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 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a 22-year followup of 3686 San Francisco longshoremen, the roles of physical activity, cigarette smoking habit, and systolic blood pressure level were evaluated independently in relation to risk of death from a broad range of diseases. Smoking pattern and blood pressure status were established in 1951 and job activity was assessed annually during the followup period. Lower levels of energy expenditure predicted increased risk of fatal heart attack and perhaps of stroke. Heavy cigarette smoking predicted increased risk of death from heart attack, cancer, chronic obstructive respiratory disease, and pneumonia. Higher levels of systolic blood pressure were associated with death from all cardiovascular diseases, diabetes mellitus, and cirrhosis. Tacit to these findings: sedentary living takes its toll largely through heart disease and stroke; the toxicity of cigarette smoking is associated with a broader range of diseases, including heart attack, cancer, and respiratory disease; and higher level of blood pressure related to an even broader range of cardiovascular disease than either of the other characteristics studied.
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PMID:Energy expenditure, cigarette smoking, and blood pressure level as related to death from specific diseases. 68 71

The outcome of untreated hypertension was investigated in a population of 17,713 persons in southern Taiwan who were aged 15 or over when they had taken part in a blood pressure survey in 1963. In the 27-year follow-up period, 55.8% of the overall mortality was comprised of those who were found to be hypertensive (as defined by WHO) in 1963, 31.3% by borderline hypertensives, and 22.6% by normotensives. The 27-year mortality rate due to stroke was much higher in hypertensives than in normotensives (11.4% vs 1.8%, respectively). The 5-year survival rates for mild, moderate and severe hypertensives were 89.9%, 82.7% and 72.3%, respectively, and the 20-year rates were 60.2%, 37.2% and 25.2%, respectively. The causes of death were also recorded: among hypertensives, stroke accounted for 23.2% of all deaths of known cause, cancer 20.5%, cardiovascular disease 21.7%, respiratory disease 11.8%, and other causes 22.9%. From the results, it is concluded that obvious differences in mortality and cause of death exist between untreated hypertensives and normotensives.
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PMID:Outcome among untreated hypertensives in the general population in Taiwan. 128 80

Many European countries experience a seasonal excess in deaths each winter compared to summer. The magnitude of the excess is greater in the United Kingdom than in many other European countries. Examination of the data for Northern Ireland indicates that myocardial infarction, respiratory disease and stroke exhibit the greatest increases during winter. Excess deaths from these conditions are closely associated with low environmental temperature.
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PMID:Deaths in winter in Northern Ireland: the role of low temperature. 234 44

Over a 6 years' period (1980-1986), 272 patients with chronic respiratory disease were admitted for respiratory failure to the same intensive care unit. The series was characterized by the high mean age of the patients (69.3 years) and by the high proportion of those who were ventilated (75%); 33.7% of the patients died within 1 month of discharge. The survival rate at 5 years estimated by the actuarial survival curve was 28%. Parameters measured during the acute decompensation phase were analyzed statistically. The main prognostic factors regarded as unfavourable were: old age and associated visceral failure particularly, important loss of weight and muscular atrophy, pre-existing neurological sequelae, left ventricular dysfunction, simplified Le Gall score above 15, presence of respiratory encephalopathy, stroke or viral infection as precipitating factors of decompensation, transfer from other hospital units after failure of medical treatment, and need for mechanical ventilation for more than 30 days.
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PMID:[Prognostic factors of decompensated chronic respiratory insufficiency. Apropos of a series of 272 cases]. 344 20

In the periods from July 1982 to June 1983 and July 1983 to June 1984, 31 strains of influenza virus, of which 19 A/H3N2 6 A/H1N1 and 6 type B, were isolated from 242 throat cultures obtained from patients with acute febrile respiratory disease. A seroepidemiological survey on 520 serum samples confirms significant activity of influenza viruses during the winterly period of 1983-1984. In the period July-August 1983 the evaluation of mortality from respiratory diseases presents an excess in respect of epidemic threshold probably ascribable to heat stroke.
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PMID:[Epidemiologic surveillance of influenza in Rome 1982-1984]. 382 65

Alpha 1-acid glycoprotein (AAG) concentrations and propranolol binding were investigated in the serum of elderly hospitalized patients with acute illness, and healthy elderly and young subjects. Significantly greater AAG concentrations and reduced unbound propranolol fraction were observed in the elderly with acute disease compared to the elderly controls. The greatest changes (up to five-fold) occurred with cancer, with lesser changes associated with myocardial infarction and ischaemic heart disease, acute infection, heart failure, chronic obstructive respiratory disease, and cerebrovascular accident. Various miscellaneous conditions were also associated with high AAG concentrations and enhanced propranolol binding. The healthy elderly had higher AAG concentrations and lower unbound propranolol fractions than the healthy young group. Overall there was a highly significant correlation between the propranolol binding ratio (bound/free) and the serum AAG concentration. These results suggest that the elderly population may be particularly susceptible to changes in AAG concentrations, and that during acute illness interpretation of serum concentrations of drugs which bind mainly to AAG, may require knowledge of their free fractions.
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PMID:Alpha 1-acid glycoprotein concentrations and propranolol binding in elderly patients with acute illness. 650 90

