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

The single breath test for carbon dioxide (SBT-CO2) is the plot of expired FCO2 or CO2% against expired volume. It can be monitored during anaesthesia and in the intensive care unit with modest additions to generally available equipment. This paper describes some aspects of a computer program for presenting SBT-CO2 during controlled ventilation, in particular, the corrections to the primary data necessary for scientific accuracy. Examples are given of how the use of SBT-CO2 has increased our understanding of factors which influence the arterial-end-tidal PCO2 difference (PaCO2-PE,CO2). PaCO2-PE, CO2 is, in a given individual, usually dependent on tidal volume and frequency. Changes in lung volume and manoeuvres such as opening the pleura also affect gas exchange. Monitoring CO2 elimination gives a measure of metabolic rate if ventilation and pulmonary perfusion are maintained. This facilitates ventilatory therapy in situations where CO2 production is greatly increased, e.g. sepsis and tetanus. On the other hand, if metabolism and ventilation are unchanged, a reduction in CO2 elimination implies reduced pulmonary perfusion. This can be seen during increased right-left shunting, such as in surgery in patients with congenital heart disease.
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PMID:On-line expiratory CO2 monitoring. 309 79

Ethiopia is a country of 45 million people in northeast Africa. With a stagnant, agriculture-based economy and a per capita gross national product of $110 in 1984, it is one of the world's poorest nations. 70% of the children are mildly to severely malnourished, and 25.7% of children born alive die before the age of 5. Life expectancy is 41 years. The population is growing at the rate of 2.9%/year, but only 2% of the people use birth control. After the 1974 revolution, the socialist government nationalized land and created 20,000 peasant associations and kebeles (urban dwellers' associations), which are the units of local government. The government has set ambitious goals for development in all sectors, including health, but famine, near famine, forced resettlement programs, and civil war have prevented any real progress from being made. The government's approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the Ministry of Health is allocated only 3.5% of the national budget. Ethiopia has 3 medical schools -- at Addis Ababa, Gondar, and the Jimma Institute of Health Sciences. Physicians are government employees but also engage in private practice. A major problem is that a large proportion of medical graduates emigrate. Ethiopia has 87 hospitals with 11,296 beds, which comes to 1 bed per 3734 people. There are 1949 health stations and 141 health centers, but many have no physician, and attrition among health workers is high due to lack of ministerial support. Health care is often dispensed legally or illegally by pharmacists. Overall, there is 1 physician for 57,876 people, but in the southwest and west central Ethiopia 1 physician serves between 200,000 and 300,000 people. In rural areas, where 90% of the population lives, 85% live at least 3 days by foot from a rural health unit. Immunization of 1-year olds against tuberculosis, diphtheria-pertussis-tetanus, poliomyelitis, and measles is 11, 6, 6, and 12% respectively. Infectious diseases dominate the medical scene in Ethiopia. In 1984, tuberculosis accounted for 11.2% of hospital admissions and 12.2% of deaths. The leading cause of childhood mortality in 1984 was diarrhea (45%). Malaria, trypanosomiasis, schistosomiasis, leishmaniasis, and meningococcal meningitis are endemic. Intestinal parasitism is rampant, and the nationwide prevalence of leprosy is 3/1000. Venereal diseases were the 9th most common cause of hospital outpatient visits in 1984, but AIDS is rare. The leading noninfectious diseases are rheumatic and syphilitic heart disease, hypertension, diabetes mellitus, hepatoma, and elephantiasis. Ethiopia has the highest number of cases of nonfilarial elephantiasis -- an estimated 350,000 cases -- in the world. Aside from a large influx of money, the most necessary changes to improve the health system are lowering the salaries of doctors and nurses, reorienting physician training toward primary health care, increasing the quality of existing health services, more efficient management, and better coordination between the Ministry of Health and the voluntary organizations.
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PMID:Health and medical care in Ethiopia. 271 Jan 85

