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

The proposition that lifestyle is a major determinant of community health is explored by contrasting the features of a rural subsistence community in the highlands of Papua New Guinea and the features of the community in urbanized, industrialized Australia. Reference is made to differences in physical environment, housing, work, social situation, human relationships, patterns of disease, population statistics, diet, growth, obesity, physical fitness, blood lipid concentrations, blood pressure, salt intake and the occurrence of hypertension, diabetes, cardiovascular disease and signs of degenerative changes in various tissues. The Papua New Guinea community is seen as a self-reliant, self-contained, socially cohesive subsistence society whose members are well adapted to their physical and social environment, free from major degenerative cardiovascular diseases, with little overt psychiatric illness, but with a heavy burden of infectious disease, with marginal nutritional levels of degenerative disease and disease from psychological stress. It is clear that health, in its fullest sense, is not the prerogative of any one type of society.
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PMID:Lifestyle, health and disease: a comparison between Papua New Guinea and Australia. 73 10

Blood pressure measurements were recorded in 522 adults and 141 10-19 year-old full and part blood Aborigines in five communities. The means for systolic and diastolic blood pressures at 40 years were close to those reported for Europeans, although below this age, values tended to be lower, and above 40 years tended to be higher than those reported in the Tecumseh study. Hypertension, as defined by the Princeton criteria, was present in 29%, more often in the men (1-6 to 1-0), and eight subjects satisfied the criteria for hypertensive heart disease (HHD). 522 electrocardiograms were recorded on adult subjects at five Aboriginal communities and classified according to categories of the Minnesota code. Of the 210 abnormalities observed, minor T wave inversions and minor S-T segment depression were the most commonly encountered, and were more frequent in female subjects. Q wave changes typical of myocardial infarction was found in 5% of the tracings and occurred mainly in older men. If hypertension and certain ECG codes are assumed to be "risk factors" for the development of clinical ischaemic heart disease (IHD), the urbanized Aboriginal had a higher prevalence compared with Caucasian subjects of the Busselton study. "Probable" and "suspect" ECG changes of IHD, although mainly in the older subjects, were found to be associated with hyperglycaemia, as recognised in Western society. It is postulated that urbanized Aborigines are prone to cardiovascular degenerative disease to a similar or possibly larger extent than Caucasians.
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PMID:Blood pressures and electrocardiographic findings in the South Australian Aborigines. 106 18

The cardiac changes resulting from mechanical overload of the left ventricle have been well documented and a variety of compensatory mechanisms described. These include a decrease in maximum velocity (V0) of shortening in the absence of reduction in active tension (P0), and a reversible decrease in myofibrillar adenosine triphosphatase activity resulting from isoenzymic shift from, predominantly, a form of myosin with high ATPase activity (V1) to another with low (V3). The thermodynamic advantage of the transition is the hypertrophied muscle possesses a more energy-efficient form of contraction. These reversible transitions resulted from altered gene expression of isoenzymic forms of myosin heavy chain. It must be borne in mind that the adaptational modifications just described appear to occur only in smaller animals such as the rat, that possesses several myosin isozymes. In large mammals it is mainly the V3 form of myosin that is present, which does not change with altered contractile state. Responses of the large arteries to hypertension have been poorly studied. This is surprising when one recalls that degenerative disease of such vessels, that include the aorta, carotids and ileo-femoral arteries is almost an obligatory concomitant of hypertension. Such studies as have been carried out indicate that hyperplasia is specific for abdominal aortic stenosis while hypertrophy is found in aortic smooth muscle in rats with systemic hypertension. Mechanically, an increase in V0 with no change in P0 have been reported; an increase in myofibrillar ATPase activity was also reported. Though two myosin heavy chain isozymes have been found in aortic smooth muscle densitometry did not reveal any difference in distribution between tissues from control and hypertensive rats.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cardiovascular adaptations to mechanical overload. 213 92

