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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1981 the authors have performed 14 orthotopic heart transplantations and one heart-lung transplantation, using cyclosporine and prednisone as immunosuppressants. Eight of the recipients had terminal congestive cardiomyopathy and six had ischemic cardiac dysfunction. The combined heart-lung transplantation was performed on a patient with a congenital ventricular septal defect with Eisenmenger's syndrome. Twelve of the patients were alive and well at follow-up 9 to 34 months (mean 17.4 months) after transplantation. One patient died of acute rejection and one of acute pancreatitis and secondary peritonitis. The third death, due to acute right ventricular failure, occurred immediately after transplantation. Rejection was diagnosed histologically on seven other occasions in four patients and was treated successfully. Infection was not a major problem. Cyclosporine -induced reversible nephrotoxicity was evident in 12 patients, 2 of whom required dialysis. Other side effects of cyclosporine seen in these patients included hypertension, gastrointestinal upset, headaches and hirsutism. This experience suggests that cyclosporine is a potent immunosuppressive agent that has greatly reduced the hazards of rejection and infection. However, the frequency of nephrotoxicity is high; careful monitoring of cyclosporine blood levels and renal function is essential.
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PMID:Cyclosporine in cardiac transplantation. 623 93

Three hundred and fifty-seven serum samples from pregnant African women were examined for Toxoplasma gondii antibodies with indirect haemagglutination test in Dar es Salaam. Out of these 222 women were normal, sixty-nine had anaemia and sixty-six were suffering from hypertension. Infection rate in normal pregnant women was 41.9%, in anaemic women 52.5%, and in those suffering from hypertension 66.7%. Highly significant relationship was observed between Toxoplasma infection and anaemia, and hypertension. Infection rate was significantly high in women who had histories of abortion. The results suggested associations of Toxoplasma gondii infection with hypertension and anaemia in African women.
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PMID:Prevalence of Toxoplasma antibodies in pregnant African women in Tanzania. 630 81

Acute glomerulonephritis is a syndrome characterized by the abrupt onset of hematuria often accompanied by proteinuria, hypertension, edema, and renal dysfunction. Acute glomerulonephritis can be subdivided into primary glomerular disease, postinfectious glomerulonephritis, and glomerulonephritis associated with systemic disease. With few exceptions, the underlying mechanism of acute glomerulonephritis is an immunologic one. To differentiate clinically the specific etiology of the glomerulonephritis, attention must be focused on the presence of signs or symptoms of systemic disease, changes in the environment of the patient, family history of renal disease, and recent history of infectious disease.
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PMID:Acute glomerulonephritis. A clinical overview. 636 24

This study reports an evaluation of care given at an urban multidisciplinary community family practice clinic. By means of an "indicator-condition" approach, the criteria and rating system developed for the Burlington Randomized Controlled Trial (BRCT) were applied to 103 randomly selected charts demonstrating 124 episodes of care given for seven specific "conditions": otitis media, hypertension, prenatal care, care of the newborn up to the age of 12 months, immunization up to the age of 24 months, depression and urinary tract infection. Overall, 83 (67%) of the episodes of care studied were rated adequate or superior. The proportion of such episodes varied from 33% for hypertension to 81% for care of the newborn. No statistically significant differences were found between these results and those of the BRCT. A total of 48 instances of inadequate care were noted, of which 21 (44%) were omissions in patient management. Inadequate preventive care and care of chronic diseases was more common than inadequate care of acute infectious diseases. The method of primary care assessment used was found to be both practical and inexpensive.
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PMID:Evaluation of primary care in a community clinic by means of explicit process criteria. 648 19

A 43-year-old man suddenly experienced severe headaches and involuntary flexion-extension movements of four limbs, which were followed by hypertonic extension of the limbs lasting for a few hours. Two days later, he experienced generalized tonic seizure without loss of consciousness. After the seizures, he remained hemiparetic on the right side. His past medical history was non-remarkable, and the histories of hypertension, diabetes mellitus, head trauma and significant infectious diseases were all denied. Cerebral angiography performed 22 days after the onset showed a segmental, irregular narrowing of the left A2 segment and an aneurysmal outpouching immediately proximal to the stenosis. CT scan revealed a low density area in the left frontal lobe, corresponding to the territory of the involved left anterior cerebral artery. Cerebral angiography was repeated twice in the succeeding 6 months. Each time, the involved A2 segment showed persistence of narrowing, but its shape showed definite changes with the passage of time. A diagnosis of dissecting aneurysm of the anterior cerebral artery was reached by the characteristic angiographic features, and the patient was treated conservatively. Dissecting aneurysm of the cerebral arteries have been reported much less frequently than those of the aorta or other extracranial arteries. Recently, however, such reports are increasing in number, seemingly due to enhancement of knowledge of typical angiographic features, such as string sign, rosette sign, pearl reaction, double lumen and several others. Most of intracranial dissecting aneurysms involve the middle cerebral artery or vertebral-basilar artery, and the ones involving solely the anterior cerebral artery as in this present case are very rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Dissecting aneurysm of the anterior cerebral artery: report of a case]. 650 59

