Academic literature on the topic 'Chronic toxic damage'

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Journal articles on the topic "Chronic toxic damage"

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Turayev, Shahkboz, and Maqsud Samadovich Hayitov. "SPECIFIC CHARACTERISTICS OF QUANTITATIVE CHANGES IN EXTRACELLULAR MATRIX COMPONENTS IN CHRONIC TOXIC LIVER INJURY." Multidisciplinary Journal of Science and Technology 5, no. 5 (2025): 1393–97. https://doi.org/10.5281/zenodo.15549516.

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This article presents an analysis of scientific sources regarding the quantitative changes of extracellular matrix components in liver tissue under chronic toxic damage. According to the research findings, prolonged exposure to toxic agents increases the levels of collagen, fibronectin, laminin, and proteoglycans, leading to the early development of liver fibrosis. The literature review serves as an important source for a deeper understanding of the morphological basis of liver injury, early diagnosis, and the development of effective therapeutic approaches.
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To'rayev, Shahzod, and Maqsud Samadovich Hayitov. "SPECIFIC CHARACTERISTICS OF QUANTITATIVE CHANGES IN EXTRACELLULAR MATRIX COMPONENTS IN CHRONIC TOXIC LIVER INJURY." Multidisciplinary Journal of Science and Technology 5, no. 5 (2025): 1491–95. https://doi.org/10.5281/zenodo.15562746.

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This article presents an analysis of scientific sources regarding the quantitative changes of extracellular matrix components in liver tissue under chronic toxic damage. According to the research findings, prolonged exposure to toxic agents increases the levels of collagen, fibronectin, laminin, and proteoglycans, leading to the early development of liver fibrosis. The literature review serves as an important source for a deeper understanding of the morphological basis of liver injury, early diagnosis, and the development of effective therapeutic approaches.
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Skuratov, A. G., A. N. Lyzikov, A. S. Shaforost, A. A. Zyatskov, and N. M. Golubykh. "Determination of the activity of pyruvate kinase isoforms in normal conditions, in toxic liver damage and during the process of its regeneration." Health and Ecology Issues, no. 3 (October 1, 2021): 116–23. http://dx.doi.org/10.51523/2708-6011.2021-18-3-14.

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Objective. To evaluate the activity of pyruvate kinase (PK) isoforms in normal conditions, in toxic damage of the liver and during its regeneration.Materials and methods. An experimental study was carried out on 45 Wistar rats. Toxic liver damage was induced by the intraperitoneal administration of carbon tetrachloride. Mechanical damage was simulated by the surgical resection of the liver. The levels of PK isoforms R/L and M in the blood serum and liver tissue of the laboratory animals were measured with an ELISA test.Results. It has been found that the level of PK isoform M signifcantly incr
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Sokolova, M. O., V. E. Sobolev, D. A. Reshetkina, and O. A. Nagibovich. "Toxic effect of organophosphate compounds on the kidneys." Bulletin of the Russian Military Medical Academy 22, no. 3 (2020): 199–205. http://dx.doi.org/10.17816/brmma50560.

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Abstract. The study describes: the toxic effect of organophosphate intoxication compounds on the human and animal organism, the contribution of organophosphate to the chronic kidney disease epidemiology and the acute kidney poisoning pathophysiology caused by organophosphate compounds. The study shows oxidative stress and systemic hemodynamic disturbance in the pathogenesis of organophosphate-induced kidney injury. We summarized effects of organophosphate substances on the structural and functional kidneys tissue characteristics in humans and animals. Biomarkers useful for early diagnosis of k
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Mukharjee, Suchismita, Sarbashri Bank, and Smarajit Maiti. "Chronic Tobacco Exposure by Smoking Develops Insulin Resistance." Endocrine, Metabolic & Immune Disorders - Drug Targets 20, no. 6 (2020): 869–77. http://dx.doi.org/10.2174/1871530320666200217123901.