Registered deaths from the vital statistics registration system of Lagos City, a system that was judged to be 60% complete, were analyzed for the year 1977. Nearly 40% of total registered deaths were from infections, parasitic diseases, and motor vehicle accidents. Of the reported deaths, 17.3% were from ill-defined conditions. Deaths from neoplasms, diseases of the nervous and sense organs, diseases of the digestive and genitourinary systems as well as those from congenital anomalies are relatively less frequent. Maternal mortality appears to be very high. The age pattern of mortality is different from that in the developed countries, a high proportion of the deaths in Lagos being those of children aged under 5 years. Infant mortality is dominated by perinatal causes which constituted a huge 38.4% of deaths of infants under 1 year, the other important causes being dysentery and diarrhea, pneumonia, and tetanus. Among adults, death from motor vehicle accidents is the most important cause accounting for more than 26% of deaths in the age group 15 years and above. Other important causes of adult deaths are cerebrovascular disease, hypertensive disease, heart disease, pneumonia, dysentery and diarrhea, and complications of pregnancy. Well organized health services stressing antenatal care, preventive and health education services are needed to effect a reduction in mortality and bring about a general improvement in the health of the people. (author's)
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PMID:Causes of mortality in an African city. 628 60

A descriptive study was conducted in 1967, 1968, and 1969 on some of the basic health characteristics of the approximately 1,100 veterinarians in Illinois. A total of 87% had consulted a physician concerning their health within the past 30 months. Within the past 18 months 47% had been vaccinated against tetanus. Over one-third of the veterinarians had received their last tetanus inoculation because of an injury. Thirty-one percent had been tested serologically for zoonotic infections other than at a meeting of the state veterinary association, 69% wore glasses, 12% were allergic to an antimicrobial, and 24% had a history of an appendectomy. Nearly one-half smoked and another 22% were former smokers. Thirteen percent had hernias with 67% of these repaired surgically. The males of the subpopulation of veterinarians had a mean height of 5 feet 6 1/2 inches and a mean weight of 179 pounds. Gastrointestinal ulcers had been diagnosed in 10%, arthritis in 11%, heart disease in 8%, hypertension in 7%, diabetes in 2% and cancer in 1%. Sixty-eight percent had not lost a single workday in the past year. The total group had a mean loss of 0.85 days due to accident and 4.09 due to illness.
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PMID:The health characteristics of veterinarians in Illinois. 733 86

UNICEF decided to achieve the 1977 World Health Organization objective Health For All By The Year 2000 through primary health care, utilizing growth monitoring, oral rehydration therapy, breast-feeding, immunization, family planning, and education of women. Since the 1960s BCG (bacillus Calmette-Guerin) vaccination, DPT (diphtheria, pertussis, tetanus) and OPV (oral polio vaccine) have been available in Sri Lanka. The expanded program of immunization has almost eliminated diphtheria, pertussis, neonatal tetanus, and poliomyelitis. Tuberculous meningitis, bone and joint tuberculosis, measles, and miliary tuberculosis have become very rare. Among other vaccine-preventable diseases, mumps is the commonest cause of aseptic meningitis and viral encephalitis in children. Maternal rubella in the first trimester causes abortion or gross teratogenic effects including congenital heart disease. Safe vaccines may be used to prevent mumps and rubella. In recent years there has been a resurgence of measles in North America among school children, and presently a 2nd dose of vaccine is recommended for children. Japanese B encephalitis has a mortality rate of over 30% and half the survivors have residual brain damage. The Ministry of Health has immunized susceptible children in some of the prevalent areas. This vaccine also gives partial protection against dengue hemorrhagic fever. In Hong Kong, Singapore, and Taiwan hepatitis B vaccine is part of the national immunization schedule because of the common occurrence of primary hepatoma of the liver. At present this vaccine is recommended for health workers in Sri Lanka. Meningococcal meningitis occurs in some Middle East countries such as Saudi Arabia, thus Haj pilgrims are advised to be vaccinated against it before the pilgrimage. In Sri Lanka beta-thalassemia major is prevalent, and as most of these patients are subjected to splenectomy, pneumococcal vaccine should be given to them. Currently research work is being carried out for development of vaccines against rotavirus, streptococcal, and hepatitis A infection.
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PMID:Improving child survival through immunisation. 814 30