Graft inclusion and vessel reattachment to openings made in the graft were employed in the treatment of 605 patients with thoracoabdominal aortic aneurysms. These patients were divided into four groups on the basis of the extent of aneurysm. Group I consisted of those patients with involvement of most of the descending thoracic and upper abdominal aorta; group II involved most of the descending thoracic aorta and most or all of the abdominal aorta; group III involved the distal descending thoracic aorta and varying segments of abdominal aorta; and group IV involved most or all of the abdominal aorta including the segment from which the visceral vessels arose. The cause of aneurysm formation was medial degenerative disease in 80%, and dissection in 17%; other causes were responsible in the remaining 3%. The median age was 65 years and associated diseases including aneurysms involving other segments, atherosclerotic occlusive disease, heart disease, chronic obstructive pulmonary disease (COPD), hypertension, and renal insufficiency were frequent. The aneurysm was symptomatic in 70% of cases and rupture had occurred in 4% of cases. There were 54 (8.9%) early (30-day) deaths and 151 late deaths; 400 (66%) patients were still alive 3 months to 20 years after operation, including 60% at 5 years. Statistically significant pre- and intraoperative variables by univariate analysis that were predictive of increased risk of early death were advancing age, associated diseases that included COPD, renal artery occlusive disease, atherosclerotic heart disease, renal insufficiency, and long aortic clamp time. Three of these (age, clamp time, and the presence of COPD) retained significance by multivariate analysis. Variables predictive of risk of late death were age, dissection, extent of aneurysm, rupture, heart disease, cerebrovascular disease, COPD, hypertension, and poor renal function. Age, rupture, renal dysfunction, extent of aneurysm, and dissection retained their significance by multivariate analysis. Variables predictive of neurologic disturbances of the lower extremities included rupture, reattachment of intercostal and lumbar arteries, clamp time, dissection, extent and age. Rupture, reattachment of vessels, dissection, and extent of aneurysm retained significance by multivariate analysis. Thus, the risk of this complication was greatest in patients with extensive lesions (group II) with aortic dissection. The greatest risk of renal failure after operation that required dialysis was in patients who had impaired renal function before operation. Methods employed did not prevent these complications.
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PMID:Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. 395 Oct 25

Many of the Nation's approximately 100 million workers are exposed to some kind of occupational health hazard: carcinogenic agents, pulmonary or other physical disease incitant, physical agents or job-related pressures of noise, crowding, or stress. Exposure to toxic chemicals or physical hazards can produce chronic lung disease, cancer, degenerative disease in a number of vital organ systems, birth defects, and genetic changes. These exposures are estimated to result in 100,000 Americans dying each year from occupationally related illnesses, with an additional 400,000 cases of occupationally related disease. Yet many workers are inadequately protected from common hazards. Recent experience has demonstrated that occupational hazards can be controlled by modifying the work environment, patterns of job performance, or both. Among the health protection measures available are those which: alter the work environment to prevent exposures and injuries; provide workers with special protective equipment; specify design and maintenance of equipment; and provide employees with proper training. Some companies have ventured into the health promotion arena and offered their employees worksite programs for promoting health through health education, physical fitness activities, stress reduction activities, and preventive medicine including screening for high blood pressure, high cholesterol, and other factors related to heart disease.
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PMID:Health protection: Occupational safety and health. 641 22

Geographic, retrospective, and prospective epidemiologic studies have revealed evidence that the environment in utero is a major determinant of later degenerative disease. Observations from Britain, Sweden, Jamaica, Australia, India, and China support the hypothesis that disproportionate retardation of fetal growth results in increased blood pressure and increased risk of cardiovascular mortality. On the basis of what has been a limited pool of observations linking maternal undernutrition and fetal growth retardation, it has been proposed that hypertension and coronary heart disease are "programmed" by nutrition status.
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PMID:Intrauterine programming of hypertension: nutrient-hormone interactions. 881 Aug 22

Experimental investigations in animals have highlighted the role of early reduced calorie and protein nutrition on fetal cardiovascular development, and the occurrence of a transition from a low fetal arterial blood pressure in late gestation to a high arterial blood pressure postnatally. These observations may explain the correlation between health, including appropriate nutrition, in pregnant women and the outcome of their pregnancies. Emphasis has been placed on low birth weight infants who have an increased risk of developing cardiovascular diseases, including hypertension, coronary heart disease and stroke in adulthood. Vascular pathology in adults is not always associated with low birth weight and animal experiments indicate that substantial changes in cardiovascular and endocrine function can result from maternal or fetal undernutrition without impairing fetal growth. Experimental investigation on organogenesis shows the pivotal role of adequate protein availability as well as total caloric intake. Amino acid metabolism in the feto-maternal unit appears to have a key influence on the development of organs involved in chronic degenerative disease in the adult. Experimental investigation has also highlighted the role of carbohydrate metabolism and its effect on the fetus in this respect. Either restriction of protein intake or diabetes in pregnant rats has intergenerational effects at least on the endocrine pancreas and the brain. Further investigation is needed to clarify the mechanisms involved and lead to a new understanding of the importance of nutrition during pregnancy. This will provide an important approach to the primary prevention of diabetes and chronic degenerative diseases.
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PMID:Intrauterine nutrition: its importance during critical periods for cardiovascular and endocrine development. 988 34