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Background and Objectives: The present review critically discusses the high occurrence rate, insulin resistance and type-2 diabetes in tobacco exposed individuals. Tobacco extracts and smoke contain a large number of toxic materials and a significant number of those are metabolic disintegrators. Discussion: Glucose and lipid homeostasis is severely impaired by this compound. Tobacco exposure contributes to adverse effects by impairing the physical, biochemical and molecular mechanisms in the tissues. The immunological components are damaged by tobacco with high production of proinflammatory cy
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Aripov, A. N., O. A. Aripov, L. L. Akhunjanova, A. O. Nabiev, D. A. Nabieva, and T. T. Khamroev. "STUDY THE ANTIFIBROUS EFFICACY OF PLANT PROANTHOCYANIDIN IN RATS WITH CHRONIC HELIOTRINE LIVER DAMAGE." Frontline Medical Sciences and Pharmaceutical Journal 02, no. 05 (2022): 16–25. http://dx.doi.org/10.37547/medical-fmspj-02-05-03.

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Under experimental conditions, the effect of plant proanthocyanidin – yantacin isolated from a camel thorn plant (Alhagi pseudalhagi) – Yantacin, when administered orally at a dose of 100 mg / kg, on possible changes in the early stages of liver fibrosis that occurred against the background of chronic heliotrine hepatitis was studied. The studies were conducted on male rats with a body weight of 100 ±10 g. The effect of yantacin on the general and biochemical parameters of the blood, as well as the amount of NO – nitrates (in connection with lipoproteins), proteins in the blood against the bac
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Avdeeva, Marina G., M. I. Kulbuzheva, Ye I. Kolod’ko, N. V. Chernikova, and O. V. Zapashnyaya. "PROBLEMS OF TREATMENT OF TOXIC HEPATITIS ON THE BACKGROUND OF CHRONIC VIRAL LESION OF HCV-ETIOLOGY. CLINICAL EXAMPLE OF SUCCESSFUL THERAPY." Epidemiology and Infectious Diseases 23, no. 1 (2018): 50–56. http://dx.doi.org/10.17816/eid42644.

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Epidemiological and clinical-laboratory features of the course of drug-induced and viral liver damage are considered. Clinical observation of severe toxic liver damage in a patient suffering from chronic viral hepatitis “C” is given. The authors share the experience of successful therapy.
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Bubalo, N. M., and G. M. Balan. "Syndrome of intrahepatic cholestasis in patients with acute and chronic intoxication with pesticides." Ukrainian Journal of Modern Toxicological Aspects 81, no. 1 (2018): 39–48. http://dx.doi.org/10.33273/2663-4570-2018-81-1-39-48.

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Objective. To study the incidence and peculiarities of intrahepatic cholestasis (IHC) syndrome in patients with toxic liver damage in acute and chronic intoxications with pesticides and to substantiate rational methods of diagnosis and treatment. Material and methods. The incidence has been analysed with the description of IHC syndrome peculiarities in acute and remote periods in 238patients with acute poisoning with pesticides: 162 — herbicides based on 2,4-dichlorophenoxyacetic acid (2,4-D), 62 — phosphororganic pesticides (POP), 14 — synthetic pyrethroids (SP) and 70 — with chronic intoxica
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Velichko, Valentyna, Halyna Cornovan, Svitlana Kovalenko, and Halyna Danilchuk. "Evaluation of the Effectiveness and Safety of Combination Therapy Using Drugs Vazonat and Entrop in Patients with Chronic Toxic Liver Damage." Family Medicine, no. 5 (November 30, 2016): 98–102. https://doi.org/10.30841/2307-5112.5.2016.248795.

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<strong>The objective:&nbsp;</strong>to study the efficacy and safety of using in the complex treatment of cytoprotector Vazonat in combination with the nootropic medicine of entropy in patients with chronic toxic liver damage. <strong>Patients and methods.&nbsp;</strong>There were examined 60 patients (36 men and 24 women) with signs of liver toxicity in age from 35 to 63 years. The average age of the examined was 43.2&plusmn;1.3 years. All patients were divided into two statistically homogeneous groups (main and control) for 30 people in each. Patients in both groups received diet therapy, h
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Kuznetsova, P. I., M. M. Tanashyan, and A. A. Kornilova. "Toxic encephalopathy in a clinicl case of polycythemia vera." Bulletin of Siberian Medicine 18, no. 4 (2020): 249–55. http://dx.doi.org/10.20538/1682-0363-2019-4-249-255.

