Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The overall improvement in the health of Americans over the 20th century is best exemplified by dramatic changes in 2 trends: 1) the age-adjusted death rate declined by about 74%, while 2) life expectancy increased 56%. Leading causes of death shifted from infectious to chronic diseases. In 1900, infectious respiratory diseases accounted for nearly a quarter of all deaths. In 1998, the 10 leading causes of death in the United States were, respectively, heart disease and cancer followed by stroke, chronic obstructive pulmonary disease, accidents (unintentional injuries), pneumonia and influenza, diabetes, suicide, kidney diseases, and chronic liver disease and cirrhosis. Together these leading causes accounted for 84% of all deaths. The size and composition of the American population is fundamentally affected by the fertility rate and the number of births. From the beginning of the century there was a steady decline in the fertility rate to a low point in 1936. The postwar baby boom peaked in 1957, when 123 of every 1000 women aged 15 to 44 years gave birth. Thereafter, fertility rates began a steady decline. Trends in the number of births parallel the trends in the fertility rate. Beginning in 1936 and continuing to 1956, there was precipitous decline in maternal mortality from 582 deaths per 100 000 live births in 1935 to 40 in 1956. Since 1950 the maternal mortality ratio dropped by 90% to 7.1 in 1998. The infant mortality rate has shown an exponential decline during the 20th century. In 1915, approximately 100 white infants per 1000 live births died in the first year of life; the rate for black infants was almost twice as high. In 1998, the infant mortality rate was 7.2 overall, 6.0 for white infants, and 14.3 for black infants. For children older than 1 year of age, the overall decline in mortality during the 20th century has been spectacular. In 1900, >3 in 100 children died between their first and 20th birthday; today, <2 in 1000 die. At the beginning of the 20th century, the leading causes of child mortality were infectious diseases, including diarrheal diseases, diphtheria, measles, pneumonia and influenza, scarlet fever, tuberculosis, typhoid and paratyphoid fevers, and whooping cough. Between 1900 and 1998, the percentage of child deaths attributable to infectious diseases declined from 61.6% to 2%. Accidents accounted for 6.3% of child deaths in 1900, but 43.9% in 1998. Between 1900 and 1998, the death rate from accidents, now usually called unintentional injuries, declined two-thirds, from 47. 5 to 15.9 deaths per 100 000. The child dependency ratio far exceeded the elderly dependency ratio during most of the 20th century, particularly during the first 70 years. The elderly ratio has gained incrementally since then and the large increase expected beginning in 2010 indicates that the difference in the 2 ratios will become considerably less by 2030. The challenge for the 21st century is how to balance the needs of children with the growing demands for a large aging population of elderly persons.
 ...
PMID:Annual summary of vital statistics: trends in the health of Americans during the 20th century. 1109 82

The updated cohort consisted of 3328 workers who were employed at the Mobil (now ExxonMobil) Torrance, California, refinery for at least 1 year between 1959 and 1997. The vital status of the cohort was determined through a variety of sources, including company employment or retirement records, the Social Security Administration's Death Master File, and the National Death Index. The updated study covered an observation period of 38 years from 1960 to 1997, with a total of 60,612 person-years of observation. A total of 705 (21.2%) cohort members were identified as having died. Mortality data were analyzed in terms of cause-specific standardized mortality ratios (SMRs) and 95% confidence intervals (95% CIs), with expected deaths based on US national cause-, gender-, race-, year-, and age-specific mortality rates. The overall mortality of the cohort was significantly lower than expected when compared with the US general population (SMR, 81.9; 95% CI, 76.0 to 88.2). Overall cancer mortality was also lower than expected (SMR, 79.8; 95% CI, 67.9 to 93.1). For specific cancer sites, significant mortality deficits were observed for cancer of the digestive system (SMR, 70.9; 95% CI, 49.4 to 98.6) and cancer of the respiratory system (SMR, 74.1; 95% CI, 55.5 to 97.0). No significant increase was reported for any site-specific cancer. For nonmalignant diseases, no significant increase was observed for any cause. In particular, significant mortality deficits were reported for ischemic heart disease (SMR, 87.7; 95% CI, 77.2 to 99.3), chronic endocardial disease and other myocardial insufficiencies (SMR, 8.3; 95% CI, 0.2 to 46.0), all other heart disease (SMR, 64.2; 95% CI, 43.0 to 92.2), and influenza and pneumonia (SMR, 59.2; 95% CI, 33.1 to 97.6). Detailed analysis by length of employment did not reveal any significant mortality excess or upward trend. Analyses of male employees by job classification (process and maintenance) were conducted. Among maintenance workers, mortality from cirrhosis of the liver (SMR, 190.1; 95% CI, 101.2 to 325.1) and suicide (SMR, 208.6; 95% CI, 111.1 to 356.7) were significantly elevated. However, these mortality excesses did not seem to be related to employment at the refinery. No other causes of death showed significant increase among maintenance workers. A similar separate analysis was conducted for process workers, and no significant excess was detected for any cause. The findings from the present study are discussed in conjunction with results from previous investigations of employees at the Torrance refinery and with results from other refinery studies. Potential limitations of the study are also discussed.
 ...
PMID:Updated mortality study of workers at a petroleum refinery in Torrance, California, 1959 to 1997. 1176 80