The objective of this study was to ascertain whether immune abnormalities were present in a group of patients with chronic stable heart failure at a time when sympathetic drive was not excessive. Elevated sympathetic tone not only plays an important role in the pathophysiologic characteristics of congestive heart failure but may also regulate certain aspects of immune function, which has been shown to be abnormal in patients with severe heart failure. Studies have indicated a high incidence of heterophil antibodies against constituents of the heart, the presence of antibody-mediated cytotoxicity against cultured heart cells, and a decrease in suppressor and natural killer-cell function in patients with idiopathic dilated cardiomyopathy. Lymphocytes were separated over a Ficoll-Hypaque gradient. Lymphocyte subtypes and well as interleukin-2 receptors were detected by means of mouse monoclonal antibodies conjugated with fluorescein or phycoerytherin, and immunofluorescence was measured with a flow cytometer. Mitogen proliferation was assessed by tritiated thymidine incorporation in the presence of either conconavalin A or tetanus toxoid. Serum was used in conjunction with iodine 125-labeled iodopindolol binding to rat cardiac membranes to attempt to detect beta-receptor antibodies. In patients with ischemic (n = 21) and idiopathic (n = 16) cardiomyopathy, the norepinephrine levels were modestly elevated (idiopathic = 482 +/- 70 pg/ml; ischemic = 501 +/- 45 pg/ml) compared with control subjects without heart disease (n = 10; norepinephrine = 252 +/- 70 pg/ml). We found no differences in the number and subtypes of circulating lymphocytes in the three groups, and there was no serum inhibition of beta-binding to rat cardiac membranes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immune function in patients with chronic stable congestive heart failure. 838 25

Long term effects of BMT in thalassemia were monitored in 33 patients transplanted between 1987 and 1995 and compared with 155 patients matched for age and treated during the same period with conventional therapy (CT). The incidence of fulminant sepsis and growth impairment was significantly higher in transplanted patients, whereas the occurrence of hypothyroidism, hypogonadism, and cardiopathy was higher in CT patients. For diabetes, liver disease, and severe infections, the differences were not statistically significant. After BMT we performed monthly erythrocytaferesis for iron removal in 23 (70%) patients, obtaining a complete normalization of iron stores in 91% of cases; among untreated patients, 60% had evidence of iron up to 8.3 years after BMT. Protection against poliovirus, tetanus, diphtheria, and hepatitis B has been lost in 74%, 47%, 78%, and 44%, respectively. After BMT a careful follow-up is needed to monitor and treat late transplant-related and thalassemia-related complications.
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PMID:Late effects of bone marrow transplantation for thalassemia. 966 51

We used the relation between intracellular Ca(2+) concentration ([Ca(2+)](i)) and cell shortening during tetanus to evaluate the endogenous characteristics of Ca(2+) responsiveness of myofibrils in mouse ventricular myocytes. Enzymatically isolated myocytes were loaded with fura-2 AM (4 microM for 10 min), and the fura-2 fluorescence ratio at 340 and 380 nm excitation wave length [F(340)/F(380)] and cell length were measured simultaneously. Following treatment with thapsigargin (0.2 microM) (an inhibitor of the Ca(2+) pump of sarcoplasmic reticulum), myocytes were stimulated at 10 Hz for 10 s to produce a tetanic contraction and an instantaneous plot of the fluorescence ratio signal versus cell length (R-L trajectory) was constructed. An increase in the extracellular Ca(2+) concentration ([Ca(2+)](o)) from 0.5 to 2 mM extended the R-L trajectory without a substantial shift of the relation. The R-L trajectory was shifted rightward by the nonselective phosphodiesterase inhibitor, 3-isobutyl-1-methyl-xantine (IBMX, 200 microM) (desensitization of the myofibrils to Ca(2+)), and shifted leftward by the Ca(2+) sensitizing thiadiazinone derivative, EMD-57033 (0.5 microM) (sensitization of the myofibrils to Ca(2+)). Beta-adrenergic stimulant, isoproterenol (5 nM), also shifted the R-L trajectory to the right, suggesting that the membrane receptor could be preserved. These results suggest that the R-L trajectory is a useful method to estimate the myofibrillar responsiveness to Ca(2+) in isolated mouse myocytes and can be applied to various mouse models of heart disease.
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PMID:Use of tetanus to investigate myofibrillar responsiveness to Ca(2+) in isolated mouse ventricular myocytes. 1204 10

