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Sample records for professionals abnormal heart

  1. DNA methylation abnormalities in congenital heart disease.

    Science.gov (United States)

    Serra-Juhé, Clara; Cuscó, Ivon; Homs, Aïda; Flores, Raquel; Torán, Núria; Pérez-Jurado, Luis A

    2015-01-01

    Congenital heart defects represent the most common malformation at birth, occurring also in ∼50% of individuals with Down syndrome. Congenital heart defects are thought to have multifactorial etiology, but the main causes are largely unknown. We have explored the global methylation profile of fetal heart DNA in comparison to blood DNA from control subjects: an absolute correlation with the type of tissue was detected. Pathway analysis revealed a significant enrichment of differential methylation at genes related to muscle contraction and cardiomyopathies in the developing heart DNA. We have also searched for abnormal methylation profiles on developing heart-tissue DNA of syndromic and non-syndromic congenital heart defects. On average, 3 regions with aberrant methylation were detected per sample and 18 regions were found differentially methylated between groups. Several epimutations were detected in candidate genes involved in growth regulation, apoptosis and folate pathway. A likely pathogenic hypermethylation of several intragenic sites at the MSX1 gene, involved in outflow tract morphogenesis, was found in a fetus with isolated heart malformation. In addition, hypermethylation of the GATA4 gene was present in fetuses with Down syndrome with or without congenital heart defects, as well as in fetuses with isolated heart malformations. Expression deregulation of the abnormally methylated genes was detected. Our data indicate that epigenetic alterations of relevant genes are present in developing heart DNA in fetuses with both isolated and syndromic heart malformations. These epimutations likely contribute to the pathogenesis of the malformation by cis-acting effects on gene expression.

  2. Heart rate monitors and abnormal heart rhythm detection.

    Science.gov (United States)

    Boudet, G; Chamoux, A

    2000-10-01

    We test the accuracy of two third generation heart rate monitors (HRM), Accurex Plus and Vantage NV and compare these data with those of an older monitor, PE 4000. Then we investigate responses of the HRM's to abnormal heart rhythms (HR). Accurex Plus and Vantage NV, and PE 4000 were tested in the laboratory under both stable and transient conditions. The Phantom 320 HR simulator gave 7 stable heart rates, each lasting 3 min. The responses of the HRM's to abnormal heart rhythms were tested with an automatic arrhythmia program lasting 17 min. The new HRM's, Accurex Plus and Vantage NV, were more accurate (89 to 94% and over 98% at +/-3 beats per min) in the stable state than the PE 4000. They all showed a smoothing effect in transient measurements, which was stronger in decelerating HR (1st case) than in accelerating HR (2nd case). - 1st case: Accurex Plus =Vantage NV >PE 4000 -2nd case: PE 4000 >Accurex =Vantage. Most isolated heart rhythm disorders (missing beat, pause 4 s, important bradycardia or tachycardia.

  3. Heart rate in professional musicians

    Directory of Open Access Journals (Sweden)

    García Daniel

    2008-07-01

    Full Text Available Abstract Background Very few studies have analysed heart rate (HR with regard to music playing, and the scarce evidence available is controversial. The purpose of this study was to analyse the HR response of professional musicians during their real-work activity. Methods Sixty-two voluntary professional musicians (20 women, 42 men, whose ages ranged between 15 and 71 years old, underwent the test while playing their instruments in real life scenarios, i.e. rehearsals, practice and public concerts. The musicians carried Sport Tester PE4000 (Polar®, Finland pulsometers to record their HR. In order to compare data from differently aged subjects we calculated their Maximum Theoretical Heart Rate (MTHR. Later on we found out the MTHR percentages (%MTHR corresponding to the registered HR of each subject in different situations. The value of the MTHR for every musician was obtained by means of the 220 – age (in years formula. Results Throughout the HR recordings, we have observed that musicians present a heightened HR while playing (in soloists, mean and maximum HR were 72% and 85%MTHR, respectively. Cardiac demand is significantly higher in concerts than in rehearsals while performing the same musical piece. The HR curves corresponding to the same musician playing in repeated concerts (with the same programme were similar. Conclusion The cardiac demand of a professional instrument player is higher than previously described, much greater than what would be expected from a supposedly sedentary activity.

  4. Heart rate in professional musicians.

    Science.gov (United States)

    Iñesta, Claudia; Terrados, Nicolás; García, Daniel; Pérez, José A

    2008-07-25

    Very few studies have analysed heart rate (HR) with regard to music playing, and the scarce evidence available is controversial. The purpose of this study was to analyse the HR response of professional musicians during their real-work activity. Sixty-two voluntary professional musicians (20 women, 42 men), whose ages ranged between 15 and 71 years old, underwent the test while playing their instruments in real life scenarios, i.e. rehearsals, practice and public concerts. The musicians carried Sport Tester PE4000 (Polar(R), Finland) pulsometers to record their HR.In order to compare data from differently aged subjects we calculated their Maximum Theoretical Heart Rate (MTHR). Later on we found out the MTHR percentages (%MTHR) corresponding to the registered HR of each subject in different situations. The value of the MTHR for every musician was obtained by means of the 220 - age (in years) formula. Throughout the HR recordings, we have observed that musicians present a heightened HR while playing (in soloists, mean and maximum HR were 72% and 85%MTHR, respectively). Cardiac demand is significantly higher in concerts than in rehearsals while performing the same musical piece. The HR curves corresponding to the same musician playing in repeated concerts (with the same programme) were similar. The cardiac demand of a professional instrument player is higher than previously described, much greater than what would be expected from a supposedly sedentary activity.

  5. Chromosomal abnormalities in patients with congenital heart disease.

    Science.gov (United States)

    Trevisan, Patrícia; Zen, Tatiana Diehl; Rosa, Rafael Fabiano Machado; Silva, Juliane Nascimento da; Koshiyama, Dayane Bohn; Paskulin, Giorgio Adriano; Zen, Paulo Ricardo Gazzola

    2013-12-01

    Chromosomal abnormalities (CAs) are an important cause of congenital heart disease (CHD). Determine the frequency, types and clinical characteristics of CAs identified in a sample of prospective and consecutive patients with CHD. Our sample consisted of patients with CHD evaluated during their first hospitalization in a cardiac intensive care unit of a pediatric referral hospital in Southern Brazil. All patients underwent clinical and cytogenetic assessment through high-resolution karyotype. CHDs were classified according to Botto et al. Chi-square, Fisher exact test and odds ratio were used in the statistical analysis (p defect. CAs detected through karyotyping are frequent in patients with CHD. Thus, professionals, especially those working in Pediatric Cardiology Services, must be aware of the implications that performing the karyotype can bring to the diagnosis, treatment and prognosis and for genetic counseling of patients and families.

  6. DNA methylation abnormalities in congenital heart disease

    OpenAIRE

    Serra-Juh?, Clara; Cusc?, Ivon; Homs, A?da; Flores, Raquel; Tor?n, N?ria; P?rez-Jurado, Luis A

    2015-01-01

    Congenital heart defects represent the most common malformation at birth, occurring also in ∼50% of individuals with Down syndrome. Congenital heart defects are thought to have multifactorial etiology, but the main causes are largely unknown. We have explored the global methylation profile of fetal heart DNA in comparison to blood DNA from control subjects: an absolute correlation with the type of tissue was detected. Pathway analysis revealed a significant enrichment of differential methylat...

  7. [Heart rhythm abnormalities in middle-aged veteran elite athletes].

    Science.gov (United States)

    Sharashdze, N S; Pagava, Z T; Saatashvili, G A; Agladze, R A

    2008-06-01

    Disrrhythmia is frequent finding in high competitive athletes. Majority of heart rhythm abnormalities in athletes, suggested being benign, however, prognostic value of it is not yet well established. Purpose of the present study was to investigate heart rhythm and relationship of heart rhythm abnormalities with LV mass in veteran elite athletes. 30 veteran elite athletes (16 soccer players and 14 water-polo players) aged 30-50 were studied. They formed main group. >10 years of active sports activity and >5 years after competitive sports cessation. All athletes were symptom free. Control group consists of 30 age - matched sedentary healthy individuals. In all study subjects ambulatory 24 hour ECG was recorded and, LV mass, dimensions and function by ultrasound-Doppler technique was evaluated. LV mass by Devereux formula was calculated and indexed to body surface area. Student's t-test for continuous variables, Descriptive statistics and Fisher's exact test for categorical variables were used. A P-value of conductivity abnormalities as well as complex arrhythmias were more frequent findings in athletes as compared with healthy sedentary subjects. Heart Rhythm abnormalities were associated with enhanced LV mass in Veteran athletes. Hence, veteran elite athletes may be at increased risk of life threatening arrhythmias. However, prognostic value of heart rhythm disturbances in veteran athletes has to be studied.

  8. Regional heart motion abnormality detection: an information theoretic approach.

    Science.gov (United States)

    Punithakumar, Kumaradevan; Ben Ayed, Ismail; Islam, Ali; Goela, Aashish; Ross, Ian G; Chong, Jaron; Li, Shuo

    2013-04-01

    Tracking regional heart motion and detecting the corresponding abnormalities play an essential role in the diagnosis of cardiovascular diseases. Based on functional images, which are subject to noise and segmentation/registration inaccuracies, regional heart motion analysis is acknowledged as a difficult problem and, therefore, incorporation of prior knowledge is desirable to enhance accuracy. Given noisy data and a nonlinear dynamic model to describe myocardial motion, an unscented Kalman smoother is proposed in this study to estimate the myocardial points. Due to the similarity between the statistical information of normal and abnormal heart motions, detecting and classifying abnormality is a challenging problem. We use the Shannon's differential entropy of the distributions of potential classifier features to detect and locate regional heart motion abnormality. A naive Bayes classifier algorithm is constructed from the Shannon's differential entropy of different features to automatically detect abnormal functional regions of the myocardium. Using 174 segmented short-axis magnetic resonance cines obtained from 58 subjects (21 normal and 37 abnormal), the proposed method is quantitatively evaluated by comparison with ground truth classifications by radiologists over 928 myocardial segments. The proposed method performed significantly better than other recent methods, and yielded an accuracy of 86.5% (base), 89.4% (mid-cavity) and 84.5% (apex). The overall classification accuracy was 87.1%. Furthermore, standard kappa statistic comparisons between the proposed method and visual wall motion scoring by radiologists showed that the proposed algorithm can yield a kappa measure of 0.73. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Genetic insights into normal and abnormal heart development.

    Science.gov (United States)

    Nemer, Mona

    2008-01-01

    Congenital heart defects (CHDs) affect 1-2% of newborn children and are the leading cause of death in infants under 1 year of age. CHDs represent the single largest class of birth defects and account for 25% of all human congenital abnormalities. Numerous epidemiologic studies have established the heritable nature of CHDs. However, despite the remarkable progress of the past decade, very few CHD-causing genes have been identified so far. Molecular and genetic analysis of heart development--which requires the execution of specific genetic programs--has led to the identification of essential cardiac regulators and mutations that are linked to human CHD. Elucidation of the mechanisms of action of these transcription factors has also provided a molecular framework that will continue to help furthering our understanding of the molecular basis of normal and abnormal heart growth. This review will summarize present knowledge of cardiac development and illustrate how analysis of heart development has helped understand the genetic basis of some CHDs and how these advances could translate into better prevention, diagnosis, and care of congenital heart disease.

  10. Hematologic Abnormalities in Cyanotic Congenital Heart Disease Patients

    Directory of Open Access Journals (Sweden)

    Soheila Chamanian

    2015-01-01

    Full Text Available Introduction: Patients with cyanotic heart disease may have an acceptable quality of life. However, they are invariably prone to several complications. The aim of this study is search about hematologic abnormalities in cyanotic congenital heart disease patients. Materials and Methods:  In this cross sectional study every cyanotic congenital heart disease patients who was referred to the adult congenital heart disease clinic was selected and asked of any possible hyperviscosity symptoms, gingival bleeding, Epistaxis, hemoptysis, hypermenorrhagia and gouty arthritis irrespective of their age, gender and primary diagnosis in a six-month period. In this regard, 02 saturation was obtained via pulse oximetry, an abdominal ultrasound was done in order to discover any gallstones and lab tests including CBC, coagulation parameters (bleeding time(BT,clotting time(CT, prothrombin time(PT,international ratio( INR, Ferritin, blood urea nitrogen (BUN and creatinine (Cr were provided as well. Results:  A total of 69 patients were enrolled in the present study. The mean age of the patients was 22.44±5.72 with a minimum of 15 and the maximum of 46 years old. Twenty two (34.4% of them were female and 45(65.6% were male. Conclusion: Our patients had less hyperuricemia, there is no correlation between hyperviscosity symptoms and haematocrit level and an inverse correlation between the Ferritin level and hyperviscosity symptoms were seen.  

  11. Regional heart motion abnormality detection via multiview fusion.

    Science.gov (United States)

    Punithakumar, Kumaradevan; Ben Ayed, Ismail; Islam, Ali; Goela, Aashish; Lil, Shuo

    2012-01-01

    This study investigates regional heart motion abnormality detection via multiview fusion in cine cardiac MR images. In contrast to previous methods which rely only on short-axis image sequences, the proposed approach exploits the information from several other long-axis image sequences, namely, 2-chamber, 3-chamber and 4-chamber MR images. Our analysis follows the standard issued by American Heart Association to identify 17 standardized left ventricular segments. The proposed method first computes an initial sequence of corresponding myocardial points using a nonrigid image registration algorithm within each sequence. Then, these points were mapped to 3D space and tracked using Unscented Kalman Filter (UKS). We propose a maximum likelihood based track-to-track fusion approach to combine UKS tracks from multiple image views. Finally, we use a Shannon's differential entropy of distributions of potential classifiers obtained from multiview fusion estimates, and a naive Bayes classifier algorithm to automatically detect abnormal functional regions of the myocardium. We proved the benefits of the proposed method by comparing the classification results with and without fusion over 480 regional myocardial segments obtained from 30 subjects. The evaluations in comparisons to the ground truth classifications by radiologists showed that the proposed fusion yielded an area-under-the-curve (AUC) of 95.9%, bringing a significant improvement of 3.8% in comparisons to previous methods that use only short-axis images.

  12. Evaluation of the Fetal Heart Rate during Amniocentesis in Fetuses with Normal and Abnormal Karyotype

    National Research Council Canada - National Science Library

    Marija Hadzi-Lega; Ana Daneva-Markova; Eva Sozovska

    2014-01-01

    Introduction. We monitored the fetal heart rate (FHR) during amniocentesis in fetuses at 16-22 weeks of gestation and investigated whether an abnormal FHR was associated with chromosomal abnormalities. Methods...

  13. Impaired isotonic contractility and structural abnormalities in the diaphragm of congestive heart failure rats.

    NARCIS (Netherlands)

    Hees, H.W.H. van; Heijden, H.F.M. van der; Hafmans, T.G.M.; Ennen, L.; Heunks, L.M.A.; Verheugt, F.W.A.; Dekhuijzen, P.N.R.

    2008-01-01

    BACKGROUND: Metabolic alterations and decreased isometric force generation have been demonstrated in different animal models for congestive heart failure (CHF). However, as few morphological examinations have been performed on the CHF diaphragm, it is unknown if structural abnormalities comprise a

  14. Lung Function Abnormalities in Smokers with Ischemic Heart Disease

    National Research Council Canada - National Science Library

    Franssen, Frits M E; Soriano, Joan B; Roche, Nicolas; Bloomfield, Paul H; Brusselle, Guy; Fabbri, Leonardo M; García-Rio, Francisco; Kearney, Mark T; Kwon, Namhee; Lundbäck, Bo; Rabe, Klaus F; Raillard, Alice; Muellerova, Hana; Cockcroft, John R

    2016-01-01

    .... To examine prebronchodilator and post-bronchodilator spirometry in outpatients aged greater than or equal to 40 years with clinically documented ischemic heart disease who were current or former smokers...

  15. Rate Of Abnormal Coagulation Test Results in Patients with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Mehmet Tayip Arslan

    2011-03-01

    Full Text Available Introduction: Coagluation abnormalities are expected in patients with congenital heart disease. We searched the rate of abnormal coagulation test in children with both cyanotic and non-cyanotic heart disease and investigated the clinical relevance of these abnormal tests. Material and Method: 49 children who have congenital heart disease and needed surgical intervention were prospectively enrolled to this study. Demographic data, primary diagnosis, bleeding complication during and after the intervention and prognosis of the patients were recorded. Platelet counts, prothrombin time, activated partial thromboplastine time and blood fibrinogen levels were measured prior to intervention. Results: 16 patients had prolonged PT, 13 patients had low fibrinogen level, 10 patients had prolonged aPTT and 5 patients had low platelet count. Conclusion: There was no increased complication risk in patients with abnormal test results, but caution must be taken during operation of these patients. [J Contemp Med 2011; 1(1.000: 6-10

  16. Radiation-Induced Heart Disease: Pathologic Abnormalities and Putative Mechanisms

    Directory of Open Access Journals (Sweden)

    Neil K Taunk

    2015-02-01

    Full Text Available Breast cancer is a common diagnosis in women. Breast radiation has become a critical in managing patients who receive breast conserving surgery, or have certain high-risk features after mastectomy. Most patients have an excellent prognosis, therefore understanding the late effects of radiation to the chest is important. Radiation induced heart disease (RIHD comprises a spectrum of cardiac pathology including myocardial fibrosis and cardiomyopathy, coronary artery disease, valvular disease, pericardial disease, and arrhythmias. Tissue fibrosis is a common mediator in RIHD. Multiple pathways converge with both acute and chronic cellular, molecular, and genetic changes to result in fibrosis. In this article, we review the pathophysiology of cardiac disease related to radiation therapy to the chest. Our understanding of these mechanisms has improved substantially, but much work remains to further refine radiation delivery techniques and develop therapeutics to battle late effects of radiation.

  17. The contribution of chromosomal abnormalities to congenital heart defects: a population-based study.

    Science.gov (United States)

    Hartman, Robert J; Rasmussen, Sonja A; Botto, Lorenzo D; Riehle-Colarusso, Tiffany; Martin, Christa L; Cragan, Janet D; Shin, Mikyong; Correa, Adolfo

    2011-12-01

    We aimed to assess the frequency of chromosomal abnormalities among infants with congenital heart defects (CHDs) in an analysis of population-based surveillance data. We reviewed data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth-defects surveillance system, to assess the frequency of chromosomal abnormalities among live-born infants and fetal deaths with CHDs delivered from January 1, 1994, to December 31, 2005. Among 4430 infants with CHDs, 547 (12.3%) had a chromosomal abnormality. CHDs most likely to be associated with a chromosomal abnormality were interrupted aortic arch (type B and not otherwise specified; 69.2%), atrioventricular septal defect (67.2%), and double-outlet right ventricle (33.3%). The most common chromosomal abnormalities observed were trisomy 21 (52.8%), trisomy 18 (12.8%), 22q11.2 deletion (12.2%), and trisomy 13 (5.7%). In conclusion, in our study, approximately 1 in 8 infants with a CHD had a chromosomal abnormality. Clinicians should have a low threshold at which to obtain testing for chromosomal abnormalities in infants with CHDs, especially those with certain types of CHDs. Use of new technologies that have become recently available (e.g., chromosomal microarray) may increase the identified contribution of chromosomal abnormalities even further.

  18. [Abnormal fetal heart rate patterns associated with different labour managements and intrauterine resuscitation techniques].

    Science.gov (United States)

    Verspyck, E; Sentilhes, L

    2008-02-01

    To determine labour management procedures associated with an increased risk of fetal heart rate anomalies and to assess the effectiveness of various intrauterine resuscitation techniques for fetal distress. The literature search was carried out systematically on Medline and Cochrane database between 1980 and June 2007 was performed. Early amniotomy and/or active management of labour reduce the duration of the first stage of labour without affecting the rate of caesarean section (level of evidence 1). Early amniotomy increases the frequency of severe variable fetal heart rate decelerations (level of evidence 1). High doses of oxytocin and decrease in the oxytocin-dosing interval for augmentation of labour both induce uterine hyperstimulation (level of evidence 1). Increased uterine activity is associated with a higher incidence of fetal heart rate abnormalities and neonatal acidosis (level of evidence 3). Fetal heart rate decelerations in supine position may disappear in the lateral position (level of evidence 3). In prophylactic maternal oxygenation administration abnormal cord blood pH values (less than 7.2) are more frequent in the oxygenation group than in the control group (level of evidence 2) and its efficacy in fetal distress is not evaluated until now. Amnioinfusion in the presence of thick meconium staining does not reduce the risk of perinatal death or meconium aspiration syndrome (level of evidence 1). Transcervical saline amnioinfusion might relieve variable decelerations during labour (level of evidence 3). Prophylactic amnioinfusion for intrapartum oligohydramnios reduces fetal heart rate abnormalities and overall rates of caesarean deliveries (level of evidence 2). Acute tocolysis may be helpful in cases of intrapartum fetal distress related to uterine hyperactivity (level of evidence 2). Early amniotomy and high doses of oxytocin may both increase the risk of fetal heart rate anomalies, but are both useful for avoiding prolonged labour. More

  19. Women with abnormal Pap smear result: a qualitative study of Swedish healthcare professionals' experiences.

    Science.gov (United States)

    Rask, M; Oscarsson, M; Lindell, G; Swahnberg, K

    2016-11-01

    A Papanicolaou (Pap) smear can be used to detect pre-cancerous cellular changes, so that they can be treated before they develop into cervical cancer. When the results of a Pap smear test are abnormal, women need further investigation, treatment and follow-up. Healthcare professionals (HCPs) are in a position to care for these women with abnormalities. The aim of this study was to explore the experiences of HCPs in caring for women with abnormal Pap smear results. In total, 20 HCPs from two counties in south-eastern Sweden participated in individual interviews, based on two open-ended questions. Interviews were recorded, transcribed verbatim and analysed using content analysis. The results showed that HCPs experienced that abnormal Pap smear results created anxiety in women, who often sought information from the Internet as a way to cope. Furthermore, the HCPs thought that it was a problem that women chose not to attend investigation, treatment and follow-ups. However, information about the seriousness of abnormal Pap smear results causes women to participate. It is a challenge for HCPs to inform in a reassuring manner. Finally, HCPs should collaborate with women to meet their information needs and to also provide support regarding finding and filtering reliable information on the Internet. © 2015 John Wiley & Sons Ltd.

  20. Hypoplastic left heart syndrome is associated with structural and vascular placental abnormalities and leptin dysregulation.

    Science.gov (United States)

    Jones, Helen N; Olbrych, Stephanie K; Smith, Kathleen L; Cnota, James F; Habli, Mounira; Ramos-Gonzales, Osniel; Owens, Kathryn J; Hinton, Andrea C; Polzin, William J; Muglia, Louis J; Hinton, Robert B

    2015-10-01

    Hypoplastic left heart syndrome (HLHS) is a severe cardiovascular malformation (CVM) associated with fetal growth abnormalities. Genetic and environmental factors have been identified that contribute to pathogenesis, but the role of the placenta is unknown. The purpose of this study was to systematically examine the placenta in HLHS with and without growth abnormalities. HLHS term singleton births were identified from a larger cohort when placenta tissue was available. Clinical data were collected from maternal and neonatal medical records, including anthropometrics and placental pathology reports. Placental tissues from cases and controls were analyzed to assess parenchymal morphology, vascular architecture and leptin signaling. HLHS cases (n = 16) and gestational age-matched controls (n = 18) were analyzed. Among cases, the average birth weight was 2993 g, including 31% that were small for gestational age. When compared with controls, gross pathology of HLHS cases demonstrated significantly reduced placental weight and increased fibrin deposition, while micropathology showed increased syncytial nuclear aggregates, decreased terminal villi, reduced vasculature and increased leptin expression in syncytiotrophoblast and endothelial cells. Placentas from pregnancies complicated by fetal HLHS are characterized by abnormal parenchymal morphology, suggesting immature structure may be due to vascular abnormalities. Increased leptin expression may indicate an attempt to compensate for these vascular abnormalities. Further investigation into the regulation of angiogenesis in the fetus and placenta may elucidate the causes of HLHS and associated growth abnormalities in some cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Abnormal Baroreflex Function is Dissociated from Central Angiotensin II Receptor Expression in Chronic Heart Failure

    OpenAIRE

    Fahim, Mohammad; Gao, Lie; Mousa, Tarek M.; Liu, Dongmei; Cornish, Kurtis G.; Zucker, Irving H.

    2012-01-01

    Neurohumoral disturbances characterize chronic heart failure (CHF) and are reflected, in part, as impairment of baroreflex sensitivity (BRS) and sympathetic function. However the mechanisms that trigger these neurohumoral abnormalities in CHF are not clear. We hypothesized that the BRS is blunted early in CHF and that the humoral effects occur later and contribute to progressive loss of cardiovascular control in CHF. We assessed the BRS (bpm/mmHg) and recorded renal sympathetic nerve activity...

  2. Professional and social activity of patients after heart transplant

    Directory of Open Access Journals (Sweden)

    Urszula Marcinkowska

    2015-08-01

    Full Text Available Objectives: The aim of the study is to describe both professional and social activities of patients after heart transplant. Material and Methods: Ninety-five heart transplant patients treated at the Silesian Center for Heart Diseases in Zabrze were surveyed, comprising 29 women (30.5% and 66 men (69.5%. The average age of respondents was 54.3 years old (standard deviation (SD = 15 years; the average period that had elapsed since the heart transplant was 7.1 years (SD = 4 years. We designed a questionnaire as a tool for collecting information from patients. Results: Twenty-five percent of patients worked at the time of completion of the questionnaire. Eighty percent of those patients were working before and after the transplant, 20% – only after transplantation (p < 0.05. A different job position at a new workplace had 47.8% of patients, 34.8% of them had the same job position at the same work place as they had had before, 63.4% of the heart transplant respondents were pensioners. Eighty-two percent of patients had a certificate with a designated degree of disability – among them: 69% had a certificate for a significant degree of disability, 22% – for a moderate degree of disability. Among those surveyed, 52.5% said that their financial situation had not changed whereas 34.5% of those surveyed reported a change for the worse. Thirty-seven percent of respondents reported changes in family relationships. Seventy-seven percent reported that they received help from family members, as compared with 19% who did not. Conclusions: Only 25.3% of the patients treated at the Silesian Centre for Heart Diseases after heart transplant are employed and it is one of the lowest employment rates in this category of patients in Europe. One third of working patients have the same work place as they had before their operation. Heart transplant is a cause of changes in family relationships. Most often family bonds are strengthened but sometimes family members

  3. Professional and social activity of patients after heart transplant.

    Science.gov (United States)

    Marcinkowska, Urszula; Kukowka, Karol; Gałeczka, Michał; Pudlo, Robert; Zakliczyński, Michał; Zembala, Marian

    2015-01-01

    The aim of the study is to describe both professional and social activities of patients after heart transplant. Ninety-five heart transplant patients treated at the Silesian Center for Heart Diseases in Zabrze were surveyed, comprising 29 women (30.5%) and 66 men (69.5%). The average age of respondents was 54.3 years old (standard deviation (SD) = 15 years); the average period that had elapsed since the heart transplant was 7.1 years (SD = 4 years). We designed a questionnaire as a tool for collecting information from patients. Twenty-five percent of patients worked at the time of completion of the questionnaire. Eighty percent of those patients were working before and after the transplant, 20%--only after transplantation (p < 0.05). A different job position at a new workplace had 47.8% of patients, 34.8% of them had the same job position at the same work place as they had had before, 63.4% of the heart transplant respondents were pensioners. Eighty-two percent of patients had a certificate with a designated degree of disability--among them: 69% had a certificate for a significant degree of disability, 22%--for a moderate degree of disability. Among those surveyed, 52.5% said that their financial situation had not changed whereas 34.5% of those surveyed reported a change for the worse. Thirty-seven percent of respondents reported changes in family relationships. Seventy-seven percent reported that they received help from family members, as compared with 19% who did not. Only 25.3% of the patients treated at the Silesian Centre for Heart Diseases after heart transplant are employed and it is one of the lowest employment rates in this category of patients in Europe. One third of working patients have the same work place as they had before their operation. Heart transplant is a cause of changes in family relationships. Most often family bonds are strengthened but sometimes family members become nervous, impatient and unwilling to talk about the transplant. This work

  4. The Relationship between Retinal Microvascular Abnormalities and Coronary Heart Disease: A Review

    Science.gov (United States)

    McClintic, Benjamin R.; McClintic, Jedediah I.; Bisognano, John D.; Block, Robert C.

    2010-01-01

    Heart disease remains the leading cause of death in the United States despite decades of advancement in its diagnosis and treatment. Due to the limitations of traditional risk stratification for heart disease, evaluation of the retinal vasculature has been proposed as an easily and safely measured adjunct to commonly used screening methods. In this article we provide a comprehensive review of the literature concerning the relationships between retinal microvascular abnormalities and coronary heart disease. We outline details of the most recent large epidemiological studies and discuss their potential implications for clinical practice. Finally, we propose a change to the current guidelines regarding the screening of “low risk” women, a group that is often failed by traditional evaluation algorithms. PMID:20362758

  5. Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part II: Acyanotic Congenital Heart Disease and Extracardiac Abnormalities.

    Science.gov (United States)

    Bhat, Venkatraman; Belaval, Vinay; Gadabanahalli, Karthik; Raj, Vimal; Shah, Sejal

    2016-06-01

    Acyanotic heart disease constitutes a significant majority of patient who may present with non-cardiac symptoms. Either they are detected incidentally or present with respiratory complaints. Equipped with knowledge of anatomy by echocardiography and radiographic methods described in previous part of this presentation, diagnosis may be confidently attempted. On plain radiography acyanotic congenital heart diseases have variable appearance depending upon severity of disease. Cardiac size, chamber enlargement and pulmonary vascular pattern are key elements. Typically left to right shunts with large volume flow are associated with pulmonary plethora. Plain radiography has an important role in detecting manifestation of pulmonary arterial hypertension. Severe stenosis of pulmonary valve is associated with pulmonary oligemia. Small intra-cardiac shunts and anomalies of coronary arteries generally present with normal cardiac size and pulmonary arterial pattern. Disease spectrum presented in this illustration demands thorough scrutiny of pulmonary, osseous and abdominal abnormalities. This section illustrates some commonly encountered spectrum of acyanotic cardiac disease.

  6. Heart Rate Variability Discriminates Competitive Levels in Professional Soccer Players.

    Science.gov (United States)

    Proietti, Riccardo; di Fronso, Selenia; Pereira, Lucas A; Bortoli, Laura; Robazza, Claudio; Nakamura, Fabio Y; Bertollo, Maurizio

    2017-06-01

    Heart rate variability (HRV) has been increasingly used to monitor team sports athletes. Besides the traditional time domain indices (i.e., the SD of successive RR intervals [SDNN] and the root mean square difference of successive normal RR intervals [RMSSD]), recently the use of the stress score (SS), which is an inverse function of the SD2 index derived from the Poincaré plot, and the sympathetic/parasympathetic ratio (S/PS) to monitor soccer players has been proposed. However, the reliability of these new indices and the ability of HRV to differentiate between soccer competitive levels are unknown. The aim of this study was to analyze the reliability of the different HRV-derived indices in professional soccer players during the competitive period and to compare HRV of professional soccer players from 3 teams of distinct competitive levels (i.e., Italian Second Division [2D], European League [EL], and Champions League [CL]). Fifty-four male professional soccer players from 3 different teams of 2 European countries (Italy and Germany) participated in the study. The intraclass correlation coefficient values of the HRV indices varied from 0.78 (very large) to 0.90 (near perfect). The coefficient of variation (CV) values for RMSSD and SDNN were all soccer players and is able to differentiate between international- and national-level players.

  7. Structural cerebral abnormalities and neurodevelopmental status in single ventricle congenital heart disease before Fontan procedure.

    Science.gov (United States)

    Knirsch, Walter; Mayer, Kristina Nadine; Scheer, Ianina; Tuura, Ruth; Schranz, Dietmar; Hahn, Andreas; Wetterling, Kristina; Beck, Ingrid; Latal, Beatrice; Reich, Bettina

    2017-04-01

    Neonates with single ventricle congenital heart disease are at risk for structural cerebral abnormalities. Little is known about the further evolution of cerebral abnormalities until Fontan procedure. Between August 2012 and July 2015, we conducted a prospective cross-sectional two centre study using cerebral magnetic resonance imaging (MRI) and neuro-developmental outcome assessed by the Bayley-III. Forty-seven children (31 male) were evaluated at a mean age of 25.9 ± 3.4 months with hypoplastic left heart syndrome (25) or other single ventricle (22). Cerebral MRI was abnormal in 17 patients (36.2%) including liquor space enlargements (10), small grey (9) and minimal white (5) matter injuries. Eight of 17 individuals had combined lesions. Median (range) cognitive composite score (CCS) (100, 65-120) and motor composite score (MCS) (97, 55-124) were comparable to the reference data, while language composite score (LCS) (97, 68-124) was significantly lower ( P  = 0.040). Liquor space enlargement was associated with poorer performance on all Bayley-III subscores (CCS: P  = 0.02; LCS: P  = 0.002; MCS: P  = 0.013). The number of re-operations [odds ratio (OR) 2.2, 95% confidence interval (CI) 1.1-4.3] ( P  = 0.03) and re-interventions (OR 2.1, 95% CI 1.1-3.8) ( P  = 0.03) was associated with a higher rate of overall MRI abnormalities. Cerebral MRI abnormalities occur in more than one third of children with single ventricle, while the neuro-developmental status is less severely affected before Fontan procedure. Liquor space enlargement is the predominant MRI finding associated with poorer neuro-developmental status, warranting further studies to determine aetiology and further evolution until school-age.

