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

Rubella during pregnancy can lead to miscarriages and stillbirths, while Congenital Rubella Syndrome results in children with severe birth defects such as congenital heart disease, cataracts, deafness, mental retardation, and microcephaly. Cost-benefit studies in several Caribbean countries indicate that investing in the eradication of rubella will bring tangible benefits within 5 years, given the high cost of care and rehabilitating children with Congenital Rubella Syndrome. If a rubella eradication program is not implemented, a large number of Congenital Rubella Syndrome cases could develop over the next 15 years. An eradication program would cost only an estimated 7% of the cost of providing care and rehabilitating rubella cases. The Council for Human and Social Development will make every possible effort to eliminate rubella and prevent the occurrence of new cases of Congenital Rubella Syndrome in the Caribbean community by the end of 2000. Furthermore, the council urges the Pan American Health Organization (PAHO) to coordinate the mobilization of resources and technical support toward eradicating rubella.
EPI Newsl 1998 Jun
PMID:Caribbean Community establishes rubella elimination goal. Resolution on the elimination of rubella. 1229 79

In western countries, heart disease is the main cause of premature death. Most of cardiac deaths occur out of hospital. Because of a continuously growing elderly population, the number of heart attacks is steadily increasing. Symptoms are often interpreted incorrectly. Victims do not survive long enough to benefit from inhospital treatments. To reduce the time before treatment, the only useful diagnostic tool to assess the presence of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision-making but require setting up new infrastructures. The pervasive solution proposed by the European EPI-MEDICS project is an intelligent Personal ECG Monitor for the early detection of cardiac events. It includes part of the patient electronic health record (EHR), embeds a web server and decision-making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care providers only if necessary, without requiring to set-up specific infrastructures. Healthcare becomes personalized, wearable and ubiquitous.
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PMID:Pervasive self-care solutions in telecardiology. Typical use cases from the EPI-MEDICS project. 1466 73

Warfarin is the primary treatment for those with atrial fibrillation at increased risk for stroke. The Randomized Evaluation of Long-Term Anticoagulation Therapy (RELY) trial demonstrated that dabigatran, a direct thrombin inhibitor, was associated with lower rates of systemic embolism compared to warfarin.1 Although individuals with a creatinine clearance of less than 30 mL/min were excluded from the trial, the FDA approved the use of dabigatran for those with creatinine clearances as low as 15 mL/min, with a lower dose of dabigatran recommended for individuals with creatinine clearances below 30 mL/min. This study calculated Glomerular Filtration Rates (GFR) via three existing formulas with varying levels of accuracy (ie, the Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]) to evaluate how patient eligibility for the RELY trial may have varied depending upon the formula used. A retrospective study was performed based on a chart review conducted at a private cardiologist's office in Honolulu, Hawai'i using patients with non-valvular atrial fibrillation. Patients included were those with a BUN/Creatinine assessment within 12 months of the chart review and a CHADS2 (Congestive Heart Disease, hypertension, age greater than 75, diabetes mellitus, and stroke or transient ischemic attack) score of 1 or greater. Of 376 subjects assessed, 64 subjects who failed to meet criteria for the RELY trial when using the Cockcroft-Gault formula (ie, GFR estimates were lower than 30 mL/min) met eligibility criteria when the MDRD formula was used (ie, GFR estimates exceeded 30 mL/min). Subgroup analysis of the 64 subjects revealed that subjects were 89-years-old on average, predominantly female (76.5%), and mostly Japanese (62.5%). Nearly one in five individuals (17%) in the studied population would have received a lower dose of dabigatran if the Cockcroft-Gaunt formula was used for estimating GFRs. The authors recommend caution while dosing dabigatran in the Asian population, as the estimates of kidney functioning vary substantially depending on the formula used to estimate GFR, which may in turn lead in some cases of inadequate dosing of dabigatran.
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PMID:A comparison of methods for estimating glomerular filtration rate for a population in Hawai'i with non-valvular atrial fibrillation. 2405 15