1995 Mar
PMID:Sensitivity of cardiac tissues with moderate and advanced hypertrophy to calcium ions. 759 94


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