Chronic subdural haematomas are mainly related to slight or moderate head trauma with consecutive lesion of bridge or cortical veins and bleeding in the subdural space. Further predisposing factors are known impairment of coagulation (coagulopathies, treatment with anticoagulants, alcohol abuse), risk factors for degenerative disease of the arteries (diabetes mellitus, arterial hypertension), and development of pressure gradients (hydrocephalus, epileptic seizures, lumbar puncture, CSF drainage and cerebral atrophy). Chronic subdural haematomas appear bilaterally in 20 to 25% of cases. We report on a 69-year-old male with a 4-day history of intermittent, proximal, painless paraparesis (BMA grade M2-5) without a trigger event. Sensibility was normal in all qualities and vigilance was not disturbed. Computed tomography of the neurocranium revealed a bitemporally located chronic subdural haematoma with extension to parietal on both sides. Trepanation was performed over the tuber parietale and temporoparietally on both sides, with release of 150 ml fluid. The neurologic deficits regressed totally within 12 hours postoperatively. To the best of our knowledge, we are the first to describe the clinical paradox of intermittent, painless paraparesis with preserved sensibility and without disturbances of vigilance, as manifestation of a chronic subdural haematoma possibly leading to impairment of cerebral blood flow in the area of the middle cerebral artery. Small changes in systemic blood pressure lead to changes in cerebral perfusion pressure due to vessel compression by the haematoma, thus explaining the intermittent character of the clinical presentation.
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PMID:[Intermittent paraparesis as manifestation of a bilateral chronic subdural hematoma]. 1046 9

There is growing evidence that inflammatory processes may be involved in the development of atherosclerosis and its complications. Viral and bacterial pathogens have been implicated as possible causative factors in the pathogenesis of coronary artery disease (CAD) and restenosis after angioplasty. Antibiotic trials are now in progress to examine whether treatment of infection can prevent the complications of CAD. Atherosclerosis, the primary pathologic process in coronary artery disease (CAD), carotid artery disease, abdominal aortic aneurysm, and peripheral vascular disease, is no longer considered to be an obscure, slowly progressive, degenerative disease. Indeed, recent molecular studies on the atherosclerotic plaque have shown that the initiation, progression, and acute sequelae of atherosclerosis can be explained in part by a low-grade inflammatory process. Studies show that mediators of inflammation can be found at all stages of the life cycle of the atherosclerotic plaque. These include activated macrophages and lymphocytes, cytokines, growth factors, matrix degenerating proteinases, and tissue factor. It is hypothesized that risk factors such as hypertension, smoking, or elevated levels of low-density lipoprotein (LDL) cholesterol result in injury to the endothelial cell of the artery, and this injury initiates the inflammatory process. However, many patients with vascular disease do not have these established risk factors, and this observation has galvanized efforts to find new risk factors. Because inflammation is now considered to be an operative paradigm for atherosclerosis, it is not a major leap to the hypothesis that infectious agents, such as viral or bacterial, may play a role. Certainly this is not a new concept, and with the recent discovery that peptic ulcer disease, heretofore considered a disease of excess acid and reduced mucosal resistance, is caused by the ubiquitous bacterium Helicobacter pylori, interest in finding an infectious etiology for atherosclerosis has increased. Accordingly, the purpose of this discussion is to review in a historical manner the evidence that infectious agents-including herpes simplex virus (HSV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), Enterovirus (adenovirus, Coxsackie virus), Chlamydia pneumoniae, and H. pylori-may play a role in atherosclerosis and its manifestations, especially as they relate to CAD.
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PMID:The role of infection in atherosclerosis and coronary artery disease: a new therapeutic target. 1172 77

Obesity is a chronic condition associated with a reduction in the quality of life and a high risk for disease and death and requiring long-term care. In Germany, 51.4% of the population is overweight, with 9 million suffering from obesity and its consequences, such as hypertension, diabetes and sleep apnea. In addition, the number of patients undergoing treatment for painful chronic-degenerative disease of the joints is on the increase. After first exhausting all conservative therapeutic options, effective surgical measures can bring about a lasting overweight reduction of up to 50%. By this means, both pain and adverse consequences of obesity can be improved.
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PMID:[Surgical treatment of obesity and its side effects is effective]. 1673 84


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