Seven epidemiological methods commonly used in China are discussed. A communicable disease reporting system is in place but this does not include rheumatic diseases. Death registers include cause of death only in selected pilot study points. Field studies using either mobile clinics or nation-wide treatment and prevention programs are useful for infectious diseases. Disease specific surveys of mortality and prevalence are available for hypertension and tuberculosis. Some case control and efficacy studies are also undertaken. Thirty longterm disease surveillance points have been established throughout China.
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PMID:Epidemiologic methodology as used in China. 658 75

From 1970 through 1980, 47 patients developed a total of 69 false femoral artery aneurysms. Of these aneurysms, 58 occurred an average of 6.2 +/- 3.1 (SD) years after the original revascularization procedure. Ten of these aneurysms occurred once after initial repair and one occurred a second time. Endarterectomy was performed in almost one third of the arteries that later developed false aneurysms. Aneurysms developed in 18 endarterectomized arteries after performance of an anastomosis with a vein patch or Dacron graft. Infection was present in only one case. The suture material in the primary anastomosis was predominantly braided Dacron. Hypertension and bleeding were not commonly associated. Endarterectomy weakens anastomoses and is a factor in false aneurysm formation.
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PMID:Host-artery weakness in the etiology of femoral anastomotic false aneurysms. 669 32

In the present study we report the renal pathological findings from autopsy material along with relevant clinical data on 21 spinal cord injury patients with end-stage renal disease (SCI-ESRD) treated with maintenance haemodialysis. These data are compared with the relevant clinical and post-mortem findings on 43 ambulatory dialysis patients who expired during the same time period. The SCI-ESRD patients exhibited markedly different clinical and renal histopathological data when compared to the ambulatory--ESRD group. Chronic pyelonephritis and amyloidosis dominated the findings and were the major causes of renal insufficiency. Acute pyelonephritis, papillary necrosis, calculous disease, pyonephrosis and perinephric abscess formation were also more frequently present in the SCI-ESRD patients. Hypertension and nephrosclerosis, which were common findings in the ambulatory--ESRD patients were comparatively rare in the SCI-ESRD patients. In addition, the incidence of acquired cystic disease (ACD) was considerably less in the SCI-ESRD group. Although the reasons for these findings are not entirely clear several possible explanations are given. Infection with gram negative sepsis was the predominant cause of death in the SCI-ESRD patients, while death secondary to cardiovascular disease predominated in the ambulatory-ESRD group. Furthermore, the urinary tract and infected decubitus ulcers were determined to be the major source for sepsis in the SCI patients. From these findings it would follow that more effective prevention and control of these infections would result in not only a lower incidence of renal failure but also a substantially reduced morbidity and mortality in chronic SCI.
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PMID:Renal pathology in end-stage renal disease associated with paraplegia. 671 46

Modern techniques of blood collection require health screening of donors by non-physicians using general guidelines. Health problems of concern to the donor and possible loss to future donation of actually individuals are inherent in this acceptance and deferral process. Of the 108,908 donors presenting at the bloodmobiles of regional blood center from September 1978 to February 1979, 9,542 were deferred. Of these, 1,203 with possible medical problems other than hepatitis, hypertension, or infectious disease were referred to their physician for further information concerning their suitability as donors. Over 80% had irregular pulses or histories suggestive of potential cardiovascular problems. The purpose of this study was to review the evaluation mechanism. Responses for evaluation were received from only 222 out of 1,203 (18%), and of these all but 29 (13%) were granted full permission to donate. Since only one evaluated individual with pulse or cardiovascular findings of possible significance was under the age of 35 years, this age is a reasonable cutoff for such deferrals. The minimum increase in collections with this change in deferral screening would be over 1,000 units per year in Connecticut, and perhaps 60,000 nationwide.
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PMID:Evaluation of individuals deferred from blood donation for medical reasons. 705 61

One hundred and one patients below 45 years and showing objective signs of cerebral ischemia were studied retrospectively for pathogenic factors. Twelve were below 15 years; the male to female ratio was 1:1. Factors known as predisposing (heart disease, hypertension, hyperlipemia, diabetes mellitus or infectious diseases) and other possible factors (e.g. trauma, abuse) were found in 41 patients. Among women using contraceptive pills there might be an increased risk of development of cerebral thrombosis, but the material was not large enough to warrant statistical analysis. In 64 patients one or more abnormal coagulation values were found, the most frequent being a deficient vessel wall fibrinolysis, which was noted in 38%. We therefore consider it worthwhile to investigate the fibrinolytic defence mechanism of the vessel wall in patients with cerebral thrombosis, since it is possible to treat this condition with specific fibrinolytic stimulating agents.
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PMID:Coagulation studies in children and young adults with cerebral ischemic episodes. 732 67


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