  8. Swimming exercise reverses aging-related contractile abnormalities of female heart by improving structural alterations.

    Science.gov (United States)

    Ozturk, Nihal; Olgar, Yusuf; Er, Hakan; Kucuk, Murathan; Ozdemir, Semir

    2017-01-01

    The objective of this study was to examine the effect of swimming exercise on aging-related Ca2+ handling alterations and structural abnormalities of female rat heart. For this purpose, 4-month and 24-month old female rats were used and divided into three following groups: sedentary young (SY), sedentary old (SO), and exercised old (Ex-O). Swimming exercise was performed for 8 weeks (60 min/day, 5 days/week). Myocyte shortening, L-type Ca2+ currents and associated Ca2+ transients were measured from ventricular myocytes at 36 ± 1°C. NOX-4 levels, aconitase activity, glutathione measurements and ultrastructural examination by electron microscopy were conducted in heart tissue. Swimming exercise reversed the reduced shortening and slowed kinetics of aged cardiomyocytes. Although the current density was similar for all groups, Ca2+ transients were higher in SO and Ex-O myocytes with respect to the SY group. Caffeine-induced Ca2+ transients and the integrated NCX current were lower in cardiomyocytes of SY rats compared with other groups, suggesting an increased sarcoplasmic reticulum Ca2+ content in an aged heart. Aging led to upregulated cardiac NOX-4 along with declined aconitase activity. Although it did not reverse these oxidative parameters, swimming exercise achieved a significant increase in glutathione levels and improved structural alterations of old rats' hearts. We conclude that swimming exercise upregulates antioxidant defense capacity and improves structural abnormalities of senescent female rat heart, although it does not change Ca2+ handling alterations further. Thereby, it improves contractile function of aged myocardium by mitigating detrimental effects of oxidative stress.

  9. Sugar-sweetened beverages and prevalence of the metabolically abnormal phenotype in the Framingham Heart Study.

    Science.gov (United States)

    Green, Angela K; Jacques, Paul F; Rogers, Gail; Fox, Caroline S; Meigs, James B; McKeown, Nicola M

    2014-05-01

    The purpose of this study was to examine the relationship between usual sugar-sweetened beverage (SSB) consumption and prevalence of abnormal metabolic health across body mass index (BMI) categories. The metabolic health of 6,842 non-diabetic adults was classified using cross-sectional data from the Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-2005) cohorts. Adults were classified as normal weight, overweight or obese and, within these categories, metabolic health was defined based on five criteria-hypertension, elevated fasting glucose, elevated triglycerides, low HDL cholesterol, and insulin resistance. Individuals without metabolic abnormalities were considered metabolically healthy. Logistic regression was used to examine the associations between categories of SSB consumption and risk of metabolic health after stratification by BMI. Comparing the highest category of SSB consumers (median of 7 SSB per week) to the lowest category (non-consumers), odds ratios (95% confidence intervals) for metabolically abnormal phenotypes, compared to the metabolically normal, were 1.9 (1.1-3.4) among the obese, 2.0 (1.4-2.9) among the overweight, and 1.9 (1.4-2.6) among the normal weight individuals. In this cross-sectional analysis, it is observed that, irrespective of weight status, consumers of SSB were more likely to display metabolic abnormalities compared to non-consumers in a dose-dependent manner. Copyright © 2014 The Obesity Society.

  10. High-calcium exposure to frog heart: a simple model representing hypercalcemia-induced ECG abnormalities.

    Science.gov (United States)

    Kazama, Itsuro

    2017-01-20

    By simply adding a high concentration of calcium solution to the surface of the bullfrog heart, we reproduced electrocardiogram (ECG) abnormalities representing those observed in hypercalcemia, such as Osborn waves and shortening of the QT interval. The rise in extracellular calcium concentration may have activated the outward potassium currents during phase 3 of the action potential, and thus decreased its duration. In addition to the known decrease in the duration of phase 2, such changes in phase 3 were also likely to contribute to the shortening of the QT interval. The dual recordings of the action potential in cardiomyocytes and the ECG waves enabled us to demonstrate the mechanisms of ECG abnormalities induced by hypercalcemia.

  11. Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure

    Directory of Open Access Journals (Sweden)

    Bombardini Tonino

    2011-11-01

    Full Text Available Abstract Background The degree of pulmonary hypertension is not independently related to the severity of left ventricular systolic dysfunction but is frequently associated with diastolic filling abnormalities. The aim of this study was to assess diastolic times at increasing heart rates in normal and in patients with and without abnormal exercise-induced increase in pulmonary artery pressure (PASP. Methods. We enrolled 109 patients (78 males, age 62 ± 13 years referred for exercise stress echocardiography and 16 controls. The PASP was derived from the tricuspid Doppler tracing. A cut-off value of PASP ≥ 50 mmHg at peak stress was considered as indicative of abnormal increase in PASP. Diastolic times and the diastolic/systolic time ratio were recorded by a precordial cutaneous force sensor based on a linear accelerometer. Results At baseline, PASP was 30 ± 5 mmHg in patients and 25 ± 4 in controls. At peak stress the PASP was normal in 95 patients (Group 1; 14 patients (Group 2 showed an abnormal increase in PASP (from 35 ± 4 to 62 ± 12 mmHg; P Conclusion The first and second heart sound vibrations non-invasively monitored by a force sensor are useful for continuously assessing diastolic time during exercise. Exercise-induced abnormal PASP was associated with reduced diastolic time at heart rates beyond 100 beats per minute.

  12. The role of the second heart field in pulmonary vein development : new insights in the origin of clinical abnormalities

    NARCIS (Netherlands)

    Douglas, Yvonne Louise

    2010-01-01

    In this thesis we describe normal and abnormal pulmonary vein development in human and mouse hearts, and focus on the histo(patho)logy of the pulmonary venous and left atrial dorsal wall, in order to elucidate the role of the posterior heart field in the formation and differentiation of the

  13. The heart truth professional education campaign on women and heart disease: needs assessment and evaluation results.

    Science.gov (United States)

    Pregler, Janet; Freund, Karen M; Kleinman, Mary; Phipps, Maureen G; Fife, Rose S; Gams, Becky; Núñez, Ana E; Seaver, Margaret R; Lazarus, Cathy J; Raymond, Nancy C; Briller, Joan; Uijtdehaage, Sebastian; Moskovic, Cindy S; Guiton, Gretchen; David, Michele; Gabeau, Geralde V; Geller, Stacie; Meekma, Kelli; Moore, Christopher; Robertson, Candace; Sarto, Gloria

    2009-10-01

    Heart disease is the leading cause of death for women in the United States. Research has identified that women are less likely than men to receive medical interventions for the prevention and treatment of heart disease. As part of a campaign to educate healthcare professionals, 1245 healthcare professionals in 11 states attended a structured 1-hour continuing medical education (CME) program based on the 2004 AHA Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women and completed a pretest and posttest evaluation. We identified significant knowledge deficits in the pretest: 45% of attendees would initially recommend lifestyle changes alone, rather than statin therapy, for women diagnosed with coronary artery disease (CAD); 38% identified statin therapy as less effective in women compared with men for preventing CAD events; 27% identified Asian American women at low risk (rather than high risk) for type 2 diabetes mellitus (DM); and 21% identified processed meat (rather than baked goods) as the principal dietary source of trans fatty acids. Overall, healthcare professionals answered 5.1 of 8 knowledge questions correctly in the pretest, improving to 6.8 questions in the posttest (p < 0.001). Family physicians, obstetrician/gynecologists, general internists, nurse practitioners/physician assistants, and registered nurses all statistically significantly improved knowledge and self-assessed skills and attitudes as measured by the posttest. Significant knowledge deficits are apparent in a cross-section of healthcare providers attending a CME lecture on women and heart disease. A 1-hour presentation was successful in improving knowledge and self-assessed skills and attitudes among primary care physicians, nurse practitioners, physician assistants, and registered nurses.

  14. Resting and postexercise heart rate variability in professional handball players.

    Science.gov (United States)

    Kayacan, Yildirim; Yildiz, Sedat

    2016-03-01

    The aim of this study was to evaluate heart rate variability (HRV) in professional handball players during rest and following a 5 min mild jogging exercise. For that purpose, electrocardiogram (ECG) of male handball players (N.=12, mean age 25±3.95 years) and sedentary controls (N.=14, mean age 23.5±2.95 years) were recorded for 5 min at rest and just after 5 min of mild jogging. ECGs were recorded and following HRV parameters were calculated: time-domain variables such as heart rate (HR), average normal-to-normal RR intervals, standard deviation of normal-to-normal RR intervals, square root of the mean of the squares of differences between adjacent NN intervals, percentage of differences between adjacent NN intervals that are greater than 50 milliseconds (pNN50), and frequency-domain variables such as very low frequency, low (LF) and high frequency (HF) of the power and LF/HF ratio. Unpaired t-test was used to find out differences among groups while paired t-test was used for comparison of each group for pre- and postjogging HRV. Pearson correlations were carried out to find out the relationships between the parameters. Blood pressures were not different between handball players and sedentary controls but exercise increased systolic blood pressure (Phandball players (Phandball players (Phandball players in response to a mild, short-time (5 min) jogging exercise. However, in sedentary subjects, either the sympathetic regulation of the autonomous nervous system increased or vagal withdrawal occurred.

  15. Heart Rate Response of Professional Musicians When Playing Music.

    Science.gov (United States)

    Vellers, Heather L; Irwin, Conor; Lightfoot, J T

    2015-06-01

    The primary aim was to determine the level of physiological stress evoked while playing music in a standing position as indicated by heart rate (HR) response. A secondary aim was to analyze the effect of music genre (classic rock, western, contemporary Christian, and metal rock) on the relative HR response. Lastly, we considered potential physiological initiators of the music-playing-induced HR response. HR response was monitored in 27 professional musicians (3 women, 24 men) between the ages of 21 and 67 yrs old during rehearsal and public performances. The percent maximal HR (%MHR) evoked was determined by taking a percentage of the age-predicted maximal HR for each musician and comparing the average %MHR in each genre during public and rehearsal events. The role of the potential initiators of these responses (e.g., number of years playing in public, event type, instrument type, tempo, etc.) was determined using multiple regression analyses. The overall average %MHR responses were 52 ± 5% and 59 ± 5% during rehearsal and public performances, respectively, with genre type having a significant effect on the HR response (p=0.01). Body mass index and tempo were each found to be significant contributors to the HR response while playing music (r²=0.506, p=0.001). Playing music professionally evokes considerable increases in HR response, with music genre influencing the level of the physiological response. We concluded that 50% of the HR response while playing music was associated with body mass index, music tempo, and instrument type.

  16. Clinical significance of exercise-induced left ventricular wall motion abnormality occurring at a low heart rate

    Energy Technology Data Exchange (ETDEWEB)

    Kimchi, A.; Rozanski, A.; Fletcher, C.; Maddahi, J.; Swan, H.J.; Berman, D.S.

    1987-10-01

    We studied the relationship between the heart rate at the time of onset of exercise-induced wall motion abnormality and the severity of coronary artery disease in 89 patients who underwent exercise equilibrium radionuclide ventriculography as part of their evaluation for coronary artery disease. Segmental wall motion was scored with a five-point system (3 = normal; -1 = dyskinesis); a decrease of one score defined the onset of wall motion abnormality. The onset of wall motion abnormality at less than or equal to 70% of maximal predicted heart rate had 100% predictive accuracy for coronary artery disease and higher sensitivity than the onset of ischemic ST segment depression at similar heart rate during exercise: 36% (25 of 69 patients with coronary disease) vs 19% (13 of 69 patients), p = 0.01. Wall motion abnormality occurring at less than or equal to 70% of maximal predicted heart rate was present in 49% of patients (23 of 47) with critical stenosis (greater than or equal to 90% luminal diameter narrowing), and in only 5% of patients (2 of 42) without such severe stenosis, p less than 0.001. The sensitivity of exercise-induced wall motion abnormality occurring at a low heart rate for the presence of severe coronary artery disease was similar to that of a deterioration in wall motion by more than two scores during exercise (49% vs 53%) or an absolute decrease of greater than or equal to 5% in exercise left ventricular ejection fraction (49% vs 45%).

  17. Extracardiac lesions and chromosomal abnormalities associated with major fetal heart defects: comparison of intrauterine, postnatal and postmortem diagnoses.

    Science.gov (United States)

    Song, M S; Hu, A; Dyamenahalli, U; Dyhamenahali, U; Chitayat, D; Winsor, E J T; Ryan, G; Smallhorn, J; Barrett, J; Yoo, S-J; Hornberger, L K

    2009-05-01

    The clinical outcome of prenatally diagnosed congenital heart defects (CHD) continues to be affected significantly by associated extracardiac and chromosomal abnormalities. We sought to: determine the frequency and type of major extracardiac abnormalities (with impact on quality of life) and chromosomal abnormalities associated with fetal CHD; and compare the extracardiac abnormalities detected prenatally to the postnatal and autopsy findings in affected fetuses, to find the incidence of extracardiac abnormalities missed on prenatal ultrasound. We reviewed the computerized database of the Division of Cardiology of the Hospital for Sick Children in Toronto to identify all cases of major CHD detected prenatally from 1990 to 2002. Medical records, fetal echocardiograms and ultrasound, cytogenetic and autopsy reports were reviewed. The types of CHD detected were grouped into categories and the frequencies of major extracardiac and chromosomal abnormalities in these categories were noted. Prenatal ultrasound findings were compared with those at autopsy or postnatal examination. Of 491 fetuses with major structural CHD, complete data were obtained for 382. Of these, there were 141 (36.9%) with major extracardiac abnormalities at autopsy or postnatal exam, of which 46 had chromosomal abnormalities and 95 did not. In the absence of chromosomal abnormalities, the organ systems most affected were urogenital (12.2%) and gastrointestinal (11.6%). CHDs with the highest incidence of extracardiac abnormalities (>25%) included: heterotaxy, single left ventricle and tricuspid atresia, hypoplastic left heart syndrome and tetralogy of Fallot. Ninety-four of 334 (28.1%) fetuses tested had chromosomal abnormalities. The most common chromosomal abnormalities were trisomies 21 (43.6%), 18 (19.1%) and 13 (9.6%), monosomy X (7.4%) and 22q11.2 deletion (7.4%). Of 289 extracardiac abnormalities from the complete series, 134 (46.4%) were not identified prenatally. Of the missed extracardiac

  18. Prognostic Value of Prothrombin Time International Normalized Ratio in Acute Decompensated Heart Failure – A Combined Marker of Hepatic Insufficiency and Hemostatic Abnormality

    National Research Council Canada - National Science Library

    Okada, Atsushi; Sugano, Yasuo; Nagai, Toshiyuki; Takashio, Seiji; Honda, Satoshi; Asaumi, Yasuhide; Aiba, Takeshi; Noguchi, Teruo; Kusano, Kengo F; Ogawa, Hisao; Yasuda, Satoshi; Anzai, Toshihisa

    2016-01-01

    .... The clinical significance of prothrombin time international normalized ratio (INR), a widely accepted marker assessing coagulation abnormalities, in acute decompensated heart failure (ADHF) remains unclear.Methods...

  19. Abnormal right ventricular tissue velocities after repair of congenital heart disease--implications for late outcomes.

    Science.gov (United States)

    Puranik, Rajesh; Greaves, Kim; Hawker, Richard E; Pressley, Lynne A; Robinson, Peter J; Celermajer, David S

    2007-08-01

    Although repair of Tetralogy of Fallot (TOF) and transposition of the great arteries (TGA) has facilitated survival into adulthood, many survivors have residual haemodynamic abnormalities, including exercise intolerance and late right ventricular (RV) failure. We studied 40 asymptomatic adult subjects (31.3+/-1.5 years) after congenital heart disease (CHD) surgery during childhood, using tissue Doppler echocardiography (TDE). We compared systolic (S') and diastolic (E' for early filling) RV and LV velocities, with 40 age matched controls (29.5+/-1.0 years). Both RV S' and E' velocities were significantly slower in the CHD group compared to controls (6.3+/-0.4 cm/s vs. 9.3+/-0.3 cm/s; 8.5+/-0.5 cm/s vs. 10.9+/-0.4 cm/s, respectively, p<0.001 for both). By contrast, LV S' and E' velocities were similar in both groups. Interestingly, in 50% of CHD subjects where RV function was reported as 'normal', both RV S' and E' velocities were significantly slower compared with controls (6.5+/-0.6 cm/s vs. 9.3+/-0.3 cm/s, p<0.0001 and 9.4+/-0.7 cm/s vs. 10.9+/-0.4 cm/s, p<0.05 respectively). RV S' and E' velocities are frequently abnormal in asymptomatic survivors of TOF and TGA repair, even where RV function appears 'normal'. Hence TDE during follow up may be a sensitive means of detecting pre-clinical abnormalities in RV performance.

  20. Cited2 participates in cardiomyocyte apoptosis and maternal diabetes-induced congenital heart abnormality.

    Science.gov (United States)

    Su, Dongmei; Song, Jun-Xian; Gao, Qianqian; Guan, Lina; Li, Qian; Shi, Cuige; Ma, Xu

    2016-10-28

    Gestational diabetes mellitus is a risk factor for abnormal heart development, but the molecular basis remains obscure. To further analyze this, the hyperglycemia rat and cell model were established in this study. The results showed that hyperglycemic rats gained significantly less weight during gestation than controls. The number of embryos per litter was significantly reduced in diabetic mothers compared to controls. Ventricular wall thickness was often decreased in the diabetic offspring and cardiomyocyte apoptosis participated in ventricular wall thinness. Our results also indicated that Cited2 expression decreased in the heart tissues of diabetic-exposed embryos comparing with the control. The vitro results showed that down-regulation of Cited2 was associated with high glucose-induced apoptosis in cardiomyocytes in vitro. Over-expression of Cited2 gene restrained the cardiomyocyte apoptosis induced by high glucose. Furthermore, Cited2 S192G mutation partly inhibited the capacity of Cited2 to suppress apoptosis induced by high glucose in cardiomyocytes. This showed the critical role of Cited2 in high glucose-induced cardiomyocytes apoptosis. Data from this study found the association of Cited2 down regulation with cardiomyocytes apoptosis and maternal diabetes-induced ventricular wall thinness genesis. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Abnormal heart rate variability in AA amyloidosis of familial Mediterranean fever.

    Science.gov (United States)

    Nussinovitch, Udi; Volovitz, Benjamin; Nussinovitch, Moshe; Lidar, Merav; Feld, Olga; Nussinovitch, Naomi; Livneh, Avi

    2011-12-01

    A scarcity of data exists relating to the effect of amyloidosis of Familial Mediterranean fever (FMF) on the autonomic nervous system. Our aim was to further investigate the presence of dysautonomia in FMF-AA amyloidosis, using a comparative case series design. The study group consisted of 40 patients with FMF: 20 without co-morbidities or amyloidosis and 20 in various stages of renal amyloidosis. Time domain and power spectral analyses of heart rate dynamics were performed according to accepted procedures. Findings were compared with 20 healthy control subjects. No statistically significant differences were found in any of the studied heart rate variability (HRV) parameters between patients with uncomplicated FMF and controls. In contrast, patients with progressive amyloidosis (post renal transplantation or on dialysis) had significantly lower HRV parameters compared to control subjects (i.e. mean low frequency power spectral components 104.30 ms² vs. 172.09 ms², p components values lower than 142.35 ms², and 12.67 (95%CI 1.04-153.96, p = 0.04) for standard deviation of all normal RR intervals values lower than 40.15?ms. Amyloidosis of FMF, particularly at a progressive stage, is associated with HRV abnormalities suggestive of the presence of autonomic nervous system dysfunction.

  2. Health care professionals in a heart failure team

    NARCIS (Netherlands)

    Jaarsma, T

    2005-01-01

    A heart failure team that treats heart failure patients often faces the challenge of managing multiple conditions requiring multiple medications and life style changes in an older patient group. A multidisciplinary team approach can optimally diagnose, carefully review and prescribe treatment, and

  3. Abnormal chronotropic reserve and heart rate recovery in patients with SLE: a case-control study.

    Science.gov (United States)

    do Prado, Dm Leite; Gualano, B; Miossi, R; Sá-Pinto, Al; Lima, Fr; Roschel, H; Borba, Ef; Bonfá, E

    2011-06-01

    Abnormal heart-rate (HR) response during or after a graded exercise test has been recognized as a strong and an independent predictor of all-cause mortality in healthy and diseased subjects. The purpose of the present study was to evaluate the HR response during exercise in women with systemic lupus erythematosus (SLE). In this case-control study, 22 women with SLE (age 29.5 ± 1.1 years) were compared with 20 gender-, BMI-, and age-matched healthy subjects (age 26.5 ± 1.4 years). A treadmill cardiorespiratory test was performed and HR response during exercise was evaluated by the chronotropic reserve (CR). HR recovery (ΔHRR) was defined as the difference between HR at peak exercise and at both first (ΔHRR1) and second (ΔHRR2) minutes after exercising. SLE patients presented lower peak VO(2) when compared with healthy subjects (27.6 ± 0.9 vs. 36.7 ± 1.1 ml/kg/min, p = 0.001, respectively). Additionally, SLE patients demonstrated lower CR (71.8 ± 2.4 vs. 98.2 ± 2.6%, p = 0.001), ΔHRR1 (22.1 ± 2.5 vs. 32.4 ± 2.2%, p = 0.004) and ΔHRR2 (39.1 ± 2.9 vs. 50.8 ± 2.5%, p = 0.001) than their healthy peers. In conclusion, SLE patients presented abnormal HR response to exercise, characterized by chronotropic incompetence and delayed ΔHRR.

  4. Fetal heart rate abnormalities during and after external cephalic version: Which fetuses are at risk and how are they delivered?

    Science.gov (United States)

    Kuppens, Simone M; Smailbegovic, Ida; Houterman, Saskia; de Leeuw, Ingrid; Hasaart, Tom H

    2017-10-17

    Fetal heart rate abnormalities (FHR) during and after external cephalic version (ECV) are relatively frequent. They may raise concern about fetal wellbeing. Only occasionally they may lead to an emergency cesarean section. Prospective cohort study in 980 women (> 34 weeks gestation) with a singleton fetus in breech presentation. During and after external cephalic version (ECV) FHR abnormalities were recorded. Obstetric variables and delivery outcome were evaluated. Primary outcome was to identify which fetuses are at risk for FHR abnormalities. Secondary outcome was to identify a possible relationship between FHR abnormalities during and after ECV and mode of delivery and fetal distress during subsequent labor. The overall success rate of ECV was 60% and in 9% of the attempts there was an abnormal FHR pattern. In two cases FHR abnormalities after ECV led to an emergency CS. Estimated fetal weight per 100 g (OR 0.90, CI: 0.87-0.94) and longer duration of the ECV-procedure (OR 1.13, CI: 1.05-1.21) were factors significantly associated with the occurrence of FHR abnormalities. FHR abnormalities were not associated with the mode of delivery or the occurrence of fetal distress during subsequent labor. FHR abnormalities during and after ECV are more frequent with lower estimated fetal weight and longer duration of the procedure. FHR abnormalities during and after ECV have no consequences for subsequent mode of delivery. They do not predict whether fetal distress will occur during labor. The Eindhoven Breech Intervention Study, NCT00516555 . Date of registration: August 13, 2007.

  5. Ultrastructural and cellular basis for the development of abnormal myocardial mechanics during the transition from hypertension to heart failure.

    Science.gov (United States)

    Shah, Sanjiv J; Aistrup, Gary L; Gupta, Deepak K; O'Toole, Matthew J; Nahhas, Amanda F; Schuster, Daniel; Chirayil, Nimi; Bassi, Nikhil; Ramakrishna, Satvik; Beussink, Lauren; Misener, Sol; Kane, Bonnie; Wang, David; Randolph, Blake; Ito, Aiko; Wu, Megan; Akintilo, Lisa; Mongkolrattanothai, Thitipong; Reddy, Mahendra; Kumar, Manvinder; Arora, Rishi; Ng, Jason; Wasserstrom, J Andrew

    2014-01-01

    Although the development of abnormal myocardial mechanics represents a key step during the transition from hypertension to overt heart failure (HF), the underlying ultrastructural and cellular basis of abnormal myocardial mechanics remains unclear. We therefore investigated how changes in transverse (T)-tubule organization and the resulting altered intracellular Ca(2+) cycling in large cell populations underlie the development of abnormal myocardial mechanics in a model of chronic hypertension. Hearts from spontaneously hypertensive rats (SHRs; n = 72) were studied at different ages and stages of hypertensive heart disease and early HF and were compared with age-matched control (Wistar-Kyoto) rats (n = 34). Echocardiography, including tissue Doppler and speckle-tracking analysis, was performed just before euthanization, after which T-tubule organization and Ca(2+) transients were studied using confocal microscopy. In SHRs, abnormalities in myocardial mechanics occurred early in response to hypertension, before the development of overt systolic dysfunction and HF. Reduced longitudinal, circumferential, and radial strain as well as reduced tissue Doppler early diastolic tissue velocities occurred in concert with T-tubule disorganization and impaired Ca(2+) cycling, all of which preceded the development of cardiac fibrosis. The time to peak of intracellular Ca(2+) transients was slowed due to T-tubule disruption, providing a link between declining cell ultrastructure and abnormal myocardial mechanics. In conclusion, subclinical abnormalities in myocardial mechanics occur early in response to hypertension and coincide with the development of T-tubule disorganization and impaired intracellular Ca(2+) cycling. These changes occur before the development of significant cardiac fibrosis and precede the development of overt cardiac dysfunction and HF.

  6. Acting in the Public Interest: The Heart of Professional Regulation.

    Science.gov (United States)

    Oetter, Heidi M; Johansen, Cynthia

    2017-01-01

    In their article, Wilke and Tzountzouris (2017) describe the traditional and emerging approaches to professional regulation as restrictive (e.g., setting entry to practice requirements for registration), reactive (responding to complaints and where necessary restricting, suspending or revoking registration) or proactive (ensuring continuing competency and supporting registrants to adapt to changes in practice environments). They note the tension that exists with proactive approaches to regulation that can be seen as professional advocacy. We argue that by ensuring best practices in organizational governance and day-to-day regulatory operations that clearly situate the regulator to be acting solely in the public interest, regulatory colleges can manage the proactive regulatory approach and eliminate any perception of professional advocacy. This is critical for sustaining the professionally led model for health regulation that exists in Canada as it does today.

  7. Evaluation of congenital heart diseases and thyroid abnormalities in children with Down syndrome.

    Science.gov (United States)

    Mıhçı, Ercan; Akçurin, Gayaz; Eren, Erdal; Kardelen, Fırat; Akçurin, Sema; Keser, Ibrahim; Ertuğ, Halil

    2010-10-01

    Congenital heart disease (CHD) associated with thyroid disease has been reported in Down syndrome (DS). The purpose of this work was to assess abnormalities of the thyroid in relation to the frequency and type of CHD on admission among children with DS. This retrospective study included 187 children with DS between August 1993- December 2005. Karyotype analysis, thyroid function tests and echocardiographic studies were performed in all children with DS. If necessary, hemodynamic study by catheterization was carried out. Thyrotropin releasing hormone (TRH) stimulation test was performed in having elevated thyroid stimulating hormone (TSH) level. Statistical analyses were performed using Chi-square, "t" test for independent samples or Mann-Whitney U test. It was found that 136 (72.73%) patients with DS had CHD. The age difference at the time of admission was statistically significant for these two groups (p=0.001) in children with /without CHD. There were 12 (11.88%) patients with congenital hypothyroidism and DS, of whom 11 had CHD. There were statistically significant differences in the levels of TSH and total thyroxine (tT4) between congenital and subclinical hypothyroid and euthyroid groups (p=0.001 for TSH and p= 0.001 for tT4). But, there was no significant relationship between having any kind of CHD and levels of TSH and tT4. Our data suggest that all patients with DS should be evaluated with careful physical and echocardiographic examination on admission. In addition, congenital or subclinical hypothyroidism should also be kept in mind in children with DS and monitored accordingly.

  8. Tumor Necrosis Factor Is a Therapeutic Target for Immunological Unbalance and Cardiac Abnormalities in Chronic Experimental Chagas’ Heart Disease

    Directory of Open Access Journals (Sweden)

    Isabela Resende Pereira

    2014-01-01

    Full Text Available Background. Chagas disease (CD is characterized by parasite persistence and immunological unbalance favoring systemic inflammatory profile. Chronic chagasic cardiomyopathy, the main manifestation of CD, occurs in a TNF-enriched milieu and frequently progresses to heart failure. Aim of the Study. To challenge the hypothesis that TNF plays a key role in Trypanosoma cruzi-induced immune deregulation and cardiac abnormalities, we tested the effect of the anti-TNF antibody Infliximab in chronically T. cruzi-infected C57BL/6 mice, a model with immunological, electrical, and histopathological abnormalities resembling Chagas’ heart disease. Results. Infliximab therapy did not reactivate parasite but reshaped the immune response as reduced TNF mRNA expression in the cardiac tissue and plasma TNF and IFNγ levels; diminished the frequency of IL-17A+ but increased IL-10+ CD4+ T-cells; reduced TNF+ but augmented IL-10+ Ly6C+ and F4/80+ cells. Further, anti-TNF therapy decreased cytotoxic activity but preserved IFNγ-producing VNHRFTLV-specific CD8+ T-cells in spleen and reduced the number of perforin+ cells infiltrating the myocardium. Importantly, Infliximab reduced the frequency of mice afflicted by arrhythmias and second degree atrioventricular blocks and decreased fibronectin deposition in the cardiac tissue. Conclusions. Our data support that TNF is a crucial player in the pathogenesis of Chagas’ heart disease fueling immunological unbalance which contributes to cardiac abnormalities.

  9. C-reactive protein and homocysteine levels are associated with abnormal heart rate recovery in women with polycystic ovary syndrome.

    Science.gov (United States)

    Kaya, Cemil; Akgül, Ebru; Pabuccu, Recai

    2010-06-01

    To determine heart rate recovery (HRR) in patients with polycystic ovary syndrome (PCOS) and its relation to C-reactive protein (CRP) and homocysteine (Hcy) levels. Prospective clinical study. University hospital. Sixty-eight women with PCOS and 68 healthy women were included this study. Heart rate recovery was evaluated. We measured serum levels of CRP and Hcy. The presence of insulin resistance was investigated using homeostasis model assesment (HOMA-IR). Heart rate recovery, CRP, Hcy. Heart rate recovery was significantly decreased in women with PCOS compared with control group women. Subjects with abnormal HRR had significantly greater levels of CRP and Hcy. The PCOS patients with HRR in the top tertile compared with the bottom quartile tended to have lower mean CRP and Hcy levels. The HRR was significantly and negatively correlated with age, CRP, Hcy, HOMA-IR, and body mass index. C-reactive protein and Hcy are independent determinants of HRR. The CRP and Hcy levels may affect the development and progression of abnormal HRR in PCOS. Crown Copyright (c) 2010. Published by Elsevier Inc. All rights reserved.

  10. Telemonitoring for chronic heart failure: the views of patients and healthcare professionals - a qualitative study.

    Science.gov (United States)

    Fairbrother, Peter; Ure, Jenny; Hanley, Janet; McCloughan, Lucy; Denvir, Martin; Sheikh, Aziz; McKinstry, Brian

    2014-01-01

    To understand the views of patients and professionals on the acceptability and perceived usefulness of telemonitoring in the management of chronic heart failure in the context of day-to-day care provision. There is an increasing interest in the potential for telemonitoring to support the home-based management of patients with chronic heart failure. However, little is known about the views of patients and professionals on the use of telemonitoring in this context. A chronic heart failure telemonitoring service was set-up by NHS Lothian, Scotland, to evaluate the intervention. A qualitative design was adopted to explore the views of patients and professionals participating in the service. Semi-structured interviews were undertaken with 18 patients (61% male, mean age 75 years) and five professionals participating at different time points in this new service. Interviews were audio recorded, coded and thematically analysed using the Framework approach. Five main themes were identified: 'information, support and reassurance'; 'compliance and dependence'; 'changes and challenges'; 'determining the criteria for patient applicability to telemonitoring'; and 'continuity of care'. Patients and professionals considered telemonitoring useful in the management of chronic heart failure, although with some caveats. Telemonitoring was popular with patients because they felt reassurance arising from what was perceived as continuous practitioner surveillance. Professionals expressed concern regarding perceived patient dependence on practitioner support. Increased workload was also a concern. Both groups acknowledged the need for improved technology and changes to service provision in order to better meet the intended objectives of the service. Although popular with patients, professionals emphasised the importance of case selection and adequate training and support, both for patients and themselves, in order to maximise the expected benefits of the service, particularly with regard

  11. Abnormal lung function in adults with congenital heart disease: prevalence, relation to cardiac anatomy, and association with survival.