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The article deals with a clinical case description of a female patient with toxic encephalopathy against the background of Ph-negative myeloproliferative diseases. The article discusses symptoms and neuroimaging of hepatic encephalopathy developed as a result of a shunt placed after portal vein thrombosis. The issues of etiology and pathogenesis of hepatic encephalopathy, principles of therapy, as well as the unique clinical picture of nervous system damage in this condition are also discussed. Data on the role of manganese in development of toxic encephalopathy, accumulation of paramagnetic s
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Books on the topic "Chronic toxic damage"

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Toxic psychiatry. St. Martin's Press, 1994.

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Turner, Neil. Mechanisms of progression of chronic kidney disease. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0136.

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Three major hypotheses attempt to explain progressive kidney disease following diverse diseases and injuries. To varying degrees they can explain the observed risk factors for progression and the ability of interventions to lower risk. The hyperfiltration hypothesis argues that progression is due to stress on residual nephrons leading to injury and damage to remaining glomeruli. The toxicity of proteinuria hypothesis proposes that serum proteins or bound substances are toxic to tubular or tubulointerstitial cells. This sets up cycles of damage which lead to tubulointerstitial scarring. The pod
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Toxic psychiatry: Why therapy, empathy, and love must replace the drugs, electroshock, and biochemical theories of the "new psychiatry". St. Martin's Press, 1991.

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D’Haese, Patrick C., Benjamin A. Vervaet, and Anja Verhulst. Heavy metal-induced tubulointerstitial nephritis. Edited by Adrian Covic. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0088.

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Environmental and occupational exposure to heavy metals should be considered an important health hazard, even more so since evidence has been provided in recent literature for toxic effects occurring even at low levels. The kidney is highly vulnerable to metal toxicity and the extent of renal damage depends on the nature, dose, route, and duration of exposure. Both acute and chronic intoxication have been demonstrated to cause kidney injury, with various levels of severity, ranging from tubular dysfunctions to severe chronic kidney disease. The epidemiology of heavy metals poisoning, their ren
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Stewart, Douglas, Gaurav Shah, Jeremiah R. Brown, and Peter A. McCullough. Contrast-induced acute kidney injury. Edited by Norbert Lameire. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0246.

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Contrast-induced acute kidney injury (CI-AKI) occurs because all forms of intravascular contrast contain iodine and their biochemical structures induce immediate changes in systemic and renal vasoreactivity. In the kidneys, contrast induces a transient decrease in renal blood flow. This is more pronounced in patients with chronic kidney disease and diabetes mellitus. The reduction in blood flow allows slowed transit of contrast and reabsorption by the proximal tubular cells where contrast is directly toxic resulting in tubular cell dysfunction and death. When there is considerable damage, a tr
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Shaibani, Aziz. Pseudoneurologic Syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190661304.003.0022.

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The term functional has almost replaced psychogenic in the neuromuscular literature for two reasons. It implies a disturbance of function, not structural damage; therefore, it defies laboratory testing such as MRIS, electromyography (EMG), and nerve conduction study (NCS). It is convenient to draw a parallel to the patients between migraine and brain tumors, as both cause headache, but brain MRI is negative in the former without minimizing the suffering of the patient. It is a “software” and not a “hardware” problem. It avoids irritating the patient by misunderstanding the word psychogenic whi
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Book chapters on the topic "Chronic toxic damage"

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Arican, Yagmur Emre. "Polycyclic Aromatic Hydrocarbons (PAHs)." In Food Safety. Nobel Tip Kitabevleri, 2024. http://dx.doi.org/10.69860/nobel.9786053358787.16.

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Polycyclic aromatic hydrocarbons (PAHs) are toxic substances that undergo bioaccumulation and can be found in various forms, including coal tar, fossil fuel burning, forest fires, grilling meats over open fires, cigarette smoke, diesel emissions, asphalt surfaces, tar roofs, aluminum and coke plants, and more. PAHs can initiate and promote tumors and may function as complete carcinogens, resulting in a high occurrence of tumors and mortality in laboratory animals. Exposure to PAHs can occur at home, outdoors, or at work, with a mixture of PAHs being more likely. Primary sources of exposure to
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Spreen, Otfried, Anthony H. Risser, and Dorothy Edgell. "Toxic Damage." In Developmental Neuropsychology. Oxford University PressNew York, NY, 1995. http://dx.doi.org/10.1093/oso/9780195067361.003.0015.

