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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors study 11 cases of myocardial infarction, hospitalized in the Cardiology Department of the University Hospital Ignace Deen in Conakry, between 1981 and 1987 inclusively, in a total of 842 patients. The series includes 9 men and 2 women, with ages varying from 40 to 63 years, mean 52.4 years. From this study, it results that the frequency of myocardial infarction reaches 1.28 p. cent. From the epidemiological standpoint, the patients belong to relatively well-to-do socio-economic strata. The coronary disease in these areas is original in that it is infrequent. However, the risks factors are the same as elsewhere: hypercholesterolemia: 8 in 11 cases, obesity: 7 in 11 cases; and tobacco abuse: 5 in 11 cases.
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PMID:[Myocardial infarction in Conakry. Apropos of 11 cases with 4 coronarographies]. 319 Jan 45

Infarction in the adult aged less than 35 is almost always accompanied by risk factors, the most common of which are tobacco abuse, lipid disturbances, obesity, a strong family history of cardiovascular disease and, in the woman, the use of contraceptives. The coronary arteries are sometimes normal (10-15 p. cent) but coronary lesions are most often single vessel, proximal and affect the anterior interventricular branch. Actual coronary thrombosis probably plays a more important role than in the older adult. Ventricular function is often markedly impaired. The infarct is most often anterior, transmural and large in size, with ventricular arrhythmias more frequent and a higher risk of sudden death. Post-hospital complications are the same as in the older adult, with possibly less good results of aorto-coronary venous bypasses. Long term mortality depends directly upon the number of vessels affected, but is markedly better than in the older adult.
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PMID:[Myocardial infarction in the adult under 35 years of age]. 630 67

Counseling patients to change unhealthy behaviors: Part I in a 3-part series. Part II details interventions for tobacco abuse and Part III covers obesity prevention and treatment.
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PMID:Putting prevention into practice: counseling patients about behavior change, part I. 1592 50

Coronary artery disease (CAD) and erectile dysfunction (ED) are both highly prevalent conditions that frequently coexist. Additionally, they share mutual vascular risk factors, suggesting that they are both manifestations of systemic vascular disease. The role of endothelial dysfunction in CAD is well established. Normal erectile function is primarily a vascular event that relies heavily on endothelially derived, nitric oxide-induced vasodilation. Accordingly, endothelial dysfunction appears to be a common pathological etiology and mechanism of disease progression between CAD and ED. The risk factors of diabetes mellitus, hypertension, hyperlipidemia, obesity and tobacco abuse contribute to endothelial dysfunction. This article reviews the role of vascular endothelium in health, the abnormalities resulting from vascular risk factors, and clinical trials evaluating the role of endothelial dysfunction in ED.
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PMID:Linking erectile dysfunction and coronary artery disease. 1639 38

The prevalence of hypogonadism has been found to be increased in certain chronic illnesses, especially diabetes, hypertension and obesity. Recently, the prevalence of hypogonadism in primary care practices mirrored that in our population of men with erectile dysfunction (ED). In this study, the prevalence of hypogonadism in nearly 1000 men with ED was tabulated, using a retrospective chart review, and analyzed for association with the various contributing medical and psychological factors. The prevalence of hypogonadism was determined in men with a variety of chronic illnesses, and was further characterized by decade. We observed an association between hypertension (P=0.025), tobacco abuse (P=0.0059), sleep apnea (P=0.0001), work stress (P=0.041) and hypogonadism. These data were further analyzed for the odds ratio and confidence interval (Forest plot), which showed strong association for sleep apnea and work stress. We did not observe any significant association between diabetes, atherosclerosis, alcohol abuse, multiple medications, asthma, seizure disorder, anxiety/depression and hypogonadism (P values for Cochran-Mantel-Haenszel general association were 0.48, 0.97, 0.25, 0.69, 0.22, 0.76 and 0.98, respectively). We suggest that a host of chronic illnesses have a high prevalence of secondary hypogonadism. Men who have chronic medical or psychological illnesses should have their testosterone level checked, especially when sexual dysfunction symptoms or signs are present.
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PMID:Hypogonadism in men with erectile dysfunction may be related to a host of chronic illnesses. 1979 59

The prevalence of cardiovascular disease in the United States is extensive and growing rapidly. Contributing factors include the aging population, tobacco abuse, obesity, and diabetes, all of which increase the prevalence of cardiovascular diseases. Treatment paradigms for cardiovascular disease have also been rapidly evolving; minimally invasive, catheter-based approaches are increasingly used as first-line therapy. Physicians from a variety of specialties have responded to this growing patient population and treatment paradigm shift by enhancing their training and expanding their practices to better care for these complex patients. This trend is a natural response of specialists to the evolving needs of their patients. In the vascular field, however, it has led to physicians acquiring skill sets that are new for that specialty and that go beyond the traditional boundaries of their practice, and which may overlap with skills classically practiced by other specialists. Surgeons are learning endovascular techniques previously performed by interventional radiologists; cardiologists are utilizing their knowledge about atherosclerosis and their catheter skills to manage noncardiac disease; neurologists and neurosurgeons are developing catheter-based techniques; and nephrologists are performing dialysis-access intervention. As a result, there is now much more overlap in the capabilities of-and services offered by-each specialty. Unhealthy and counterproductive competition among traditional disciplines has developed in the field of vascular care. This article describes the development of a multispecialty collaborative vascular center at a large urban academic medical center to demonstrate a new practice paradigm designed to improve quality of care for patients and enhance collaborative professional education and research.
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PMID:The Massachusetts General Hospital Vascular Center: emergence of a multidisciplinary program designed to improve quality outcomes for patients. 2087 68