    Science.gov (United States)

    Alonso-Gonzalez, Rafael; Borgia, Francesco; Diller, Gerhard-Paul; Inuzuka, Ryo; Kempny, Aleksander; Martinez-Naharro, Ana; Tutarel, Oktay; Marino, Philip; Wustmann, Kerstin; Charalambides, Menelaos; Silva, Margarida; Swan, Lorna; Dimopoulos, Konstantinos; Gatzoulis, Michael A

    2013-02-26

    Restrictive lung defects are associated with higher mortality in patients with acquired chronic heart failure. We investigated the prevalence of abnormal lung function, its relation to severity of underlying cardiac defect, its surgical history, and its impact on outcome across the spectrum of adult congenital heart disease. A total of 1188 patients with adult congenital heart disease (age, 33.1±13.1 years) undergoing lung function testing between 2000 and 2009 were included. Patients were classified according to the severity of lung dysfunction based on predicted values of forced vital capacity. Lung function was normal in 53% of patients with adult congenital heart disease, mildly impaired in 17%, and moderately to severely impaired in the remainder (30%). Moderate to severe impairment of lung function related to complexity of underlying cardiac defect, enlarged cardiothoracic ratio, previous thoracotomy/ies, body mass index, scoliosis, and diaphragm palsy. Over a median follow-up period of 6.7 years, 106 patients died. Moderate to severe impairment of lung function was an independent predictor of survival in this cohort. Patients with reduced force vital capacity of at least moderate severity had a 1.6-fold increased risk of death compared with patients with normal lung function (P=0.04). A reduced forced vital capacity is prevalent in patients with adult congenital heart disease; its severity relates to the complexity of the underlying heart defect, surgical history, and scoliosis. Moderate to severe impairment of lung function is an independent predictor of mortality in contemporary patients with adult congenital heart disease.

  12. Unawareness of memory impairment and behavioral abnormalities in patients with Alzheimer's disease: relation to professional health care burden.

    Science.gov (United States)

    Al-Aloucy, M J; Cotteret, R; Thomas, P; Volteau, M; Benmaou, I; Dalla Barba, G

    2011-05-01

    The present study investigates the impact of unawareness of deficit (anosognosia) in patients with Alzheimer's disease upon professional health care burden. Cross-sectional study with a consecutive clinical sample from an Alzheimer day-care hospital in France. 65 patients with probable AD, aged from 75 to 94 years old, consecutively admitted at the Alzheimer Day Hospital to complete a program of cognitive stimulation and psychosocial rehabilitation. Each patient was submitted to a standardized evaluation including clinical investigation, cerebral imagery, and neuropsychological assessment. Anosognosia of memory deficit and anosognosia of behavioral disturbances were measured as the "discrepancy scores" between patients' self-reports and family member ratings of patient memory performance and behavioral disturbances. Professional health care burden was assessed with the Professional Health Care Dementia Burden Index (PCDBI; maximal score: 12), designed for this study. Multiple linear regressions were used to examine the correlations between the PCDBI and the severity of anosognosia. The findings showed a significant positive correlation between the PCDBI and both anosognosia of memory impairment and behavioral abnormalities (both p at least less than 0.05). However, there was no significant correlation between the severity of the burden and the severity of cognitive decline or functional impairment (both p at least>0.05). Anosognosia in Alzheimer disease patients has a negative impact upon the professional caregivers' burden over and above the cognitive deficit and the functional impairments.

  13. Fluid loading to reduce abnormalities of fetal heart rate and maternal hypotension during epidural analgesia in labour.

    Science.gov (United States)

    Collins, K M; Bevan, D R; Beard, R W

    1978-01-01

    Fetal heart rate (FHR) was recorded and maternal blood pressure measured in 104 patients in whom lumbar epidural analgesia was induced in labour. Fifty-one patients received an intravenous load of 11 of Hartmann's solution immediately before the epidural injection. This infusion significantly reduced the incidence of abnormalities of FHR from 34% to 12% and of maternal hypotension from 28% to 2%. We did not study mothers with pre-eclampsia and hypertension, but we conclude that there is a strong case for preloading all other mothers in whom lumbar epidural analgesia is induced in labour. PMID:719463

  14. Remote ECG Monitoring Kit to Predict Patient-Specific Heart Abnormalities

    Directory of Open Access Journals (Sweden)

    Jiaming Chen

    2017-08-01

    Full Text Available Electrocardiogram (ECG signals are widely used to examine heart rhythms and general health conditions. However, the majority of commercial ECG kits are generic and their normal ranges are set based on the averages obtained from a large population of people with normal heart conditions. This averaging ignores the extreme inherent variability of normal heart signals. As such, many false alarms are generated if the thresholds are selected too strict and true alarms are missed if the thresholds are set too loose. Furthermore, false alarms may arise due to the high physical activity of the test person. In this paper, we developed a prototype for patient-specific heart monitoring kit, which learns the properties of a patient's normal ECG signal over time and reports significant deviations from this normal behavior, in addition to presenting significant violations from the global norms. Further, false alarms due to high physical activity levels are eliminated through processing the utilized accelerometer signal. This personalized remote heart monitoring kit with the proposed signal processing and self-tuning capabilities and wireless connectivity provides more detailed information and insightful interpretations of ECG signals compared to generic devices, therefore can be used for remote heart monitoring of high-risk people.

  15. At the heart of primary progressive multiple sclerosis: three cases with diffuse MRI abnormalities only

    NARCIS (Netherlands)

    Zwemmer, J.N.P.; Bot, J.C.J.; Jelles, B.; Barkhof, F.; Polman, C.H.

    2008-01-01

    We present three patients with a clinical course and cerebrospinal fluid findings consistent with a diagnosis of primary progressive multiple sclerosis (PPMS). Extensive and repeated magnetic resonance imaging (MRI) examinations showed only diffuse abnormality in brain and spinal cord, but no focal

  16. The effects of resistance exercise on skeletal muscle abnormalities in patients with advanced heart failure.

    Science.gov (United States)

    King, L

    2001-01-01

    Resistance exercise increases muscular strength and endurance, which prevents injuries associated with musculoskeletal disorders, favorably alters muscle fiber type distribution, and up-regulates the genetic expression of certain enzymes seen in dysfunctional skeletal muscles. Although the benefits of resistance exercise are well documented in the literature, this form of exercise is not routinely recommended for patients with heart failure for fear of symptom exacerbation, and because of poor understanding of how best to prescribe this type of exercise. Because muscle atrophy and deconditioning states are common findings in patients with heart failure, these patients stand to benefit substantially from resistance training because this type of physical activity results in functional adaptations in the neuromuscular system. This article addresses changes in skeletal muscle pathophysiology that occur in patients with heart failure and the potential role resistance training may play in reversing this sequela, and recommends a weight lifting exercise prescription for these patients. (c)2001 CHF, Inc.

  17. Heart murmurs

    Science.gov (United States)

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  18. Mid-gestation brain Doppler and head biometry in fetuses with congenital heart disease predict abnormal brain development at birth.

    Science.gov (United States)

    Masoller, N; Sanz-CortéS, M; Crispi, F; Gómez, O; Bennasar, M; Egaña-Ugrinovic, G; Bargalló, N; Martínez, J M; Gratacós, E

    2016-01-01

    Fetuses with congenital heart disease (CHD) show evidence of abnormal brain development before birth, which is thought to contribute to adverse neurodevelopment during childhood. Our aim was to evaluate whether brain development in late pregnancy can be predicted by fetal brain Doppler, head biometry and the clinical form of CHD at the time of diagnosis. This was a prospective cohort study including 58 fetuses with CHD, diagnosed at 20-24 weeks' gestation, and 58 normal control fetuses. At the time of diagnosis, we recorded fetal head circumference (HC), biparietal diameter, middle cerebral artery pulsatility index (MCA-PI), cerebroplacental ratio (CPR) and brain perfusion by fractional moving blood volume. We classified cases into one of two clinical types defined by the expected levels (high or low) of placental (well-oxygenated) blood perfusion, according to the anatomical defect. All fetuses underwent subsequent 3T-magnetic resonance imaging (MRI) at 36-38 weeks' gestation. Abnormal prenatal brain development was defined by a composite score including any of the following findings on MRI: total brain volume type of CHD was not. Fetal brain Doppler and head biometry at the time of CHD diagnosis are independent predictors of abnormal brain development at birth, and could be used in future algorithms to improve counseling and targeted interventions. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  19. A Follow-Up Study of the Prevalence of Valvular Heart Abnormalities in Hyperprolactinemic Patients Treated With Cabergoline.

    Science.gov (United States)

    Drake, William M; Stiles, Craig E; Bevan, John S; Karavitaki, Niki; Trainer, Peter J; Rees, D Aled; Richardson, Tristan I; Baldeweg, Stephanie E; Stojanovic, Nemanja; Murray, Robert D; Toogood, Andrew A; Martin, Niamh M; Vaidya, Bijay; Han, Than S; Steeds, Rick P; Baldeweg, F C; Sheikh, U E; Kyriakakis, N; Parasuraman, S K; Taylor, L; Butt, N; Anyiam, S

    2016-11-01

    Uncertainty exists whether the long-term use of ergot-derived dopamine agonist (DA) drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease and whether current regulatory authority guidelines for echocardiographic screening are clinically appropriate. Our objective was to provide follow-up echocardiographic data on a previously described cohort of patients treated with DA for lactotrope pituitary tumors and to explore possible associations between structural and functional valve abnormalities with the cumulative dose of drug used. Follow-up echocardiographic data were collected from a proportion of our previously reported cohort of patients; all had received continuous DA therapy for at least 2 years in the intervening period. Studies were performed according to British Society of Echocardiography minimum standards for adult transthoracic echocardiography. Generalized estimating equations with backward selection were used to determine odds ratios of valvular heart abnormalities according to tertiles of cumulative cabergoline dose, using the lowest tertile as the reference group. Thirteen centers of secondary/tertiary endocrine care across the United Kingdom were included. There were 192 patients (81 males; median age, 51 years; interquartile range [IQR], 42-62). Median (IQR) cumulative cabergoline doses at the first and second echocardiograms were 97 mg (20-377) and 232 mg (91-551), respectively. Median (IQR) duration of uninterrupted cabergoline therapy between echocardiograms was 34 months (24-42). No associations were observed between cumulative doses of dopamine agonist used and the age-corrected prevalence of any valvular abnormality. This large UK follow-up study does not support a clinically significant association between the use of DA for the treatment of hyperprolactinemia and cardiac valvulopathy.

  20. Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals

    OpenAIRE

    Thimmapuram, Jayaram; Pargament, Robert; Sibliss, Kedesha; Grim, Rodney; Risques, Rosana; Toorens, Erik

    2017-01-01

    ABSTRACT Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals. Objective: We assessed the effects of a 12-week ?Heartfulness Meditation? program on burnout, emotional wellness, and telomere length in residents,...

  1. Part I: heart failure home management: patients, multidisciplinary health care professionals and family caregivers' perspectives.

    Science.gov (United States)

    Piamjariyakul, Ubolrat; Smith, Carol E; Werkowitch, Marilyn; Elyachar, Andrea

    2012-11-01

    Using qualitative research study methods, this study identified the key factors that patients, health care professionals, and family caregivers perceived as most helpful in effectively managing heart failure (HF) at home. These key factors were the following: (a) family caregiver involvement, (b) continuous learning about HF, (c) acceptance of and coping with HF diagnosis, (d) learning from other patients with HF, (e) guidance for daily problem solving, (f) lifestyle changes, and (g) financial resources. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Speed ratio but cabin temperature positively correlated with increased heart rates among professional drivers during car races

    National Research Council Canada - National Science Library

    Yanagida, Ryo; Takahashi, Kiichi; Miura, Masaru; Nomura, Masahiro; Ogawa, Yojiro; Aoki, Ken; Iwasaki, Ken-ichi

    2016-01-01

    The present study measures heart rate (HR) on a number of professional race-car drivers during actual car races through annual seasons to test hypotheses that faster relative speed and higher cabin temperature would induce higher...

  3. Percutaneous Lymphatic Embolization of Abnormal Pulmonary Lymphatic Flow as Treatment of Plastic Bronchitis in Patients With Congenital Heart Disease.

    Science.gov (United States)

    Dori, Yoav; Keller, Marc S; Rome, Jonathan J; Gillespie, Matthew J; Glatz, Andrew C; Dodds, Kathryn; Goldberg, David J; Goldfarb, Samuel; Rychik, Jack; Itkin, Maxim

    2016-03-22

    Plastic bronchitis is a potentially fatal disorder occurring in children with single-ventricle physiology, and other diseases, as well, such as asthma. In this study, we report findings of abnormal pulmonary lymphatic flow, demonstrated by MRI lymphatic imaging, in patients with plastic bronchitis and percutaneous lymphatic intervention as a treatment for these patients. This is a retrospective case series of 18 patients with surgically corrected congenital heart disease and plastic bronchitis who presented for lymphatic imaging and intervention. Lymphatic imaging included heavy T2-weighted MRI and dynamic contrast-enhanced magnetic resonance lymphangiogram. All patients underwent bilateral intranodal lymphangiogram, and most patients underwent percutaneous lymphatic intervention. In 16 of 18 patients, MRI or lymphangiogram or both demonstrated retrograde lymphatic flow from the thoracic duct toward lung parenchyma. Intranodal lymphangiogram and thoracic duct catheterization was successful in all patients. Seventeen of 18 patients underwent either lymphatic embolization procedures or thoracic duct stenting with covered stents to exclude retrograde flow into the lungs. One of the 2 patients who did not have retrograde lymphatic flow did not undergo a lymphatic interventional procedure. A total of 15 of 17(88%) patients who underwent an intervention had significant symptomatic improvement at a median follow-up of 315 days (range, 45-770 days). The most common complication observed was nonspecific transient abdominal pain and transient hypotension. In this study, we demonstrated abnormal pulmonary lymphatic perfusion in most patients with plastic bronchitis. Interruption of the lymphatic flow resulted in significant improvement of symptoms in these patients and, in some cases, at least temporary resolution of cast formation. © 2016 American Heart Association, Inc.

  4. Assessment of Structural and Functional Abnormalities of the Myocardium and the Ascending Aorta in Fetus with Hypoplastic Left Heart Syndrome

    Directory of Open Access Journals (Sweden)

    Yan Jiang

    2016-01-01

    Full Text Available Aims. To detect anatomical and intrinsic histopathological features of the ascending aorta and left ventricular (LV myocardium and evaluate right ventricular (RV function in fetuses with hypoplastic left heart syndrome (HLHS. Methods. Twenty-five fetuses diagnosed with HLHS were followed up in the antenatal and postpartum periods. 12 necropsy heart specimens were analyzed for morphological and histological changes. Results. Prenatal echocardiography and pathologic anatomy displayed the typical characteristics of HLHS as a severe underdevelopment of the LV in the form of mitral stenosis or atresia or as aortic atresia or stenosis, with a decreased ratio of aortic diameter to pulmonary artery diameter (median of 0.49 with a range of 0.24 to 0.69, p≤0.001 and a higher ratio of RV diameter to LV diameter (median of 2.44 with a range of 1.33 to 6.25, p≤0.001. The RV volume, stroke volume, and cardiac output in HLHS fetuses were increased compared with the gestational age-matched normal controls (p<0.01. Histological changes in the 12 HLHS specimens included LV myocardial fibrosis, aortic elastic fragmentation, and fibrosis. Conclusions. In addition to severe anatomical deformity, distinct histological abnormalities in the LV myocardium and aortic wall were identified in the fetuses with HLHS. RV function damage may be potentially exists.

  5. Assessment of Structural and Functional Abnormalities of the Myocardium and the Ascending Aorta in Fetus with Hypoplastic Left Heart Syndrome

    Science.gov (United States)

    Jiang, Yan; Xu, Yali; Tang, Jinliang; Xia, Hongmei

    2016-01-01

    Aims. To detect anatomical and intrinsic histopathological features of the ascending aorta and left ventricular (LV) myocardium and evaluate right ventricular (RV) function in fetuses with hypoplastic left heart syndrome (HLHS). Methods. Twenty-five fetuses diagnosed with HLHS were followed up in the antenatal and postpartum periods. 12 necropsy heart specimens were analyzed for morphological and histological changes. Results. Prenatal echocardiography and pathologic anatomy displayed the typical characteristics of HLHS as a severe underdevelopment of the LV in the form of mitral stenosis or atresia or as aortic atresia or stenosis, with a decreased ratio of aortic diameter to pulmonary artery diameter (median of 0.49 with a range of 0.24 to 0.69, p ≤ 0.001) and a higher ratio of RV diameter to LV diameter (median of 2.44 with a range of 1.33 to 6.25, p ≤ 0.001). The RV volume, stroke volume, and cardiac output in HLHS fetuses were increased compared with the gestational age-matched normal controls (p < 0.01). Histological changes in the 12 HLHS specimens included LV myocardial fibrosis, aortic elastic fragmentation, and fibrosis. Conclusions. In addition to severe anatomical deformity, distinct histological abnormalities in the LV myocardium and aortic wall were identified in the fetuses with HLHS. RV function damage may be potentially exists. PMID:26981527

  6. Somatic, Endurance Performance and Heart Rate Variability Profiles of Professional Soccer Players Grouped According to Age

    Directory of Open Access Journals (Sweden)

    Botek Michal

    2016-12-01

    Full Text Available This cross-sectional study compared somatic, endurance performance determinants and heart rate variability (HRV profiles of professional soccer players divided into different age groups: GI (17–19.9 years; n = 23, GII (20–24.9 years; n = 45, GIII (25–29.9 years; n = 30, and GIV (30–39 years; n = 26. Players underwent somatic and HRV assessment and maximal exercise testing. HRV was analyzed by spectral analysis of HRV, and high (HF and low (LF frequency power was transformed by a natural logarithm (Ln. Players in GIV (83 ± 7 kg were heavier (p 25 years showed negligible differences in Pmax unlike the age group differences demonstrated in VO2max. A shift towards relative sympathetic dominance, particularly due to reduced vagal activity, was apparent after approximately 8 years of competing at the professional level.

  7. Heart Disease

    Science.gov (United States)

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  8. Modulation of serotonin transporter function during fetal development causes dilated heart cardiomyopathy and lifelong behavioral abnormalities.

    Directory of Open Access Journals (Sweden)

    Cornelle W Noorlander

    Full Text Available BACKGROUND: Women are at great risk for mood and anxiety disorders during their childbearing years and may become pregnant while taking antidepressant drugs. In the treatment of depression and anxiety disorders, selective serotonin reuptake inhibitors (SSRIs are the most frequently prescribed drugs, while it is largely unknown whether this medication affects the development of the central nervous system of the fetus. The possible effects are the product of placental transfer efficiency, time of administration and dose of the respective SSRI. METHODOLOGY/PRINCIPAL FINDINGS: In order to attain this information we have setup a study in which these parameters were measured and the consequences in terms of physiology and behavior are mapped. The placental transfer of fluoxetine and fluvoxamine, two commonly used SSRIs, was similar between mouse and human, indicating that the fetal exposure of these SSRIs in mice is comparable with the human situation. Fluvoxamine displayed a relatively low placental transfer, while fluoxetine showed a relatively high placental transfer. Using clinical doses of fluoxetine the mortality of the offspring increased dramatically, whereas the mortality was unaffected after fluvoxamine exposure. The majority of the fluoxetine-exposed offspring died postnatally of severe heart failure caused by dilated cardiomyopathy. Molecular analysis of fluoxetine-exposed offspring showed long-term alterations in serotonin transporter levels in the raphe nucleus. Furthermore, prenatal fluoxetine exposure resulted in depressive- and anxiety-related behavior in adult mice. In contrast, fluvoxamine-exposed mice did not show alterations in behavior and serotonin transporter levels. Decreasing the dose of fluoxetine resulted in higher survival rates and less dramatic effects on the long-term behavior in the offspring. CONCLUSIONS: These results indicate that prenatal fluoxetine exposure affects fetal development, resulting in cardiomyopathy

  9. Transcatheter closure of abnormal vessels and arteriovenous fistulas with the Amplatzer vascular plug 4 in patients with congenital heart disease.

    Science.gov (United States)

    Wiegand, Gesa; Sieverding, Ludger; Bocksch, Wolfgang; Hofbeck, Michael

    2013-10-01

    Although vascular plugs allow the interventional closure of medium-sized to large abnormal vessels, their application is limited by the need for long sheaths or large guiding catheters. The authors report their experience with the new Amplatzer vascular plug 4 (AVP 4), a self-expanding spindle-shaped occluder made of Nitinol wire mash, which can be placed through 4-Fr catheters with an internal diameter of 0.038 in. or larger. From October 2009 until June 2012, 14 AVP 4 devices were deployed in 12 patients (ages, 0.3-48.8 years). Nine patients had venovenous or arteriovenous collaterals in functional univentricular hearts. One patient had pulmonary atresia with a ventricular septal defect and major aortopulmonary collateral arteries, and one patient had a pulmonary arteriovenous fistula. One child had a large coronary artery fistula to the right atrium. The authors used AVP 4 devices with diameters of 4-8 mm. In all the patients, the AVP 4 was implanted successfully. No occluder dislocations and no complications related to the procedure occurred. Complete vessel occlusion was achieved in seven cases. In seven additional cases, a residual shunt was present at the end of the procedure while the patients were still fully heparinized. In 2 of 14 vessels, the decision was made to place additional devices to abolish residual shunting. According to the authors' experience, the AVP 4 allows safe and effective occlusion of medium-size and large abnormal vessels. It is also well suited for tortuous high-flow vessels such as coronary or pulmonary arteriovenous fistulas. In case of a suboptimal position, it is possible to reposition the occluder with ease. Further studies are needed to determine whether initial residual shunting in heparinized patients disappears during follow-up care. The AVP 4 represents a valuable new device for the interventional treatment of complex congenital vessel malformations.

  10. Abnormalities in intracellular calcium regulation and contractile function in myocardium from dogs with pacing-induced heart failure

    Science.gov (United States)

    Perreault, C. L.; Shannon, R. P.; Komamura, K.; Vatner, S. F.; Morgan, J. P.

    1992-01-01

    24 d of rapid ventricular pacing induced dilated cardiomyopathy with both systolic and diastolic dysfunction in conscious, chronically instrumented dogs. We studied mechanical properties and intracellular calcium (Ca2+i) transients of trabeculae carneae isolated from 15 control dogs (n = 32) and 11 dogs with pacing-induced cardiac failure (n = 26). Muscles were stretched to maximum length at 30 degrees C and stimulated at 0.33 Hz; a subset (n = 17 control, n = 17 myopathic) was loaded with the [Ca2+]i indicator aequorin. Peak tension was depressed in the myopathic muscles, even in the presence of maximally effective (i.e., 16 mM) [Ca2+] in the perfusate. However, peak [Ca2+]i was similar (0.80 +/- 0.13 vs. 0.71 +/- 0.05 microM; [Ca2+]o = 2.5 mM), suggesting that a decrease in Cai2+ availability was not responsible for the decreased contractility. The time for decline from the peak of the Cai2+ transient was prolonged in the myopathic group, which correlated with prolongation of isometric contraction and relaxation. However, similar end-diastolic [Ca2+]i was achieved in both groups (0.29 +/- 0.05 vs. 0.31 +/- 0.02 microM), indicating that Cai2+ homeostasis can be maintained in myopathic hearts. The inotropic response of the myopathic muscles to milrinone was depressed compared with the controls. However, when cAMP production was stimulated by pretreatment with forskolin, the response of the myopathic muscles to milrinone was improved. Our findings provide direct evidence that abnormal [Ca2+]i handling is an important cause of contractile dysfunction in dogs with pacing-induced heart failure and suggest that deficient production of cAMP may be an important cause of these changes in excitation-contraction coupling.

  11. Introduction: December 2015 HeartWeek Issue of Cardiology in the Young - Highlights of HeartWeek 2015: Challenges and Dilemmas of Pediatric Cardiac Care including Heart Failure in Children and Congenital Abnormalities of the Coronary Arteries.

    Science.gov (United States)

    Jacobs, Jeffrey P

    2015-12-01

    This December Issue of Cardiology in the Young represents the 13th annual publication in Cardiology in the Young generated from the two meetings that composed "HeartWeek in Florida". "HeartWeek in Florida", the joint collaborative project sponsored by the Cardiac Centre at the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, together with Johns Hopkins All Children's Heart Institute of Saint Petersburg, Florida, averages over 1000 attendees every year and is now recognised as one of the major planks of continuing medical and nursing education for those working in the fields of diagnosis and treatment of cardiac disease in the foetus, neonate, infant, child, and adult. "HeartWeek in Florida" combines the International Symposium on Congenital Heart Disease, organised by All Children's Hospital and Johns Hopkins Medicine, and entering its 16th year, with the Annual Postgraduate Course in Paediatric Cardiovascular Disease, organised by The Children's Hospital of Philadelphia entering its 19th year. This December 2015 Issue of Cardiology in the Young features highlights of the two meetings that compose HeartWeek. Johns Hopkins All Children's Heart Institute's 15th Annual International Symposium on Congenital Heart Disease was held at the Renaissance Vinoy Resort & Golf Club, Saint Petersburg, Florida, from Friday, 6 February, 2015, to Monday, 9 February, 2015. This Symposium was co-sponsored by The American Association for Thoracic Surgery and its special focus was "Congenital Abnormalities of the Coronary Arteries". The Children's Hospital of Philadelphia's annual meeting - Cardiology 2015, the 18th Annual Update on Paediatric and Congenital Cardiovascular Disease: "Challenges and Dilemmas" - was held at the Hyatt Regency Scottsdale Resort and Spa at Gainey Ranch, Scottsdale, Arizona, from Wednesday, 11 February, 2015, to Sunday, 15 February, 2015. We would like to acknowledge the tremendous contributions made to paediatric and congenital cardiac care

  12. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    Science.gov (United States)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.

    2007-01-01

    Some individuals with Chagas disease develop right precordial lead ST segment elevation in response to an ajmaline challenge test, and the prevalence of right bundle branch block (RBBB) is also high in Chagas disease. Because these same electrocardiographic abnormalities occur in the Brugada syndrome, which involves genetically defective cardiac sodium channels, acquired damage to cardiac sodium channels may also occur in Chagas disease. We studied several conventional and advanced resting 12-lead/derived Frank-lead ECG parameters in 34 patients with Chagas -related heart disease (mean age 39 14 years) and in 34 age-/gender-matched healthy controls. All ECG recordings were of 5-10 min duration, obtained in the supine position using high fidelity hardware/software (CardioSoft, Houston, TX). Even after excluding those Chagas patients who had resting BBBs, tachycardia and/or pathologic arrhythmia (n=8), significant differences remained in multiple conventional and advanced ECG parameters between the Chagas and control groups (n=26/group), especially in their respective QT interval variability indices, maximal spatial QRS-T angles and low frequency HRV powers (p=0.0006, p=0.0015 and p=0.0314 respectively). In relation to the issue of potential damage to cardiac sodium channels, the Chagas patients had: 1) greater than or equal to twice the incidence of resting ST segment elevation in leads V1-V3 (n=10/26 vs. n=5/26) and of both leftward (n=5/26 versus n=0/26) and rightward (n=7/26 versus n=3/26) QRS axis deviation than controls; 2) significantly increased filtered (40-250 Hz) QRS interval durations (92.1 8.5 versus 85.3 plus or minus 9.0 ms, p=0.022) versus controls; and 3) significantly decreased QT and especially JT interval durations versus controls (QT interval: 387.5 plus or minus 26.4 versus 408.9 plus or minus 34.6 ms, p=0.013; JT interval: 290.5 plus or minus 26.3 versus 314.8 plus or minus 31.3 ms; p=0.0029). Heart rates and Bazett-corrected QTc/JTc intervals

  13. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular or abnormal ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  14. A survey of views and opinions of health professionals managing thirst in chronic heart failure.

    Science.gov (United States)

    Allida, Sabine M; Inglis, Sally C; Davidson, Patricia M; Hayward, Christopher S; Shehab, Sajad; Newton, Phillip J

    2016-01-01

    Thirst is a common and burdensome symptom of chronic heart failure (CHF) which affects adherence to self-care practices specifically fluid restriction. Despite this, there is no standard clinical practice for managing the symptom of thirst. The aim is to identify the current strategies recommended by health professionals to help relieve thirst in CHF patients and their perceived usefulness of these strategies. A survey was distributed to attendees of the 8th Annual Scientific Meeting of Australasian Cardiovascular Nursing College. There were 42 of 70 respondents to the survey. The majority (33 of 40; 82.5%) had recommended various strategies to alleviate thirst. The most recommended strategy was ice chips (36 of 38; 94.7%). Overall, the respondents reported 'some use' in all of the strategies. Information from this survey may help in the incorporation of thirst-relieving strategies into evidence-based guidelines; further improving the quality of care of patients.

  15. Basic life support revisited – New American Heart Association, 2015, guidelines: An update for dental professionals

    Directory of Open Access Journals (Sweden)

    Mohammed Nadeem Ahmed Bijle

    2015-01-01

    Full Text Available American Heart Association (AHA - a professional organization dealing with appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke, portrays the necessity of continuous evaluated evidence-based medicine. Thus, AHA formally introduces every 5 years their guidelines for the Emergency Cardiovascular Care on the basis of a thorough evidence search to make provision of the best possible treatment for patients with cardiac emergencies. Since, new 2015 AHA guidelines are established very recently, awareness of our fellow dentists with its major changes at least with respect to basic life support (BLS seems important. Hence, this communication is scripted to throw light on the significant changes in 2015 AHA guidelines has brought in BLS protocols.

  16. (13)N-Ammonia PET/CT Detection of Myocardial Perfusion Abnormalities in Beagle Dogs After Local Heart Irradiation.

    Science.gov (United States)

    Song, Jianbo; Yan, Rui; Wu, Zhifang; Li, Jianguo; Yan, Min; Hao, Xinzhong; Liu, Jianzhong; Li, Sijin

    2017-04-01

    Our objective was to determine the potential value of (13)N-ammonia PET/CT myocardial perfusion imaging (MPI) for early detection of myocardial perfusion changes induced by radiation damage. Methods: Thirty-six Beagle dogs were randomly divided into a control group (n = 18) or an irradiation group (n = 18). The latter underwent local irradiation to the left ventricular anterior cardiac wall with a single dose of 20 Gy, whereas the former received sham irradiation. All dogs underwent (13)N-ammonia PET/CT MPI 1 wk before irradiation and at 3, 6, and 12 mo after sham or local irradiation. One week after undergoing (13)N-ammonia PET/CT MPI, the irradiation group underwent coronary angiography. Six randomly selected dogs from each group were sacrificed and used to detect pathologic cardiac injury at 3, 6, and 12 mo after irradiation. Results: Compared with the control group and baseline, the irradiation group showed significantly increased perfusion in the irradiated area of the heart at 3 mo after irradiation, perfusion reduction at 6 mo after irradiation, and a perfusion defect at 12 mo after irradiation. There was no significant difference in the left ventricular ejection fraction between the control and irradiation groups at baseline or at 3 mo after irradiation. The irradiation group showed a reduction of left ventricular ejection fraction compared with the control group at 6 mo (50.0% ± 8.1% vs. 59.3% ± 4.1%, P = 0.016) and 12 mo (47.2% ± 6.7% vs. 57.4% ± 3.3%, P = 0.002) after irradiation. No coronary stenosis was observed in the irradiation group. Regional wall motion abnormalities appeared in the irradiated area at 6 mo after irradiation, and its extent was enlarged at 12 mo after irradiation. Pathologic changes were observed; radiation-induced myocardial tissue damage and microvascular fibrosis in the irradiated area progressively increased over time. Conclusion:(13)N-ammonia PET/CT MPI can dynamically detect myocardial perfusion changes together with

  17. Evening heart rate measured at home is associated with visceral obesity and abnormal fat distribution in patients with hypertension.

    Science.gov (United States)

    Yano, Yuichiro; Haimoto, Hajime; Hoshide, Satoshi; Kabutoya, Tomoyuki; Eguchi, Kazuo; Kario, Kazuomi

    2011-07-01

    Our aim was to examine the association between heart rate (HR) and visceral obesity and abnormal fat distribution in patients undergoing treatment for hypertension. We also ascertained whether such associations differ depending on the time of day when HR is measured and the venue at which the measurement is carried out (office or home). The study enrolled a total of 390 patients (mean age 63.9 years; 45% men) receiving treatment with antihypertensive drugs other than β blockers or nondihydropyridine Ca-channel blockers. Office blood pressure (BP) and HR as well as home BP and HR, both morning and evening, were measured in all these patients for 14 days. The amount of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were determined using abdominal computed tomography (CT). Evening HR was positively associated with VAT (r = 0.26) and negatively associated with SAT (r = -0.16); as a consequence, evening HR was closely associated with the VAT/SAT ratio (r = 0.30; all P logistic regression analysis revealed that a 1-s.d. increase (10 beats per minute) in evening HR was significantly associated with visceral obesity (defined as VAT ≥100 cm)(2) (odds ratio (95% confidence interval: 1.7 (1.3-2.3)), P < 0.001), and that this association was independent of body mass index (BMI) and abdominal obesity (waist circumference ≥85 cm for men and ≥90 cm for women). In these patients receiving treatment for hypertension, high evening HR was associated with visceral obesity, independent of the presence of subcutaneous fat and BMI. This novel finding could explain why cardiovascular risk is higher in individuals with high HR.