The pregnant woman is susceptible to a variety of respiratory complications. When a pregnant patient presents with an abnormal chest x-ray or a pulmonary complaint, an understanding of the pathophysiology of pregnancy will guide the clinician in establishing a diagnosis. Pregnancy brings about many changes to a woman's body. One of the more intriguing is a decrease in the T helper cells, resulting in a state of relative immunosuppression. Despite this, the prevalence of infectious pneumonia is not increased in pregnancy. Complications from pneumonia, however, are increased in the pregnant host. Most notably are increases in both mortality related to influenza infection and the risk for dissemination of coccidioidomycosis. Other physiologic changes predispose the pregnant woman to certain disease processes. Hypercoagulability associated with pregnancy results in a marked increase in the incidence of thromboembolic disease. Although rare, pregnancy is also associated with other embolic phenomena including amniotic fluid embolism, air embolism, and trophoblastic embolism. Because of the increases in intravascular volume and cardiac output that occur in pregnancy, women with underlying structural heart disease will frequently present for the first time or have an exacerbation of their disease. This is especially true of mitral stenosis. Peripartum cardiomyopathy also can occur, and for the majority of patients, the heart remains damaged for life. Finally, although uncommon, lymphangioleiomyomatosis will often present or become exacerbated during pregnancy. Patients with this disorder need to be counseled concerning the increased risk associated with pregnancy. This paper reviews the various respiratory complications associated with pregnancy.
 ...
PMID:Respiratory complications of pregnancy. 1177 30

An intense process of epidemiological transition due to the change in mortality has superseded the eras of pestilence, pandemic disease, and chronic-degenerative diseases in Mexico. But the change has not been uniformly progressive, for instance, recurrence of malaria after its eradication indicates reverse transition. Enteritis, influenza, and pneumonia ranked among the primary causes of death between 1955 and 1957, whereas by 1980 heart disease became the leading cause followed by accidents, influenza, and enteritis. A polarized epidemiology can be observed in the post-transitional period: the poorest segment of the population continues to have high rates of infections and nutritional deficiencies. According to Mexican health service mortality data gathered in 1981 industrial workers had similar rates of infectious and chronic-degenerative diseases (11.7% and 12.0%, respectively), while agricultural workers had high rates of infectious and parasitic diseases (26.7%) and a low rate of chronic-degenerative diseases (5.6%). Illnesses of perinatal origin were also higher in agricultural workers than in industrial workers (26.1% vs. 13.7%), whereas circulatory diseases were more frequent among industrial workers (14.2% vs. 7.2%). It is the task of the health care system to meet the challenge of the complexity of this epidemiological mosaic.
 ...
PMID:[The health transition in Mexico: a proper model]. 1215 27