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Abstract Exposure of the mother during pregnancy or of the child after birth to any type of toxin may result in acute or chronic intoxication of the fetus and various forms of short- and long-term impairment during childhood. One example of an intoxication during pregnancy is toxemia of pregnancy (gestosis), which is presumed to result from a variety of pathological conditions. These are essentially metabolic disturbances in the mother that may cause nausea, vomiting, gastric pains, headache, hypertension and edema (pre-eclampsia), and sudden convulsions and even coma (eclampsia).Another mater
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Reddy, M. Vijayaraj, Gary R. Blackburn, William T. Bleicher, Susan E. Irwin, Myron A. Mehlman,, and Carl R. Mackerer. "32P-Postlabelling assays of DNA adducts formed in vitro and in vivo with benzene and its metabolites: new assays to measure adducts as 5’-P-labelled dinucleotides and nucleoside monophosphates." In Human Carcinogen Exposure. Oxford University PressOxford, 1991. http://dx.doi.org/10.1093/oso/9780199631858.003.0032.

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Abstract Studies of Maltoni et al. and the National Toxicology Program have shown that the chronic high-dose adminstration of benzene to rats produces solid tumours in Zymbal gland, oral cavity, nasal cavity, and possibly mammary gland. Also, the chronic administration of benzene to rodents causes aplastic anemia and other blood disorders. Investigations on the mechanism(s) underlying the carcinogenic and toxic actions of benzene have focused on its conversion to toxic metabolites and its ability to damage DNA.
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Scherrer, Lucas Mota, Gabriel Barreto de Sousa, Júlia Ferri Leal Borges, Lucas Barreto de Sousa, Júlia Pelissari Barraqui, and João Victor Smarzaro. "Toxic impacts of inhalants: Diagnosis, treatment, and clinical perspectives." In Connections Exploring Interdisciplinarity in Health. Seven Editora, 2024. http://dx.doi.org/10.56238/sevened2024.025-013.

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Introduction: Inhalant abuse, especially among children and adolescents, is a growing public health concern due to the severe neurotoxic and systemic effects that these substances can induce. Inhalants, which are often accessible and inexpensive, carry a significant risk of acute and chronic health problems, including irreversible damage to the central nervous system. This chapter addresses the multifaceted challenges of diagnosing and treating inhalant poisoning, highlighting the importance of early detection and intervention to mitigate the long-term consequences. Objective: To provide a com
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Jangid, Nirmala Kumari, Anjali Yadav, Sapana Jadoun, Anamika Srivastava, and Manish Srivastava. "Outdoor Pollution Management by Nanotechnology." In Impact of Textile Dyes on Public Health and the Environment. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-0311-9.ch012.

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Remediation of environmental pollution has become a hot issue in the world. Environmental pollution, mainly caused by toxic chemicals, includes air, water, and soil pollution. This pollution results not only in the destruction of biodiversity, but also the degradation of human health. Textile industrial effluent often contains the significant amount of synthetic and toxic dyes. Some dyes are water-soluble, dyes such as azo dyes, sulfonated azo dyes, etc. Hazardous effect of dyes results in the formation of tumor, cancer, liver or kidney damage, insomnia, diarrhea, nausea, vomiting, dermatitis,
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Singh, Anubhav, Anuj Sharma, Rohit K. Verma, et al. "Heavy Metal Contamination of Water and Their Toxic Effect on Living Organisms." In The Toxicity of Environmental Pollutants [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.105075.

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Water has become a major threat in today’s world. Collection of heavy metals, a few of them, is potentially toxic and these get distributed to different areas through different pathways. With an increase in the earth’s population, development and industrialization are taking place rapidly and these get the major source of water contamination. With heavy metals in lakes, rivers, groundwater, and various water sources, water gets polluted by the increased concentration of heavy metals and metalloids through release from the suddenly mine tailings, disposal of high metal wastes, growing industria
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Aguirre Baez, Mauricio, and Rodrigo Castillo Iturria. "Glaucoma and Dry Eye." In Dry Eye [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.98799.