  18. Patient, carer and professional perspectives on barriers and facilitators to quality care in advanced heart failure.

    Directory of Open Access Journals (Sweden)

    Susan Browne

    Full Text Available Those with advanced heart failure (HF experience high levels of morbidity and mortality, similar to common cancers. However, there remains evidence of inequity of access to palliative care services compared to people with cancer. This study examines patient, carer, and professional perspectives on current management of advanced HF and barriers and facilitators to improved care.Qualitative study involving semi-structured interviews and focus groups with advanced HF patients (n = 30, carers (n = 20, and professionals (n = 65. Data analysed using Normalisation Process Theory (NPT as the underpinning conceptual framework.Uncertainty is ubiquitous in accounts from advanced HF patients and their caregivers. This uncertainty relates to understanding of the implications of their diagnosis, appropriate treatments, and when and how to seek effective help. Health professionals agree this is a major problem but feel they lack knowledge, opportunities, or adequate support to improve the situation. Fragmented care with lack of coordination and poor communication makes life difficult. Poor understanding of the condition extends to the wider circle of carers and means that requests for help may not be perceived as legitimate, and those with advanced HF are not prioritised for social and financial supports. Patient and caregiver accounts of emergency care are uniformly poor. Managing polypharmacy and enduring concomitant side effects is a major burden, and the potential for rationalisation exists. This study has potential limitations because it was undertaken within a single geographical location within the United Kingdom.Little progress is being made to improve care experiences for those with advanced HF. Even in the terminal stages, patients and caregivers are heavily and unnecessarily burdened by health care services that are poorly coordinated and offer fragmented care. There is evidence that these poor experiences could be improved to a large extent by

  19. Effect of heartfulness meditation on burnout, emotional wellness, and telomere length in health care professionals.

    Science.gov (United States)

    Thimmapuram, Jayaram; Pargament, Robert; Sibliss, Kedesha; Grim, Rodney; Risques, Rosana; Toorens, Erik

    2017-01-01

    Background: Burnout poses significant challenges during training years in residency and later in the career. Meditation is a tool to treat stress-related conditions and promote wellness. Telomere length may be affected by burnout and stress. However, the benefits of meditation have not been fully demonstrated in health care professionals. Objective: We assessed the effects of a 12-week 'Heartfulness Meditation' program on burnout, emotional wellness, and telomere length in residents, faculty members, and nurses at a large community teaching hospital during the 2015-16 academic year. Methods: All subjects completed a baseline Maslach Burnout Inventory (MBI) and Emotional Wellness Assessment (EWA) at the beginning of the study. Meditators received instructions in Heartfulness Meditation. At week 12, subjects completed a follow up MBI and EWA scores. Salivary telomere length was measured at baseline and week 12. Results: Twenty-seven out of a total 155 residents (17.4%) along with eight faculty physicians and 12 nurses participated in the study. Thirty-five enrolled as meditators and 12 as controls. At 12 weeks, the meditators had statistically significant improvement in all measures of burnout and in nearly all attributes of EWA. Controls showed no statistically significant changes in either burnout or emotional wellness scores. Relative telomere length increased with statistical significance in a younger subset of meditators. Conclusion: Our results indicate that meditation offers an accessible and efficient method by which physician and nurse burnout can be ameliorated and wellness can be enhanced. The increased telomere length is an interesting finding but needs to be confirmed with further research. Abbreviations: EWA: Emotional wellness assessment; MBI: Maslach burnout inventory; EE: Emotional exhaustion; DP: Depersonalization; PA: Personal accomplishment; PI: Prinicipal investigator; JT: Jayaram Thimmapuram.

  20. Persistent abnormalities in pulmonary arterial compliance after heart transplantation in patients with combined post-capillary and pre-capillary pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Stefano Ghio

    Full Text Available The hemodynamic definitions of pulmonary hypertension (PH in left heart disease have recently been refined to better match the characteristics required to reflect the presence of pulmonary vascular disease. Accordingly, we tested the hypothesis that abnormalities in the stiffness of pulmonary circulation would persist after heart transplantation in patients with combined post-capillary and pre-capillary PH (Cpc-PH in contrast to those with isolated post-capillary PH (Ipc-PH.We retrospectively analyzed right heart hemodynamics in a cohort of 295 consecutive patients with heart failure and advanced left ventricular systolic dysfunction (LVSD before and 1 year after heart transplantation.According to their baseline hemodynamic profile, patients were classified as: 75 Cpc-PH, 111 Ipc-PH, and 98 without PH (no-PH, and 11 pre-capillary PH. One year after heart transplantation, pulmonary artery pressures, pulmonary vascular resistance and cardiac index normalized in all patients regardless of the baseline hemodynamic profile. However, pulmonary arterial compliance remained lower in Cpc-PH patients (from 1.6±1.2 at baseline to 3.7±1.4 ml/mmHg at 1 year than in Ipc-PH (from 1.2±2.0 to 4.4±2.3 ml/mmHg and no-PH patients (from 3.7±2.0 to 4.5±1.8 ml/mmHg; (adjusted p = 0.03 Ipc-PH vs. Cpc-PH INT<0.001.In heart failure patients with advanced LVSD, a hemodynamic profile characterized by Cpc-PH predicts the persistence of a stiffer pulmonary circulation at 1 year after heart transplantation.

  1. Social media in paediatric heart disease: professional use and opportunities to improve cardiac care.

    Science.gov (United States)

    Schumacher, Kurt R; Lee, Joyce M; Pasquali, Sara K

    2015-12-01

    Social media is any type of communication utilising electronic technology that follows two guiding principles: free publishing or sharing of content and ideas and group collaboration and inter-connectedness. Over the last 10 years, social media technology has made tremendous inroads into all facets of communication. Modalities such as Facebook, YouTube, and Twitter are no longer viewed as new communication technologies. Owing to their tremendous usage, they are now common ways to conduct a dialogue with individuals and groups. Greater than 91% of teenagers and 89% of young adults routinely use social media. Further, 24% of teenagers reported being online "almost constantly". These forms of communication are readily used by individuals cared for in the field of paediatric cardiology; thus, they should carry significant interest for cardiology care providers; however, social media's influence on medicine extends beyond use by patients. It directly affects all medical providers, both users and non-users. Further, social media has the ability to improve care for patients with paediatric heart disease. This article details social media's current influence on paediatric cardiology, including considerations for professional use of social media and potential opportunities to improve cardiac care.

  2. The association between white-matter tract abnormalities, and neuropsychiatric and cognitive symptoms in retired professional football players with multiple concussions.

    Science.gov (United States)

    Multani, Namita; Goswami, Ruma; Khodadadi, Mozhgan; Ebraheem, Ahmed; Davis, Karen D; Tator, Charles H; Wennberg, Richard; Mikulis, David J; Ezerins, Leo; Tartaglia, Maria Carmela

    2016-07-01

    Retired professional athletes, who have suffered repetitive concussions, report symptoms of depression, anxiety, and memory impairment over time. Moreover, recent imaging data suggest chronic white-matter tract deterioration in sport-related concussion. The aim of this study is to evaluate the impact of repetitive concussions in retired professional football players on white-matter tracts, and relate these changes to neuropsychological function. All subjects (18 retired professional football players and 17 healthy controls) underwent imaging, neuropsychological assessment, and reported on concussion-related symptoms. Whole brain tract-based spatial statistics analysis revealed increased axial diffusivity in the right hemisphere of retired players in the (1) superior longitudinal fasciculus (SLF), (2) corticospinal tract, and (3) anterior thalamic radiations, suggesting chronic axonal degeneration in these tracts. Moreover, retired players report significantly higher neuropsychiatric and cognitive symptoms than healthy controls, and worsening of these symptoms since their last concussion. Loss of integrity in the right SLF significantly correlated with participants' visual learning ability. In sum, these results suggest that repetitive concussions in retired professional football players are associated with focal white-matter tract abnormalities that could explain some of the neuropsychiatric symptoms and cognitive deficits experienced by these retired athletes.

  3. Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care.

    Science.gov (United States)

    Gund, Anna; Lindecrantz, Kaj; Schaufelberger, Maria; Patel, Harshida; Sjöqvist, Bengt Arne

    2012-11-28

    eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of healthcare ICT, and 54% had high

  4. Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care

    Science.gov (United States)

    2012-01-01

    Background eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. Method This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Results Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of

  5. Nurses in post-operative heart surgery: professional competencies and organization strategies.

    Science.gov (United States)

    Santos, Ana Paula Azevedo; Camelo, Silvia Helena Henriques; Santos, Fabiana Cristina Dos; Leal, Laura Andrian; Silva, Beatriz Regina da

    2016-01-01

    To analyze nurses' competencies with regard to their work in post-operative heart surgery and the strategies implemented to mobilize these competencies. This was an exploratory study with a qualitative approach and a methodological design of collective case study. It was carried out in three post-operative heart surgery units, consisting of 18 nurses. Direct observation and semi-structured interviews were employed to collect data. Data were construed through thematic analysis. nine competencies were found, as follows: theoretical-practical knowledge; high-complexity nursing care; nursing supervision; leadership in nursing; decision making; conflict management; personnel management; material and financial resources management; and on-job continued education. Organizational and individual strategies were employed to develop and improve competencies such as regular offerings of courses and lectures, in addition to the individual pursuit for knowledge and improvement. the study is expected to lead future nurses and training centers to evaluate the need for furthur training required to work in cardiac units, and also the need for implementing programs aimed at developing the competencies of these professionals. Analisar as competências dos enfermeiros para atuarem no pós-operatório de cirurgia cardíaca e estratégias implementadas para a mobilização dessas competências. Estudo exploratório, com abordagem qualitativa e desenho metodológico estudo de caso coletivo. Foi realizado em três unidades pós-operatórias de cirurgias cardíacas, com 18 enfermeiros. Na coleta de dados utilizou-se observação direta e entrevista semiestruturada. Para interpretação dos dados optou-se pela análise temática. Foram identificadas nove competências, sendo: conhecimento teórico-prático, cuidados de enfermagem de alta complexidade, supervisão e liderança em enfermagem, tomada de decisão, gerenciamento de conflitos, de recursos humanos, materiais, financeiros e educa

  6. Communicating with Professionals

    Medline Plus

    Full Text Available ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart ... than you (or your professionals) want. Simple communication skills can help you get what you need – over ...

  7. Percutaneous Lymphatic Embolization of Abnormal Pulmonary Lymphatic Flow as Treatment of Plastic Bronchitis in Patients With Congenital Heart Disease

    National Research Council Canada - National Science Library

    Dori, Yoav; Keller, Marc S; Rome, Jonathan J; Gillespie, Matthew J; Glatz, Andrew C; Dodds, Kathryn; Goldberg, David J; Goldfarb, Samuel; Rychik, Jack; Itkin, Maxim

    2016-01-01

    ... as a treatment for these patients. METHODS AND RESULTS—This is a retrospective case series of 18 patients with surgically corrected congenital heart disease and plastic bronchitis who presented for lymphatic imaging and intervention...

  8. Increased stiffness is the major early abnormality in a pig model of severe aortic stenosis and predisposes to congestive heart failure in the absence of systolic dysfunction.

    Science.gov (United States)

    Ishikawa, Kiyotake; Aguero, Jaume; Oh, Jae Gyun; Hammoudi, Nadjib; Fish, Lauren A; Leonardson, Lauren; Picatoste, Belén; Santos-Gallego, Carlos G; Fish, Kenneth M; Hajjar, Roger J

    2015-05-20

    It remains unclear whether abnormal systolic function and relaxation are essential for developing heart failure in pathophysiology of severe aortic stenosis. Yorkshire pigs underwent surgical banding of the ascending aorta. The animals were followed for up to 5 months after surgery, and cardiac function was assessed comprehensively by invasive pressure-volume measurements, 3-dimensional echocardiography, echocardiographic speckle-tracking strain, and postmortem molecular and histological analyses. Pigs with aortic banding (n=6) exhibited significant left ventricular hypertrophy with increased stiffness compared with the control pigs (n=7) (end-diastolic pressure-volume relationship β: 0.053±0.017 versus 0.028±0.009 mm Hg/mL, P=0.007); however, all other parameters corresponding to systolic function, including ejection fraction, end-systolic pressure-volume relationship, preload recruitable stroke work, echocardiographic circumferential strain, and longitudinal strain, were not impaired in pigs with aortic banding. Relaxation parameters were also similar between groups. Sarcoplasmic reticulum calcium (Ca(2+)) ATPase protein levels in the left ventricle were similar. There were significant increases in 3-dimensional echocardiographic left atrial volumes, suggesting the usefulness of these indexes to detect increased stiffness. Right atrial pacing with a heart rate of 120 beats per minute induced increased end-diastolic pressure in pigs with aortic banding in contrast to decreased end-diastolic pressure in the control pigs. Histological evaluation revealed that increased stiffness was accompanied by cardiomyocyte hypertrophy and increased perimysial and perivascular fibrosis. Increased stiffness is the major early pathological process that predisposes to congestive heart failure without abnormalities in systolic function and relaxation in a clinically relevant animal model of aortic stenosis. © 2015 The Authors. Published on behalf of the American Heart

  9. Pulmonary Vein, Dorsal Atrial Wall and Atrial Septum Abnormalities in Podoplanin Knockout Mice With Disturbed Posterior Heart Field Contribution

    NARCIS (Netherlands)

    Douglas, Yvonne L.; Mahtab, Edris A. F.; Jongbloed, Monique R. M.; Uhrin, Pavel; Zaujec, Jan; Binder, Bernd R.; Schalij, Martin J.; Poelmann, Robert E.; Deruiter, Marco C.; Gittenberger-De Groot, Adriana C.

    The developing sinus venosus myocardium, derived from the posterior heart field, contributes to the atrial septum, the posterior atrial wall, the sino-atrial node, and myocardium lining the pulmonary and cardinal veins, all expressing podoplanin, a coelomic and myocardial marker. . We compared

  10. Plasma Amino Acid Abnormalities in Chronic Heart Failure. Mechanisms, Potential Risks and Targets in Human Myocardium Metabolism.

    Science.gov (United States)

    Aquilani, Roberto; La Rovere, Maria Teresa; Corbellini, Daniela; Pasini, Evasio; Verri, Manuela; Barbieri, Annalisa; Condino, Anna Maria; Boschi, Federica

    2017-11-15

    The goal of this study was to measure arterial amino acid levels in patients with chronic heart failure (CHF), and relate them to left ventricular function and disease severity. Amino acids (AAs) play a crucial role for heart protein-energy metabolism. In heart failure, arterial AAs, which are the major determinant of AA uptake by the myocardium, are rarely measured. Forty-one subjects with clinically stable CHF (New York Heart Association (NYHA) class II to IV) were analyzed. After overnight fasting, blood samples from the radial artery were taken to measure AA concentrations. Calorie (KcalI), protein-, fat-, carbohydrate-intake, resting energy expenditure (REE), total daily energy expenditure (REE × 1.3), and cardiac right catheterization variables were all measured. Eight matched controls were compared for all measurements, with the exception of cardiac catheterization. Compared with controls, CHF patients had reduced arterial AA levels, of which both their number and reduced rates are related to Heart Failure (HF) severity. Arterial aspartic acid correlated with stroke volume index (r = 0.6263; p < 0.0001) and cardiac index (r = 0.4243; p = 0.0028). The value of arterial aspartic acid (µmol/L) multiplied by the cardiac index was associated with left ventricular ejection fraction (r = 0.3765; p = 0.0076). All NYHA groups had adequate protein intake (≥1.1 g/kg/day) and inadequate calorie intake (KcalI < REE × 1.3) was found only in class IV patients. This study showed that CHF patients had reduced arterial AA levels directly related to clinical disease severity and left ventricular dysfunction.

  11. Plasma Amino Acid Abnormalities in Chronic Heart Failure. Mechanisms, Potential Risks and Targets in Human Myocardium Metabolism

    Directory of Open Access Journals (Sweden)

    Roberto Aquilani

    2017-11-01

    Full Text Available The goal of this study was to measure arterial amino acid levels in patients with chronic heart failure (CHF, and relate them to left ventricular function and disease severity. Amino acids (AAs play a crucial role for heart protein-energy metabolism. In heart failure, arterial AAs, which are the major determinant of AA uptake by the myocardium, are rarely measured. Forty-one subjects with clinically stable CHF (New York Heart Association (NYHA class II to IV were analyzed. After overnight fasting, blood samples from the radial artery were taken to measure AA concentrations. Calorie (KcalI, protein-, fat-, carbohydrate-intake, resting energy expenditure (REE, total daily energy expenditure (REE × 1.3, and cardiac right catheterization variables were all measured. Eight matched controls were compared for all measurements, with the exception of cardiac catheterization. Compared with controls, CHF patients had reduced arterial AA levels, of which both their number and reduced rates are related to Heart Failure (HF severity. Arterial aspartic acid correlated with stroke volume index (r = 0.6263; p < 0.0001 and cardiac index (r = 0.4243; p = 0.0028. The value of arterial aspartic acid (µmol/L multiplied by the cardiac index was associated with left ventricular ejection fraction (r = 0.3765; p = 0.0076. All NYHA groups had adequate protein intake (≥1.1 g/kg/day and inadequate calorie intake (KcalI < REE × 1.3 was found only in class IV patients. This study showed that CHF patients had reduced arterial AA levels directly related to clinical disease severity and left ventricular dysfunction.

  12. New Lethal Skeletal Dysplasia with Dandy-Walker Malformation, Congenital Heart Defects, Abnormal Thumbs, Hypoplastic Genitalia, and Distinctive Facies

    Science.gov (United States)

    Stevens, Cathy A.; Lachman, Ralph S.

    2011-01-01

    We report on two sibs with a lethal form of bone dysplasia with distinctive skeletal findings including rhizomelic and mesomelic limb shortening, hooked clavicles, dumbbell femurs, and absence of talus and calcaneus ossification. Other clinical features include Dandy-Walker malformation, congenital heart defects, joint contractures, genital hypoplasia, and distinctive facial features. These sibs appear to have a previously undescribed skeletal dysplasia, which is most likely inherited in an autosomal recessive fashion. PMID:20602491

  13. Long-Term Persistency of Abnormal Heart Rate Variability following Long NICU Stay and Surgery at Birth

    Directory of Open Access Journals (Sweden)

    Mélanie Morin

    2014-01-01

    Full Text Available Preterm birth is associated with painful procedures during the neonatal intensive care unit (NICU stay. Full-term newborns can also experience pain, following surgery. These procedures can have long-lasting consequences. It has been shown that children born preterm show pain responses and cardiac alterations. This study aimed to explore the heart rate reactivity to pain in 107 subjects born either preterm or full-term who were between 7 and 25 years old at testing. We also evaluated the effect of pain experienced at birth, as represented by a longer NICU stay, time under ventilation, and surgery at birth. Participants were asked to immerse their right forearm in 10°C water for 2 minutes. Electrocardiograms were recorded at baseline and during the immersion procedure. Full-term subjects showed a stable increase in heart rate throughout the procedure, whereas preterm ones showed a strong increase at the beginning, which decreased over time. Also, preterm and full-term subjects who experienced pain at birth showed higher resting heart rate, stronger sympathetic activity, and lower cardiac vagal activity. Our study demonstrated a long-term impact of a long NICU stay and surgery at birth on cardiac autonomic activity. This could lead to impaired reactions to pain or stress in later life.

  14. Health Professionals' Expectations Versus Experiences of Internet-Based Telemonitoring : Survey Among Heart Failure Clinics

    NARCIS (Netherlands)

    de Vries, Arjen E.; van der Wal, Martje H. L.; Nieuwenhuis, Maurice M. W.; de Jong, Richard M.; van Dijk, Rene B.; Jaarsma, Tiny; Hillege, Hans L.

    Background: Although telemonitoring is increasingly used in heart failure care, data on expectations, experiences, and organizational implications concerning telemonitoring are rarely addressed, and the optimal profile of patients who can benefit from telemonitoring has yet to be defined. Objective:

  15. Health professionals' expectations versus experiences of internet-based telemonitoring: survey among heart failure clinics.

    Science.gov (United States)

    de Vries, Arjen E; van der Wal, Martje H L; Nieuwenhuis, Maurice M W; de Jong, Richard M; van Dijk, Rene B; Jaarsma, Tiny; Hillege, Hans L

    2013-01-10

    Although telemonitoring is increasingly used in heart failure care, data on expectations, experiences, and organizational implications concerning telemonitoring are rarely addressed, and the optimal profile of patients who can benefit from telemonitoring has yet to be defined. To assess the actual status of use of telemonitoring and to describe the expectations, experiences, and organizational aspects involved in working with telemonitoring in heart failure in the Netherlands. In collaboration with the Netherlands Organization for Applied Scientific Research (TNO), a 19-item survey was sent to all outpatient heart failure clinics in the Netherlands, addressed to cardiologists and heart failure nurses working in the clinics. Of the 109 heart failure clinics who received a survey, 86 clinics responded (79%). In total, 31 out of 86 (36%) heart failure clinics were using telemonitoring and 12 heart failure clinics (14%) planned to use telemonitoring within one year. The number of heart failure patients receiving telemonitoring generally varied between 10 and 50; although in two clinics more than 75 patients used telemonitoring. The main goals for using telemonitoring are "monitoring physical condition", "monitoring signs of deterioration" (n=39, 91%), "monitoring treatment" (n=32, 74%), "adjusting medication" (n=24, 56%), and "educating patients" (n=33, 77%). Most patients using telemonitoring were in the New York Heart Association (NYHA) functional classes II (n=19, 61%) and III (n=27, 87%) and were offered the use of the telemonitoring system "as long as needed" or without a time limit. However, the expectations of the use of telemonitoring were not met after implementation. Eight of the 11 items about expectations versus experiences were significantly decreased (Ptelemonitoring in their work, in particular with respect to "keeping up with current development" (before 7.2, after 6.8, P=.15), "being innovative" (before 7.0, after 6.1, P=.003), and "better guideline

  16. New insights in professional horse racing; "in-race" heart rate data, elevated fracture risk, hydration, nutritional and lifestyle analysis of elite professional jockeys.

    Science.gov (United States)

    O'Reilly, John; Cheng, Hoi Lun; Poon, Eric Tsz-Chun

    2017-03-01

    Weight-making practices have been shown to impair musculoskeletal and physiological function of jockeys. This study investigated the "in-race" heart rate (HR) responses and hydration status during competitive racing, as well as selected physiological and lifestyle parameters of professional jockeys based in Hong Kong. "In-race" HR responses and early morning hydration status of 20 male jockeys were examined in hot and moderate climactic occasions. Additionally, bone mineral density (BMD), dietary intake and lifestyle choices were assessed. Osteopenia was observed in the calcanei of jockeys (left: 0.51 ± 0.06; right: 0.46 ± 0.12 g · cm-2). Energy and protein intake were significantly lower on a race day compared to a non-race day (P hydration status and nutritional intake, which can significantly enhance the fracture risk. Further research should develop exercise and nutrition guidelines for optimising their skeletal health.

  17. Prevalence and presentation of externalized conductors and electrical abnormalities in Riata defibrillator leads after fluoroscopic screening: report from the Netherlands Heart Rhythm Association Device Advisory Committee.

    Science.gov (United States)

    Theuns, Dominic A M J; Elvan, Arif; de Voogt, Willem; de Cock, Carel C; van Erven, Lieselot; Meine, Mathias

    2012-12-01

    The Riata family of implantable cardioverter-defibrillator (ICD) leads is prone to a specific insulation abrasion characterized by externalization of conductor cables. The objective of this study was to determine the prevalence of externalized conductors and electrical abnormalities in Riata ICD leads by fluoroscopic screening and standard ICD interrogation. All ICD implantation centers were contacted by the Netherlands Heart Rhythm Association Device Advisory Committee to identify all patients with an active Riata ICD lead and to perform fluoroscopic screening of the lead. In addition, the electrical integrity of the lead was assessed. As of March 1, 2012, data for 1029 active Riata leads were available; 47% of these were 8-F Riata and 53% were 7-F Riata ST. Externalized conductors were observed in 147 leads (14.3%). Proportion of externalized conductors was higher in 8-F Riata compared with 7-F Riata ST (21.4% vs 8.0%; Pconductors was 65.3 months. The estimated rates of externalized conductors were 6.9% and 36.6% at 5 and 8 years after implantation, respectively. Of the 147 leads with externalized conductors, 10.9% had abnormal electrical parameters vs 3.5% in nonexternalized leads (Pconductors in Riata leads is significantly high (14.3%) using fluoroscopic screening. The majority of externalized conductors are not detectable with standard ICD interrogation. Screening with fluoroscopy is reasonable.

  18. Effects of Yoga on Stress, Stress Adaption, and Heart Rate Variability Among Mental Health Professionals--A Randomized Controlled Trial.

    Science.gov (United States)

    Lin, Shu-Ling; Huang, Ching-Ya; Shiu, Shau-Ping; Yeh, Shu-Hui

    2015-08-01

    Mental health professionals experiencing work-related stress may experience burn out, leading to a negative impact on their organization and patients. The aim of this study was to examine the effects of yoga classes on work-related stress, stress adaptation, and autonomic nerve activity among mental health professionals. A randomized controlled trial was used, which compared the outcomes between the experimental (e.g., yoga program) and the control groups (e.g., no yoga exercise) for 12 weeks. Work-related stress and stress adaptation were assessed before and after the program. Heart rate variability (HRV) was measured at baseline, midpoint through the weekly yoga classes (6 weeks), and postintervention (after 12 weeks of yoga classes). The results showed that the mental health professionals in the yoga group experienced a significant reduction in work-related stress (t = -6.225, p yoga and control groups, we found the yoga group significantly decreased work-related stress (t = -3.216, p = .002), but there was no significant change in stress adaptation (p = .084). While controlling for the pretest scores of work-related stress, participants in yoga, but not the control group, revealed a significant increase in autonomic nerve activity at midpoint (6 weeks) test (t = -2.799, p = .007), and at posttest (12 weeks; t = -2.099, p = .040). Because mental health professionals experienced a reduction in work-related stress and an increase in autonomic nerve activity in a weekly yoga program for 12 weeks, clinicians, administrators, and educators should offer yoga classes as a strategy to help health professionals reduce their work-related stress and balance autonomic nerve activities. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Society for Worldviews on Evidence-Based Nursing.

  19. Abnormal Ca2+ homeostasis, atrial arrhythmogenesis and sinus node dysfunction in murine hearts modelling RyR2 modification

    Directory of Open Access Journals (Sweden)

    Yanmin eZhang

    2013-06-01

    Full Text Available RyR2 mutations are implicated in catecholaminergic polymorphic ventricular tachycardia thought to result from altered myocyte Ca2+ homeostasis reflecting inappropriate ‘leakiness’ of RyR2-Ca2+ release channels arising from increases in their basal activity, alterations in their phosphorylation, or defective interactions with other molecules or ions. The latter include calstabin, calsequestrin-2, Mg2+, and extraluminal or intraluminal Ca2+. Recent clinical studies additionally associate RyR2 abnormalities with atrial arrhythmias including atrial tachycardia, fibrillation and standstill, and sinus node dysfunction. Some RyR2 mutations associated with CPVT in mouse models also show such arrhythmias that similarly correlate with altered Ca2+ homeostasis. Some examples show evidence for increased Ca2+/calmodulin-dependent protein kinase II phosphorylation of RyR2. A homozygotic RyR2-P2328S variant demonstrates potential arrhythmic substrate resulting from reduced conduction velocity in addition to delayed afterdepolarizations and ectopic action potential firing. Finally, one model with an increased RyR2 activity in the sino-atrial node shows decreased automaticity in the presence of Ca2+-dependent decreases in ICa,L and diastolic sarcoplasmic reticular Ca2+ depletion.

  20. Immediate effects of reiki on heart rate variability, cortisol levels, and body temperature in health care professionals with burnout.

    Science.gov (United States)

    Díaz-Rodríguez, Lourdes; Arroyo-Morales, Manuel; Fernández-de-las-Peñas, Cesar; García-Lafuente, Francisca; García-Royo, Carmen; Tomás-Rojas, Inmaculada

    2011-10-01

    Burnout is a work-related mental health impairment comprising three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Reiki aims to help replenish and rebalance the body's energetic system, thus stimulating the healing process. The objective of this placebo-controlled, repeated measures, crossover, single-blind, randomized trial was to analyze the immediate effects of Reiki on heart rate variability (HRV), body temperature, and salivary flow rate and cortisol level in health care professionals with burnout syndrome (BS). Participants included 21 health care professionals with BS, who were asked to complete two visits to the laboratory with a 1-week interval between sessions. They were randomly assigned the order in which they would receive a Reiki session applied by an experienced therapist and a placebo treatment applied by a therapist with no knowledge of Reiki, who mimicked the Reiki treatment. Temperature, Holter ECG recordings (standard deviation of the normal-to-normal interval [SDNN], square root of mean squared differences of successive NN intervals [RMSSD], HRV index, low frequency component [LF], and high frequency component [HF]), salivary flow rate and cortisol levels were measured at baseline and postintervention by an assessor blinded to allocation group. SDNN and body temperature were significantly higher after the Reiki treatment than after the placebo. LF was significantly lower after the Reiki treatment. The decrease in the LF domain was associated with the increase in body temperature. These results suggest that Reiki has an effect on the parasympathetic nervous system when applied to health care professionals with BS.

  1. Hospitalized congestive heart failure patients with preserved versus abnormal left ventricular systolic function: clinical characteristics and drug therapy.

    Science.gov (United States)

    McDermott, M M; Feinglass, J; Sy, J; Gheorghiade, M

    1995-12-01

    To compare clinical characteristics of and pharmacologic therapy for hospitalized patients with congestive heart failure (CHF) and left ventricular systolic dysfunction or normal left ventricular systolic function. Medical records were reviewed for all patients discharged with a principal diagnosis of CHF from a university hospital and a community hospital between September 1, 1991 and August 31, 1992. Pertinent medical history items and prescribed drug therapies at discharge were recorded for each patient's first calendar year admission. Patients were categorized as having either normal left ventricular systolic function or systolic dysfunction based on the results of echocardiography and radionuclide angiography or contrast ventriculogram. Of 298 patients with CHF, 92 (31%) had normal left ventricular systolic function. Patients with normal systolic function were older, were more often women, were less likely to have a history of coronary artery disease, and were more likely to have a history of hypothyroidism than patients with systolic dysfunction. However, the prevalence of clinical characteristics overlapped considerably between the two groups. Among patients with systolic dysfunction, 79% were discharged on a therapeutic regimen of digoxin, 65% on an angiotensin-converting enzyme inhibitor, and 26% on either a beta-blocker or a calcium channel blocker. Among patients with normal systolic function, 50% were discharged on a regimen of a beta-blocker or a calcium channel blocker and 38% were discharged on digoxin. Twenty-six percent of patients with normal systolic function and without a history of atrial fibrillation were discharged on a digoxin regimen. Hospitalized CHF patients with normal left ventricular systolic function and those with diminished left ventricular systolic function share many clinical features. Since recommended drug therapy and prognosis differ, our data underscore the importance of diagnostic testing to assess left ventricular systolic

  2. Health Professionals' Expectations Versus Experiences of Internet-Based Telemonitoring: Survey Among Heart Failure Clinics

    OpenAIRE

    Arjen E. de Vries; van der Wal, Martje H. L.; Nieuwenhuis, Maurice M. W.; Jong, Richard M. de; Rene B. van Dijk; Jaarsma, Tiny; Hillege, Hans L.

    2013-01-01

    Background: Although telemonitoring is increasingly used in heart failure care, data on expectations, experiences, and organizational implications concerning telemonitoring are rarely addressed, and the optimal profile of patients who can benefit from telemonitoring has yet to be defined. less thanbrgreater than less thanbrgreater thanObjective: To assess the actual status of use of telemonitoring and to describe the expectations, experiences, and organizational aspects involved in working wi...

  3. Pathology and nuclear abnormalities in hearts of transgenic mice expressing M371K lamin A encoded by an LMNA mutation causing Emery-Dreifuss muscular dystrophy.

    Science.gov (United States)

    Wang, Yuexia; Herron, Alan J; Worman, Howard J

    2006-08-15

    Mutations in LMNA, which encodes nuclear lamins A and C, cause a broad range of diseases, including autosomal dominant Emery-Dreifuss muscular dystrophy (EDMD) and related disorders with a predominant cardiomyopathy. Homozygous Lmna model "knock-in" and null mice develop cardiomyopathy, whereas heterozygous mice do not. Overexpression of lamin A mutants that cause cardiomyopathy in cultured cells induces morphological abnormalities in the nuclear envelope and lamina; however, effects on tissue and organ pathology have not been determined. We used the heart-selective alpha-myosin heavy chain promoter to drive expression in transgenic mice of human wild-type and M371K lamin A, which causes EDMD. Mice expressing M371K lamin A were born at approximately 0.07 of the expected frequency and those born typically died at 2-7 weeks of age. Histological analysis showed increased eosinophilia and fragmentation of cardiomyofibrils, nuclear pyknosis and edema without fibrosis or significant inflammation, indicative of acute or subacute injury. Mice expressing human wild-type lamin A were born at only slightly less than the expected frequency and had normal life spans. Confocal immunofluorescence microscopy demonstrated abnormal nuclear envelopes with intranuclear foci of lamins in cardiac cells expressing M371K lamin A. Electron microscopy revealed extensively convoluted nuclear envelopes, intranuclear inclusions and chromatin clumps in cardiomyocyte nuclei. These results demonstrate that expression of a lamin A mutant that induces alterations in nuclear morphology can cause tissue and organ damage in mice with a normal complement of wild-type lamins.