Three significant recent trends in Mexican mortality are the decline in deaths due to large groups of causes, the increasing proportion of deaths due to nontransmissible causes, and the convergence of state mortality rates. The World Bank has proposed a classification of causes of death into three large groups according to the type of intervention required to reduce them: transmissible, maternal, and perinatal; nontransmissible; and accidents and injuries. The first group concentrates disorders susceptible to reduction with low cost and highly effective interventions such as vaccines and sanitary measures, generally available at the primary level of care. The nontransmissible disorders include chronic degenerative diseases requiring more expensive and prolonged treatment corresponding to the second and third levels of care and implying lifestyle changes. Injuries and accidents are potentially preventable through specific programs of the health system. The proportion of Mexican deaths due to nontransmissible causes increased from 53.4% in 1979 to 67.8% in 1992. Five of the ten main causes of death are nontransmissible: heart disease, malignant tumors, cerebrovascular diseases, cirrhosis, and diabetes mellitus. The increased proportion of deaths due to nontransmissible diseases is a consequence of the rapid decline in deaths from transmissible causes. Deaths due to transmissible causes declined by 47.5% between 1979 and 1992. Increased educational levels, potable water and sewage services, increased vaccination coverage and similar interventions contributed to mortality decline in the least developed regions. The greatest mortality gains were in the areas with the highest initial rates, which helped to homogenize state mortality rates. Among transmissible diseases, diarrhea and pneumonia and influenza dropped from first and second to tenth and eighth place, respectively. In 1992, only Chiapas and Oaxaca maintained mortality rates significantly higher than the rest of the country. The current trend in mortality rates by cause and population aging will increase future demands for health care for nontransmissible diseases. Modifications will be required in the Mexican health system.
 ...
PMID:[Mortality by cause. The trends demand changes in the health system]. 1215 57

An abbreviated life table for Mexico is presented, based on findings of the 1990 census and deaths registered around 1990. The estimated life expectancy at birth in 1990 of 69.99 years was 3.5 years higher than the corresponding estimate based on the 1980 census. The gain in life expectancy averaged 3 years for ages 1-20 years, 2 years for ages 30-40 years, and 1-1.5 years for ages 45-65. The principal causes of general mortality were heart disease, accidents, malignant tumors, infectious intestinal diseases, and diabetes mellitus. The 5 principal causes of infant mortality were disorders arising in the perinatal period, infectious intestinal disorders, pneumonia and influenza, congenital anomalies, and nutritional deficiency disorders. Gains in life expectancy during the 1980s were significant because of the decline in infant mortality, but infant mortality levels remain high compared to those of other countries. Differentials in infant mortality rates in different states were significant, with 1990 rates ranging from 70/1000 in Oaxaca to 30 in the Federal District. The differentials in infant mortality rates were reflected in life expectancies. In the Federal District and the states of Nuevo Leon, Nayarit, and Tamaulipas, life expectancy exceeded the national average by 2-5 years. The proportion of deaths in the earliest age group that were not reported declined at the national level from around 20% in 1980 to around 10% in 1990. Census-based infant mortality estimates for 1990 were more reliable than those for 1980.
 ...
PMID:[Mortality in 1990. Mortality levels as indicated in the 1990 population census]. 1215 78

Women over 40 years of age comprise only between 9% and 20% of the population of Latin America and the Caribbean, but their numbers are growing. Life expectancy for women in the region is expected to exceed 71 years by the year 2000. In Costa Rica, women are responsible for more than 36% of urban households headed by persons over 60, according to a report. Many women in developing countries continue to bear children in their forties. In the 1980s the major causes of death for women over 45 in Latin America were heart disease, cerebrovascular diseases, cancer, diabetes mellitus, accidents and pneumonia/influenza. Cancer is the leading cause of death followed by heart disease. In urbanized countries chronic liver disease is a prime cause of death, often as the result of alcohol abuse. Infectious diseases such as influenza, pneumonia, and intestinal infections are more lethal in countries with more rural populations. Beginning at about age 35, cancer ranks first or second as a cause of death. Breast and uterine cervix cancers are the most deadly for both Latin American and Caribbean women. In the less developed and rural countries cancer of the cervix predominates. In more developed countries breast cancer is more prevalent. Lower cervical cancer rates in more developed countries occur because of greater use of PAP smears. Among women aged 65 years and older, heart disease and strokes are the main causes of death in both Latin America and the Caribbean. Diabetes and other chronic degenerative diseases are increasing throughout Latin America and the Caribbean. Diabetes is among the leading causes of death both in midlife and older women in 13 of the 18 Latin American countries and 6 of the 10 Caribbean nations. Among Latin American and Caribbean women at midlife and older chronic undernutrition is common. An estimated 37% of adult women in the Caribbean are anemic, 26% in Central America, 14% in tropical South America, and 12% in temperate South America. Osteoporosis with the potential for fractures is common among older women in the region. Community-based and home health care programs may be the solution for the health care needs of midlife and older women.
 ...
PMID:The invisible force. Midlife and older women. 1215 75

