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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 56 patients aged over 60 years features peculiar to the diagnosis and the course of rheumatic heart diseases were studied. Clinical and laboratory findings, those of roentgenoscopy and roentgenography of the heart, as well as of electro- and phonocardiography were used. In 35 lethal cases clinico-anatomic comparisons and histological investigation were made for elucidating the activity of the rheumatic process. In persons aged over 60 the relapses of rheumatism have been found to be of rare occurrence and rheumatic affections run a course without any marked hypertension in the lesser circulation and become complicated by cardiac insufficiency no sooner than many years after establishiment fo the diagnosis. In individuals older than 60 an active rheumatic process according to histological investigations and the authors occurs in 14.3 per cent of the cases.
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PMID:[Characteristics of diagnosis and clinical course of rheumatic heart defects in middle- and old age]. 102 34

Many cases of cardiovascular diseases have been examined in reference to the distribution of ABO blood-groups, in order to calculate the relative risk of disease and the hemogroupal distributive significance in our samples as related to those of other authors, using combined calculation. The analysis concerned the following cases: 746 with arterial hypertension, 3258 with congenital heart disease, 4503 with articular rheumatism, 1047 with acquired valvulopathia, and respective controls. It was found that blood-group phenotypes represent an important biophysiopathological action in regard to articular rheumatism and its cardiac consequences, in myocardial infarction and in hypertension, males only. On the contrary, no action in regard to congenital heart disease was found, with the exception of some single anomalies which have yet to be confirmed. This hemogroupal action greatly exceeds the one limited to the immunitary analogy and is a noticeable part of family heredity. It shows itself in: -- a significant negative association with group O and positive association with group A in the myocardial infarction; -- a significant negative association with group O and positive for the others in the valvulopathic (rheumatic) diseases; -- a positive association with A phenotype and negative with B in arterial hypertension, males only; -- no association with ABO blood-groups and congenital heart disease.
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PMID:[ABO blood-group phenotypes and pathogenesis of cardiovascular diseases. Congenital, rheumatic and coronaric heart disease and arterial hypertension (author's transl)]. 120 47

Among the measures of medical rehabilitation of patients who survived cardiovascular surgical procedures an important place belongs to the problems of physical readaptation. Its degree is determined by exercise tests, among which veloergometry has gained wide recognition. The methods of bicycle tests are discussed with reference to this category of patients. A study of the exercise tolerance and of the nature of the response conducted according to several cardiovascular functional indices in patients following closed mitral commissurotomy and surgical correction of non-cyanotic congenital heart diseases indicated that a certain discrepancy exists between the commonly accepted evaluation of the results of surgery and the degree of physical readaptation. The latter depends on several factors: the duration of the history of the disease, relapse of rheumatism, pulmonary hypertension, atrial fibrillation. In order to evaluate the effect of physical training on the degree of readaptation a comparative study is necessary between the rehabilitation group and a "control" group. In patients operated for symptomatic hypertension (renovascular, adrenal, coarctation of the aorta) the assessment of the results of surgery should not be limited by the determination of the decrease or normalization of the arterial pressure alone, but should be supplemented by a general clinical evaluation of the state of the patients. Rational hypotensive therapy significantly improves the results of surgery. The exercise tests permit to establish the functional reserves of the patients, to properly determine the tactics of their treatment and their occupational prognosis.
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PMID:[Medical rehabilitation of patients having undergone cardiovascular operations]. 123 May 21

Cross-sectional and prospective data were collected and analyzed to identify risk factors for the development of peptic ulcer disease in a population of 34,198 white, non-Hispanic Seventh-Day Adventists. On a life-style questionnaire administered in 1976, 3853 subjects reported ever having had a physician-diagnosed peptic ulcer for a lifetime prevalence of 13.5% for men and 11.0% for women. Odds ratios of greater than 2.0 (P less than 0.0001) were observed for use of "stronger pain relievers," current cigarette smoking, and history of rheumatism or other arthritis and coronary disease. For both sexes, lower but statistically significant odds ratios (P less than 0.05) were found for eating white bread, "snacking," ever having smoked cigarettes, low church involvement, poor dietary adherence, high blood pressure, rheumatoid arthritis, aspirin use, job frustration and dissatisfaction, having a "blue collar household," and having less education. During 3 years of follow-up, 154 incident cases of ulcer were identified. The average annual incidence was 1.7 per 1000. Multivariate adjusted relative risks were statistically significant for using stronger pain relievers (P less than 0.001), having rheumatic conditions (P = 0.006), and using aspirin (P = 0.013). These findings suggest that rheumatic disease and use of aspirin and stronger pain relievers are more important risk factors for development of peptic ulcer disease in certain populations than diet, life-style, or psychological or socioeconomic characteristics.
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PMID:A prospective study of risk for peptic ulcer disease in Seventh-Day Adventists. 153