  4. Short-term exposure to ambient fine particulate matter (PM2,5 and PM10 and the risk of heart rhythm abnormalities and stroke

    Directory of Open Access Journals (Sweden)

    Małgorzata Kowalska

    2016-09-01

    Full Text Available Results of epidemiological studies suggest a significant impact of ambient particulate matter air pollution (PM10 and PM2,5 on the health of the population. Increased level of these pollutants is connected with increased rate of daily mortality and hospitalizations due to cardiovascular diseases. Among analyzed health effects, heart arrhythmias and stroke are mentioned most frequently. The aim of the study was to present the current knowledge of potential influence of the exposure to fine particulate matter on the presence of arrhythmias and strokes. Subject literature review suggests, that there is a link between short-term exposure to fine dust and the occurrence of arrhythmias. Results of previous studies indicates that this exposure may lead to significant electrophysiological changes in heart, resulting in higher susceptibility to cardiac rhythm abnormalities. In case of stroke, a stronger correlation between number of hospitalizations and death cases and exposure to fine dust was seen for ischaemic stroke than for haemorhhagic stroke. In addition, a significantly more harmful impact of the exposure to ultra particles (particles of aerodynamic diameter below 2,5 μm has been confirmed. Among important mechanisms responsible for observed health impact of particulate matter there are: induction and intensification of inflammation, increased oxidative stress, increased autonomic nervous system activity, vasoconstriction, rheological changes and endothelial dysfunction. Among people of higher susceptibility to fine dust negative health impact are: elderly (over 65 years old, obese people, patients with respiratory and cardiovascular diseases, patients with diabetes and those with coagulation disorders. For further improvement of general health status, actions aimed at reducing the risk associated with fine dust and at the same time at continuing studies to clarify the biological mechanisms explaining the influence of fine dust on human health

  5. Update on hormones, menopause, and heart disease: evaluating professional responses to the Women's Health Initiative.

    Science.gov (United States)

    Derry, Paula S

    2008-08-01

    The Women's Health Initiative (WHI) randomized controlled clinical trials provided evidence that, contrary to the common wisdom and clinical practice of the day, estrogen and estrogen/progestin hormone therapies (HT) were not safe or effective interventions to prevent chronic illnesses, especially heart disease, among postmenopausal women. A recent criticism of WHI, the timing hypothesis, asserts that HT would be cardioprotective if started around the time of menopause. This article critiques the timing hypothesis. The hypothesis relies on rejecting traditional criteria for scientific evidence, overinterpreting weak evidence, underemphasizing harm, and valuing the metatheory that menopause is an estrogen deficiency disease.

  6. Using heart rate to detect high-intensity efforts during professional soccer competition.

    Science.gov (United States)

    García García, Oscar; Rial Boubeta, Antonio; Real Deus, Eulogio

    2012-08-01

    The goal of this article is to detect, describe, and compare 2 heart rate (HR) conditions associated with high-intensity efforts but somewhat different in nature: The first one is indicated by HR values close to the maximum heart reserve (MHRR), and the second is indicated by a marked increase in the HR values (MIHR). It was expected that both conditions were associated with different game situations. A sample of 441 game situations (241 MIHRs and 200 MHRRs), taken from HR records and individual filming of 12 elite soccer players, was assessed along 7 preseason competition matches. The game situations in which each of these 441 HR conditions took place were identified, using a previously established taxonomy of a combination of field formats and category systems in the Match Vision Studio Premium. For the recording of the HR condition, an HRM Polar was attached to the players when in competition, together with a simultaneous filming of their performance during the game. The HRM and video recordings were synchronized beforehand to be able to relate the game situation in the film with HR conditions. The results showed significant differences between both HR conditions for 4 criteria of game situations (Ball in play, Game Center, Role, and Opposition). In all the cases, the MIHR is more associated with active participation of the players in the game, whereas the MHRR is more associated with the end of this participation. Thus, the results suggest that MIHR could be a useful complementary measurement to assess the intensity of physiological load that elite soccer players bear during competition, together with more traditional measurements such as MHRR.

  7. Alternating myocardial sympathetic neural function of athlete's heart in professional cycle racers examined with iodine-123-MIBG myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Keiko; Inoue, Tomio; Hasegawa, Akira; Oriuchi, Noboru; Okamoto, Eiichi; Tomaru, Yumi; Endo, Keigo [Gunma Univ., Maebashi (Japan). School of Medicine

    2001-08-01

    Myocardial sympathetic neural function in professional athletes who had the long-term tremendous cardiac load has not been fully investigated by myocardial iodine-123-metaiodobenzylguanidine (MIBG) uptake in comparison with power spectral analysis (PSA) in electrocardiography. Eleven male professional cycle racers and age-matched 11 male healthy volunteers were enrolled in this study. The low frequency components in the power spectral density (LF), the high frequency components in the power spectral density (HF), the LF/HF ratio and mean R-R interval were derived from PSA and time-domain analysis of heart rate variability in electrocardiography. The mean heart-to-mediastinum uptake ratio (H/M ratio) of the MIBG uptake, in professional cycle racers was significantly lower than that in healthy volunteers (p<0.01) and HF power in professional cycle racers was significantly higher than that in healthy volunteers (p<0.05). In the group of professional cycle racers, the H/M ratio showed a significant correlation with the R-R interval, as indices of parasympathetic nerve activity (r=0.80, p<0.01), but not with the LF/HF ratio as an index of sympathetic nerve activity. These results may indicate that parasympathetic nerve activity has an effect on MIBG uptake in a cyclist's heart. (author)

  8. Do big athletes have big hearts? Impact of extreme anthropometry upon cardiac hypertrophy in professional male athletes

    Science.gov (United States)

    Riding, Nathan R; Salah, Othman; Sharma, Sanjay; Carré, François; O'Hanlon, Rory; George, Keith P; Hamilton, Bruce; Chalabi, Hakim; Whyte, Gregory P; Wilson, Mathew G

    2012-01-01

    Aim Differentiating physiological cardiac hypertrophy from pathology is challenging when the athlete presents with extreme anthropometry. While upper normal limits exist for maximal left ventricular (LV) wall thickness (14 mm) and LV internal diameter in diastole (LVIDd, 65 mm), it is unknown if these limits are applicable to athletes with a body surface area (BSA) >2.3 m2. Purpose To investigate cardiac structure in professional male athletes with a BSA>2.3 m2, and to assess the validity of established upper normal limits for physiological cardiac hypertrophy. Methods 836 asymptomatic athletes without a family history of sudden death underwent ECG and echocardiographic screening. Athletes were grouped according to BSA (Group 1, BSA>2.3 m2, n=100; Group 2, 2–2.29 m2, n=244; Group 3, athlete with a normal ECG presented a maximal wall thickness and LVIDd greater than 13 and 65 mm, respectively. In Group 3 athletes, Black African ethnicity was associated with larger cardiac dimensions than either Caucasian or West Asian ethnicity. Three athletes were diagnosed with a cardiomyopathy (0.4% prevalence); with two athletes presenting a maximal wall thickness >13 mm, but in combination with an abnormal ECG suspicious of an inherited cardiac disease. Conclusion Regardless of extreme anthropometry, established upper limits for physiological cardiac hypertrophy of 14 mm for maximal wall thickness and 65 mm for LVIDd are clinically appropriate for all athletes. However, the abnormal ECG is key to diagnosis and guides follow-up, particularly when cardiac dimensions are within accepted limits. PMID:23097487

  9. The phenomenon of “QT stunning”: The abnormal QT prolongation provoked by standing persists even as the heart rate returns to normal in patients with long QT syndrome

    Science.gov (United States)

    Adler, Arnon; van der Werf, Christian; Postema, Pieter G.; Rosso, Raphael; Bhuiyan, Zahir A.; Kalman, Jonathan M.; Vohra, Jitendra K.; Guevara-Valdivia, Milton E.; Marquez, Manlio F.; Halkin, Amir; Benhorin, Jesaia; Antzelevitch, Charles; Wilde, Arthur A.M.; Viskin, Sami

    2012-01-01

    BACKGROUND Patients with long QT syndrome (LQTS) have inadequate shortening of the QT interval in response to the sudden heart rate accelerations provoked by standing—a phenomenon of diagnostic value. We now validate our original observations in a cohort twice as large. We also describe that this abnormal QT-interval response persists as the heart rate acceleration returns to baseline. OBJECTIVES To describe a novel observation, termed “QT stunning” and to validate previous observations regarding the “QT-stretching” phenomenon in patients with LQTS by using our recently described “standing test.” METHODS The electrocardiograms of 108 patients with LQTS and 112 healthy subjects were recorded in the supine position. Subjects were then instructed to stand up quickly and remain standing for 5 minutes during continuous electrocardiographic recording. The corrected QT interval was measured at baseline (QTcbase), when heart rate acceleration without appropriate QT-interval shortening leads to maximal QT stretching (QTcstretch) and upon return of heart rate to baseline (QTcreturn). RESULTS QTcstretch lengthened significantly more in patients with LQTS (103 ± 80 ms vs 66 ± 40 ms in controls; P QT interval in response to standing in patients with LQTS. Our study also shows that this abnormal response persists even after the heart rate slows back to baseline. PMID:22300664

  10. Accelerometery and Heart Rate Responses of Professional Fast-Medium Bowlers in One-Day and Multi-Day Cricket

    Science.gov (United States)

    Johnstone, James A.; Hughes, Gerwyn; Mitchell, Andrew C.; Ford, Paul A.; Watson, Tim; Duffield, Rob; Gordon, Dan; Roberts, Justin D.; Garrett, Andrew T.

    2017-01-01

    The physical demands of fast-medium bowling are increasingly being recognised, yet comparative exploration of the differing demands between competitive formats (i.e. one-day [OD] versus multi-day [MD] matches) remain minimal. The aim of this study was to describe in-match physiological profiles of professional fast-medium bowlers from England across different versions of competitive matches using a multivariable wearable monitoring device. Seven professional cricket fast-medium bowlers wore the BioharnessTM monitoring device during matches, over three seasons (>80 hours in-match). Heart Rate (HR) and Acceleromety (ACC) was compared across match types (OD, MD) and different in-match activity states (Bowling, Between over bowling, Fielding). Peak acceleration during OD bowling was significantly higher in comparison to MD cricket ([OD vs. MD] 234.1 ± 57.9 vs 226.6 ± 32.9 ct·episode-1, p technology and the findings provided give a valuable appreciation of the differences in match loads, and thus required physiological preparation and recovery in fast-medium bowlers. Key points One Day cricket has a greater overall physical strain on fast-medium bowlers providing shorter time for recovery between bowling episodes in comparison to Multi Day format. Wearable physiological monitoring technology can provide enhanced in-match workload monitoring replacing the need for simulated match-play environments. Adopting a standard global approach when defining bowling and between over episodes has been provided permitting comparative analysis to occur between teams/players enhancing coaches understanding of performance. PMID:28912647

  11. Relationship between professional dental care in childhood and coronary heart disease in adulthood in a single urban dental clinic.

    Science.gov (United States)

    Ahmed, Shameer; Burke, Timothy; Weiss, Michael; Trapp, Taylor; Neri, Lori; Matsumura, Martin E

    2012-01-01

    A growing body of evidence supports an association between coronary heart disease (CHD) and dental diseases, particularly periodontitis (PD). The present study was designed to assess the relationship between childhood dental care and adult CHD in a single community dental clinic. Consecutive patients (n = 223) at a single urban U.S. dental clinic were asked to complete a questionnaire regarding the details of their childhood and present dental care as well as CHD and PD diagnoses. A significantly greater proportion of patients who reported a lack of prophylactic dental care in childhood also reported a present diagnosis of CHD (54.2% vs 23.6%, P history, age and sex, the relationship between dental care in childhood and reduced CHD remained significant (OR = 0.318, 95% CI = 0.159-0.635, P = 0.001). This association cannot be explained wholly by a mechanism involving the development of PD in patients with poor childhood dental care, as PD was not significantly associated with CHD in the multivariate model (OR = 1.646, 95% CI = 0.836-3.239, P = 0.149). In our single dental clinic assessment, adequate childhood professional dental prophylactic care was associated with reduced CHD in adulthood, an association independent of traditional risk factors. Further studies are required to better define the magnitude of this association.

  12. The imbalance between oxygen demand and supply as a potential mechanism in the pathophysiology of heart failure : The role of microvascular growth and abnormalities

    NARCIS (Netherlands)

    De Boer, RA; Pinto, YM; van Veldhuisen, DJ

    In heart failure., a deficient oxygen supply often is a primary cause for myocardial dysfunction. The reverse however, may also be true; the changes that occur in the failing heart may predispose for the existence of tissue hypoxia, which further affects the function of the heart. Specifically,

  13. Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden: a cross-sectional study.

    Science.gov (United States)

    Nordgren, Lena; Söderlund, Anne

    2016-01-01

    The aim of this study was to investigate associations between socio-demographic factors, experiences of positive/negative encounters with healthcare professionals, and the encounters' impact on the ability to return to work in a population of people on sick leave due to heart failure. This was a cross-sectional study. Data were collected from two official registries in Sweden and from a postal questionnaire. In all, 590 people with heart failure responded to the questionnaire. Associations between variables were calculated with bivariate correlation analyses and logistic regression analyses. For people on sick leave due to heart failure, positive encounters with healthcare professionals are associated with being Swedish-born, female gender, and high income. People with high income are more likely to be supported back to work by positive encounters with healthcare professionals. To perceive that healthcare professionals believe in person's ability to return to work can be facilitating. Women, people who are not foreign-born, and people with high income are more likely to perceive encounters with healthcare professionals as positive. Healthcare professionals who work with rehabilitation for people with heart failure need to be aware of social inequalities and that being on sick leave is a process of change. A failing heart limits everyday life implying risk for long-term sick leave. Even though there are rehabilitation programs for people with heart failure, vocational rehabilitation is often over-looked. The knowledge about factors associated with sick leave due to heart failure is scarce. Experiences of positive encounters with healthcare professionals were associated with being Swedish-born, female gender, and high income. People with high income were more likely to be supported back to work by positive encounters with healthcare professionals. Healthcare professionals who work with rehabilitation for people with heart failure can support patients with heart

  14. Managing Feelings about Heart Failure

    Science.gov (United States)

    ... About Heart Failure Module 6: Managing Feelings About Heart Failure Download Module Order Hardcopy Heart failure can cause ... professional help for emotional problems. Common Feelings About Heart Failure It is common for people to feel depressed ...

  15. Management of Pregnancy in Patients With Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Canobbio, Mary M; Warnes, Carole A; Aboulhosn, Jamil; Connolly, Heidi M; Khanna, Amber; Koos, Brian J; Mital, Seema; Rose, Carl; Silversides, Candice; Stout, Karen

    2017-02-21

    Today, most female children born with congenital heart disease will reach childbearing age. For many women with complex congenital heart disease, carrying a pregnancy carries a moderate to high risk for both the mother and her fetus. Many such women, however, do not have access to adult congenital heart disease tertiary centers with experienced reproductive programs. Therefore, it is important that all practitioners who will be managing these women have current information not only on preconception counseling and diagnostic evaluation to determine maternal and fetal risk but also on how to manage them once they are pregnant and when to refer them to a regional center with expertise in pregnancy management. © 2017 American Heart Association, Inc.

  16. Meiotic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  17. Loss of mRor1 Enhances the Heart and Skeletal Abnormalities in mRor2-Deficient Mice: Redundant and Pleiotropic Functions of mRor1 and mRor2 Receptor Tyrosine Kinases

    OpenAIRE

    Nomi, Masashi; Oishi, Isao; Kani, Shuichi; Suzuki, Hiroaki; Matsuda, Takeru; Yoda, Akinori; Kitamura, Makiko; Itoh, Kyoko; Takeuchi, Shigeto; Takeda, Kiyoshi; Akira, Shizuo; Ikeya, Makoto; Takada, Shinji; Minami, Yasuhiro

    2001-01-01

    The mammalian Ror family of receptor tyrosine kinases consists of two structurally related proteins, Ror1 and Ror2. We have shown that mRor2-deficient mice exhibit widespread skeletal abnormalities, ventricular septal defects in the heart, and respiratory dysfunction, leading to neonatal lethality (S. Takeuchi, K. Takeda, I. Oishi, M. Nomi, M. Ikeya, K. Itoh, S. Tamura, T. Ueda, T. Hatta, H. Otani, T. Terashima, S. Takada, H. Yamamura, S. Akira, and Y. Minami, Genes Cells 5:71–78, 2000). Here...

  18. Implementing telemonitoring in heart failure care : Barriers from the perspectives of patients, healthcare professionals and healthcare organizations

    NARCIS (Netherlands)

    Boyne, J.J.; Vrijhoef, H.J.M.

    2013-01-01

    The increasing prevalence of chronic diseases, such as heart failure, presents a substantial challenge to healthcare systems. Telemonitoring is believed to be a useful instrument in the delivery of heart failure care. However, a widespread use of telemonitoring is currently failing for various

  19. Congenital Abnormalities

    Science.gov (United States)

    ... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... course of action. Additional Information Your Family Health History & Genetics Detecting Genetic Abnormalities Prenatal Genetic Counseling Children ...

  20. Walking abnormalities

    Science.gov (United States)

    ... with short-term or long-term gait disorders. Therapy will reduce the risk of falls and other injuries. For an abnormal gait that occurs with conversion disorder, counseling and support from family members are ...

  1. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation.

    Science.gov (United States)

    Klein, Samuel; Burke, Lora E; Bray, George A; Blair, Steven; Allison, David B; Pi-Sunyer, Xavier; Hong, Yuling; Eckel, Robert H

    2004-11-02

    Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides practical weight management treatment guidelines for cardiovascular healthcare professionals. The data demonstrate that weight loss and physical activity can prevent and treat obesity-related coronary heart disease risk factors and should be considered a primary therapy for obese patients with cardiovascular disease.

  2. Abnormal Uterine Bleeding

    OpenAIRE

    Benetti-Pinto, Cristina Laguna; Rosa-e-Silva, Ana Carolina Japur de Sá; Yela, Daniela Angerame; Soares Júnior,José Maria

    2017-01-01

    Abstract Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evi...

  3. Next-generation sequencing of 100 candidate genes in young victims of suspected sudden cardiac death with structural abnormalities of the heart

    DEFF Research Database (Denmark)

    Hertz, C L; Christiansen, S L; Ferrero-Miliani, Laura

    2016-01-01

    SCD cases with non-diagnostic and diagnostic cardiac abnormalities, respectively. Although the interpretation of broad NGS screening is challenging, it can support the forensic investigation and help the cardiologist's decision to offer counselling and clinical evaluation to relatives of young SCD...

  4. A combined abnormality in heart rate variation and QT corrected interval is a strong predictor of cardiovascular death in type 1 diabetes

    DEFF Research Database (Denmark)

    Lykke, J A; Tarnow, Lise; Parving, H H

    2008-01-01

    Long-term diabetes is associated with excess morbidity and mortality, and cardiovascular autonomic neuropathy and QTc interval abnormalities are both predictive of early cardiovascular death in diabetes. We aimed to investigate the effect of these risk factors in a large cohort of type 1 diabetic...

  5. Communicating with Professionals

    Medline Plus

    Full Text Available ... Living for Heart.org Conditions for Heart.org Support for Heart.org Professional for Heart.org Research ... surgery, including how to maximize your recovery at home. Cardiac Rehab Tools & Resources Cardiac Rehab Referral Card | ...

  6. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Powers, William J; Rabinstein, Alejandro A; Ackerson, Teri; Adeoye, Opeolu M; Bambakidis, Nicholas C; Becker, Kyra; Biller, José; Brown, Michael; Demaerschalk, Bart M; Hoh, Brian; Jauch, Edward C; Kidwell, Chelsea S; Leslie-Mazwi, Thabele M; Ovbiagele, Bruce; Scott, Phillip A; Sheth, Kevin N; Southerland, Andrew M; Summers, Deborah V; Tirschwell, David L

    2018-01-24

    The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations for clinicians caring for adult patients with acute arterial ischemic stroke in a single document. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 guidelines and subsequent updates. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained. Members were not allowed to participate in discussions or to vote on topics relevant to their relations with industry. The members of the writing group unanimously approved all recommendations except when relations with industry precluded members voting. Prerelease review of the draft guideline was performed by 4 expert peer reviewers and by the members of the Stroke Council's Scientific Statements Oversight Committee and Stroke Council Leadership Committee. These guidelines use the American College of Cardiology/American Heart Association 2015 Class of Recommendations and Levels of Evidence and the new American Heart Association guidelines format. These guidelines detail prehospital care, urgent and emergency evaluation and treatment with intravenous and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are appropriately instituted within the first 2 weeks. The guidelines support the overarching concept of stroke systems of care in both the prehospital and hospital settings. These guidelines are based on the best evidence currently available. In many instances, however, only limited data exist demonstrating the urgent need for continued research on treatment of acute ischemic stroke. © 2018 American Heart Association, Inc.

  7. Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Towfighi, Amytis; Ovbiagele, Bruce; El Husseini, Nada; Hackett, Maree L; Jorge, Ricardo E; Kissela, Brett M; Mitchell, Pamela H; Skolarus, Lesli E; Whooley, Mary A; Williams, Linda S

    2017-02-01

    Poststroke depression (PSD) is common, affecting approximately one third of stroke survivors at any one time after stroke. Individuals with PSD are at a higher risk for suboptimal recovery, recurrent vascular events, poor quality of life, and mortality. Although PSD is prevalent, uncertainty remains regarding predisposing risk factors and optimal strategies for prevention and treatment. This is the first scientific statement from the American Heart Association on the topic of PSD. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion. This multispecialty statement provides a comprehensive review of the current evidence and gaps in current knowledge of the epidemiology, pathophysiology, outcomes, management, and prevention of PSD, and provides implications for clinical practice. © 2016 American Heart Association, Inc.

  8. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association.

    Science.gov (United States)

    McCrindle, Brian W; Rowley, Anne H; Newburger, Jane W; Burns, Jane C; Bolger, Anne F; Gewitz, Michael; Baker, Annette L; Jackson, Mary Anne; Takahashi, Masato; Shah, Pinak B; Kobayashi, Tohru; Wu, Mei-Hwan; Saji, Tsutomu T; Pahl, Elfriede

    2017-04-25

    Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management. Although the cause remains unknown, discussion sections highlight new insights into the epidemiology, genetics, pathogenesis, pathology, natural history, and long-term outcomes. Prompt diagnosis is essential, and an updated algorithm defines supplemental information to be used to assist the diagnosis when classic clinical criteria are incomplete. Although intravenous immune globulin is the mainstay of initial treatment, the role for additional primary therapy in selected patients is discussed. Approximately 10% to 20% of patients do not respond to initial intravenous immune globulin, and recommendations for additional therapies are provided. Careful initial management of evolving coronary artery abnormalities is essential, necessitating an increased frequency of assessments and escalation of thromboprophylaxis. Risk stratification for long-term management is based primarily on maximal coronary artery luminal dimensions, normalized as Z scores, and is calibrated to both past and current involvement. Patients with aneurysms require life-long and uninterrupted cardiology follow-up. These recommendations provide updated and best evidence-based guidance to healthcare providers who diagnose and manage Kawasaki disease, but clinical decision making should be individualized to specific patient circumstances. © 2017 American Heart Association, Inc.

  9. Serum and immunoglobulin G from the mother of a child with congenital heart block induce conduction abnormalities and inhibit L-type calcium channels in a rat heart model.

    Science.gov (United States)

    Boutjdir, M; Chen, L; Zhang, Z H; Tseng, C E; El-Sherif, N; Buyon, J P

    1998-07-01

    Although a strong clinical association exists between congenital heart block (CHB) and an immune response to SSA/Ro and SSB/La proteins, a causative role of these antibodies in the pathogenesis is just emerging. In a preliminary report, we have demonstrated that IgG fractions isolated from the sera of mothers whose children have CHB are arrhythmogenic in the human fetal heart. To more precisely define the arrhythmogenic effect of anti-SSA/Ro-SSB/La antibodies, we used the readily available rat heart model to record: 1) ECGs from Langendorff beating hearts; 2) action potentials from atrioventricular (AV) nodal preparations; 3) L-type Ca currents, I(Ca) at the whole-cell and single channel levels; and 4) other currents such as the transient outward K+ current, I(to), the inward rectifier K+ current, I(K1), and the Na+ current, I(Na). Perfusion of hearts with purified IgG (800 microg/mL), isolated from the serum of a mother with SSA/Ro and SSB/La antibodies whose child had CHB, resulted in bradycardia associated with 2:1 AV block. Simultaneous action potentials were recorded from dissected atrial and AV nodal areas of the rat heart. Superfusion of these preparations with the same mother's IgG fraction resulted in 2:1 AV block followed by complete inhibition of AV nodal action potential. Because AV nodal electrogenesis is largely dependent on I(Ca), the effect of these antibodies on I(Ca) was subsequently determined. Superfusion of myocytes with whole serum or purified IgG (80 microg/mL) from the same mother consistently inhibited whole cell I(Ca), ensemble average Ba2+ currents (I(Ba)) and open state probability, p(o), without affecting the channel conductance. IgG had no significant effect on I(to), I(K1), or I(Na). Whole sera and IgG fractions from a healthy mother with no detectable anti-SSA/Ro or SSB/La antibodies did not inhibit I(Ca) or I(Ba). These results demonstrate that IgG containing anti-SSA/Ro and -SSB/La antibodies induces complete AV block in beating

  10. VE/VCO2 slope is associated with abnormal resting haemodynamics and is a predictor of long-term survival in chronic heart failure.

    Science.gov (United States)

    Nanas, Serafim N; Nanas, John N; Sakellariou, Dimitrios Ch; Dimopoulos, Stavros K; Drakos, Stavros G; Kapsimalakou, Smaragdo G; Mpatziou, Christina A; Papazachou, Ourania G; Dalianis, Anargyros S; Anastasiou-Nana, Maria I; Roussos, Charis

    2006-06-01

    Patients with chronic heart failure (CHF) present with exercise-induced hyperpnea, but its pathophysiological mechanism has not been thoroughly investigated. We aimed to determine the relationship between exercise-induced hyperpnea, resting haemodynamic measurements and the validity of ventilatory response (V(E)/V(CO(2)) slope) as a mortality predictor in CHF patients. Ninety-eight CHF patients (90M/8F) underwent a symptom-limited treadmill cardiopulmonary exercise test (CPET). Right heart catheterization and radionuclide ventriculography were performed within 72 h of CPET. Twenty-seven patients died from cardiac causes during 20+/-6 months follow-up. Non-survivors had a lower peak oxygen consumption (V(O(2)p)), (16.5+/-4.9 vs. 20.2+/-6.1, ml/kg/min, p=0.003), a steeper V(E)/V(CO(2)) slope (34.8+/-8.3 vs. 28.9+/-4.8, pslope as a continuous variable was an independent prognostic factor (chi(2): 8.5, relative risk: 1.1, 95% CI: 1.03-1.18, p=0.004). Overall mortality was 52% in patients with V(E)/V(CO(2)) slope > or =34 and 18% in those with V(E)/V(CO(2)) slope slope was a significant predictor of mortality (relative risk: 6.2, 95% CI: 1.7-22.2, p=0.002). Patients with high V(E)/V(CO(2)) slope had higher resting PCWP (19.9+/-9.1 vs. 11.3+/-5.7 mmHg, pslope correlated significantly with PCWP (r: 0.57, pslope, as an index of ventilatory response to exercise, improves the risk stratification of CHF patients. Interstitial pulmonary oedema may be a pathophysiological mechanism of inefficient ventilation during exercise in these patients.

  11. The medical history of adults with complex congenital heart disease affects their social development and professional activity.

    Science.gov (United States)

    Karsenty, Clement; Maury, Philippe; Blot-Souletie, Nathalie; Ladouceur, Magalie; Leobon, Bertrand; Senac, Valérie; Mondoly, Pierre; Elbaz, Meyer; Galinier, Michel; Dulac, Yves; Carrié, Didier; Acar, Philippe; Hascoet, Sebastien

    2015-11-01

    In recent decades, advances in surgery and therapeutic catheterization have steadily increased the life expectancy and prevalence of adults with congenital heart disease (CHD). We assessed medical and psychosocial variables of adults with CHD, according to the disease complexity. We included, from a single-centre observational cohort study, 135 consecutive adults with CHD (median age of 40 years, interquartile range: 28.0-51.0) followed in our cardiology unit, who answered a questionnaire assessing daily activity and psychosocial functioning. Disease complexity was classified according to the Bethesda conference. Cardiac malformation complexity was simple in 61 (45.2%), moderate in 50 (37.0%) and complex in 24 (17.8%) patients. Cardiac surgery had been performed in 86.5% of moderate and complex patients. Complications (such as heart failure, arrhythmia and pulmonary hypertension) were mainly observed in the complex group (P=0.003). Physical activity was lower in the complex group (no activity in 58.8%, but sport previously contraindicated in 50% of these; P=0.03). Education level tended to be lower in the complex and moderate groups than in the simple group (respectively, 31.2% and 33.3% vs. 45.7% had passed the Baccalaureate; P=0.47). The pass rate was lower in patients with complications (P=0.037) or more than one cardiac surgery (P=0.03). In the complex group, 56.3% of patients were unemployed (P=0.048). Complexity of heart disease and medical history affect education level and employment of adults with CHD. Academic education of children with a complex defect and career counselling are important to prevent unemployment among adults with CHD. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Jauch, Edward C; Saver, Jeffrey L; Adams, Harold P; Bruno, Askiel; Connors, J J Buddy; Demaerschalk, Bart M; Khatri, Pooja; McMullan, Paul W; Qureshi, Adnan I; Rosenfield, Kenneth; Scott, Phillip A; Summers, Debbie R; Wang, David Z; Wintermark, Max; Yonas, Howard

    2013-03-01

    The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators responsible for the care of acute ischemic stroke patients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates. Members of the writing committee were appointed by the American Stroke Association Stroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart Association Stroke Council's Level of Evidence grading algorithm. The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses early stroke evaluation and general medical care, as well as ischemic stroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation. Because many of the recommendations are based on limited data, additional research on treatment of acute ischemic stroke remains urgently needed.

  13. Common echocardiographic abnormalities in Nigerians of different ...

    African Journals Online (AJOL)

    Conclusion: This study has reaffirmed rheumatic heart disease (predominantly mitral valve regurgitation) as the commonest cardiac abnormality in adolescents and young adults. Degenerative valvular diseases, left ventricular diastolic dysfunction, and atrial septal defects were the commonest abnormalities in the elderly, ...

  14. An evaluation of the use of new Doppler methods for detecting longitudinal function abnormalities in a pacing-induced heart failure model

    Science.gov (United States)

    Tabata, Tomotsugu; Cardon, Lisa A.; Armstrong, Guy P.; Fukamach, Kiyotaka; Takagaki, Masami; Ochiai, Yoshie; McCarthy, Patrick M.; Thomas, James D.

    2003-01-01

    BACKGROUND: Doppler tissue echocardiography and color M-mode Doppler flow propagation velocity have proven useful in evaluating cross-sections of patients with left ventricular (LV) dysfunction, but experience with serial changes is limited. Purpose and methods: We tested their use by evaluating the temporal changes of LV function in a pacing-induced congestive heart failure model. Rapid ventricular pacing was initiated and maintained in 20 dogs for 4 weeks. Echocardiography was performed at baseline and weekly during brief pacing cessation. RESULTS: With rapid pacing, LV volume significantly increased and ejection fraction (57%-28%), stroke volume (37-18 mL), and mitral annulus systolic velocity (16.1-6.6 cm/s) by Doppler tissue echocardiography significantly decreased, with ejection fraction and mitral annulus systolic velocity closely correlated (r = 0.706, P function, respectively. CONCLUSIONS: Doppler tissue echocardiography and color M-mode Doppler flow could evaluate the serial deterioration in LV dysfunction throughout the pacing period. These were more useful in quantifying progressive LV dysfunction than conventional ehocardiographic techniques, and were probably relatively independent of preload. These techniques could be suitable for longitudinal evaluation in addition to the cross-sectional study.

  15. Heart rate-based training intensity and its impact on injury incidence among elite-level professional soccer players.

    Science.gov (United States)

    Owen, Adam L; Forsyth, Jacky J; Wong, Del P; Dellal, Alexandre; Connelly, Sean P; Chamari, Karim

    2015-06-01

    Elite-level professional soccer players are suggested to have increased physical, technical, tactical, and psychological capabilities when compared with their subelite counterparts. Ensuring these players remain at the elite level generally involves training many different bodily systems to a high intensity or level within a short duration. This study aimed to examine whether an increase in training volume at high-intensity levels was related to injury incidence, or increased the odds of sustaining an injury. Training intensity was monitored through time spent in high-intensity (T-HI) and very high-intensity (T-VHI) zones of 85-training volume at T-HI and injury incidence (r = 0.57, p = 0.005). Further analysis revealed how players achieving more time in the T-VHI zone during training increased the odds of sustaining a match injury (odds ratio = 1.87; 95% CI, 1.12-3.12, p = 0.02) but did not increase the odds of sustaining a training injury. Reducing the number of competitive match injuries among elite-level professional players may be possible if greater focus is placed on the training intensity and volume over a period of time ensuring the potential reduction of fatigue or overuse injuries. In addition, it is important to understand the optimal training load at which adaptation occurs without raising the risk of injury.

