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

One hundred consecutive female patients with active systemic lupus erythematosus (SLE) were studied from the cardiovascular point of view by means of non invasive methods. Seventy percent of the cases presented some type of cardiovascular anomaly. Seventy four percent of the resting electrocardiograms were abnormal as well as 72% of the M mode echocardiograms and 55% of the cardiac X ray series. The most frequent observed complications were: pericarditis and or pericardial effusion (39%), arterial hypertension (22%), ischemic heart disease (16%), myocarditis (14%), congestive heart failure (10%), pulmonary hypertension (9%), valvular heart disease (9%), pleural effusion (7%) and cerebro vascular accident (3%). We analyzed each one of these complications and found of special interest the high incidence of ischemic heart disease which is more frequent than has been hitherto reported. Ischemic heart disease was observed in two types of patients: a) Those with long term steroid therapy. In these, the mechanism seems to be an atherosclerotic disease probably induced by the chronic use of steroids. The management of these cases do not differ from other types of coronary heart disease due to atherosclerosis. b) Those with frank episodes of vasculitis in whom the basic mechanism is an inflammatory process of the coronary arteries and its treatment is fundamentally that of the vasculitis. We consider necessary to study routinely all patients with SLE through non invasive cardiological methods.
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PMID:Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. 402 48

Chronic intermittent hemodialysis may relieve some medical problems of terminal uremia (for example, azotemia, acidosis, hypertension, neuro-muscular disorders, bleeding, pericarditis) to such a degree that many patients are able to resume their normal activity. There remain, however, problems which are not readily changed by hemodialysis (anemia, peripheral neuropathy, pruritus, sexual impotence, renal osteodystrophy). These, together with medical problems possibly caused by hemodialysis (for example, osmotic disequilibrium, errors in dialysate composition, hepatitis, hemosiderosis, isoimmunization from blood transfusions, shunt problems and psychological problems of dependency upon the artificial kidney) represent a limitation of the present type of hemodialysis therapy.
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PMID:Some medical problems of chronic hemodialysis. 486 55

No large series of patients with cardiovascular disease has yet been reported from Ethiopia, where only limited means for investigation are at present available. The authors therefore studied the types of heart disease detected by mass miniature radiography in a largely self-selected population at the Addis Ababa Tuberculosis Centre, and examined the value of this method of cardiac case-finding. Rheumatic heart disease occurred in 34.8% of patients, but syphilitic aortitis, hypertension, "cardiomyopathy" and tuberculous pericarditis were also common. Endomyocardial fibrosis was not seen; this may be a further significant fact in the search for its cause. Mass miniature radiography is valuable for detecting symptomatic patients with the cardiovascular diseases mentioned above. The technique described in this paper could be used in other developing countries as it uses a single method of screening for 2 groups of diseases.
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PMID:Ethiopian cardiovascular studies. Case-finding by mass miniature radiography. 530 99

Cardiovascular manifestations of Systemic Lupus Erythematosus (SLE) in 32 unselected patients, with active disease were reviewed. Primary cardiac disease manifested as pericarditis (22%), myocarditis (16%), and valvular disease (9%), was recognized along with secondary disease as heart failure with or without systemic hypertension. Comparison with previous work by others, suggest that our cases are more representative of actual clinical picture of cardiac SLE. It is interesting to notice tht 9% of our patients had valvular disease, and this alteration is only occasionally found in other Hospitals. Valvular disease is rarely noticed during life, although is highly prevalent in autopsy series. We stress the diagnosis and management of the cardiac manifestations of SLE, in order to lower the morbidity and mortality of this condition.
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PMID:[The heart in systemic lupus erythematosus. Study in 32 non-selected patients (author's transl)]. 621 24

Based on the study of the echocardiography data in 44 patients with chronic renal failure it has been shown that the incidence and the degree of left ventricle hypertrophy is related to the duration of arterial hypertension, increased cardiac output, and metabolic abnormalities. Echocardiographic studies made over time revealed a progressive deterioration of myocardial contractility. Pericarditis that ensues promotes the deterioration of left ventricle contractility and aggravates heart insufficiency. The diastolic murmur of aortal regurgitation should be differentiated as pertaining to infectious endocarditis or to relative insufficiency of the aortal valve. Two-dimensional echocardiography favours differentiation of left ventricle myocardial hypertrophy, makes it possible to locate the fluid in the pericardium more accurately, and to evaluate the treatment efficacy for pericarditis.
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PMID:[The cardiovascular system in patients with chronic renal failure (echocardiographic data)]. 624 Jul 97

Twenty-six out of a total of 49 patients who were treated for Wilms' tumor at the Mallinckrodt Institute of Radiology between January 1960 and December 1975 have survived at least five years. The median follow-up time is 153 months (12 years, 9 months). One girl, who received pelvic irradiation, has not reached puberty at age 14, but the other 25 patients are currently in good health and have no major complaints or functional impairments at present. Twenty-one patients have, however, developed some complication at some time since treatment. Serious side-effects requiring hospitalization included one case of pericarditis and one of esophageal varices secondary to portal hypertension. Both these patients, however, had advanced tumors requiring aggressive treatment and their complications should be seen in perspective. There has also been one case of temporary low grade renal failure and one of transient hypertension. More common complications were 14 instances of scoliosis (only three have had any symptoms, however), five of osseous hypoplasia, three of soft tissue hypoplasia, three of liver damage and three of lung damage. There was one case of osteochondroma within a radiotherapy field. The factors pertaining to these complications and the anticancer therapy which preceded them are discussed in detail. We conclude that, whereas structural changes following modern radiotherapy for Wilms' tumor are very common, severe dysfunctions are infrequent. Even more extended periods of observation will be required before the total number of abnormalities is ascertained. However, the striking observation from this study is the lack of late functional effects.
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PMID:Late effects of treatment for Wilms' tumor. 630 94