The reality of regression of atherosclerotic plaques was established as long ago as 1987 by aggressive cholesterol reduction even before the era of statin therapy. Nevertheless, the most important aspect of patient benefit to prevent cardiovascular (CV) disease events is stabilization of these plaques so they will not rupture. Lowering of low-density lipoproteins is critical to this goal and can be considered the gold standard of preventive CV medicine. The major goal for the high-risk patient and the diabetic patient is lowering these harmful lipoproteins to less than 70 mg/dL. No discussion of CV disease prevention is complete without considering tobacco abuse and its elimination. Even secondhand smoke has been established as harmful. Control of hypertension is another major aspect of CV disease prevention, and a blood pressure less than 120/80 mm Hg is ideal. With obesity a major problem in the developed world, its role in the metabolic syndrome is of major significance as is the high prevalence of this so-called syndrome versus collection of specific risk factors in a population with poor health habits. Control of diabetes mellitus has established benefit from the standpoint of CV disease prevention except that some problems have been reported with extremely tight blood sugar control. Exercise was long considered good but now there are evidence-based reasons to recommend it as essential in CV disease prevention. There are many unforeseen frontiers in CV disease prevention but, for now, everything points to elevation of high-density lipoproteins as the next focus of this prevention.
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PMID:Atherosclerosis: current status of prevention and treatment. 2320 22

The relationship between sexually transmitted infections (STIs) and prostate cancer (PC) remains inconclusive. Moreover, all such studies to date have been conducted in Western populations. This study aimed to investigate the risk of PC following STI using a population-based matched-cohort design in Taiwan. The study cohort comprised 1055 patients with STIs, and 10 550 randomly selected subjects were used as a comparison cohort. Cox proportional hazards regression analysis revealed that the hazard ratio for PC during the 5-year follow-up period for patients with a STI was 1.95 (95% confidence interval 1.18-3.23), that of comparison subjects after adjusting for urbanization level, geographical region, monthly income, hypertension, diabetes, hyperlipidaemia, obesity, chronic prostatitis, history of vasectomy, tobacco use disorder, and alcohol abuse. We concluded that the risk of PC was higher for men who were diagnosed with a STI in an Asian population.
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PMID:Increased risk of prostate cancer following sexually transmitted infection in an Asian population. 2346 84

The author presents a surgical procedure for chest-wall soft tissue reconstruction due to large losses based on a modified thoracoabdominal myocutaneous flap. Designed in a bilobed shape, it rests on the superior epigastric vessels and may include the cranial one fourth of the rectus abdominis muscle and the premuscular fascia of external oblique muscle and constitutes one of the largest flaps based on a single minor artery. Local recurrent breast tumors and adjuvant therapy associated to obesity, high blood pressure, type II diabetes, and tobacco abuse on previously debilitated patients render the usual reconstructive procedure difficulties. These become indications for this flap, whose safety is improved by maintaining the deep fascia of the external oblique muscle attached to the flap to preserve the network of the arteries close to the fascia and a wide-ranging interarterial choke anastomosis alongside the lateral projection of the flap on the thorax. Thus, a wide range of angles allows us to reach even the opposite site of the thorax over the sterna area with an easy closure of the donor site facilitated by the vertical portion of the abdominal donor site. The flap was used in 55 patients, and no serious complications, including necrosis, notable dehiscence, hematoma, seroma, or abdominal wall weakness, were observed. The overall aspect is acceptable with the visible scars over the upper part of the abdomen.
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PMID:A bilobed thoracoabdominal myocutaneous flap for large thoracic defects. 2504 74

The majority of articles in this issue report on clinical conditions, adding to our knowledge base with which we practice family medicine. Topics range from childhood obesity to tobacco abuse treatment for patients with psychiatric disorders. We also have clinical papers on testing for group A streptococcus pharyngitis, incidentalomas identified in chest computed tomography exams, and a case of migraines associated with an ovarian teratoma. Others include long-term use of opioids (with information that could be surprising), and hand washing and face touching in the office. Enjoy the panoply of clinical information! We also have useful information on implementing medication reconciliation, 3 articles that relate to the integration of behavioral health into family medicine, and another 2 articles about recertification.
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PMID:A panoply of information for the practice of family medicine. 2480 5


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