  16. Heart rate' based training intensity and its impact on injury incidence amongst elite level professional soccer players.

    Science.gov (United States)

    Owen, Adam L; Forsyth, Jacky J; Wong, Del P; Dellal, Alexandre; Connelly, Sean; Chamari, Karim

    2014-12-24

    Elite level professional soccer players are suggested to have increased physical, technical, tactical and psychological capabilities when compared to their sub-elite counterparts. Ensuring these players remain at the elite level generally involves training many different bodily systems to a high intensity or level within a short duration. This study aimed to examine whether an increase in training volume at high intensity levels were related to injury incidence, or increased the odds of sustaining an injury. Training intensity was monitored through time spent in high- (T-HI) and very high- (T-VHI) intensity zones of 85-training volume at T-HI and injury incidence (r=0.57, p=0.005). Further analysis revealed how players achieving more time in the T-VHI zone during training increased the odds of sustaining a match injury (odds ratio=1.87, 95% CI 1.12 to 3.12, p=0.02), but did not increase the odds of sustaining a training injury. Reducing the number of competitive match injuries amongst elite professional level players may be possible if greater focus is placed on the training intensity and volume over a period of time ensuring the potential reduction of fatigue or overuse injuries. In addition, it is important to understand the optimal training load at which adaptation occurs without raising the risk of injury.

  17. Outdoor Air Pollution, Heart Attack and Stroke

    Science.gov (United States)

    Elevated outdoor ambient air particle pollution triggers heart attacks, strokes, and abnormal heart rhythms and worsens heart failure in individuals at high risk due to underlying medical conditions. Emergency Medical Services in communities are the first responders to these eme...

  18. What Are Heart Disease and Stroke?

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More What Are Heart Disease and Stroke? Updated:Dec 8,2015 There are ... include: High blood pressure Smoking Diabetes High cholesterol Heart disease Atrial fibrillation (Abnormal heart rhythm) Call 9-1- ...

  19. Palliative and end-of-life care in stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Holloway, Robert G; Arnold, Robert M; Creutzfeldt, Claire J; Lewis, Eldrin F; Lutz, Barbara J; McCann, Robert M; Rabinstein, Alejandro A; Saposnik, Gustavo; Sheth, Kevin N; Zahuranec, Darin B; Zipfel, Gregory J; Zorowitz, Richard D

    2014-06-01

    The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by providers and healthcare services across hospitals and community settings when caring for patients and families with stroke. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were chosen to reflect the diversity and expertise of professional roles in delivering optimal palliative care. Writing group members were assigned topics relevant to their areas of expertise, reviewed the appropriate literature, and drafted manuscript content and recommendations in accordance with the American Heart Association's framework for defining classes and level of evidence and recommendations. The palliative care needs of patients with serious or life-threatening stroke and their families are enormous: complex decision making, aligning treatment with goals, and symptom control. Primary palliative care should be available to all patients with serious or life-threatening stroke and their families throughout the entire course of illness. To optimally deliver primary palliative care, stroke systems of care and provider teams should (1) promote and practice patient- and family-centered care; (2) effectively estimate prognosis; (3) develop appropriate goals of care; (4) be familiar with the evidence for common stroke decisions with end-of-life implications; (5) assess and effectively manage emerging stroke symptoms; (6) possess experience with palliative treatments at the end of life; (7) assist with care coordination, including referral to a palliative care specialist or hospice if necessary; (8) provide the patient and family the opportunity for personal growth and make bereavement resources available if death is anticipated; and (9) actively participate in

  20. Detection of myocardial metabolic abnormalities by 18F-FDG PET/CT and corresponding pathological changes in beagles with local heart irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Rul [Nursing College of Shanxi Medical University, Taiyuan (China); Song, Jianbo; Wu, Zhi Fang; Liu, Jian Zhang; Hao, Xin Zhong; Li, Sijin [Dept. of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan (China); Guo, Min [Dept. of Cardiology, First Hospital of Shanxi Medical University, Taiyuan (China); Li, Jianguo [Dept. of Radiological and Environmental Medicine, China Institute for Radiation Protection, Taiyuan (China)

    2015-08-15

    To determine the efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the detection of radiation-induced myocardial damage in beagles by comparing two pre-scan preparation protocols as well as to determine the correlation between abnormal myocardial FDG uptake and pathological findings. The anterior myocardium of 12 beagles received radiotherapy locally with a single X-ray dose of 20 Gy. 18F-FDG cardiac PET/CT was performed at baseline and 3 months after radiation. Twelve beagles underwent two protocols before PET/CT: 12 hours of fasting (12H-F), 12H-F followed by a high-fat diet (F-HFD). Regions of interest were drawn on the irradiation and the non-irradiation fields to obtain their maximal standardized uptake values (SUVmax). Then the ratio of the SUV of the irradiation to the non-irradiation fields (INR) was computed. Histopathological changes were identified by light and electron microscopy. Using the 12H-F protocol, the average INRs were 1.18 ± 0.10 and 1.41 ± 0.18 before and after irradiation, respectively (p = 0.021). Using the F-HFD protocol, the average INRs were 0.99 ± 0.15 and 2.54 ± 0.43, respectively (p < 0.001). High FDG uptake in irradiation field was detected in 33.3% (4/12) of 12H-F protocol and 83.3% (10/12) of F-HFD protocol in visual analysis, respectively (p = 0.031). The pathology of the irradiated myocardium showed obvious perivascular fibrosis and changes in mitochondrial vacuoles. High FDG uptake in an irradiated field may be related with radiation-induced myocardial damage resulting from microvascular damage and mitochondrial injury. An F-HFD preparation protocol used before obtaining PET/CT can improve the sensitivity of the detection of cardiotoxicity associated with radiotherapy.

  1. Management of Brain Arteriovenous Malformations: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Derdeyn, Colin P; Zipfel, Gregory J; Albuquerque, Felipe C; Cooke, Daniel L; Feldmann, Edward; Sheehan, Jason P; Torner, James C

    2017-08-01

    The aim of this statement is to review the current data and to make suggestions for the diagnosis and management of both ruptured and unruptured brain arteriovenous malformations. The writing group met in person and by teleconference to establish search terms and to discuss narrative text and suggestions. Authors performed their own literature searches of PubMed, Medline, or Embase, specific to their allocated section, through the end of January 2015. Prerelease review of the draft statement was performed by expert peer reviewers and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. The focus of the scientific statement was subdivided into epidemiology; diagnosis; natural history; treatment, including the roles of surgery, stereotactic radiosurgery, and embolization; and management of ruptured and unruptured brain arteriovenous malformations. Areas requiring more evidence were identified. Brain arteriovenous malformations are a relatively uncommon but important cause of hemorrhagic stroke, especially in young adults. This statement describes the current knowledge of the natural history and treatment of patients with ruptured and unruptured brain arteriovenous malformations, suggestions for management, and implications for future research. © 2017 American Heart Association, Inc.

  2. Heart rate responses and technical comparison between small- vs. large-sided games in elite professional soccer.

    Science.gov (United States)

    Owen, Adam L; Wong, Del P; McKenna, Michael; Dellal, Alexandre

    2011-08-01

    This study aims to examine the difference in heart rate (HR) responses and technical activities placed upon European elite players when exposed to 2-sided games differing in the number of players and playing area. Fifteen male soccer players from a Scottish Premier League team (26.3 ± 4.85 years, 182.4 ± 6.99 cm, 79.5 ± 8.05 kg, VO2max of 54.36 ± 5.45 ml·kg(-1)·min(-1)) performed both small (3 vs. 3 plus goalkeepers) and large (9 vs. 9 plus goalkeepers) sided games each lasting for 3 × 5 minutes interspersed with 4-minute passive recovery during the 2009-2010 season. The HR responses and players' technical actions were recorded throughout all sided games. Results show that small-sided games (SSG) induced significantly (p games. Furthermore, during SSGs, players spent significantly longer time in the >85% maximal HR zone (p games. Technical analysis revealed a large practical difference (effect size ranged from 1.5 to 21.2) between small- and large-sided games: less number of blocks, headers, interceptions, passes, and receives but more dribbles, shots, and tackles in SSG. Furthermore, SSG induced significantly lesser total ball contacts per game (p games. The different technical requirements also enable coaches to carry out training games more suitable to specific playing positions such as SSG for midfielders (more dribbles, tackles, and ball contacts per player) strikers (more shots), and large-sided games for defender (more blocks, headers, and interceptions).

  3. Relationships between rating-of-perceived-exertion- and heart-rate-derived internal training load in professional soccer players: a comparison of on-field integrated training sessions.

    Science.gov (United States)

    Campos-Vazquez, Miguel Angel; Mendez-Villanueva, Alberto; Gonzalez-Jurado, Jose Antonio; León-Prados, Juan Antonio; Santalla, Alfredo; Suarez-Arrones, Luis

    2015-07-01

    To describe the internal training load (ITL) of common training sessions performed during a typical week and to determine the relationships between different indicators of ITL commonly employed in professional football (soccer). Session-rating-of-perceived-exertion TL (sRPE-TL) and heart-rate- (HR) derived measurements of ITL as Edwards TL and Stagno training impulses (TRIMPMOD) were used in 9 players during 3 periods of the season. The relationships between them were analyzed in different training sessions during a typical week: skill drills/circuit training + small-sided games (SCT+SSGs), ball-possession games+technical-tactical exercises (BPG+TTE), tactical training (TT), and prematch activation (PMa). HR values obtained during SCT+SSGs and BPG+TTE were substantially greater than those in the other 2 sessions, all the ITL markers and session duration were substantially greater in SCT+SSGs than in any other session, and all ITL measures in BPG+TTE were substantially greater than in TT and PMa sessions. Large relationships were found between HR>80% HRmax and HR>90% HRmax vs sRPE-TL during BPG+TTE and TT sessions (r=.61-.68). Very large relationships were found between Edwards TL and sRPE-TL and between TRIMPMOD and sRPE-TL in sessions with BPG+TTE and TT (r=.73-.87). Correlations between the different HR-based methods were always extremely large (r=.92-.98), and unclear correlations were observed for other relationships between variables. sRPE-TL provided variable-magnitude within-individual correlations with HR-derived measures of training intensity and load during different types of training sessions typically performed during a week in professional soccer. Caution should be applied when using RPE- or HR-derived measures of exercise intensity/load in soccer training interchangeably.

  4. Professional Environment for Teacher Professional Development

    Science.gov (United States)

    Zascerinska, Jelena

    2010-01-01

    Introduction. Teaching and training are at the heart of the knowledge society where the continuing professional development of teachers and trainers provides the cornerstone for the development of a high quality education and training systems. The Aim of the Study. To identify a design of professional environment for teacher professional…

  5. EFECTOS TERATOGÉNICOS DE ALGUNOS FÁRMACOS QUE PUEDEN PRODUCIR CARDIOPATÍAS CONGÉNITAS Y OTRAS ANOMALÍAS / Teratogenic effects of some drugs that can cause congenital heart disease and other abnormalities

    Directory of Open Access Journals (Sweden)

    Lissett Batista Santos

    2012-03-01

    Full Text Available Resumen Muchas de las malformaciones o anomalías de carácter anatómico o funcional provocadas en el feto se deben a la utilización de medicamentos por la madre, durante la gestación. Estos trastornos pueden detectarse en la vida intrauterina, inmediatamente después del nacimiento o, en ocasiones, muchos años después; pero generalmente se diagnostican tempranamente y en determinadas circunstancias pueden comprometer la vida del enfermo. En este artículo se exponen, de forma general, los principales efectos teratogénicos de algunos fármacos que pueden predisponer a cardiopatías y otras anomalías congénitas. El ambiente de una gestante se encuentra cargado de sustancias agresivas para el futuro producto de la gestación. La mayoría de las malformaciones más importantes son producidas durante el período teratogénico que comprende de la tercera a la octava semana de la gestación. Las medidas de prevención secundaria se sustentan en el diagnóstico prenatal y el asesoramiento genético. / Abstract Many of the malformations or abnormalities of anatomical or functional character provoked in the fetus are due to drug use by the mother during gestation. These disorders can be detected during intrauterine life, immediately after birth or at times, many years later, but they are generally diagnosed early and in certain circumstances they can compromise the life of the newborn. The main teratogenic effects of some drugs that can predispose to heart diseases and other congenital abnormalities are set out in this article in a general way. The environment of a pregnant woman is loaded with aggressive substances for the future product of gestation. The majority of the most relevant malformations are produced during the teratogenic period, which comprises weeks third to eigth of gestation. Secondary prevention measures are based on prenatal diagnosis and genetic counseling.

  6. Communicating with Professionals

    Medline Plus

    Full Text Available ... of High Cholesterol Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of ... HBP Tools & Resources Stroke Vascular Health Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Communicating with Professionals ...

  7. Abnormalities of heart rhythm in newborns

    Directory of Open Access Journals (Sweden)

    Garrido García Luis Martín

    2014-07-01

    The natural history of arrhythmias in the neonatal period differs impor- tantly from arrhythmias presented in other pediatric age groups. They can be classified as: sinus arrhythmia, tachyarrhythmias, long QT syndrome and bradyarrhythmias. It is important that the physicians responsible for the management of these patients recognize the causes for the development of arrhythmias as well as the diagnostic and therapeutic options available.

  8. Being on sick leave due to heart failure: self-rated health, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work.

    Science.gov (United States)

    Nordgren, Lena; Söderlund, Anne

    2015-01-01

    Younger people with heart failure often experience poor self-rated health. Furthermore, poor self-rated health is associated with long-term sick leave and disability pension. Socio-demographic factors affect the ability to return to work. However, little is known about people on sick leave due to heart failure. The aim of this study was to investigate associations between self-rated health, mood, socio-demographic factors, sick leave compensation, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work, for people on sick leave due to heart failure. This population-based investigation had a cross-sectional design. Data were collected in Sweden in 2012 from two official registries and from a postal questionnaire. In total, 590 subjects, aged 23-67, responded (response rate 45.8%). Descriptive statistics, correlation analyses (Spearman bivariate analysis) and logistic regression analyses were used to investigate associations. Poor self-rated health was strongly associated with full sick leave compensation (OR = 4.1, p work (OR = 3.3, p work imposes reduced quality of life. Positive encounters with healthcare professionals and social insurance officers can be supportive when people with heart failure struggle to remain in working life.

  9. Acute heart failure syndrome

    African Journals Online (AJOL)

    Heart failure can be defined as a clinical syndrome in which a structural or functional cardiac abnormality impairs the capacity of the ventricle to fill or eject enough blood for the requirements of the body. Acute heart failure syndrome represents a complex, heterogeneous set of clinical conditions, all with the common.

  10. Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the american heart association/american stroke association.

    Science.gov (United States)

    Biller, José; Sacco, Ralph L; Albuquerque, Felipe C; Demaerschalk, Bart M; Fayad, Pierre; Long, Preston H; Noorollah, Lori D; Panagos, Peter D; Schievink, Wouter I; Schwartz, Neil E; Shuaib, Ashfaq; Thaler, David E; Tirschwell, David L

    2014-10-01

    Cervical artery dissections (CDs) are among the most common causes of stroke in young and middle-aged adults. The aim of this scientific statement is to review the current state of evidence on the diagnosis and management of CDs and their statistical association with cervical manipulative therapy (CMT). In some forms of CMT, a high or low amplitude thrust is applied to the cervical spine by a healthcare professional. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. Patients with CD may present with unilateral headaches, posterior cervical pain, or cerebral or retinal ischemia (transient ischemic or strokes) attributable mainly to artery-artery embolism, CD cranial nerve palsies, oculosympathetic palsy, or pulsatile tinnitus. Diagnosis of CD depends on a thorough history, physical examination, and targeted ancillary investigations. Although the role of trivial trauma is debatable, mechanical forces can lead to intimal injuries of the vertebral arteries and internal carotid arteries and result in CD. Disability levels vary among CD patients with many having good outcomes, but serious neurological sequelae can occur. No evidence-based guidelines are currently available to endorse best management strategies for CDs. Antiplatelet and anticoagulant treatments are both used for prevention of local thrombus and secondary embolism. Case-control and other articles have suggested an epidemiologic association between CD, particularly vertebral artery dissection

  11. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    OpenAIRE

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A

  12. Take Steps to Keep Your Heart Healthy on Dialysis

    Science.gov (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z ... heart attack, stroke, or even death. Two common types of heart disease are: Heart failure. Heart failure ...

  13. Drug therapy of high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing

    National Research Council Canada - National Science Library

    McCrindle, Brian W; Urbina, Elaine M; Dennison, Barbara A; Jacobson, Marc S; Steinberger, Julia; Rocchini, Albert P; Hayman, Laura L; Daniels, Stephen R

    2007-01-01

    .... The purpose of this statement is to examine new evidence on the association of lipid abnormalities with early atherosclerosis, discuss challenges with previous guidelines, and highlight results...

  14. Future Care Planning for patients approaching end-of-life with advanced heart disease: an interview study with patients, carers and healthcare professionals exploring the content, rationale and design of a randomised clinical trial.

    Science.gov (United States)

    Denvir, Martin A; Highet, Gill; Robertson, Shirley; Cudmore, Sarah; Reid, Janet; Ness, Andrea; Hogg, Karen; Weir, Christopher; Murray, Scott; Boyd, Kirsty

    2014-07-14

    To explore the optimal content and design of a clinical trial of an end-of-life intervention for advanced heart disease with patients, carers and healthcare professionals. Qualitative interview and focus group study. Community and hospital-based focus groups and interviews. Stable community-dwelling patients, informal carers (PC, n=15) and primary and secondary care based healthcare professionals (HCP, n=11). PC highlighted fragmentation of services and difficulty in accessing specialist care as key barriers to good care. They felt that time for discussion with HCP was inadequate within current National Health Service (NHS) healthcare systems. HCP highlighted uncertainty of prognosis, explaining mortality risk to patients and switching from curative to palliative approaches as key challenges. Patient selection, nature of the intervention and relevance of trial outcomes were identified by HCP as key challenges in the design of a clinical trial. PC and HCP expressed a number of concerns relevant to the nature and content of an end-of-life intervention for patients with advanced heart disease. The findings of this study are being used to support a phase II randomised clinical trial of Future Care Planning in advanced heart disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Future Care Planning for patients approaching end-of-life with advanced heart disease: an interview study with patients, carers and healthcare professionals exploring the content, rationale and design of a randomised clinical trial

    Science.gov (United States)

    Denvir, Martin A; Highet, Gill; Robertson, Shirley; Cudmore, Sarah; Reid, Janet; Ness, Andrea; Hogg, Karen; Weir, Christopher; Murray, Scott; Boyd, Kirsty

    2014-01-01

    Objective To explore the optimal content and design of a clinical trial of an end-of-life intervention for advanced heart disease with patients, carers and healthcare professionals. Design Qualitative interview and focus group study. Setting Community and hospital-based focus groups and interviews. Participants Stable community-dwelling patients, informal carers (PC, n=15) and primary and secondary care based healthcare professionals (HCP, n=11). Results PC highlighted fragmentation of services and difficulty in accessing specialist care as key barriers to good care. They felt that time for discussion with HCP was inadequate within current National Health Service (NHS) healthcare systems. HCP highlighted uncertainty of prognosis, explaining mortality risk to patients and switching from curative to palliative approaches as key challenges. Patient selection, nature of the intervention and relevance of trial outcomes were identified by HCP as key challenges in the design of a clinical trial. Conclusions PC and HCP expressed a number of concerns relevant to the nature and content of an end-of-life intervention for patients with advanced heart disease. The findings of this study are being used to support a phase II randomised clinical trial of Future Care Planning in advanced heart disease. PMID:25023130

  16. Improving care for people with heart failure in Uganda: serial in-depth interviews with patients' and their health care professionals.

    Science.gov (United States)

    Namukwaya, Elizabeth; Grant, Liz; Downing, Julia; Leng, Mhoira; Murray, Scott A

    2017-05-25

    The short prognosis of patients with advanced heart failure (HF) and the associated multidimensional distress as illustrated in literature from high income countries necessitates the integration of palliative care into the care of advanced HF patients to address these needs and improve their quality of life. These needs, which are subjective, have not been described from the patients' and health care professionals'(HPs) view point in the Ugandan setting, a low income country with a different socio-cultural context. This study aimed at bridging this gap in knowledge by eliciting patients' and HPs' views of HF patients' needs over the course of their illness to enable generalists, cardiologists and palliative care clinicians to develop guidelines to provide patient-centred realistic care in Uganda. Serial qualitative in-depth interviews were conducted with HF patients who were purposively sampled and recruited in Mulago National Referral Hospital (MNRH) until thematic saturation. In-depth interviews were conducted at three time points with intervals of 3 month between interviews over the course of their illness in the hospital and their home context. One-off interviews were conducted with HPs that manage HF in MNRH. We used a grounded theory approach in data analysis. The Uganda National Council of science and technology approved the research. Forty-eight interviews were conducted with 21 patients and their carers and eight interviews with their HPs. Multidimensional needs including physical, psychological, social, spiritual and information needs were identified. These highlighted the underpinning need to have normal functioning, control, to cope and adapt to a changed life and to find meaning. Spiritual needs were less recognised by HPs than the other multidimensional needs. Information needs were commonly unmet. Patients and HPs suggested improvements in care that were congruent with the recommendations in chronic disease care and the six pillars of the WHO

  17. Heart Health for Women

    Science.gov (United States)

    ... lower your cholesterol . 3. Get the facts about aspirin. Daily use of aspirin to prevent heart attacks ... State & Local Officials Consumers Health Professionals Science & Research Industry Scroll back to top Popular Content Home Latest ...

  18. Comorbid Mental Health Symptoms and Heart Diseases: Can Health Care and Mental Health Care Professionals Collaboratively Improve the Assessment and Management?

    Science.gov (United States)

    Ai, Amy L.; Rollman, Bruce L.; Berger, Candyce S.

    2010-01-01

    On the basis of current epidemiological and clinical research, this article describes how mental health symptoms are associated with heart disease, a major chronic condition that occurs primarily in middle and late life. The article describes the culturally and historically important link between heart and mind. It then describes depression and…

  19. Erectile Dysfunction: A Sign of Heart Disease?

    Science.gov (United States)

    ... cause erectile dysfunction. Alcohol Use. Drinking too much alcohol can cause heart disease and might contribute to other causes of heart disease, such as high blood pressure or abnormal cholesterol. Alcohol also impairs erections. High blood pressure. Over time, ...

  20. Heart Health - Brave Heart

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  1. Heart MRI

    Science.gov (United States)

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  2. Professional Team Sports Clubs

    DEFF Research Database (Denmark)

    Storm, Rasmus K.

    Professional football in Europe is characterized by persistent deficits, growing debts and additional financial problems among the majority of the top league clubs. Despite these problems, these clubs have an abnormally high survival rate. This paper focuses on this apparent paradox and poses the...... in Europe, this paper argues that professional team sports clubs (PTSCs) are cases of an economic phenomenon normally found in socialist or post-socialist economies....

  3. Eclampsia and abnormal QTc | Isezuo | West African Journal of ...

    African Journals Online (AJOL)

    Background: Abnormalities of calcium and magnesium metabolism are known risk factors for QT interval prolongation and have been reported in eclampsia. Objective: To determine if eclampsia is associated with QT abnormalities. Methods: In a prospective study, the QT interval corrected for heart rate (QTc), serum calcium, ...

  4. Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Thompson, B Gregory; Brown, Robert D; Amin-Hanjani, Sepideh; Broderick, Joseph P; Cockroft, Kevin M; Connolly, E Sander; Duckwiler, Gary R; Harris, Catherine C; Howard, Virginia J; Johnston, S Claiborne Clay; Meyers, Philip M; Molyneux, Andrew; Ogilvy, Christopher S; Ringer, Andrew J; Torner, James

    2015-08-01

    The aim of this updated statement is to provide comprehensive and evidence-based recommendations for management of patients with unruptured intracranial aneurysms. Writing group members used systematic literature reviews from January 1977 up to June 2014. They also reviewed contemporary published evidence-based guidelines, personal files, and published expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulated recommendations using standard American Heart Association criteria. The guideline underwent extensive peer review, including review by the Stroke Council Leadership and Stroke Scientific Statement Oversight Committees, before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. Evidence-based guidelines are presented for the care of patients presenting with unruptured intracranial aneurysms. The guidelines address presentation, natural history, epidemiology, risk factors, screening, diagnosis, imaging and outcomes from surgical and endovascular treatment. © 2015 American Heart Association, Inc.

  5. Commonly Asked Questions about Children and Heart Disease

    Science.gov (United States)

    ... an enlarged heart include weakness of the heart muscle (a condition called dilated cardiomyopathy), rheumatic fever (infrequent in the United States ), infection of the heart valves (called endocarditis), and a previously unknown congenital abnormality of the heart or blood vessels. Heart attacks, ...

  6. Heart Conditions and Pregnancy: Know the Risks

    Science.gov (United States)

    ... Accessed May 16, 2017. Nanna M, et al. Pregnancy complicated by valvular heart disease. Journal of the American ... http://www.merckmanuals.com/professional/gynecology-and-obstetrics/pregnancy-complicated-by-disease/heart-disorders-in-pregnancy. Accessed May ...

  7. Opportunities in the failing heart

    NARCIS (Netherlands)

    Gho, J.M.I.H.

    2015-01-01

    Heart failure (HF) is a syndrome with typical signs and symptoms that can result from abnormal cardiac structure or function. It can lead to impaired quality of life, decreased functional capacity, hospital admissions and mortality. Heart failure has been associated with focal and diffuse myocardial

  8. Structurally abnormal human autosomes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 25, discusses structurally abnormal human autosomes. This discussion includes: structurally abnormal chromosomes, chromosomal polymorphisms, pericentric inversions, paracentric inversions, deletions or partial monosomies, cri du chat (cat cry) syndrome, ring chromosomes, insertions, duplication or pure partial trisomy and mosaicism. 71 refs., 8 figs.

  9. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Baddour, Larry M; Wilson, Walter R; Bayer, Arnold S; Fowler, Vance G; Tleyjeh, Imad M; Rybak, Michael J; Barsic, Bruno; Lockhart, Peter B; Gewitz, Michael H; Levison, Matthew E; Bolger, Ann F; Steckelberg, James M; Baltimore, Robert S; Fink, Anne M; O'Gara, Patrick; Taubert, Kathryn A

    2015-10-13

    Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today's myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances. This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It includes an evidence-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations. Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management. © 2015 American Heart Association, Inc.

  10. Lungs in Heart Failure

    Directory of Open Access Journals (Sweden)

    Anna Apostolo

    2012-01-01

    Full Text Available Lung function abnormalities both at rest and during exercise are frequently observed in patients with chronic heart failure, also in the absence of respiratory disease. Alterations of respiratory mechanics and of gas exchange capacity are strictly related to heart failure. Severe heart failure patients often show a restrictive respiratory pattern, secondary to heart enlargement and increased lung fluids, and impairment of alveolar-capillary gas diffusion, mainly due to an increased resistance to molecular diffusion across the alveolar capillary membrane. Reduced gas diffusion contributes to exercise intolerance and to a worse prognosis. Cardiopulmonary exercise test is considered the “gold standard” when studying the cardiovascular, pulmonary, and metabolic adaptations to exercise in cardiac patients. During exercise, hyperventilation and consequent reduction of ventilation efficiency are often observed in heart failure patients, resulting in an increased slope of ventilation/carbon dioxide (VE/VCO2 relationship. Ventilatory efficiency is as strong prognostic and an important stratification marker. This paper describes the pulmonary abnormalities at rest and during exercise in the patients with heart failure, highlighting the principal diagnostic tools for evaluation of lungs function, the possible pharmacological interventions, and the parameters that could be useful in prognostic assessment of heart failure patients.

  11. Heart rate turbulence.

    Science.gov (United States)

    Cygankiewicz, Iwona

    2013-01-01

    Heart rate turbulence (HRT) is a baroreflex-mediated biphasic reaction of heart rate in response to premature ventricular beats. Heart rate turbulence is quantified by: turbulence onset (TO) reflecting the initial acceleration of heart rate following premature beat and turbulence slope (TS) describing subsequent deceleration of heart rate. Abnormal HRT identifies patients with autonomic dysfunction or impaired baroreflex sensitivity due to variety of disorders, but also may reflect changes in autonomic nervous system induced by different therapeutic modalities such as drugs, revascularization, or cardiac resynchronization therapy. More importantly, impaired HRT has been shown to identify patients at high risk of all-cause mortality and sudden death, particularly in postinfarction and congestive heart failure patients. It should be emphasized that abnormal HRT has a well-established role in stratification of postinfarction and heart failure patients with relatively preserved left ventricular ejection fraction. The ongoing clinical trials will document whether HRT can be used to guide implantation of cardioverter-defibrillators in this subset of patients, not covered yet by ICD guidelines. This review focuses on the current state-of-the-art knowledge regarding clinical significance of HRT in detection of autonomic dysfunction and regarding the prognostic significance of this parameter in predicting all-cause mortality and sudden death. © 2013.

  12. "The Heart Game"

    DEFF Research Database (Denmark)

    Dithmer, Marcus; Rasmussen, Jack Ord; Grönvall, Erik

    2016-01-01

    Objective: The aim of this article is to describe the development and testing of a prototype application (“The Heart Game”) using gamification principles to assist heart patients in their telerehabilitation process in the Teledialog project. Materials and Methods: A prototype game was developed via...... (interviews, participant observations, focus group interviews, and workshop) was used. Interviews with three healthcare professionals and 10 patients were carried out over a period of 2 weeks in order to evaluate the use of the prototype. Results: The heart patients reported the application to be a useful...... activities. Conclusions: “The Heart Game” concept presents a new way to motivate heart patients by using technology as a social and active approach to telerehabilitation. The findings show the potential of using gamification for heart patients as part of a telerehabilitation program. The evaluation indicated...

  13. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    Science.gov (United States)

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A screening with the possible addition of uterine artery PI assessment in the midtrimester. PMID:20638576

  14. Iodine-123 phenylpentadecanoic acid and single photon emission computed tomography in identifying left ventricular regional metabolic abnormalities in patients with coronary heart disease: comparison with thallium-201 myocardial tomography.

    Science.gov (United States)

    Hansen, C L; Corbett, J R; Pippin, J J; Jansen, D E; Kulkarni, P V; Ugolini, V; Henderson, E; Akers, M; Buja, L M; Parkey, R W

    1988-07-01

    Iodine-123 phenylpentadecanoic acid (IPPA) is a synthetic long chain fatty acid with myocardial kinetics similar to palmitate. Two hypotheses were tested in this study. The first hypothesis was that IPPA imaging with single photon emission computed tomography (SPECT) is useful in the identification of patients with coronary artery disease. Fourteen normal volunteers (aged 27 +/- 2 years) and 33 patients (aged 54 +/- 11 years) with stable symptomatic coronary artery disease and at least one major coronary artery with luminal diameter narrowing greater than or equal to 70% were studied with symptom-limited maximal exercise testing. The IPPA (6 to 8 mCi) was injected 1 min before the termination of exercise, and tomographic imaging was performed beginning at 9 min and repeated at 40 min after the injection of IPPA. Nine of the normal volunteers and 13 of the patients had a second examination performed at rest on another day. Using the limits of normal as 2 SD from the normal mean values, 27 of the 33 patients with coronary artery disease demonstrated abnormalities in either the initial distribution or the clearance of IPPA, or both. Nineteen of the 33 patients had a maximal variation of activity distribution of greater than or equal to 25% on the 9 min IPPA images. Twenty-two of the 33 patients had a maximal variation in IPPA washout greater than 17% and 17 had a washout rate less than or equal to 2%. There was good agreement between the location of significant coronary artery stenoses and abnormalities in the initial distribution and clearance of IPPA. The second hypothesis tested was that IPPA imaging is as or more sensitive and, therefore, complementary to thallium-201 imaging in the identification of exercise-induced ischemia in patients. Twenty-five of the 33 patients underwent both thallium-201 and IPPA tomographic imaging after symptom-limited maximal exercise testing. The amount of exercise performed by each patient during both studies was similar. Twenty

  15. Athlete's heart patterns in elite rugby players: effects of training specificities.

    Science.gov (United States)

    Chevalier, Laurent; Kervio, Gaëlle; Corneloup, Luc; Vincent, Marie-Pierre; Baudot, Christophe; Rebeyrol, Jean-Louis; Merle, Francis; Gencel, Laurent; Carré, François

    2013-02-01

    Athlete's heart patterns have been widely described. However, to our knowledge, few studies have focused on professional rugby players, who train differently according to their field position. To describe electrocardiographic and echocardiographic patterns observed in elite rugby players according to their field position. One hundred and thirty-five professional rugby players at the end of the competitive season were included. According to a modified Pelliccia's classification, 68.1% of electrocardiograms were normal or had minor abnormalities, 27.2% were mildly abnormal and 3.7% were distinctly abnormal. Heart rate was higher in scrum first-row players (P<0.05). Absolute and indexed left ventricular end-diastolic internal diameters (LVIDd; absolute value 59.3±4.7 mm) exceeded 65 mm and 32 mm/m2 in 13% and 1.5% of players, respectively. Indexed LVIDd values were higher in back players (P<0.001). Left ventricular interventricular septum and posterior wall thicknesses (absolute values 9.4±1.7 mm and 9.2±1.6 mm, respectively) exceeded 13 mm in 3.7% of players. Concentric cardiac hypertrophy was noted in 3.7% of players. Except for one Wolff-Parkinson-White pattern, players with significant ECG or echocardiographic abnormalities showed no cardiovascular event or disease during follow-up. Thus, elite rugby players present similar heart patterns to elite athletes in other sports. Major electrocardiographic and echocardiographic abnormalities are quite rare. Eccentric cardiac remodelling is more frequent in back players. Copyright © 2013. Published by Elsevier Masson SAS.

