Two hundred and twenty-eight patients with acute rheumatic fever (ARF), who were admitted to Dr Sami Ulus Children's Hospital between January 1990 and November 1992, were evaluated. Compared with the 1980s, an increase in the frequency of the disease was observed. The majority of patients (56.5%) were between 9 and 12 years old and 36.8% were admitted in winter. One hundred patients had arthritis only, 59 carditis and 40 chorea; 5 had carditis and chorea and 24 had arthritis and carditis. Nineteen percent of patients had a history of a previous attack. Seven of 84 patients with carditis had congestive heart failure and 2 had pericarditis. Cardiomegaly was present in 36 patients. The mitral valve was affected in 77 patients, tricuspid valve in 1 patient and both miral and aortic valves in 6 patients. One patient died as a result of severe congestive cardiac failure. Twenty-one patients had a recurrent attack. We observed that ARF is still a significant cause of morbidity in our country. As the disease is preventable by the eradication of streptococcus, we conclude that more effort should be made in the early detection and treatment of streptococcal infections.
An observational study determining the long-term impact of chronic kidney disease (CKD) on patients undergoing percutaneous coronary intervention at a tertiary cardiac referral center. CKD is associated with poor in-hospital outcomes after percutaneous coronary intervention, but its effect beyond 1 year, particularly in the drug-eluting stent (DES) era, has not been reported.
Baseline creatinine was available for 11,953 patients entered into a prospective registry (April 2000 to September 2007). Patients were stratified: those with or without at least moderate CKD (creatinine clearance,
The aim of this study was to investigate admittance rates and doctors workload during Christmas. In addition, we examined if admittance data supports the common notions that overeating during Christmas results in increased rate of admittances for abdominal problems and that there is an increase in admittance of the elderly at the end of Christmas (i.e. "granny dumping").
A retrospective study analyzing data from the database of the hospital units of Sydvestjysk Sygehus was performed. Data covered admittance in the months spanning from November through January in 1994-2010. Data from Christmas was compared with data from adjacent months.
During Christmas more patients with abdominal complaints were admitted to the hospital (p
A recent prospective three-year follow-up study of 1931 men in Finland demonstrated a significant 2.2-fold greater risk of acute myocardial infarct in 42- to 60-year-old men who had serum ferritin concentrations above 200 micrograms/dL. However, the mean plasma ferritin concentration in this population was high and the prevalence of hemochromatosis was unknown; these issues mitigate the suggestion that high-normal iron stores leads to heart disease.
This paper presents initial findings of the Canadian Heart Health Initiative, Ontario Project (CHHIOP). CHHIOP has two primary objectives. The programmatic objective is to coordinate and refine a system for supporting effective, sustained community-based heart health activities. This paper addresses the scientific objective: to develop knowledge of factors that influence the development of predisposition and capacity to undertake community-based heart health activities in public health departments. A systems theory framework for an ecological approach to health promotion informs the conceptualization of the key constructs, measured using a two-stage longitudinal design which combines quantitative and qualitative methods. This paper reports the results of the first round of quantitative survey data collected from all health departments in Ontario (N = 42) and individuals within each health department involved in heart health promotion (n = 262). Results indicate low levels of implementation of heart health activities, both overall and for particular risk factors and settings. Levels of capacity are also generally low, yet predisposition to undertake heart health promotion activities is reportedly high. Analyses show that implementation is positively related to capacity but not predisposition, while predisposition and capacity are positively related. Overall, results suggest predisposition is a necessary but not sufficient condition for implementation to occur; capacity-related factors appear to be the primary constraint. These findings are used to inform strategies to address CHHIOP's programmatic objective.
Although, the relationship between childhood physical abuse and adult heart disease has been documented, very few studies have controlled for many of the known risk factors for heart disease. The objective of the current study, therefore, was to investigate the association between childhood physical abuse and adult heart disease while controlling for the following established risk factors: (1) childhood stressors; (2) adult health behaviors; (3) adult stressors; (4) depression; and, (5) high pressure.