A three-year prospective study of 3,180 non-dementia persons in Sendai City, Japan was conducted to examine the effects of physical status and diseases diagnosed on dementia incidence. This cohort had been made at the initial survey in 1988 and the evaluation for incident dementia was performed on 2,461 respondents (77.4%) in a follow-up survey in 1991. Regarding physical status, the logistic regression including sex, age, health status, ambulatory activity and activities of daily living indicated that the poor health status and the limitation of ambulatory activity were significantly associated with an increased risk of dementia. The significant positive association with dementia was observed on stroke, respiratory disease and depression. This study identified the high risk population for dementia in the aspect of physical status.
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PMID:Physical status and dementia risk: a three-year prospective study in urban Japan. 762 40

The "Health Transition" describes the medical consequences which accompany the demographic transition and development. In many Asian countries, as the infectious diseases of infancy decline, such as diarrhea, acute respiratory disease, measles and malaria, so too, do infant mortality rates. As a consequence of falling infant mortality rates and declines in fertility, the age pyramid has become more rectangular. No longer is nearly half of the population under the age of 15 years. Diseases of adults are beginning to become predominant: trauma, heart disease, cancer, stroke and diabetes. Life expectancy has increased along with costs of the health care system. As a fraction of per capita gross domestic product, health care is beginning to become a major national expense. It is ironic that the one vector-borne infectious disease likely to bridge the health transition in tropical countries is dengue. As evidenced by the experience of Singapore and Taiwan, modern housing and commercial development provide more, rather than fewer breeding places for Aedes aegypti. Greater affluence often means less compliance with mosquito control programs. Meanwhile, the dengue viruses, heeding some unknown genetic imperative, cause ever more severe disease. Modern Asian societies must count dengue as a real and enduring threat. To prevent costly hospitalizations and a sense of social disorder, effective measures must be adopted to achieve a significant reduction of Aedes aegypti populations. Sustained dengue control requires source reduction which, in turn depends upon imaginative leadership, skilled man power, legislative authority, an authentic national research program and intersectoral cooperation. A leadership role beckons for new actors in the control of Aedes aegypti: large municipalities, environmental agencies and the private sector.
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PMID:Dengue in the health transition. 784 46

We conducted a retrospective analysis of 37 children with Escherichia coli O157:H7-associated hemolytic-uremic syndrome. The infection was traced to contaminated hamburgers at a fast-food restaurant chain. Within 5 days of the first confirmed case, the Washington State Department of Health identified the source and interrupted transmission of infection. Ninety-five percent of the children initially had severe hemorrhagic colitis. Nineteen patients (51%) had significant extrarenal abnormalities, including pancreatitis, colonic necrosis, glucose intolerance, coma, stroke, seizures, myocardial dysfunction, pericardial effusions, adult respiratory disease syndrome, and pleural effusions. Three deaths occurred, each in children with severe multisystem disease. At follow-up two children have significant impairment of renal function (glomerular filtration rate < 80 ml/min/per 1.73 Hm2); both of these children have a normal serum creatinine concentration. Hemolytic-uremic syndrome is the most common cause of acute renal failure in children, and this experience emphasizes the systemic nature of this disease. Clinicians should anticipate that multisystem involvement may occur in these patients, necessitating acute intervention or chronic follow-up. This outbreak of Hemolytic-uremic syndrome also highlights the microbiologic hazards of inadequately prepared food and emphasizes the importance of public health intervention in controlling Hemolytic-uremic syndrome.
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PMID:Escherichia coli O 157:H7-associated hemolytic-uremic syndrome after ingestion of contaminated hamburgers. 793 69

It has been known for many years that humans possess internal time clocks that regulate multiple physiologic factors (chronobiology). Epidemiologic studies have demonstrated that the peak incidence of many diseases, including respiratory disease (asthma, allergy), cardiovascular disease (hypotension, angina, myocardial infarction, stroke), as well as several others, tends to occur in a circadian pattern. In particular, studies utilizing ambulatory blood pressure monitoring have demonstrated that blood pressure has a very definite and reproducible circadian pattern over a 24-h period. Blood pressure is highest during the day; lowest during sleep, and then rapidly increases during the period 0400 h to 1200 h. Because recent data have demonstrated a possible cause-effect relationship between increases in blood pressure and angina, effective antihypertensive control in the early morning is desirable. Some once-a-day drugs taken in the morning may lose efficacy in the last few hours of the dosing interval, resulting in increases in blood pressure during the early morning period. In an attempt to ensure peak plasma levels during the early morning period, novel, controlled-onset, extended release-delivery systems have been developed. Studies using these delivery systems have demonstrated that, when dosed at night, these formulations provide maximal plasma levels during the period 0600 h to 1200 h, when blood pressure is physiologically rising at its greatest rate. The use of drugs designed to have peak efficacy at certain desirable times in the circadian pattern is referred to as chronotherapeutics.
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PMID:The circadian pattern of blood pressure: cardiovascular risk and therapeutic opportunities. 926 68


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