In 1958 a mediastinal tumor was discovered in an asymptomatic patient. The tumor was resected and diagnosed as a nonchromaffin chemodectoma. Additionally an oesophageal abnormality was discovered but not treated. At subsequent follow-ups the mediastinum never appeared normal and the heart size progressively increased. In 1974 a small opacity appeared in the left lung. In 1975 the patient was operated: a pulmonary osteochondroma, a pericarditis and an intrapericardial aortopulmonary chemodectoma were discovered. The oesophagus was not explored. In july 1979 an inoperable epidermoid carcinoma of the main bronchus of the left lung was discovered and the patient died in september 1979. There was no hypertension and no catecholamine excess. A post-mortem section was refused. After the recent description by Carney of the triad: extra-adrenal paraganglioma, lung chondroma and gastro-intestinal leiomyo(sarco)ma, we feel that our patient could present this syndrome and that the oesophageal tumor could be a benign leiomyoma. However the exact diagnosis of the oesophageal lesion is still unknown.
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PMID:[The triad: mediastinal chemodectoma, chondroma of the lung and esophageal leiomyoma]. 632 47

The chest X-ray films of 251 patients with cardiovascular lesions, collected in the major hospitals of Papua New Guinea, were reviewed. Cor pulmonale (18%) and rheumatic heart disease (16%) were the predominant cardiac disorders, and cor pulmonale was the most common cause of cardiac failure (58%). Cardiomegaly or cardiac failure of unknown cause, possibly due to cardiomyopathy or myocarditis, made up 9% of the group and may be more important than has been thought previously. Aortic-arch calcification typical of atheroma was present in 21% of the patients, and is thus quite common, even though ischaemic heart disease remains very rare (1%). More than half of the patients with aortic atheroma had chronic lung disease, and though this could be explained by the coincidental frequency of both conditions, the possibility of an association or link in pathogenesis between them deserves further consideration. Anaemia was a common cause of cardiac enlargement (14%), and sometimes led to cardiac failure. Only 16 patients had hypertension (essential in 10 patients and renal in six), and this may indicate a change from the previously reported predominance of renal hypertension in Papua New Guinea towards a more equal incidence of the two conditions. Aneurysms of unknown cause were encountered in three fairly young patients. They had some resemblance to the aneurysms in arteritis of obscure origin described in Africa. There were also two dissecting aneurysms and one syphilitic aneurysm of the aorta. Congenital lesions (8%), pericarditis due to various causes (including tuberculosis), bacterial endocarditis (in four patients with rheumatic heart disease), and miscellaneous conditions made up the remainder of the series.
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PMID:Cardiovascular disease in Papua New Guinea. 644 34

17 patients on maintenance hemodialysis were monitored for cardiac arrhythmias using ambulatory electrocardiographic recording. Atrioventricular dissociation was found in a patient with an elevated serum digoxin concentration, intradialytic supraventricular tachycardia had been present in a second patient during acute uremic pericarditis prior to the study. Ventricular premature beats (VPB) were absent or of low grade (occasional/uniform) in 14 patients and did not increase on dialysis. 3 patients had potentially dangerous VPB of higher grades (multiform, salvos or R on T) which occurred on or after dialysis in 2. 2 of these 3 patients were overdigitalized, and 2 had severe cardiac disease (amyloid, old myocardial infarction). Several other risk factors (age, hypertension, cardiac hypertrophy, smoking, hyperlipidemia, electrolyte changes) did not seem to be of importance for VPB. In these patients on maintenance hemodialysis, potentially dangerous VPB were rare and occurred mainly during or after dialysis in patients with preexisting heart disease and/or digitalization.
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PMID:Cardiac arrhythmias in patients on maintenance hemodialysis. 683 65

Experience with 37 patients surviving 10 years of hemodialysis therapy was reviewed. These patients were compared with 103 patients who began hemodialysis between 1967 and 1971 and who subsequently died. Males had an excess risk of death. Patients with polycystic kidneys survived longer. There was more uncontrolled hypertension among a control group than in 10-year survivors. In survivors, the hematocrit level increased over time and averaged 30.4 percent at 10 years. Over 10 years, many complications arose including parathyroidectomy (24), pericarditis (13), gastrointestinal bleeding (11), myocardial infarction (10), septicemia (eight), and active tuberculosis (six). Despite complications, most patients are now stable. Between their eighth and 10th years they required an average of only one hospitalization with a mean stay of 9.7 days. Eighteen patients were not hospitalized. Excluding housewives, 67 percent of patients between ages 20 and 59 years are employed full-time and 10 percent part-time. Patients surviving 10 years are not progressively deteriorating and may look to the future with cautious optimism.
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PMID:Patients surviving 10 years of hemodialysis. 685 68


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