Cases reported "cardiovascular diseases"

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1/249. A unique case of vibroacoustic disease: a tribute to an extraordinary patient.

    This paper describes the case of a patient, Mr. A, who died in 1987. The information provided by Mr. A in life, and his insistence on making a will demanding an autopsy on his death, has given us invaluable data on Vibroacoustic disease (VAD). Mr. A was an intellectually curious man who researched the medical literature related to his condition, and compared it to his own experience. He would describe all his sensations during his many epileptic seizures. Solely because of the results of Mr. A's autopsy, new avenues of research were initiated. These have led to new concepts and exciting new perspectives on noise-induced extraaural pathology. VAD is today a well-established and easily diagnosed entity. This paper is a tribute to Mr. A, in whose honor we have an on-going commitment to establish VAD as an occupational disease, reimbursable by Worker's Compensation. ( info)

2/249. Cardiovascular consequences of renal anaemia and erythropoietin therapy.

    Cardiovascular disease is the leading cause of increased mortality in patients with renal failure and vigorous attention to cardiovascular risk factors is therefore required to improve patient outcome. The availability of recombinant human Epo has focused the interest on the role of chronic anaemia in the pathogenesis of cardiovascular disease. Severalfold evidence indicates that anaemia can contribute to cardiac volume overload and together with overhydration, fistula flow and the pressure overload secondary to arterial hypertension, it may play a significant role in the development of cardiac hypertrophy. As in the general population left ventricular hypertrophy is a severe adverse risk factor in renal patients. In addition, in the presence of ischaemic heart disease anaemia may further worsen cardiac oxygen supply. This dual effect of anaemia probably explains why epidemiological studies have shown that a 1 g/dl decrease in haemoglobin levels is an independent, statistically significant risk factor for the development of cardiac morbidity and mortality. Follow-up examinations have demonstrated that partial correction of anaemia with recombinant Epo can improve cardiac oxygen supply and partially reverse pathological changes in left ventricular geometry. However, although partial anaemia correction regularly reduces left ventricular volume, the effects on wall thickness are far less significant. Moreover, in patients with advanced cardiac disease it has recently not been possible to demonstrate that a normalization of haemoglobin levels provides further benefit. It is not unlikely therefore that the development of severe anaemia has to be prevented by early implementation of Epo therapy in order to achieve the maximum benefit with respect to the cardiovascular system. ( info)

3/249. Cardiovascular involvement in a boy with Sweet's syndrome.

    Acute febrile neutrophilic dermatosis (Sweet's syndrome) is a rare disease in infancy. It may present in an isolated manner or be associated with diverse conditions. Only two children with postinflammatory slack skin who developed cardiovascular disease have been described to date, both of whom died from coronary artery occlusion. We report a boy with Sweet's syndrome and diffuse vascular disease involving the aorta and the supraaortic vessels, the pulmonary trunk, and the right coronary artery but without signs of coronary obstruction. ( info)

4/249. methemoglobinemia as an uncommon cause of cyanosis.

    cyanosis is usually caused by decreased arterial oxygen saturation due to pulmonary or cardiac diseases. methemoglobinemia is a rare cause, sometimes with lethal outcome. Two patients are described, both with an unremarkable cardiopulmonary history, presented with severe cyanosis due to aniline-induced methemoglobinemia that developed at work. The symptoms and the treatment of methemoglobinemia are discussed. ( info)

5/249. Preoperative evaluation of a patient for abdominal aortic aneurysm repair.

    Coexistent cardiovascular disease is common in patients presenting for repair of aortic aneurysms. However, preoperative cardiac evaluation prior to abdominal aortic aneurysm (AAA) surgery remains contentious with significant variations in practice between countries, institutions and individual anesthetists. The following case report raises some everyday issues confronting clinical anesthetists. ( info)

6/249. The many faces of Kawasaki syndrome.

    The clinical challenge lies in recognizing cases not fully meeting the syndrome's diagnostic criteria and those that strongly resemble a variety of infectious and reactive disorders. Prompt treatment with high-dose intravenous immune globulin in combination with aspirin can significantly reduce the frequency and severity of cardiovascular complications. ( info)

7/249. Familial thrombophilia associated with homozygosity for the cystathionine beta-synthase 833T-->C mutation.

    Severe hyperhomocysteinemia due to cystathionine beta-synthase (CBS) deficiency is a strong risk factor for premature cardiovascular disease. Among untreated patients, approximately 50% have suffered a thromboembolic event by 30 years of age. We report on 3 sisters with severe hyperhomocysteinemia due to homozygosity for the CBS 833T-->C mutation. These patients, who displayed no other known thrombophilic predisposition, had suffered single or multiple venous thrombosis before CBS deficiency was diagnosed relatively late in life. In this family, homozygosity for the 833T-->C mutation was associated with a mild phenotype with respect to other sequelae of CBS deficiency. Consequently, our results indicate that most cases with this genotype may remain undiagnosed. Investigated family members heterozygous for the 833T-->C mutation displayed normal total homocysteine in plasma (tHcy) levels, even when they were homozygous for the methylenetetrahydrofolate reductase 677C-->T polymorphism. The prevalence of homozygosity for the 833T-->C mutation has previously been estimated at no less than 1:20 500 in our population. Because a reduction of the severely elevated levels of tHcy in CBS deficiency reduces cardiovascular risk and because homozygosity for the 833T-->C mutation is more prevalent than previously thought, our results emphasize the importance of measuring tHcy routinely in thrombophilia screening. ( info)

8/249. Hemangiomas of the cecum. Colonoscopic diagnosis and therapy.

    Five cases of hemangiomas of the cecum and gastrointestinal bleeding are presented. All were demonstrated by colonscopy after more conventional diagnostic methods failed. The hemangiomas were bright red, flat lesions clearly seen through the colonscope. They were successfully treated by electrocoagulation. All patients in this series had some type of associated cardiac or vascular disease. These patients may represent a syndrome of gastrointestinal blood loss of obscure cause, hemangiomas of the cecum, and cardiovascular disease. ( info)

9/249. Cardiac complications in pediatric patients on the ketogenic diet.

    Cardiac complications of the ketogenic diet, in the absence of selenium deficiency, have not been reported. Twenty patients on the ketogenic diet at one institution were investigated. Prolonged QT interval (QTc) was found in 3 patients (15%). There was a significant correlation between prolonged QTc and both low serum bicarbonate and high beta-hydroxybutyrate. In addition, three patients had evidence of cardiac chamber enlargement. One patient with severe dilated cardiomyopathy and prolonged QTc normalized when the diet was discontinued. ( info)

10/249. The veterans' Administration Cooperative Urological research Group studies of carcinoma of the prostate: a review.

    The veterans' Administration Cooperative Urological research Group has conducted three consecutive randomized clinical trials of various treatments for all stages of prostatic carcinoma. Thus far, a total of 3774 patients have been entered into these three main studies. The first study showed that early endocrine treatment of patients with advanced prostatic cancer did not increase overall survival when compared to initial treatment with placebo alone. diethylstilbestrol, when given in a dose of 5.0 mg/day, was associated with an increased incidence of cardiovascular deaths. In the second study, diethylstilbestrol given in a dose of 1.0 mg/day has been as effective as the 5.0-mg dose in controlling the prostatic carcinoma but has been associated with a lower incidence of cardiovascular deaths. patients are still being entered into the third study and it is too early to report the findings in detail. ( info)
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