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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is substantial evidence that physical disability results from chronic diseases and that the number of chronic diseases is associated with the presence and severity of disability. There is some evidence that interactions between specific diseases are of import in causing disability. Beyond arthritis, however, little is known of the disease pairs that may be important to focus on in future research. This study explores the associations between multiple disease pairs and different types of physical disability, with the objective of hypothesis development regarding the importance of disease interactions. The study population comprised a representative sample of 3841 women 65 years and older living in Baltimore, screened for participation in the Women's Health and Aging Study. The study design was cross-sectional. An interviewer-administered screening questionnaire was administered regarding self-reported physical disability in 15 tasks of daily life, history of physician diagnosis of 14 chronic diseases, and MiniMental State examination. Task difficulty was empirically grouped into six subsets of minimally overlapping disabilities, with a comparison group consisting of those with no difficulty in any task subset. Multiple logistic regression models were fit assessing the relationship of major chronic diseases and of interactions of disease pairs with each disability subtype and with any disability, adjusting for confounders. Fourteen percent of the population reported mobility difficulty only; 5%, upper extremity difficulty only; 9%, both of these difficulties but no others; 7%, difficulty in higher function but not self-care tasks; 7%, self-care task difficulty but not higher function tasks; and 15%, difficulty in both higher function and self-care (weighted data). Almost all in the latter three groups had difficulty, as well, in mobility or upper extremity tasks. In regression models, specific disease pairs were synergistically associated with different types of disability. For example, important disease pairs that recurred in their associations with different disability types were the presence of arthritis and visual impairments, arthritis and high blood pressure, heart disease and cancer, lung disease and cancer, and stroke and high blood pressure. In addition, the type of disability that a disease was associated with varied, depending on the other disease that was present. Finally, when interactions were accounted for, many diseases were no longer, in themselves, independently associated with a given type of disability. Partitioning disability into six subtypes was more informative in terms of associations than was evaluating a summary category of "any disability." These findings provide a basis for further hypothesis development and testing of synergistic relationships of specific diseases with disabilities. If testing confirms these observations, these findings could provide a basis for new strategies for prevention of disability by minimizing comorbid interactions.
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PMID:Association of comorbidity with disability in older women: the Women's Health and Aging Study. 997 71

Ten boys and 15 girls below the age of 16, were referred to the National Hospital in Norway for evaluation for heart or lung transplantation 1990-97. 24 of the children and their families went through a thorough psychosocial assessment in order to assess the supportive measures the children and their families might need for coping with stress during the evaluation and the follow-up period. The patients were divided into three diagnostic groups: Two had cystic fibrosis and one an obstructive lung disease, heart-lung group, eight had congenital heart disease and 13 cardiomyopathy. 15 children were accepted for transplantation and placed on the waiting list. The others were rejected for medical reasons. Seven children (29%) filled the criteria for a psychiatric diagnosis (six anxiety disorders and one depression). Five others had considerable anxiety symptoms. The cardiomyopathy group had fewer problems than the heart-lung and congenital heart disease groups. The study shows that families with children suffering from life-threatening disease live with a great deal of stress and are in need of help and support. Many families are either not aware of their rights or too exhausted to seek help.
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PMID:[Chronic heart or lung disease and psychosocial stress]. 1008 52

Exercise echocardiography is a versatile technique that includes not only two-dimensional imaging, but also Doppler of aortic, mitral, and tricuspid valves. Doppler echocardiography can be useful in the evaluation of global left ventricular systolic and diastolic function, valvular function, transvalvular gradients, and pulmonary artery pressure. The technique lends itself to the study of the cardiac response to exercise in a variety of disease states, including pulmonary, coronary artery, valvular, and congenital heart disease. We review our experience using agitated saline-enhanced Doppler of tricuspid insufficiency to determine pulmonary artery pressure throughout exercise in chronic lung disease.
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PMID:Exercise Doppler: functional evaluation of right heart dynamics. 1014 87