Systemic lupus erythematosus (SLE) is a collagen vascular disease that may have a tremendous impact on pregnancy. The pregnant patient with SLE is at increased risk for fetal wastage, intrauterine growth retardation (IUGR), intrauterine fetal demise (IUFD), pregnancy-induced hypertension (PIH), and exacerbations of the lupus process. SLE is an autoimmune disease with tremendous implications for pregnancy. The diagnosis of SLE is based on criteria developed by The American Rheumatism Association. The recent identification of circulating antibodies associated with women who have lupus has led to some confusion. The circulating antibodies are associated with an increased risk of fetal wastage. However, those antibodies have been documented in women who do not have lupus. The diagnosis of SLE and pregnancy requires intensive obstetrical care. SLE may also affect the neonate, from skin lesions to complete heart block. This article describes the effects of SLE on the mother, pregnancy, and the neonate.
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PMID:Systemic lupus erythematosus: obstetric and neonatal implications. 220 68

The prevalence of reported chronic diseases was studied in quintiles of waist/hip ratio and Quetelet index in 11,825 women aged 40-73 presenting for mammographic screening in the DOM-project. After adjustment for age and Quetelet index, increased waist/hip ratio was found to be associated with an increased prevalence of diabetes mellitus, hypertension, cholecystectomy and a lower prevalence of varicose veins. No associations were observed between waist/hip ratio and the prevalence of angina pectoris, gout and rheumatism. The odds ratios, adjusted for age and Quetelet index, of the highest versus the lowest quintile of waist/hip ratio were 3.4 (95% CI 1.4-8.3) for diabetes mellitus; 2.2 (95% CI 1.7-2.8) for hypertension; 2.0 (95% CI 1.2-3.4) for cholecystectomy, and 0.81 (95% CI 0.68-0.95) for varicose veins. After adjustment for waist/hip ratio and age, Quetelet index was found to be associated with an increased prevalence of hypertension, cholecystectomy and varicose veins. Quetelet index, however, was not found to be related to diabetes, gout or rheumatism. We conclude that in a representative sample of Dutch women older than 40 years, fat distribution in addition to overweight is related to important chronic diseases.
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PMID:The relationship between fat distribution and some chronic diseases in 11,825 women participating in the DOM-project. 226 49

Federal recognition of the tribal status of the Klamath Indians of Oregon was terminated by Congress in 1954, along with all health, education, and welfare services. In the winter and spring of 1985 a health status and health care needs assessment was conducted among 202 Klamath Indians ages 40 years and older with the use of a shortened version of the Older Americans Resources and Services (OARS) instrument. Twenty percent of the Klamaths surveyed reported having diabetes, and more than 30 percent reported having arthritis, rheumatism, or hypertension, or having had their gallbladder removed. The data were compared with those of national surveys of Indian and non-Indian elders that also used the OARS instrument. Even though the Klamaths surveyed were younger than the comparison groups, their health status was no better than that of other Indians and was worse than that of the non-Indian population. Moreover, among these Klamath adults, health insurance coverage was lower, and perceived unmet needs for medical care were higher than in either of the comparison groups.
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PMID:A health survey of Klamath Indian elders 30 years after the loss of tribal status. 312 33