  16. Prevention of Stroke in Patients With Silent Cerebrovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Smith, Eric E; Saposnik, Gustavo; Biessels, Geert Jan; Doubal, Fergus N; Fornage, Myriam; Gorelick, Philip B; Greenberg, Steven M; Higashida, Randall T; Kasner, Scott E; Seshadri, Sudha

    2017-02-01

    Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds. The writing committee found strong evidence that silent cerebrovascular disease is a common problem of aging and that silent brain infarcts and white matter hyperintensities are associated with future symptomatic stroke risk independently of other vascular risk factors. In patients with cerebral microbleeds, there was evidence of a modestly increased risk of symptomatic intracranial hemorrhage in patients treated with thrombolysis for acute ischemic stroke but little prospective evidence on the risk of symptomatic hemorrhage in patients on anticoagulation. There were no randomized controlled trials targeted specifically to participants with silent cerebrovascular disease to prevent stroke. Primary stroke prevention is indicated in patients with silent brain infarcts, white matter hyperintensities, or microbleeds. Adoption of standard terms and definitions for silent cerebrovascular disease, as provided by prior American Heart Association/American Stroke Association statements and by a consensus group, may facilitate diagnosis and communication of findings from radiologists to clinicians. © 2016 American Heart Association, Inc.

  17. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Billinger, Sandra A; Arena, Ross; Bernhardt, Julie; Eng, Janice J; Franklin, Barry A; Johnson, Cheryl Mortag; MacKay-Lyons, Marilyn; Macko, Richard F; Mead, Gillian E; Roth, Elliot J; Shaughnessy, Marianne; Tang, Ada

    2014-08-01

    This scientific statement provides an overview of the evidence on physical activity and exercise recommendations for stroke survivors. Evidence suggests that stroke survivors experience physical deconditioning and lead sedentary lifestyles. Therefore, this updated scientific statement serves as an overall guide for practitioners to gain a better understanding of the benefits of physical activity and recommendations for prescribing exercise for stroke survivors across all stages of recovery. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and indicate gaps in current knowledge. Physical inactivity after stroke is highly prevalent. The assessed body of evidence clearly supports the use of exercise training (both aerobic and strength training) for stroke survivors. Exercise training improves functional capacity, the ability to perform activities of daily living, and quality of life, and it reduces the risk for subsequent cardiovascular events. Physical activity goals and exercise prescription for stroke survivors need to be customized for the individual to maximize long-term adherence. The recommendation from this writing group is that physical activity and exercise prescription should be incorporated into the management of stroke survivors. The promotion of physical activity in stroke survivors should emphasize low- to moderate-intensity aerobic activity, muscle-strengthening activity, reduction of sedentary behavior, and risk management for secondary prevention of stroke. © 2014 American Heart Association, Inc.

  18. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  19. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  20. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Hemphill, J Claude; Greenberg, Steven M; Anderson, Craig S; Becker, Kyra; Bendok, Bernard R; Cushman, Mary; Fung, Gordon L; Goldstein, Joshua N; Macdonald, R Loch; Mitchell, Pamela H; Scott, Phillip A; Selim, Magdy H; Woo, Daniel

    2015-07-01

    The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of spontaneous intracerebral hemorrhage. A formal literature search of PubMed was performed through the end of August 2013. The writing committee met by teleconference to discuss narrative text and recommendations. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. Evidence-based guidelines are presented for the care of patients with acute intracerebral hemorrhage. Topics focused on diagnosis, management of coagulopathy and blood pressure, prevention and control of secondary brain injury and intracranial pressure, the role of surgery, outcome prediction, rehabilitation, secondary prevention, and future considerations. Results of new phase 3 trials were incorporated. Intracerebral hemorrhage remains a serious condition for which early aggressive care is warranted. These guidelines provide a framework for goal-directed treatment of the patient with intracerebral hemorrhage. © 2015 American Heart Association, Inc.

  1. Electrocardiogram Abnormalities and Coronary Calcification in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Siamak Sabour

    2010-03-01

    Results: LVH was found in 2.7% (n = 15 of the women. The prevalence of T-axis abnormality was 6% (n = 34, whereas 8.5% (n = 48 had a QRS-T angle abnormality. CAC was found in 62% of the women. Compared to women with a normal T-axis, women with borderline or abnormal T-axes were 3.8 fold more likely to have CAC (95% CI: 1.4-10.2. Similarly, compared to women with a normal QRS-T angle, in women with borderline or abnormal QRS-T angle, CAC was 2.0 fold more likely to be present (95% CI: 1.0-4.1. Conclusion: Among women with ECG abnormalities reflecting subclinical ischemia, CAC is commonly found and may in part explain the increased coronary heart disease risk associated with these ECG abnormalities.

  2. Laboratory Professionals: Who's Who in the Lab

    Science.gov (United States)

    ... eGFR) Estrogen/Progesterone Receptor Status Estrogens Ethanol Extractable Nuclear Antigen Antibodies (ENA) Panel Factor V Leiden Mutation ... and Acute Coronary Syndrome Heart Disease Hemochromatosis Hemoglobin Abnormalities Hepatitis HIV Infection and AIDS Huntington Disease Hypertension ...

  3. Universal design of a microcontroller and IoT system to detect the heart rate

    Science.gov (United States)

    Uwamahoro, Raphael; Mushikiwabeza, Alexie; Minani, Gerard; Mohan Murari, Bhaskar

    2017-11-01

    Heart rate analysis provides vital information of the present condition of the human body. It helps medical professionals in diagnosis of various malfunctions of the body. The limitation of vision impaired and blind people to access medical devices cause a considerable loss of life. In this paper, we intended to develop a heart rate detection system that is usable for people with normal and abnormal vision. The system is based on a non-invasive method of measuring the variation of the tissue blood flow rate by means of a photo transmitter and detector through fingertip known as photoplethysmography (PPG). The signal detected is firstly passed through active low pass filter and then amplified by a two stages high gain amplifier. The amplified signal is feed into the microcontroller to calculate the heart rate and displays the heart beat via sound systems and Liquid Crystal Display (LCD). To distinguish arrhythmia, normal heart rate and abnormal working conditions of the system, recognition is provided in different sounds, LCD readings and Light Emitting Diodes (LED).

  4. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association.

    Science.gov (United States)

    Gorelick, Philip B; Scuteri, Angelo; Black, Sandra E; Decarli, Charles; Greenberg, Steven M; Iadecola, Costantino; Launer, Lenore J; Laurent, Stephane; Lopez, Oscar L; Nyenhuis, David; Petersen, Ronald C; Schneider, Julie A; Tzourio, Christophe; Arnett, Donna K; Bennett, David A; Chui, Helena C; Higashida, Randall T; Lindquist, Ruth; Nilsson, Peter M; Roman, Gustavo C; Sellke, Frank W; Seshadri, Sudha

    2011-09-01

    This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment. Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee. The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury-not solely stroke-ranging from mild cognitive impairment through fully developed dementia. Dysfunction of the neurovascular

  5. Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Wijdicks, Eelco F M; Sheth, Kevin N; Carter, Bob S; Greer, David M; Kasner, Scott E; Kimberly, W Taylor; Schwab, Stefan; Smith, Eric E; Tamargo, Rafael J; Wintermark, Max

    2014-04-01

    There are uncertainties surrounding the optimal management of patients with brain swelling after an ischemic stroke. Guidelines are needed on how to manage this major complication, how to provide the best comprehensive neurological and medical care, and how to best inform families facing complex decisions on surgical intervention in deteriorating patients. This scientific statement addresses the early approach to the patient with a swollen ischemic stroke in a cerebral or cerebellar hemisphere. The writing group used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. The panel reviewed the most relevant articles on adults through computerized searches of the medical literature using MEDLINE, EMBASE, and Web of Science through March 2013. The evidence is organized within the context of the American Heart Association framework and is classified according to the joint American Heart Association/American College of Cardiology Foundation and supplementary American Heart Association Stroke Council methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive American Heart Association internal peer review. Clinical criteria are available for hemispheric (involving the entire middle cerebral artery territory or more) and cerebellar (involving the posterior inferior cerebellar artery or superior cerebellar artery) swelling caused by ischemic infarction. Clinical signs that signify deterioration in swollen supratentorial hemispheric ischemic stroke include new or further impairment of consciousness, cerebral ptosis, and changes in pupillary size. In swollen cerebellar infarction, a decrease in level of consciousness occurs as a result of brainstem compression and therefore may

  6. Teaching Abnormal Psychology to Improve Attitudes toward Mental Illness and Help-Seeking

    Science.gov (United States)

    Kendra, Matthew S.; Cattaneo, Lauren B.; Mohr, Jonathan J.

    2012-01-01

    Abnormal psychology instructors often use traditional and personal methods to educate students about and improve student attitudes toward mental illness and professional help-seeking. Data from abnormal psychology students (N = 190) were used to determine if and how students' attitudes toward mental illness and professional help-seeking attitudes…

  7. Communicating with Professionals

    Medline Plus

    Full Text Available ... Heart Attack Life After a Heart Attack Heart Failure About Heart Failure Causes and Risks for Heart Failure Warning Signs for Heart Failure Diagnosing Heart Failure Treatment Options for Heart Failure Living With ...

  8. Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Goudis, Christos A; Konstantinidis, Athanasios K; Ntalas, Ioannis V; Korantzopoulos, Panagiotis

    2015-11-15

    Chronic obstructive pulmonary disease (COPD) is independently associated with an increased burden of cardiovascular disease. Besides coronary artery disease (CAD) and congestive heart failure (CHF), specific electrocardiographic (ECG) abnormalities and cardiac arrhythmias seem to have a significant impact on cardiovascular prognosis of COPD patients. Disturbances of heart rhythm include premature atrial contractions (PACs), premature ventricular contractions (PVCs), atrial fibrillation (AF), atrial flutter (AFL), multifocal atrial tachycardia (MAT), and ventricular tachycardia (VT). Of note, the identification of ECG abnormalities and the evaluation of the arrhythmic risk may have significant implications in the management and outcome of patients with COPD. This article provides a concise overview of the available data regarding ECG abnormalities and arrhythmias in these patients, including an elaborated description of the underlying arrhythmogenic mechanisms. The clinical impact and prognostic significance of ECG abnormalities and arrhythmias in COPD as well as the appropriate antiarrhythmic therapy and interventions in this setting are also discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Heart development: learning from mistakes.

    Science.gov (United States)

    McFadden, David G; Olson, Eric N

    2002-06-01

    Congenital heart disease in humans results from abnormal morphogenesis of the embryonic cardiovascular system. The characterization of mutations affecting cardiovascular development in animal models ranging from flies to mice has identified many of the key signaling molecules and transcriptional regulators of heart formation. Many of these molecules are also mutated in familial forms of human congenital heart disease. Through the use of animal models combined with analysis of human pedigrees, a molecular framework that controls formation of the vertebrate heart is beginning to emerge.

  10. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Winstein, Carolee J; Stein, Joel; Arena, Ross; Bates, Barbara; Cherney, Leora R; Cramer, Steven C; Deruyter, Frank; Eng, Janice J; Fisher, Beth; Harvey, Richard L; Lang, Catherine E; MacKay-Lyons, Marilyn; Ottenbacher, Kenneth J; Pugh, Sue; Reeves, Mathew J; Richards, Lorie G; Stiers, William; Zorowitz, Richard D

    2016-06-01

    The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness and efficiency of rehabilitation and underlie this entire guideline. Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential. As systems of care evolve in response to healthcare reform efforts, postacute care and rehabilitation are often considered a costly area of care to be trimmed but without recognition of their clinical impact and ability to reduce the risk of downstream medical morbidity resulting from

  11. Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Yaghi, Shadi; Willey, Joshua Z; Cucchiara, Brett; Goldstein, Joshua N; Gonzales, Nicole R; Khatri, Pooja; Kim, Louis J; Mayer, Stephan A; Sheth, Kevin N; Schwamm, Lee H

    2017-12-01

    Symptomatic intracranial hemorrhage (sICH) is the most feared complication of intravenous thrombolytic therapy in acute ischemic stroke. Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment. A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH. The document sections were divided among writing group members who performed the literature review, summarized the literature, and provided suggestions on the diagnosis and treatment of patients with sICH caused by systemic thrombolysis with alteplase. Several drafts were circulated among writing group members until a consensus was achieved. sICH is an uncommon but severe complication of systemic thrombolysis in acute ischemic stroke. Prompt diagnosis and early correction of the coagulopathy after alteplase have remained the mainstay of treatment. Further research is required to establish treatments aimed at maintaining integrity of the blood-brain barrier in acute ischemic stroke based on inhibition of the underlying biochemical processes. © 2017 American Heart Association, Inc.

  12. Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Wechsler, Lawrence R; Demaerschalk, Bart M; Schwamm, Lee H; Adeoye, Opeolu M; Audebert, Heinrich J; Fanale, Christopher V; Hess, David C; Majersik, Jennifer J; Nystrom, Karin V; Reeves, Mathew J; Rosamond, Wayne D; Switzer, Jeffrey A

    2017-01-01

    Telestroke is one of the most frequently used and rapidly expanding applications of telemedicine, delivering much-needed stroke expertise to hospitals and patients. This document reviews the current status of telestroke and suggests measures for ongoing quality and outcome monitoring to improve performance and to enhance delivery of care. A literature search was undertaken to examine the current status of telestroke and relevant quality indicators. The members of the writing committee contributed to the review of specific quality and outcome measures with specific suggestions for metrics in telestroke networks. The drafts were circulated and revised by all committee members, and suggestions were discussed for consensus. Models of telestroke and the role of telestroke in stroke systems of care are reviewed. A brief description of the science of quality monitoring and prior experience in quality measures for stroke is provided. Process measures, outcomes, tissue-type plasminogen activator use, patient and provider satisfaction, and telestroke technology are reviewed, and suggestions are provided for quality metrics. Additional topics include licensing, credentialing, training, and documentation. © 2016 American Heart Association, Inc.

  13. Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Barnason, Susan; White-Williams, Connie; Rossi, Laura P; Centeno, Mae; Crabbe, Deborah L; Lee, Kyoung Suk; McCabe, Nancy; Nauser, Julie; Schulz, Paula; Stamp, Kelly; Wood, Kathryn

    2017-06-01

    The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions. There was variability in methodological approaches across settings and disease conditions. The most effective interventions were tailored to individual patient needs, used multiple components to improve self-management outcomes, and often used multidisciplinary approaches. This synthesis of evidence expands the base of knowledge related to the development of patient self-management skills and provides direction for more rigorous research. Recommendations are provided to guide the implementation of therapeutic patient education in clinical practice and the design of comprehensive self-management interventions to improve outcomes for cardiovascular patients. © 2017 American Heart Association, Inc.

  14. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Sacco, Ralph L; Kasner, Scott E; Broderick, Joseph P; Caplan, Louis R; Connors, J J Buddy; Culebras, Antonio; Elkind, Mitchell S V; George, Mary G; Hamdan, Allen D; Higashida, Randall T; Hoh, Brian L; Janis, L Scott; Kase, Carlos S; Kleindorfer, Dawn O; Lee, Jin-Moo; Moseley, Michael E; Peterson, Eric D; Turan, Tanya N; Valderrama, Amy L; Vinters, Harry V

    2013-07-01

    Despite the global impact and advances in understanding the pathophysiology of cerebrovascular diseases, the term "stroke" is not consistently defined in clinical practice, in clinical research, or in assessments of the public health. The classic definition is mainly clinical and does not account for advances in science and technology. The Stroke Council of the American Heart Association/American Stroke Association convened a writing group to develop an expert consensus document for an updated definition of stroke for the 21st century. Central nervous system infarction is defined as brain, spinal cord, or retinal cell death attributable to ischemia, based on neuropathological, neuroimaging, and/or clinical evidence of permanent injury. Central nervous system infarction occurs over a clinical spectrum: Ischemic stroke specifically refers to central nervous system infarction accompanied by overt symptoms, while silent infarction by definition causes no known symptoms. Stroke also broadly includes intracerebral hemorrhage and subarachnoid hemorrhage. The updated definition of stroke incorporates clinical and tissue criteria and can be incorporated into practice, research, and assessments of the public health.

  15. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association.

    Science.gov (United States)

    Connolly, E Sander; Rabinstein, Alejandro A; Carhuapoma, J Ricardo; Derdeyn, Colin P; Dion, Jacques; Higashida, Randall T; Hoh, Brian L; Kirkness, Catherine J; Naidech, Andrew M; Ogilvy, Christopher S; Patel, Aman B; Thompson, B Gregory; Vespa, Paul

    2012-06-01

    The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH). A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation. The guideline draft was reviewed by 7 expert peer reviewers and by the members of the Stroke Council Leadership and Manuscript Oversight Committees. It is intended that this guideline be fully updated every 3 years. Evidence-based guidelines are presented for the care of patients presenting with aSAH. The focus of the guideline was subdivided into incidence, risk factors, prevention, natural history and outcome, diagnosis, prevention of rebleeding, surgical and endovascular repair of ruptured aneurysms, systems of care, anesthetic management during repair, management of vasospasm and delayed cerebral ischemia, management of hydrocephalus, management of seizures, and management of medical complications. aSAH is a serious medical condition in which outcome can be dramatically impacted by early, aggressive, expert care. The guidelines offer a framework for goal-directed treatment of the patient with aSAH.

  16. Enhancing Knowledge and InterProfessional care for Heart Failure (EKWIP-HF) in long-term care: a pilot study.

    Science.gov (United States)

    Heckman, George A; Boscart, Veronique M; Huson, Kelsey; Costa, Andrew; Harkness, Karen; Hirdes, John P; Stolee, Paul; McKelvie, Robert S

    2018-01-01

    Heart failure (HF) affects 20% of long-term care (LTC) residents and is associated with significant morbidity, acute care visits, and mortality. Barriers to HF management are staff knowledge gaps and ineffective interprofessional (IP) communication. This pilot study assessed the acceptability, feasibility, and impact of an intervention to (1) improve HF knowledge; (2) improve IP communication; and (3) integrate improved knowledge and communication processes into work routines. The intervention provides multimodal IP education about HF in LTC, including specialist-supported bedside teaching. It was piloted on single units in two facilities. A mixed-methods repeated-measures approach was used to collect qualitative and quantitative process and outcome data at baseline and 6 months post-intervention. Results were similar at both sites. Participants developed optimized IP communication to promote HF care. Results indicate a perceived increase in staff confidence and self-efficacy, strengthened assessment and clinical proficiency skills, and more effective IP collaboration. Staff deemed the intervention useful and feasible. This pilot study suggests that a novel intervention in which HF-specific knowledge is applied by LTC staff to improve IP collaboration in their own work place is acceptable and feasible and has a favourable preliminary impact on staff knowledge and IP communication.

  17. Abnormal Head Position

    Science.gov (United States)

    ... non-ocular causes of an abnormal head position? Congenital shortening of the neck muscles (sternocleidomastoid) can cause a head tilt. This is ... amblyopia) are other treatment alternatives. Physical therapy helps congenital torticollis from tight neck muscles. Updated ... Terms & Conditions Most Common ...

  18. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Bushnell, Cheryl; McCullough, Louise D; Awad, Issam A; Chireau, Monique V; Fedder, Wende N; Furie, Karen L; Howard, Virginia J; Lichtman, Judith H; Lisabeth, Lynda D; Piña, Ileana L; Reeves, Mathew J; Rexrode, Kathryn M; Saposnik, Gustavo; Singh, Vineeta; Towfighi, Amytis; Vaccarino, Viola; Walters, Matthew R

    2014-05-01

    The aim of this statement is to summarize data on stroke risk factors that are unique to and more common in women than men and to expand on the data provided in prior stroke guidelines and cardiovascular prevention guidelines for women. This guideline focuses on the risk factors unique to women, such as reproductive factors, and those that are more common in women, including migraine with aura, obesity, metabolic syndrome, and atrial fibrillation. Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through May 15, 2013. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA Stroke Council methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. We provide current evidence, research gaps, and recommendations on risk of stroke related to preeclampsia, oral contraceptives, menopause, and hormone replacement, as well as those risk factors more common in women, such as obesity/metabolic syndrome, atrial fibrillation, and migraine with aura. To more accurately reflect the risk of stroke in women across the lifespan, as well as the clear gaps in current risk scores, we believe a female-specific stroke risk score is warranted.

  19. Heart Failure

    Science.gov (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  20. Cardiac Arrhythmias and Abnormal Electrocardiograms After Acute Stroke.

    Science.gov (United States)

    Ruthirago, Doungporn; Julayanont, Parunyou; Tantrachoti, Pakpoom; Kim, Jongyeol; Nugent, Kenneth

    2016-01-01

    Cardiac arrhythmias and electrocardiogram (ECG) abnormalities occur frequently but are often underrecognized after strokes. Acute ischemic and hemorrhagic strokes in some particular area of brain can disrupt central autonomic control of the heart, precipitating cardiac arrhythmias, ECG abnormalities, myocardial injury and sometimes sudden death. Identification of high-risk patients after acute stroke is important to arrange appropriate cardiac monitoring and effective management of arrhythmias, and to prevent cardiac morbidity and mortality. More studies are needed to better clarify pathogenesis, localization of areas associated with arrhythmias and practical management of arrhythmias and abnormal ECGs after acute stroke. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  1. Congenital Heart Disease: Causes, Diagnosis, Symptoms, and Treatments.

    Science.gov (United States)

    Sun, RongRong; Liu, Min; Lu, Lei; Zheng, Yi; Zhang, Peiying

    2015-07-01

    The congenital heart disease includes abnormalities in heart structure that occur before birth. Such defects occur in the fetus while it is developing in the uterus during pregnancy. About 500,000 adults have congenital heart disease in USA (WebMD, Congenital heart defects medications, www.WebMD.com/heart-disease/tc/congenital-heart-defects-medications , 2014). 1 in every 100 children has defects in their heart due to genetic or chromosomal abnormalities, such as Down syndrome. The excessive alcohol consumption during pregnancy and use of medications, maternal viral infection, such as Rubella virus, measles (German), in the first trimester of pregnancy, all these are risk factors for congenital heart disease in children, and the risk increases if parent or sibling has a congenital heart defect. These are heart valves defects, atrial and ventricular septa defects, stenosis, the heart muscle abnormalities, and a hole inside wall of the heart which causes defect in blood circulation, heart failure, and eventual death. There are no particular symptoms of congenital heart disease, but shortness of breath and limited ability to do exercise, fatigue, abnormal sound of heart as heart murmur, which is diagnosed by a physician while listening to the heart beats. The echocardiogram or transesophageal echocardiogram, electrocardiogram, chest X-ray, cardiac catheterization, and MRI methods are used to detect congenital heart disease. Several medications are given depending on the severity of this disease, and catheter method and surgery are required for serious cases to repair heart valves or heart transplantation as in endocarditis. For genetic study, first DNA is extracted from blood followed by DNA sequence analysis and any defect in nucleotide sequence of DNA is determined. For congenital heart disease, genes in chromosome 1 show some defects in nucleotide sequence. In this review the causes, diagnosis, symptoms, and treatments of congenital heart disease are described.

  2. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Goldstein, Larry B; Bushnell, Cheryl D; Adams, Robert J; Appel, Lawrence J; Braun, Lynne T; Chaturvedi, Seemant; Creager, Mark A; Culebras, Antonio; Eckel, Robert H; Hart, Robert G; Hinchey, Judith A; Howard, Virginia J; Jauch, Edward C; Levine, Steven R; Meschia, James F; Moore, Wesley S; Nixon, J V Ian; Pearson, Thomas A

    2011-02-01

    This guideline provides an overview of the evidence on established and emerging risk factors for stroke to provide evidence-based recommendations for the reduction of risk of a first stroke. Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council Scientific Statement Oversight Committee and the AHA Manuscript Oversight Committee. The writing group used systematic literature reviews (covering the time since the last review was published in 2006 up to April 2009), reference to previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate recommendations using standard AHA criteria (Tables 1 and 2). All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. The guideline underwent extensive peer review by the Stroke Council leadership and the AHA scientific statements oversight committees before consideration and approval by the AHA Science Advisory and Coordinating Committee. Schemes for assessing a person's risk of a first stroke were evaluated. Risk factors or risk markers for a first stroke were classified according to potential for modification (nonmodifiable, modifiable, or potentially modifiable) and strength of evidence (well documented or less well documented). Nonmodifiable risk factors include age, sex, low birth weight, race/ethnicity, and genetic predisposition. Well-documented and modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia, carotid artery stenosis, sickle cell disease, postmenopausal hormone therapy, poor diet, physical inactivity, and obesity and body fat distribution. Less well-documented or potentially modifiable risk factors

  3. The professional perspective on patient involvement in the development of quality indicators: a qualitative analysis using the example of chronic heart failure in the German health care setting.

    Science.gov (United States)

    Pohontsch, Nadine Janis; Herzberg, Heidrun; Joos, Stefanie; Welti, Felix; Scherer, Martin; Blozik, Eva

    2015-01-01

    There is an international consensus that quality indicators (QIs) of health care ought to represent patient-relevant aspects. Therefore, patient involvement in the development process is essential. However, there is no methodological gold standard for involving patients in QI development. The aim of this study is to explore experts' views on the representation of patient-relevant aspects in the QI development process using the QIs developed in the context of the German National Disease Management Guideline for Heart Failure as an example. Semi-structured, open telephone interviews were conducted with 15 German experts (patient representatives, physicians, researchers, and methodologists involved in guideline development or quality assessment). Interview themes were the relevance of the exemplary set of QIs for patients, as well as the legitimacy of, competence of, and collaboration with the patient representative who participated in the development process. Interviews were fully transcribed and content analyzed. Deductive categories derived from the research questions were supplemented by inductively formed categories during the review of the interview material. The qualitative analysis suggests a discrepancy between the guidelines' QIs and those relevant to patients from an expert's point of view, such as physician-patient communication and quality of counseling. Experts reported only minor communication and cooperation problems while working together in the guideline/QI development team. Concerns existed, for example, regarding the recruitment of patient representatives for diseases without self-help organizations, the financing of patient representation, and the training of patient representatives. Only few potential strategies for improving the process of patient involvement were mentioned. Integrating the patients' perspectives through the recruitment of a patient representative to participate in the development team was well established and broadly accepted

  4. Heart Anatomy

    Science.gov (United States)

    ... kilometers), which is far enough to circle the earth more than twice! See also on other sites: ... For the Public Heart Information Center Project Heart Women’s Heart Health Clinical Trials 6770 Bertner Avenue Houston, ...

  5. Heart Transplant

    Science.gov (United States)

    ... your transplanted heart. You should also have routine medical checkups to maintain overall health. Activity Restrictions Heart transplant recipients have no specific activity restrictions. Discuss activity ideas with your ... to some medical and dental procedures to prevent endocarditis, most heart ...

  6. Correlation of sole prenatal indication to fetal chromosomal karyotype abnormality

    Directory of Open Access Journals (Sweden)

    Ying XU

    2017-04-01

    Full Text Available Objective  To analysis the clinical high risk factors for fetal chromosomal abnormalities. Methods  Amniocentesis, chromosomal karyotype analysis and other related methods were performed on 4829 pregnant women, who presented sole indication of prenatal diagnosis such as advanced age, high risk factors and fetal ultrasound abnormalities, for analyzing the correlations of those women to the incidence of fetal chromosomal abnormalities. Results  The detection rates of abnormal karyotype were 5.0% (57/1143, 1.7% (40/2367 and 4.3% (57/1319 in the older women group (age>35, abnormal maternal serological screening group and abnormal fetal ultrasound finding group, respectively. The detection rats of karyotype abnormality were 6.9% (23/333 in women with fetal congenital heart diseases, 8.5% (20/234 in those with abnormal amniotic fluid, 1.1% (1/89 in those with fetal ventriculomegaly, 1.1% (10/898 in those with fetal intracardiac hyperechogenicity, 5.9% (2/34 in those with fetal choroid cyst and 5.6% (1/18 in those with fetal renal pelvis broadening. Conclusion  The pregnant women with age>35, fetal sonographic structural anomalies or two or more soft marker abnormalities should be prenatally diagnosed and doing the genetic counseling combined with the family history. DOI: 10.11855/j.issn.0577-7402.2017.02.14

  7. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

  8. Design of a case management model for people with chronic disease (Heart Failure and COPD. Phase I: modeling and identification of the main components of the intervention through their actors: patients and professionals (DELTA-icE-PRO Study

    Directory of Open Access Journals (Sweden)

    Rodríguez-Salvador Maria M

    2010-12-01

    Full Text Available Abstract Background Chronic diseases account for nearly 60% of deaths around the world. The extent of this silent epidemic has not met determined responses in governments, policies or professionals in order to transform old Health Care Systems, configured for acute diseases. There is a large list of research about alternative models for people with chronic conditions, many of them with an advanced practice nurse as a key provider, as case management. But some methodological concerns raise, above all, the design of the intervention (intensity, frequency, components, etc. Methods/Design Objectives: General: To develop the first and second phases (theorization and modeling for designing a multifaceted case-management intervention in people with chronic conditions (COPD and heart failure and their caregivers. Specific aims: 1 To identify key events in people living with chronic disease and their relation with the Health Care System, from their point of view. 2 To know the coping mechanisms developed by patients and their caregivers along the story with the disease. 3 To know the information processing and its utilization in their interactions with health care providers. 4 To detect potential unmet needs and the ways deployed by patients and their caregivers to resolve them. 5 To obtain a description from patients and caregivers, about their itineraries along the Health Care System, in terms of continuity, accessibility and comprehensiveness of care. 6 To build up a list of promising case-management interventions in patients with Heart Failure and COPD with this information in order to frame it into theoretical models for its reproducibility and conceptualization. 7 To undergo this list to expert judgment to assess its feasibility and pertinence in the Andalusian Health Care. Design: Qualitative research with two phases: For the first five objectives, a qualitative technique with biographic stories will be developed and, for the remaining objectives

  9. Cardiac Biomarkers in Adult Congenital Heart Disease

    NARCIS (Netherlands)

    J.A. Eindhoven (Jannet)

    2015-01-01

    markdownabstract__Abstract__ Congenital heart disease (ConHD) is the most common congenital abnormality in newborns, with a birth prevalence of 9 per 1000 live births.2 ConHD comprises a number of cardiac abnormalities with varying aetiology which can be divided into simple, moderate and

  10. The Teaching of Abnormal Psychology through the Cinema.

    Science.gov (United States)

    Nissim-Sabat, Denis

    1979-01-01

    Describes abnormal psychology course centered around films which include "King of Hearts,""A Woman Under the Influence,""David and Lisa,""In Cold Blood," and "The Boys in the Band." Each film deals with a fundamental concept such as psychopathology, neurosis, psychosis, insanity, and sexuality. (KC)

  11. Heart Diseases

    Science.gov (United States)

    ... you're like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the ... of disability. There are many different forms of heart disease. The most common cause of heart disease ...

  12. Heart Transplantation

    Science.gov (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  13. Heart Attack

    Science.gov (United States)

    Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly ... it's important to know the symptoms of a heart attack and call 9-1-1 if you or ...

  14. Communicating with Professionals

    Medline Plus

    Full Text Available ... Risks to Prevent a Heart Attack Diagnosing a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure Causes and Risks for Heart Failure Warning Signs for Heart Failure Diagnosing Heart Failure Treatment Options for Heart Failure Living With HF and ...

  15. Symptoms associated with an abnormal echocardiogram in elderly primary care hypertension patients

    NARCIS (Netherlands)

    L. Ringoir (Lianne); J.W. Widdershoven (Jos); S.S. Pedersen (Susanne); J.M. Keyzer (J.); V.J.M. Pop (Victor)

    2014-01-01

    textabstractBackground The prevalence and diagnostic value of heart failure symptoms in elderly primary care patients with hypertension is unknown. Aim To assess the prevalence, sensitivity, specificity, positive and negative predictive value of symptoms in association with an abnormal

  16. [Congenital heart diseases in clinical practice].

    Science.gov (United States)

    Ratti, Carlo; Veronesi, Benedetta; Grassi, Laura; Bompani, Bruno

    2012-05-01

    Congenital heart diseases are abnormalities in the heart's structure that are present at birth. Some are known to be associated with genetic disorders. They affect 8 out of every 1,000 newborns. They range from simple defects with no symptoms to complex defects. They are divided in two types: cyanotic and not cyanotic.