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Glaucoma treatment is closely related to the appearance or worsening of dry eye symptoms. The current topical treatment produces chronic inflammation that affects globet cells, meibomian glands and cornea, which translates into a decrease in the quantity and quality of the tear. It is characterized by increased osmolarity, which perpetuates damage to the ocular surface. Preservatives currently play a fundamental role in damage the ocular surface. There are numerous studies that have shown their toxic effects on the eye. Currently there are numerous preservative-free formulations and new therap
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Kul, Ali Rıza, Nurullah Başak, Sibel Ergin, and Veysel Benek. "Physical Chemical Properties of Some Heavy Metals (Arsenic, Lead and Copper) and Their Effects on Health." In Current Researches in Health Sciences-IV. Özgür Yayınları, 2023. http://dx.doi.org/10.58830/ozgur.pub387.c1601.

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Heavy metals are associated with industrial processes, environmental pollution and natural resources and can have serious adverse effects on human health. Due to their toxic properties and their tendency to accumulate in biological systems, these metals can damage vital organs such as the nervous system, kidneys and liver. Through their chemical reactivity and by affecting biological systems, they can disrupt enzyme function, cause DNA damage and have carcinogenic properties. Due to their bioaccumulation, long-term exposure, even at low levels, can lead to serious health problems.&#x0D; Arseni
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Rashid, Ansari, Pawan Gupta, Yogesh Chaudhari, Thangaraj Devadoss, Rahul Kumar Garg, and Rewati Wanjari. "Environmental Exposure and Oxidative Stress." In Advances in Medical Diagnosis, Treatment, and Care. IGI Global, 2025. https://doi.org/10.4018/979-8-3693-7919-6.ch004.

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Exposure to environmental pollutants/toxins has progressively been identified as a major cause of different health concerns. Air pollution, occupational and radiation exposures, and agricultural chemicals are significant environmental factors contributing to oxidative stress (OS) and adverse health outcomes. Air pollution (particulate matter/toxic gases) is worsening respiratory and cardiovascular diseases. The occupational exposures to harmful substances can create chronic oxidative conditions which affects overall health. Radiation exposures (medical procedures /environmental sources) and ag
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Barss, Peter, Gordon S. Smith, Susan P. Baker, and Dinesh Mohan. "The Epidemiologic Basis for Prevention." In Injury Prevention: An International Perspective, Epidemiology, Surveillance, and Policy. Oxford University PressNew York, NY, 1998. http://dx.doi.org/10.1093/oso/9780195119824.003.0002.

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Abstract To the control of events (Last, 1990). The usefulness of epidemiology is far-reaching and not limited to public health professionals (Gordon, 1940, 1949). The epidemiologic approach is distinguished from the clinical approach in that the focus of epidemiologic investigation and prevention is a group (i.e. a community or population) rather than an individual. An injury is damage to an organism (host) and is defined by the following two factors: Sub-acute exposures to energy over long periods of time cause many chronic diseases and disabilities. It is the acuteness of exposure that diff
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Conference papers on the topic "Chronic toxic damage"

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Olefirenko, M., and Tatyana Lukaschuk. "THE INFLUENCE OF ARSENIC ON THE BODY." In II All-Russian Scientific and Practical Conference of students, teachers, practitioners "Education-Science-Practice". Autonomous Non-Profit Educational Organization of Higher Education "Kuban Institute of Vocational Education", 2025. https://doi.org/10.64007/conferencearticle_683d99f69e94f4.66376142.