History of diagnosed illnesses, medical symptoms, and reproductive outcomes and their relation to combat intensity and herbicide exposure were studied, via a mailed questionnaire, among 6810 American Legionnaires who served during the Vietnam War (42% in Southeast Asia, 58% elsewhere). Heart disease, venereal disease, and benign fatty tumors were reported significantly more often by Vietnam veterans than by controls. Combat intensity was significantly dosage-related to history of high blood pressure, ulcers, arthritis and rheumatism, genito-urinary problems, nervous system disease, major injury, hepatitis, and benign fatty tumors. Agent Orange exposure was significantly dosage-related to history of benign fatty tumors, adult acne, skin rash with blisters, and increased sensitivity of eyes to light. Rates of the latter two conditions and of change in skin color were especially elevated in men whose military occupations involved direct handling of herbicides. Five "symptom complex" scales were constructed via factor analysis to measure degrees of feeling faint, fatigue or physical depression, body aches, colds, and skin irritation. Means of all five scales were significantly higher in Vietnam veterans compared to controls, and in herbicide handlers compared to nonhandlers. Both combat and Agent Orange exposure were significant, independent predictors of each of the five scales. Neither combat nor Agent Orange exposure was associated with difficulty in conception, time to conception of first child, or to birthweight or sex ratio of offspring, but maternal smoking was strongly related to reduced birthweight. The percentage of spouses' pregnancies which resulted in miscarriages was significantly higher for Vietnam veterans than controls (7.6% vs 5.5%, P less than 0.001). Logistic regression analysis showed that Agent Orange exposure and maternal smoking were both independently and significantly associated with miscarriage rates in a dose-related manner.
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PMID:Health and reproductive outcomes among American Legionnaires in relation to combat and herbicide exposure in Vietnam. 326 69

In the free-living population, approximately 30% of men and 53% of women over the age of 55 years have peripheral joint complaint. Neck and low back complaints occur in 25% of men and 40% of women in the corresponding age group. One third of free-living elderly people suffer from rheumatism. About 25% have shortness of breath, and another 25% have hypertension. Diabetes ranks seventh among self-reported diseases. Approximately 40% of elderly people report a poor health condition, 20-50% cannot perform all activities of daily life, and about 30% are physically handicapped. An examination of problems seen by general practitioners reveals that overweight ranks first (prevalence, 20% of visits per year), osteoarthritis second (19% of visits per year), and hypertension third (17.5% of visits per year); diabetes, however, ranks thirteenth among problems seen during annual visits to the general practitioner. Only 20-50% of people suffering from osteoarthritis or entesopathies soft-tissue rheumatisms visit their general practitioners, while three quarter do so in the case of rheumatoid arthritis. For people older than 55 years of age, 40-60% of men, and 55-82% of women use drugs daily. Analgesics and antirheumatic drugs are used daily by 15% of women and 5% of men over 55 years old. In view of our aging population, it can be anticipated that soon after the year 2000, the percentage of elderly people will be doubled in most European countries reaching 25% of the total population, while 40% will be older than 55 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidemiologic considerations of the geriatric population. 326 92

Between April 1983 and November 1985, 14 patients have undergone a heart transplant, or 10 men and 4 women, aged from 17 to 55 years. The surgical indication was a cardiomyopathy in terminal evolutive phase, of which the etiology was ischemia in 8 cases, congestion in 5 cases and rheumatism in one case. There was one operative death (7.1%) from acute rejection and a late death secondary to chronic rejection. The actuarial rate of survival at one and 2 years was 81.9%. Post-operative complications, most frequent at an early stage, were arterial hypertension (9 cases), rejection (8 cases) and renal insufficiency (6 cases). During an average post-operative evolution of 13 months, 17 rejection episodes occurred in 10 patients (71.4%) and 5 patients (35.7%) presented with 7 infectious episodes, one of them severe. Cyclosporin's toxicity appeared in the immediate post-operative period by an always reversible increase of the bilirubin and creatinin levels. On a long term, all patients present with arterial hypertension, accompanied by a moderate renal insufficiency (creatinin between 2.2 and 2.4 mg%). Among the survivors, 9 patients (75%) remain completely asymptomatic and have resumed normal physical activities. Cardiac transplantation has therefore become a valid therapeutic alternative, able to greatly improve survival and the functional condition of patients with terminal cardiomyopathy.
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PMID:[The surgical alternative in the treatment of terminal cardiomyopathies: cardiac transplantation]. 353 17


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