Pneumonia, more frequent in the elderly, results in higher morbidity and mortality, and is a frequent cause of hospitalisation. Although the incidence of pneumonia increases with age, mainly after 70-75 years, life in institution, comorbid medical illness (heart disease, chronic obstructive pulmonary disease, dementia), malnutrition and defence impairments are independent risk factors. Older patients with pneumonia complain of significantly fewer symptoms than younger patients. Streptococcus pneumonia is the most common cause of pneumonia, atypical pathogen are rare. There is a shift toward gram-negative bacteria and opportunistic flora with increasing age and severity of concomitant medical illness. Anaerobic bacteria are frequent in aspiration pneumonia. To hospitalize or not is the first decision to take, based on clinical criteria and risks factors. Use of the guidelines for empirical treatment of pneumonia is recommended. Old patients often recover slowly. Pneumococcal and influenza vaccinations are effective and warranted.
 ...
PMID:[Community acquired pneumonia in the elderly]. 1455 64

We describe a 40-year-old man with limited scleroderma who presented with acute heart failure following a flu-like illness. He was known to have incomplete left anterior bundle branch block, initial isolated pulmonary hypertension with enlarged right atrium, and no pulmonary fibrosis. He received therapy for acute heart failure and was transferred to a scleroderma centre for specific treatment of scleroderma cardiomyopathy. Investigations showed raised inflammatory markers and diffuse hyperechogenic thickening of the myocardium on echocardiography. Contrast-enhanced (Gd-DOTA) cardiovascular magnetic resonance imaging (CV-MRI) showed multiple areas of non-homogeneous delayed hyperenhancement in the left ventricle, suggestive of myocarditis. Antiadenovirus IgM antibodies were detected with a titer consistent with recent infection. Six weeks later a repeat Gd-DOTA CV-MRI showed an almost complete resolution of the areas of hyperenhancement and there was a significant reduction in the adenovirus antibody titer with serological conversion to IgG. To our knowledge this is the first report of viral myocarditis in scleroderma. Infections are important causes of morbidity and mortality in this disease and should always be included in the differential diagnosis of cardiac symptoms. We propose that contrast-enhanced CV-MRI is valuable in a non-invasive diagnosis of heart disease in patients with scleroderma.
 ...
PMID:Acute myocarditis associated with adenoviral infection in a patient with scleroderma. 1467 36

Stroke is a disease with well-defined modifiable risk factors such as arterial hypertension, smoking, diabetes, hyperlipidemia and atrial fibrillation. The need of new risk factors is based on the fact that only half the cardiovascular disease risk is explained by conventional risk factors. Inflammatory markers, infection, homocysteine and sleep-disordered breathing rank as the four most important new risk factors in cerebral atherosclerosis. C-reactive protein is the inflammatory marker that has been most thoroughly studied. Elevated concentrations of C-reactive protein increase the risk of heart disease and thromboembolic stroke in men and women. The role of Chlamydia pneumoniae is still controversial. Influenza vaccination is a simple and effective preventive measure against stroke. Despite the potential relationship between homocysteine and stroke, we should wait to the results of the ongoing trials to know if the reduction of homocysteine levels with vitamin therapy is of clinical benefit. Sleep-disordered breathing is a potential new risk factor with an effective therapy. Neurologists should not forget to look for sleep disorders in their stroke patients and probably manage them with breathing therapy from the acute phase.
 ...
PMID:Cerebral ischemia: new risk factors. 1469 79


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>