This brief review has highlighted some of the research done by the MRC in the South Wales valleys. The two MRC Units published, in total, over 2000 reports ranging from letters to journals to conference proceedings, with around 200 reports appearing in the BMJ, Lancet and Nature alone. The expertise gained in South Wales meant that the Pneumoconiosis Research Unit team was involved internationally in co-ordinating research on coal workers' lung disease, and later on the health effects of asbestos and other respirable dusts. It is remarkable that the early large-scale studies were conducted and analysed without the benefits of modern computers and statistical packages. The varied Epidemiology Unit research programme enabled Cochrane to develop his ideas on defining health and evaluating health services, and also Elwood, who directed the Unit from 1974 to 1995, to pioneer studies of aspirin prophylaxis in cardiovascular disease. A steady stream of occupational health studies were carried out by Epidemiology Unit staff and many other large surveys were conducted in other parts of South Wales and across the country. Later MRC Epidemiology Unit work has focused on the town of Caerphilly where a prospective study of some 2500 men, established in 1979, has so far resulted in over 100 papers, notably on haemostatic factors related to heart disease. The study has run in tandem with a similar survey in the Speedwell area of Bristol which was established by former Epidemiology Unit staff working for the health authority in that area. Other medical research groups have also worked in the South Wales valleys. In 1961 Julian Tudor Hart left the Epidemiology Unit after a year's research to enter general practice, and establish the famous research practice at Glyncorrwg, over the mountain from the Rhondda Fawr. This year the extensive collection of MRC survey records is being transferred to the Department of Social Medicine at Bristol, and it is quite likely that further research will be undertaken relating Rhondda survey data collected over 40 years ago to subsequent mortality. The South Wales valleys will continue to contribute to medical research into the next millennium. Archie Cochrane's papers have been catalogued and are available for study at the Cochrane Archive established at Llandough Hospital.
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PMID:Medical research in the Rhondda valleys. 1053 25

RSV is the most important respiratory pathogen in infants and young children. About 1% of primary RSV infections result in hospitalization. The virus is spread by large droplets of secretions or contact with contaminated secretions. Infants infected with RSV may demonstrate poor feeding, rhinorrhea, apnea, lethargy, wheezing, and respiratory distress. Diagnosis may be made by clinical signs and symptoms (especially those observed during epidemics), by chest radiographs showing hyperinflation, or by rapid antigen detection with immunofluorescence of nasopharyngeal aspirates. Risk factors for severe disease accompanied by complications include chronic heart disease, chronic lung disease, immunodeficiency, HIV, and prematurity. Immunity is incomplete and of short duration, and reinfection is common. Treatment remains supportive and consists of oxygen administration, hydration, and diligent monitoring. Use of corticosteroids, bronchodilators, antibiotics, and ribavirin is controversial and is dependent largely on physician preference. Use of ribavirin should be reserved for patients who have severe underlying conditions associated with increased mortality rates. Intravenous RSV Ig has been replaced by palivizumab, which is generally recommended for infants at high risk for severe RSV, including those with a history of prematurity and those with chronic lung disease.
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PMID:RSV infection in infants and young children. What's new in diagnosis, treatment, and prevention? 1060 68

This study analyzed one respondent per household who was age 70 or more at the time of the household's inclusion in Wave 1 (1993-1994) and whose survival status was determinable at Wave 2 (1995-1996) of the Survey on Asset and Health Dynamics Among the Oldest Old (AHEAD Survey). At age 76 at Wave 1, there was a racial crossover in the cumulative number of six potentially fatal diagnoses (chronic lung disease, cancer, heart disease, hypertension, diabetes, and stroke) from a higher cumulative average number for blacks to a higher average number for whites. Also, there was a racial crossover at age 86 in the cumulative average number of disabilities in the Advanced Activities of Daily Living (AADLs), from a higher average for blacks to a higher average for whites. Between Waves 1 and 2, there was a racial crossover in the odds of mortality from higher odds for blacks to higher odds for whites; this occurred at about age 81. The results are consistent with the interpretation that the racial crossover in comorbidity (but not the crossover in AADL disability) propelled the racial crossover in mortality.
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PMID:The racial crossover in comorbidity, disability, and mortality. 1095 3