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Arsenic is one of the most toxic elements, negatively affecting the human body even in small doses. Its compounds are widely distributed in the environment, increasing the risk of chronic poisoning. The article examines the mechanisms of arsenic’s impact at the cellular level, main routes of entry into the body, and health consequences, including the development of cancer, damage to the nervous and cardiovascular systems. Special attention is paid to poisoning prevention and detoxification methods.
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Isametov, Davran Rashitovich, Nurbol Soltybekovich Shauenov, Zhaksylyk Orazbaevich Maulenov, and Daulet Zhumanovich Zhumagali. "EXPERIENCE OF ACCESS TO CENTRAL VENOUS VESSELS BY IMPLANTATION OF PORT VENOUS SYSTEMS IN CLINICAL ONCOLOGY." In Themed collection of papers from III Foreign International Scientific Conference «Science in the Era of Challenges and Global Changes» by HNRI «National development» in cooperation with AFP (Puerto Cabezas, Nicaragua). June 2025. Crossref, 2025. https://doi.org/10.37539/250626.2025.20.97.009.

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Providing central venous access during the development of critical conditions caused by systemic vasoconstriction, as well as access to main vessels in chronic toxic damage to the vascular intima, is a critically important aspect in routine oncological practice. In recent years, approaches to the installation of port-venous systems have been modernized and improved, as have the port models themselves, which differ significantly in external modification but retain a single operating principle and functionality [3,4]. Considering the increasing importance of cytostatic drug therapy in oncology (
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Rozman, Iza, Alja Štern, and Bojana Žegura. "New Approaches for Testing the (Geno)Toxic Activity of Nano-particles In Vitro." In Socratic lectures 10. University of Lubljana Press, 2024. http://dx.doi.org/10.55295/psl.2024.ii8.

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Abstract:The safety of nanomaterials, whether they are made of natural or artificial substances, represents a significant challenge because nanotechnology, as a young and up-and-coming field, is developing very quickly, while nanotoxicology and nanoecotoxicology are falling behind. Since the production, use, and consequently, the exposure of people to nanomaterials is increasing significantly, the acquisition of data on potential acute and chronic toxicity plays a crucial role. It is known that nanomaterials due to their high surface-to-volume ratio, high reactivity, and unique physical, chemi
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Zoja, C., L. Furci, F. Ghilardi, P. Zilio, A. Benigni, and G. Remuzzi. "CYCLOSPORIN A (CyA) INDUCED ENDOTHELIAL CELL INJURY." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644123.

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The chronic administration of CyA to animals and humans to prevent graft rejection may induce renal arteriolar damage resembling hemolytic uremic syndrome (HUS). This is a syndrome of vascular damage with thrombotic occlusions of the microcirculation. Endothelial damage is considered the first event in the pathogenetic cascade leading to HUS. We have used bovine aortic endothelial cells in culture to address the issue of CyA-induced arteriolar damage. CyA-induced a time (1-24 hours) and dose (1-50 μM) dependent cell damage. CyA-induced injury was characterized by an early cell detachment follo
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Boogaerts, M. A., P. Zachée, M. P. Emonds, W. Goossens, R. L. Verwilghen, and R. L. Lins. "ERYTHROCYTES(RBC) AS SUICIDAL ENDOGENOUS SCAVENGERS IN IMMUNE TRIGGERED GRANULOCYTE(PMN)MEDIATED VASCULAR DAMAGE." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643162.

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PMN produced toxic oxygen radicals(TOR)have been implicated in the generation of endothelial injury in a number of clinical conditions e.g. in apheresis,hemodialysis, ARDS and atherosclerosis. RBC have shown to inhibit TOR induced damage in a number of hyper-oxic lung injury models.We surmised RBC may serve as endogenous TOR scavengers in those in vivo situations where PMN are immunologically triggered(e.g. complement-activation in hemodialysis)to produce endothelial damage.However, RBC in their role as scavengers may became more vulnerable to further oxydant stress and display a reduced life
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McGoron, Anthony J., and Alicia Fernandez-Fernandez. "Development of a Multiple Indicator Dilution Technique Using Fluorescent Dyes to Measure Cardiac Capillary Permeability." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192955.

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Anthracyclines are widely-used drugs for the treatment of cancer. Although these drugs are effective in reducing or containing tumor progress, their long-term use is limited by toxicity effects. A special area of concern is related to the toxic effects that these drugs have on the myocardial tissue, including interstitial edema, fibrosis, degeneration of myocardial cells, and cardiac dilatation, among others. The end result is an overall impairment in cardiac function that limits the use of these agents [1,2]. This damage in heart function can be life-threatening, and it causes special concern
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