Data was obtained from the 2005 Canadian Community Health Survey. The sample included 13,093 respondents from the Canadian provinces of Manitoba and Saskatchewan, of whom 7.4% (n=1025) reported that they had been physically abused as a child by someone close to them and 4.4% (n=850) reported that they had been diagnosed with heart disease by a health professional. The regional level response rate was 84%.
The age-gender-race adjusted odds ratio of heart disease among those who had reported childhood physical abuse was 1.57 (95% CI=1.12, 2.20). When adjustments were made for all of the established risk factors the odds ratio declined to 1.45 (95% CI=1.01, 2.08).
The relationship between childhood physical abuse and heart disease persists even when controlling for five types of factors previously thought to mediate the relationship.
Further research would benefit from a closer analysis of the potential mechanisms linking childhood physical abuse and heart disease.
OBJECTIVE: To compare complication rates after rectal resection using a conventional surgical technique (1983-1992) and mesorectal excision (1993-2000), and to find out whether the rate of complications changed with time after the introduction of mesorectal excision. DESIGN: Prospective, observational study. SETTING: University hospital, Norway. PATIENTS: All patients who had rectal resections for cancer in the period 1983-2000. INTERVENTIONS: In the conventional surgery period 217, and in the mesorectal excision period 176, patients had rectal resections. The mesorectal excision period was split in two, the early and the late mesorectal excision period, 88 rectal resections being performed in each period. Total mesorectal excision was done in 118 patients, and partial mesorectal excision in 58. MAIN OUTCOME MEASURES: Major surgical complications in both periods; intraoperative bleeding, transfusions during the hospital stay, and cardiovascular complications in the mesorectal excision period. RESULTS: 23/217 (11%) developed major surgical complications in the conventional surgery period, compared with 17/88 (19%) in the early mesorectal excision period (p = 0.04). This was caused by an increased incidence of anastomotic leaks after low anterior resection, being 11/122 (9%) in the conventional surgery period and 12/52 (23%) in the early mesorectal excision period (p = 0.01). The incidence of anastomotic leaks declined to 5/61 (8%) in the late mesorectal excision period (p = 0.03). Multiple regression analysis identified a low anastomosis, major bleeding, and age over 75 years as significant risk factors for the development of anastomotic leaks. Major intraoperative bleeding occurred in 36/84 (43%) of the patients in the early and 22/82 (27%) in the late mesorectal period (p = 0.04). Blood transfusions were given to 61/84 (74%) in the early mesorectal period and 41/82 (50%) in the late period (p
The experimental model of HgCl(2) injection is characterized by a systemic autoimmune disease which leads to the development of nephrotic syndrome (NS). NS seems to be accompanied by cardiovascular alterations, since patients with NS present an increased incidence in cardiac disease. The aim of our work was to study the effects of HgCl(2)-induced NS on myocardial function and morphometry. Normotensive Brown-Norway rats were injected with HgCl(2) (1 mg/kg, HgCl(2) group; n = 6, subcutaneous) or the vehicle (control group; n = 6, subcutaneous) on days 0, 2, 4, 7, 9 and 11. The animals were placed in metabolic cages for evaluation of urinary excretion of noradrenaline, sodium, total proteins, albumin and creatinine. Fourteen and 21 days after the first HgCl(2) injection, left ventricle (LV) hemodynamics was evaluated through pressure micromanometers in basal and isovolumetric heartbeats. The heart and gastrocnemius muscle weights and tibial length were also examined. In an additional group of animals cardiac dimensions and ejection fraction were assessed by echocardiography and LV apoptosis and fibrosis were studied. HgCl(2)-injected rats presented proteinuria, albuminuria, hyperlipidemia, anemia, sodium retention and ascites at day 14. These alterations were accompanied by LV hemodynamic changes only in isovolumetric heartbeats. Similarly, on day 21, HgCl(2)-injected rats presented proteinuria, albuminuria, hyperlipidemia, anemia, but no sodium retention or ascites. These animals presented LV systolic and diastolic dysfunction in both basal and isovolumetric heartbeats, as well as cardiac atrophy, LV fibrosis and an increase in myocyte apoptosis. In conclusion, HgCl(2)-induced NS is accompanied by LV dysfunction and can be a promising model for studying the link between NS and cardiac disease.