In the spring of 1992 a child health survey (Monitoring Scheme for Mortality of Children Under 5 Years of Age in China) was conducted in Henan Province among 10 representative cities and counties. The sample included the monitoring sites at Gongyi City, Mi County, and Lushi County. The sample population included 710,570 of which 55,740 were aged 0-4 years, 1473 were born in 1991, and 579 died in 1991. Child mortality was 55.58% and close to the national average. The ratio of male/female child mortality was 1:1.3. Infant mortality was 85.8% of total child mortality. 72.85% of infant mortality was newborn mortality (46.40% within the first 24 hours and 81.76% within 7 days of birth). Child mortality was higher in rural areas. 59.3% of mortality occurred while the child was at home and 28.7% on the way to medical treatment, and 24.35% did not have treatment or parents consciously decided not to seek treatment. The primary causes of death at 0-7 days were suffocation during birth, premature delivery at birth, pneumonia, neural tube defects, accidental suffocation, and newborn tetanus. Ranked causes at 0-18 days from high to low were suffocation during birth, pneumonia, premature delivery, neural tube defects, accidental suffocation, and newborn tetanus. At under 1 year the causes were pneumonia, suffocation during birth, premature delivery, accidental suffocation, neural tube defects, and congenital heart disease. At 1-4 years the primary causes were pneumonia, accidental suffocation, congenital heart diseases, other malformation, and other diseases. For mortality under 4 years of age the causes were pneumonia, congenital malformations, premature delivery, accidental suffocation, neural tube defects, and congenital heart diseases. The 1990 Summit Conference on Children's Issues in the World recommended reducing child mortality by 33% by the year 2000. This means a considerable reduction for China.
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PMID:An analysis of mortality causes of children under five years of age in 10 cities and counties in Henan Province in 1991. 1228 75

In India, maternal and child deaths account for 60% of total mortality. Reductions in maternal mortality require the identification of all pregnant women in the community, prenatal care, the early detection of medical problems and pregnancy-related complications, tetanus toxoid immunization, identification of the most appropriate setting for delivery, prevention of maternal malnutrition, and motivation to practice breastfeeding and birth spacing in the postpartum period. To reduce child mortality, infants should be breastfed, immunization against common infectious diseases should be provided, and growth should be monitored at regular check-ups. As part of the village health worker's regular household visits, pregnant women should be motivated to seek prenatal care. Ideally, there should be a prenatal visit monthly for the 1st 7 months of pregnancy, once every 2 weeks until 36 weeks, and weekly thereafter. If long distance from a medical facility or the loss of wages make this impossible, there should be at least 4-5 visits at the 10th, 20th, 30th, 35th, and 35th weeks of gestation. Care should be taken to identify the major factors in high-risk pregnancies: moderate to severe toxemia, chronic hypertension, significant rental or heart disease, hydramnios or oligohydramnios, and uterine rupture. In areas where financial and human resources in the primary health care sector are limited, inputs should be targeted to high-risk groups and activities of preventive and therapeutic value that are most cost- effective. All interventions should be based on a thorough analysis of the major determinants of mortality, the incidence of specific diseases, the responsiveness of diseases to available technologies, the community's nutritional status, and the cultural milieu. Rather than create new schemes and categories of workers, existing health facilities should be fully utilized.
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PMID:Strategies for promoting child health. 1231 87


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