The time course of intensive care for severe respiratory syncytial virus (RSV) lower respiratory tract illness may be predicted by the severity of gas exchange during the first 48 h of mechanical ventilation. To test this hypothesis, two studies were undertaken in RSV-positive mechanically ventilated patients who did not have chronic lung disease, congenital heart disease or immunodeficiency. First, a retrospective criteria-generating review of 45 infants was carried out. In these infants, more severe lower airway disease, as demonstrated by four-quadrant consolidation on chest X-ray, was associated with 'best' alveolar arterial oxygen gradients (AaDO2, torr) and mean airway pressure (MAP, cm H2O) values as follows: first 24h, AaDO2 > 400 and MAP > 10 (positive and negative predictive values 100% and 97%, respectively); second 24 h, AaDO2 > or = 300 and MAP > 10 (positive and negative predictive values 91% and 100%, respectively). The second study, a prospective, hypothesis-testing, analysis of length-of-stay in 44 infants stratified according to the above AaDO2 and MAP criteria demonstrated that the duration of intensive care was longer in the severe group: median (interquartile range in days) 17 (15-39) vs 7 (4-8) (p < 0.01). We suggest that, in mechanically ventilated infants with RSV, the time course of intensive care is predictable based on early clinical features and respiratory parameters. Therefore reports on the effectiveness of special therapies using intensive care stay as a measure of outcome should be interpreted with respect to these observations before drawing conclusions about efficacy.
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PMID:Time course of severe respiratory syncytial virus infection in mechanically ventilated infants. 1097 23

Appalachians remain at high risk for cancer, heart and lung disease, in part because of their high prevalence of tobacco use; yet, information about their tobacco consumption patterns is limited. The purpose of this study was to describe tobacco consumption variables among rural adult Appalachian tobacco users. Subjects, aged 18 and older (N = 249), participated in a face-to-face interview about tobacco consumption variables and knowledge regarding the health effects of tobacco at fairs in two rural Ohio Appalachian counties. The majority of participants were categorized as precontemplators, although 21 percent were classified in preparation stage of change. Mean age of initiation was 16.6 years and number of cigarettes smoked per day (cpd) was significantly higher for men, as compared to women. One-third of males reported the use of smokeless tobacco. The majority had not tried to quit for more than a year and the average number of previous quit attempts was low. One-half of the sample had been advised in the past to quit by their physician. Few had used nicotine replacement with past quit attempts but greater than half would consider this approach with future attempts. Knowledge about the health effects of smoking indicated that most were aware of the relationship between smoking and cancer but less than one-half recognized its association with heart disease. Those with less education were less informed about the health effects to self and non-smokers. While a sizeable portion expressed interest in quitting, knowledge about the health effects of smoking is lacking, especially with regard to heart disease and among those with less education.
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PMID:Tobacco use characteristics among rural Ohio Appalachians. 1098 11

Cardiac malformations involving low-pressure chambers (i.e., either of the atria) are more often diagnosed later in life than lesions that involve high-pressure systems such as ventricular septal defects or persistent ducti arteriosi. Patients with congenital heart disease involving the atria may present only symptoms suggesting lung disease. We report on a child with recurrent episodes of wheezing, which did not respond to albuterol nebulizations and intravenous corticosteroids; he was subsequently found to have cor triatriatum. When a patient suffers from recurrent episodes of lower pulmonary infection and wheezing, despite appropriate management for asthma, less common (including cardiac) causes should be considered.
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PMID:Wheezing as the sole clinical manifestation of cor triatriatum. 1101 37

Recent studies have shown that particulate air pollution is a risk factor for hospitalization for heart and lung disease; however, little is known about what subpopulations are most sensitive to this pollutant. We analyzed Medicare hospital admissions for heart disease, chronic obstructive pulmonary disorders (COPD) and pneumonia in Chicago, Cook County, Illinois, between 1985 and 1994. We examined whether previous admissions or secondary diagnoses for selected conditions predisposed persons to having a greater risk from air pollution. We also considered effect modification by age, sex, and race. We found that the air-pollution-associated increase in hospital admissions for cardiovascular diseases was almost doubled in subjects with concurrent respiratory infections. The risk was also increased by a previous admission for conduction disorders. For COPD and pneumonia admissions, diagnosis of conduction disorders or dysrhythmias increased the risk of particulate matter < 10 microm in aerodynamic diameter (PM(10))-associated admissions. Persons with asthma had twice the risk of a PM(10)-associated pneumonia admission and persons with heart failure had twice the risk of PM(10)-induced COPD admissions. The PM(10) effect did not vary by sex, age, and race. These results suggest that patients with acute respiratory infections or defects in the electrical control of the heart are a risk group for particulate matter effects.
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PMID:Are there sensitive subgroups for the effects of airborne particles? 1101 88


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