  17. Implantation of total artificial heart in congenital heart disease.

    Science.gov (United States)

    Adachi, Iki; Morales, David S L

    2014-07-18

    In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation. In the case presented here, a 17 year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressively worsening HF due to his congenital condition. He was hospitalized multiple times and received an implantable cardioverter defibrillator (ICD). However, his condition soon deteriorated to end-stage HF with multisystem organ failure. Due to the patient's grave clinical condition and the presence of complex cardiac lesions, the decision was made to proceed with a TAH. The abnormal arrangement of the patient's ventricles and great arteries required modifications to the TAH during implantation. With the TAH in place, the patient was able to return home and regain strength and physical well-being while awaiting a donor heart. He was successfully bridged to heart transplantation 5 months after receiving the device. This report highlights the TAH is feasible even in patients with structurally abnormal hearts, with technical modification.

  18. Take heart!

    CERN Document Server

    Alizée Dauvergne

    2010-01-01

    Recently, ten new semi-automatic defibrillators were installed at various locations around CERN. This is a preventive measure intended to provide cardiac arrest victims with the best possible response. The first responder could be you!   The Director-General has welcomed the initiative of the Medical Service and Fire Brigade for the installation of ten new semi-automatic defibrillators. You have probably seen them on your way to the restaurant, for example:  brand new semi-automatic defibrillators, ready for an emergency. Housed in a white wall-mounted case, the bright red defibrillators are marked with a white heart symbol crossed by a lightning bolt (see photo). The defibrillator is designed so that anyone can use it. “Anyone can use it, you don’t need to be a health professional,” says Dr Reymond from CERN's Medical Service. Together with the CERN Fire Brigade, he is behind the initiative to have these units put in place. And with good reason, as the unit...

  19. Prenatal diagnosis of chromosomal abnormalities in fetuses with abnormal cardiac ultrasound findings: evaluation of chromosomal microarray-based analysis.

    Science.gov (United States)

    Mademont-Soler, I; Morales, C; Soler, A; Martínez-Crespo, J M; Shen, Y; Margarit, E; Clusellas, N; Obón, M; Wu, B L; Sánchez, A

    2013-04-01

    To assess the frequency of karyotype abnormalities and chromosome 22q11.2 deletion syndrome among fetuses with abnormal cardiac ultrasound findings, and to evaluate the clinical value of chromosomal microarray-based analysis (CMA) in the study of such pregnancies. First, we carried out retrospective analysis of karyotype abnormalities and 22q11.2 deletion syndrome cases diagnosed between January 2009 and December 2011 in our center among fetuses with abnormal cardiac ultrasound findings (n = 276). Second, CMA was performed in 51 of the fetuses with such findings, normal karyotype and negative or no 22q11.2 deletion syndrome study, and in the only fetus with a heart defect and an apparently balanced de novo chromosomal rearrangement. Out of the 276 pregnancies with abnormal cardiac ultrasound findings, karyotyping revealed a chromosomal abnormality in 44 (15.9%). Of fetuses with normal karyotype in which 22q11.2 deletion syndrome studies were performed, 6.4% (5/78) had this microdeletion syndrome. Among fetuses with abnormal cardiac findings, normal karyotype and negative or no 22q11.2 deletion syndrome study that underwent CMA, the detection rate of pathogenic copy number variants not detected by conventional cytogenetics was 2.0% (1/51), and no variants of uncertain clinical significance were found. In the fetus with a heart defect and an apparently balanced de novo chromosomal rearrangement, CMA revealed that the rearrangement was not truly balanced. In the assessment of genetic abnormalities in pregnancies with abnormal cardiac ultrasound findings, the diagnostic yield may be increased by 2% if CMA is used as a complementary tool to conventional cytogenetics. Our results suggest that CMA could be a good alternative to karyotyping in these pregnancies. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  20. Etiological Peculiarities in Pediatric Heart Failure

    OpenAIRE

    Angela, Butnariu; Gabriel, Samasca

    2015-01-01

    Heart failure in children presents important characteristic features different from adult congestive failure, from a pathophysiological and mostly from an etiopathogenic point of view. Heart failure in children is, in most cases, a consequence of congenital structural cardiac abnormalities that remained unoperated, underwent a palliative operation or presented post-surgery complications, or of cardiomyopathy. Based on the nature of the clinical presentation, new onset heart failure can be dif...

  1. Communicating with Professionals

    Medline Plus

    Full Text Available ... Tools & Resources Heart Attack About Heart Attacks Warning Signs of a Heart Attack Understand Your Risks to ... Failure Causes and Risks for Heart Failure Warning Signs for Heart Failure Diagnosing Heart Failure Treatment Options ...

  2. Communicating with Professionals

    Medline Plus

    Full Text Available ... Congenital Heart Defects Congenital Heart Defects Tools & Resources Heart Attack About Heart Attacks Warning Signs of a Heart Attack Understand Your Risks to Prevent a Heart Attack ...

  3. Prevalence of Low Sperm Count and Abnormal Semen Parameters ...

    African Journals Online (AJOL)

    elearning

    and hot tubs e.t.c. More semen abnormalities identified in civil servants than other professionals in this study are curious, as no association has been found between semen qualities and occupation13. Although there was no history of occupational exposure of our patients to environmental factors that can adversely affect.

  4. The heart and hypothyroidism | Bennett | South African Medical ...

    African Journals Online (AJOL)

    The association of hypothyroidism with heart disease is reviewed. The. relative rarity of cardiac failure due to hypothyroidism is stressed, and structural abnormalities of the heart due to hypothyroidism are discussed. The clinical management of hypothyroid patients with heart disease is described.

  5. Professional Certification

    Science.gov (United States)

    WaterSense recognizes certification programs for irrigation professionals that meet the specification criteria. Certification programs cover three areas: irrigation system design, installation and maintenance, and system auditing.

  6. Metabolic mechanisms in heart failure.

    Science.gov (United States)

    Ashrafian, Houman; Frenneaux, Michael P; Opie, Lionel H

    2007-07-24

    Although neurohumoral antagonism has successfully reduced heart failure morbidity and mortality, the residual disability and death rate remains unacceptably high. Though abnormalities of myocardial metabolism are associated with heart failure, recent data suggest that heart failure may itself promote metabolic changes such as insulin resistance, in part through neurohumoral activation. A detrimental self-perpetuating cycle (heart failure --> altered metabolism --> heart failure) that promotes the progression of heart failure may thus be postulated. Accordingly, we review the cellular mechanisms and pathophysiology of altered metabolism and insulin resistance in heart failure. It is hypothesized that the ensuing detrimental myocardial energetic perturbations result from neurohumoral activation, increased adverse free fatty acid metabolism, decreased protective glucose metabolism, and in some cases insulin resistance. The result is depletion of myocardial ATP, phosphocreatine, and creatine kinase with decreased efficiency of mechanical work. On the basis of the mechanisms outlined, appropriate therapies to mitigate aberrant metabolism include intense neurohumoral antagonism, limitation of diuretics, correction of hypokalemia, exercise, and diet. We also discuss more novel mechanistic-based therapies to ameliorate metabolism and insulin resistance in heart failure. For example, metabolic modulators may optimize myocardial substrate utilization to improve cardiac function and exercise performance beyond standard care. The ultimate success of metabolic-based therapy will be manifest by its capacity further to lessen the residual mortality in heart failure.

  7. Fibrinogen function is impaired in whole blood from patients with cyanotic congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Johansson, Pär I.; Bochsen, Louise

    2013-01-01

    BACKGROUND: Patients with cyanotic congenital heart disease (CCHD) have haemostatic abnormities associated with bleeding and thrombo-embolic events. The haemostatic abnormalities are not fully understood, but recent studies indicate that elevated haematocrit and fibrinogen function may...

  8. Heart transplantation.

    Science.gov (United States)

    Cheng, Allen; Slaughter, Mark S

    2014-08-01

    Heart failure remains a major global problem with approximately 6 million individuals suffering from heart failure in the United States alone. The surgical technique of heart transplantation, popularized by Dr. Norman Shumway, has led to its success and currently remains the best treatment options for patients with end-stage. However, with the continued limitation of donor organs and the rapid development of ventricular assist device technology, the number of patients bridged to transplant with mechanical circulatory support has increased significantly. This has created some new technical challenges for heart transplantation. Therefore, it is now important to be familiar with multiple new technical challenges associated with the surgical techniques of heart transplantation with an ultimate goal in reducing donor heart ischemic time, recipient cardiopulmonary bypass time and post-operative complications. In this review, we described our technique of heart transplantation including the timing of the operation, recipient cardiectomy and donor heart implantation.

  9. Enlarged Heart

    Science.gov (United States)

    ... the valves are damaged by conditions such as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may ...

  10. Heart Truth

    Science.gov (United States)

    ... health! Get a free badge or banner to post to your website or blog. Are you at risk for heart disease? Here's how to find out . Planning to use The Heart Truth logo? Check out our logo guidelines and downloads. ...

  11. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  12. Heart Failure

    DEFF Research Database (Denmark)

    Jorsal, Anders; Wiggers, Henrik; McMurray, John J V

    2018-01-01

    This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint.......This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint....

  13. Dysglycemia induces abnormal circadian blood pressure variability

    Directory of Open Access Journals (Sweden)

    Kumarasamy Sivarajan

    2011-11-01

    Full Text Available Abstract Background Prediabetes (PreDM in asymptomatic adults is associated with abnormal circadian blood pressure variability (abnormal CBPV. Hypothesis Systemic inflammation and glycemia influence circadian blood pressure variability. Methods Dahl salt-sensitive (S rats (n = 19 after weaning were fed either an American (AD or a standard (SD diet. The AD (high-glycemic-index, high-fat simulated customary human diet, provided daily overabundant calories which over time lead to body weight gain. The SD (low-glycemic-index, low-fat mirrored desirable balanced human diet for maintaining body weight. Body weight and serum concentrations for fasting glucose (FG, adipokines (leptin and adiponectin, and proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1 and tumor necrosis factor-α (TNF-α] were measured. Rats were surgically implanted with C40 transmitters and blood pressure (BP-both systolic; SBP and diastolic; DBP and heart rate (HR were recorded by telemetry every 5 minutes during both sleep (day and active (night periods. Pulse pressure (PP was calculated (PP = SBP-DBP. Results [mean(SEM]: The AD fed group displayed significant increase in body weight (after 90 days; p Conclusion These data validate our stated hypothesis that systemic inflammation and glycemia influence circadian blood pressure variability. This study, for the first time, demonstrates a cause and effect relationship between caloric excess, enhanced systemic inflammation, dysglycemia, loss of blood pressure control and abnormal CBPV. Our results provide the fundamental basis for examining the relationship between dysglycemia and perturbation of the underlying mechanisms (adipose tissue dysfunction induced local and systemic inflammation, insulin resistance and alteration of adipose tissue precursors for the renin-aldosterone-angiotensin system which generate abnormal CBPV.

  14. Scn3b knockout mice exhibit abnormal ventricular electrophysiological properties.

    Science.gov (United States)

    Hakim, Parvez; Gurung, Iman S; Pedersen, Thomas H; Thresher, Rosemary; Brice, Nicola; Lawrence, Jason; Grace, Andrew A; Huang, Christopher L-H

    2008-01-01

    We report for the first time abnormalities in cardiac ventricular electrophysiology in a genetically modified murine model lacking the Scn3b gene (Scn3b(-/-)). Scn3b(-/-) mice were created by homologous recombination in embryonic stem (ES) cells. RT-PCR analysis confirmed that Scn3b mRNA was expressed in the ventricles of wild-type (WT) hearts but was absent in the Scn3b(-/-) hearts. These hearts also showed increased expression levels of Scn1b mRNA in both ventricles and Scn5a mRNA in the right ventricles compared to findings in WT hearts. Scn1b and Scn5a mRNA was expressed at higher levels in the left than in the right ventricles of both Scn3b(-/-) and WT hearts. Bipolar electrogram and monophasic action potential recordings from the ventricles of Langendorff-perfused Scn3b(-/-) hearts demonstrated significantly shorter ventricular effective refractory periods (VERPs), larger ratios of electrogram duration obtained at the shortest and longest S(1)-S(2) intervals, and ventricular tachycardias (VTs) induced by programmed electrical stimulation. Such arrhythmogenesis took the form of either monomorphic or polymorphic VT. Despite shorter action potential durations (APDs) in both the endocardium and epicardium, Scn3b(-/-) hearts showed DeltaAPD(90) values that remained similar to those shown in WT hearts. The whole-cell patch-clamp technique applied to ventricular myocytes isolated from Scn3b(-/-) hearts demonstrated reduced peak Na(+) current densities and inactivation curves that were shifted in the negative direction, relative to those shown in WT myocytes. Together, these findings associate the lack of the Scn3b gene with arrhythmic tendencies in intact perfused hearts and electrophysiological features similar to those in Scn5a(+/-) hearts.

  15. Abnormal uterine bleeding.

    Science.gov (United States)

    Whitaker, Lucy; Critchley, Hilary O D

    2016-07-01

    Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the Fédération International de Gynécologie et d'Obstétrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Office hysteroscopy and increasing sophisticated imaging will assist provision of robust evidence for the underlying cause. Increased availability of medical options has expanded the choice for women and many will no longer need to recourse to potentially complicated surgery. Treatment must remain individualised and encompass the impact of pressure symptoms, desire for retention of fertility and contraceptive needs, as well as address the management of AUB in order to achieve improved quality of life. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Evaluation of nail abnormalities.

    Science.gov (United States)

    Tully, Amber S; Trayes, Kathryn P; Studdiford, James S

    2012-04-15

    Knowledge of the anatomy and function of the nail apparatus is essential when performing the physical examination. Inspection may reveal localized nail abnormalities that should be treated, or may provide clues to an underlying systemic disease that requires further workup. Excessive keratinaceous material under the nail bed in a distal and lateral distribution should prompt an evaluation for onychomycosis. Onychomycosis may be diagnosed through potassium hydroxide examination of scrapings. If potassium hydroxide testing is negative for the condition, a nail culture or nail plate biopsy should be performed. A proliferating, erythematous, disruptive mass in the nail bed should be carefully evaluated for underlying squamous cell carcinoma. Longitudinal melanonychia (vertical nail bands) must be differentiated from subungual melanomas, which account for 50 percent of melanomas in persons with dark skin. Dystrophic longitudinal ridges and subungual hematomas are local conditions caused by trauma. Edema and erythema of the proximal and lateral nail folds are hallmark features of acute and chronic paronychia. Clubbing may suggest an underlying disease such as cirrhosis, chronic obstructive pulmonary disease, or celiac sprue. Koilonychia (spoon nail) is commonly associated with iron deficiency anemia. Splinter hemorrhages may herald endocarditis, although other causes should be considered. Beau lines can mark the onset of a severe underlying illness, whereas Muehrcke lines are associated with hypoalbuminemia. A pincer nail deformity is inherited or acquired and can be associated with beta-blocker use, psoriasis, onychomycosis, tumors of the nail apparatus, systemic lupus erythematosus, Kawasaki disease, and malignancy.

  17. Communication and abnormal behaviour.

    Science.gov (United States)

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

  18. HEART RETRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    R. Sh. Saitgareev

    2016-01-01

    Full Text Available The number of patients with transplanted heart is continuously increasing; therefore, the number of patients requiring heart retransplantation grows. Analysis of the results of published studies focused on safety of cardiac retransplantation and risk factors for adverse events in perioperative, early and late postoperative periods is presented in our review. The results of published studies suggest that heart retransplantation is the main radical treatment option for cardiac allograft dysfunction, but the results of heart retransplantation are slightly worse than those of primary cardiac transplantation. On the other hand, the favorable long-term prognosis after heart retransplantation should be expected in carefully selected recipients. 

  19. Holy Psychopathology Batman: The Pedagogical Use of Comic Books in the Teaching of Abnormal Psychology

    Science.gov (United States)

    Rahman, Reece O.; Zeglin, Robert J.

    2014-01-01

    Many undergraduate psychology students eventually choose a career providing clinical mental health services. A background in abnormal psychology (psychopathology) is helpful and requisite in these graduate academic and future professional venues. The creativity needed to adequately teach the complex material covered in most abnormal psychology…

  20. Professional Synergy.

    Science.gov (United States)

    Harris, P. R.

    1981-01-01

    True professionals develop and create together a better future by their human endeavors in synergy. They must operate comfortably in two cultures--the industrial culture which is disappearing, and the superindustrial or cyberculture which is emerging. (CT)

  1. PROFESSIONAL CATEGORIES

    Directory of Open Access Journals (Sweden)

    Sorin Fildan

    2012-01-01

    Full Text Available The transition process which Romanian commercial law underwent has affected both the term of ‘trader’, by redefining it, and the classification of professional categories. Currently, the term of ‘professional’ is conveyed by a descriptive listing of the categories of persons it comprises: traders, entrepreneurs, business operators, as well as any other person authorized to carry out economic or professional activities.

  2. Electrocardiographic abnormalities in centenarians: impact on survival

    Directory of Open Access Journals (Sweden)

    Rabuñal-Rey Ramón

    2012-04-01

    Full Text Available Abstract Background The centenarian population is gradually increasing, so it is becoming more common to see centenarians in clinical practice. Electrocardiogram abnormalities in the elderly have been reported, but several methodological biases have been detected that limit the validity of their results. The aim of this study is to analyse the ECG abnormalities in a prospective study of the centenarian population and to assess their impact on survival. Method We performed a domiciliary visit, where a medical history, an ECG and blood analysis were obtained. Barthel index (BI, cognitive mini-exam (CME and Charlson index (ChI were all determined. Patients were followed up by telephone up until their death. Results A total of 80 centenarians were studied, 26 men and 64 women, mean age 100.8 (SD 1.3. Of these, 81% had been admitted to the hospital at least once in the past, 81.3% were taking drugs (mean 3.3, rank 0–11. ChI was 1.21 (SD 1.19. Men had higher scores both for BI (70 -SD 34.4- vs. 50.4 -SD 36.6-, P = .005 and CME (16.5 -SD 9.1- vs. 9.1 –SD 11.6-, P = .008; 40.3% of the centenarians had anaemia, 67.5% renal failure, 13% hyperglycaemia, 22.1% hypoalbuminaemia and 10.7% dyslipidaemia, without statistically significant differences regarding sex. Only 7% had a normal ECG; 21 (26.3% had atrial fibrillation (AF, 30 (37.5% conduction defects and 31 (38.8% abnormalities suggestive of ischemia, without sex-related differences. A history of heart disease was significantly associated with the presence of AF (P = .002, OR 5.2, CI 95% 1.8 to 15.2 and changes suggestive of ischemia (P = .019, OR 3.2, CI 95% 1.2-8.7. Mean survival was 628 days (SD 578.5, median 481 days. Mortality risk was independently associated with the presence of AF (RR 2.0, P = .011, hyperglycaemia (RR 2.2, P = .032, hypoalbuminaemia (RR 3.5, P P = .024. Conclusion Although ECG abnormalities are common in centenarians, they are not related to

  3. Hypoplastic left heart syndrome

    Science.gov (United States)

    HLHS; Congenital heart - hypoplastic left heart; Cyanotic heart disease - hypoplastic left heart ... Hypoplastic left heart is a rare type of congenital heart disease. It is more common in males than in females. As ...

  4. Frequency of Electrocardiographic Abnormalities in Patients With Psoriasis

    DEFF Research Database (Denmark)

    Hansen, Peter Riis; Juhl, Christian Rimer; Isaksen, Jonas Lynggaard

    2018-01-01

    Psoriasis is a chronic inflammatory disease associated with cardiovascular disease, for example, myocardial infarction, stroke, cardiovascular death, and arrhythmias. The resting electrocardiogram may carry prognostic information, but limited evidence is available of electrocardiographic findings...... with a marginal increase in resting heart rate, which was driven by smoking and increased body mass index. All other examined electrocardiographic variables were similar between the 2 groups. The results suggest that psoriasis per se is not associated with significant abnormalities of the electrocardiogram....

  5. Professionals vs. role-professionals

    DEFF Research Database (Denmark)

    Milana, Marcella; Skrypnyk, Oleksandra

    2010-01-01

    several occupations in the field of adult education that position themselves along a continuum. Consequently the authors suggest that professionalization among adult education practitioners should be assessed in light of the knowledge about adult learning theories practitioners possess, the ethical...

  6. Hypoxia and Fetal Heart Development

    Science.gov (United States)

    Patterson, A.J.; Zhang, L

    2010-01-01

    Fetal hearts show a remarkable ability to develop under hypoxic conditions. The metabolic flexibility of fetal hearts allows sustained development under low oxygen conditions. In fact, hypoxia is critical for proper myocardial formation. Particularly, hypoxia inducible factor 1 (HIF-1) and vascular endothelial growth factor play central roles in hypoxia-dependent signaling in fetal heart formation, impacting embryonic outflow track remodeling and coronary vessel growth. Although HIF is not the only gene involved in adaptation to hypoxia, its role places it as a central figure in orchestrating events needed for adaptation to hypoxic stress. Although “normal” hypoxia (lower oxygen tension in the fetus as compared with the adult) is essential in heart formation, further abnormal hypoxia in utero adversely affects cardiogenesis. Prenatal hypoxia alters myocardial structure and causes a decline in cardiac performance. Not only are the effects of hypoxia apparent during the perinatal period, but prolonged hypoxia in utero also causes fetal programming of abnormality in the heart’s development. The altered expression pattern of cardioprotective genes such as protein kinase c epsilon, heat shock protein 70, and endothelial nitric oxide synthase, likely predispose the developing heart to increased vulnerability to ischemia and reperfusion injury later in life. The events underlying the long-term changes in gene expression are not clear, but likely involve variation in epigenetic regulation. PMID:20712587

  7. Communicating with Professionals

    Medline Plus

    Full Text Available ... Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & ...

  8. Heart transplant

    Science.gov (United States)

    ... check for infections Tests of your kidney and liver Tests to evaluate your heart, such as EKG , echocardiogram , and cardiac catheterization Tests to look for cancer Tissue and blood typing , to help make sure your body will not reject the donated heart Ultrasound of your neck and legs You will want ...

  9. Heart Attack

    Science.gov (United States)

    ... This substance travels to your heart. A special camera uses the substance to produce pictures. These show ... guard against certain diseases, including heart disease. New studies have shown ... If you have an acute case of angina (chest pain), your doctor will probably ...

  10. If Your Child Has a Heart Defect (For Parents)

    Science.gov (United States)

    ... vessel or heart valve. Another procedure, transcatheter device occlusion, might be used to close abnormal openings or ... that could introduce bacteria into the bloodstream, including dental work or surgery in places in the body ...

  11. Abnormalities in Alternative Splicing of Apoptotic Genes and Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Zodwa Dlamini

    2015-11-01

    Full Text Available Apoptosis is required for normal heart development in the embryo, but has also been shown to be an important factor in the occurrence of heart disease. Alternative splicing of apoptotic genes is currently emerging as a diagnostic and therapeutic target for heart disease. This review addresses the involvement of abnormalities in alternative splicing of apoptotic genes in cardiac disorders including cardiomyopathy, myocardial ischemia and heart failure. Many pro-apoptotic members of the Bcl-2 family have alternatively spliced isoforms that lack important active domains. These isoforms can play a negative regulatory role by binding to and inhibiting the pro-apoptotic forms. Alternative splicing is observed to be increased in various cardiovascular diseases with the level of alternate transcripts increasing elevated in diseased hearts compared to healthy subjects. In many cases these isoforms appear to be the underlying cause of the disease, while in others they may be induced in response to cardiovascular pathologies. Regardless of this, the detection of alternate splicing events in the heart can serve as useful diagnostic or prognostic tools, while those splicing events that seem to play a causative role in cardiovascular disease make attractive future drug targets.

  12. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  13. Simple, heart-smart substitutions

    Science.gov (United States)

    Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart ...

  14. Interactions of the heart and the liver

    DEFF Research Database (Denmark)

    Møller, Søren; Bernardi, Mauro

    2013-01-01

    There is a mutual interaction between the function of the heart and the liver and a broad spectrum of acute and chronic entities that affect both the heart and the liver. These can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting...... the heart and the liver at the same time. In chronic and acute cardiac hepatopathy, owing to cardiac failure, a combination of reduced arterial perfusion and passive congestion leads to cardiac cirrhosis and cardiogenic hypoxic hepatitis. These conditions may impair the liver function and treatment should...... be directed towards the primary heart disease and seek to secure perfusion of vital organs. In patients with advanced cirrhosis, physical and/or pharmacological stress may reveal a reduced cardiac performance with systolic and diastolic dysfunction and electrophysical abnormalities termed cirrhotic...

  15. Transcription Factor Pathways and Congenital Heart Disease

    Science.gov (United States)

    McCulley, David J.; Black, Brian L.

    2013-01-01

    Congenital heart disease is a major cause of morbidity and mortality throughout life. Mutations in numerous transcription factors have been identified in patients and families with some of the most common forms of cardiac malformations and arrhythmias. This review discusses factor pathways known to be important for normal heart development and how abnormalities in these pathways have been linked to morphological and functional forms of congenital heart defects. A comprehensive, current list of known transcription factor mutations associated with congenital heart disease is provided, but the review focuses primarily on three key transcription factors, Nkx2-5, GATA4, and Tbx5, and their known biochemical and genetic partners. By understanding the interaction partners, transcriptional targets, and upstream activators of these core cardiac transcription factors, additional information about normal heart formation and further insight into genes and pathways affected in congenital heart disease should result. PMID:22449847

  16. Epidemiology of congenital heart disease in Brazil

    OpenAIRE

    Pinto Júnior,Valdester Cavalcante; Branco,Klébia Magalhães P. Castello; Cavalcante,Rodrigo Cardoso; Carvalho Junior,Waldemiro; Lima,José Rubens Costa; Freitas,Sílvia Maria de; Fraga,Maria Nazaré de Oliveira; Souza,Nayana Maria Gomes de

    2015-01-01

    AbstractIntroduction:Congenital heart disease is an abnormality in the structure or cardiocirculatory function, occurring from birth, even if diagnosed later. It can result in intrauterine death in childhood or in adulthood. Accounted for 6% of infant deaths in Brazil in 2007.Objective:To estimate underreporting in the prevalence of congenital heart disease in Brazil and its subtypes.Methods:The calculations of prevalence were performed by applying coefficients, giving them function rates for...

  17. Communicating with Professionals

    Medline Plus

    Full Text Available ... Languages Careers Volunteer Donate Search Heart.org Search Get Your Local Info Find out what is happening ... Giving for Heart.org Media for Heart.org Little Hats Big Hearts Volunteers from around the country ...

  18. Communicating with Professionals

    Medline Plus

    Full Text Available ... Heart Defects Symptoms & Diagnosis of Congenital Heart Defects Care & Treatment for Congenital Heart Defects Congenital Heart Defects ... your medical team. You can help improve the care you receive at follow-up appointments by talking ...

  19. Communicating with Professionals

    Medline Plus

    Full Text Available ... Pressure Readings 2 Sodium and Salt 3 Target Heart Rates 4 Heart Attack Symptoms in Women 5 How ... Symptoms of High Blood Pressure? 7 All About Heart Rate (Pulse) 8 Tachycardia | Fast Heart Rate 9 Warning ...

  20. Women's experiences of abnormal Pap smear results - A qualitative study.

    Science.gov (United States)

    Rask, Marie; Swahnberg, Katarina; Lindell, Gunnel; Oscarsson, Marie

    2017-06-01

    To describe women's experiences of abnormal Pap smear result. Ten women were recruited from a women's health clinic. Qualitative interviews based on six open-ended questions were conducted, transcribed verbatim, and analyzed by content analysis. The women believed that their abnormal Pap smear result was indicative of having cancer. This created anxiety in the women, which resulted in the need for emotional support and information. Testing positive with human papillomavirus (HPV) also meant consequences for the relatives as well as concerns about the sexually transmitted nature of the virus. Finally, the women had a need to be treated with respect by the healthcare professionals in order to reduce feelings of being abused. In general, women have a low level of awareness of HPV and its relation to abnormal Pap smear results. Women who receive abnormal Pap smear results need oral information, based on the individual women's situation, and delivered at the time the women receive the test result. It is also essential that a good emotional contact be established between the women and the healthcare professionals. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Obesity and heart failure.

    Science.gov (United States)

    De Pergola, Giovanni; Nardecchia, Adele; Giagulli, Vito Angelo; Triggiani, Vincenzo; Guastamacchia, Edoardo; Minischetti, Manuela Castiglione; Silvestris, Franco

    2013-03-01

    Epidemiological studies have recently shown that obesity, and abdominal obesity in particular, is an independent risk factor for the development of heart failure (HF). Higher cardiac oxidative stress is the early stage of heart dysfunction due to obesity, and it is the result of insulin resistance, altered fatty acid and glucose metabolism, and impaired mitochondrial biogenesis. Extense myocyte hypertrophy and myocardial fibrosis are early microscopic changes in patients with HF, whereas circumferential strain during the left ventricular (LV) systole, LV increase in both chamber size and wall thickness (LV hypertrophy), and LV dilatation are the early macroscopic and functional alterations in obese developing heart failure. LV hypertrophy leads to diastolic dysfunction and subendocardial ischemia in obesity, and pericardial fat has been shown to be significantly associated with LV diastolic dysfunction. Evolving abnormalities of diastolic dysfunction may include progressive hypertrophy and systolic dysfunction, and various degrees of eccentric and/or concentric LV hypertrophy may be present with time. Once HF is established, overweight and obese have a better prognosis than do their lean counterparts with the same level of cardiovascular disease, and this phenomenon is called "obesity paradox". It is mainly due to lower muscle protein degradation, brain natriuretic peptide circulating levels and cardio-respiratory fitness than normal weight patients with HF.

  2. Hemostatic biomarkers in dogs with chronic congestive heart failure

    DEFF Research Database (Denmark)

    Tarnow, Inge; Falk, Torkel; Tidholm, Anna

    2007-01-01

    Background: Chronic congestive heart failure (CHF) in humans is associated with abnormal hemostasis, and abnormalities in hemostatic biomarkers carry a poor prognosis. Alterations in hemostatic pathways can be involved in the pathogenesis of CHF in dogs, and microthrombosis in the myocardium coul...

  3. Wine and heart health

    Science.gov (United States)

    Health and wine; Wine and heart disease; Preventing heart disease - wine; Preventing heart disease - alcohol ... more often just to lower your risk of heart disease. Heavier drinking can harm the heart and ...

  4. What Is Heart Failure?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  5. What Causes Heart Failure?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  6. Living with Heart Failure

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  7. About Heart Attacks

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More About Heart Attacks Updated:Jan 27,2017 A heart attack is ... coronary artery damage leads to a heart attack . Heart Attack Questions and Answers What is a heart attack? ...

  8. Men and Heart Disease

    Science.gov (United States)

    ... Pressure Salt Cholesterol Million Hearts® WISEWOMAN Men and Heart Disease Fact Sheet Recommend on Facebook Tweet Share Compartir Source: Interactive Atlas of Heart Disease and Stroke Heart Disease Facts in Men Heart disease is the leading ...

  9. Heart Disease (For Kids)

    Science.gov (United States)

    ... System Taking Care of Your Teeth Bad Breath Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  10. Heart Attack

    Science.gov (United States)

    ... pain Fatigue Heart attack Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  11. Heart pacemaker

    Science.gov (United States)

    ... rhythms Bleeding Punctured lung. This is rare. Infection Puncture of the heart, which can lead to bleeding ... Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the ...

  12. Heart block

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007658.htm Heart block To use the sharing features on this page, ... Date 4/16/2017 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of ...

  13. Heart attack

    Science.gov (United States)

    ... heart attack. A stent is a small, metal mesh tube that opens up (expands) inside a coronary ... e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718 . Anderson JL. ST segment elevation acute myocardial ...

  14. Right heart on multidetector CT

    Science.gov (United States)

    Gopalan, D

    2011-01-01

    Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart. PMID:22723537

  15. Being Professional

    DEFF Research Database (Denmark)

    Jensen, Anne Winther

    The paper discusses students' process of acquiring a feeling of being professionals within a vocational education programme for elderly care in Denmark. The focus is on what seems to be a paradox within the programme: the future care helper being constructed within the overall term ‘the professio......The paper discusses students' process of acquiring a feeling of being professionals within a vocational education programme for elderly care in Denmark. The focus is on what seems to be a paradox within the programme: the future care helper being constructed within the overall term ‘the...... professional care helper’ in the school setting but the job being closely related to daily life's routine tasks; the paper points to difficulties for students in identifying the exact content of the term ‘professional’. Furthermore students seem to be uncertain about their ‘professionalism’ in relation...... ‘storyline’, c.f. Bronwyn Davies and the empirical material consists of observations and interviews in the theoretical periods and in the traineeships....

  16. A heart within a heart.

    Science.gov (United States)

    Carreras, Edward T; Barghash, Maya; Givertz, Michael M; Bhatt, Deepak L

    2017-06-01

    A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. Abnormal glucose tolerance and lipid abnormalities in Indian ...

    African Journals Online (AJOL)

    quency of abnormal glucose tolerance (impaired glucose tole- rance and diabetes mellitus) in Indian patients with CAD is similar to that in White patients.9 However, with respect to the lipid profile there have been conflicting reports; hypercholeste- rolaemia was present in 37% ofthe series described by McKech- nie' and ...

  18. History of the Congenital Heart Surgeons' Society.

    Science.gov (United States)

    Mavroudis, Constantine; Williams, William G

    2015-10-01

    The Congenital Heart Surgeons' Society is a group of over 100 pediatric heart surgeons representing 72 institutions that specialize in the treatment of patients with congenital heart defects. The Society began in 1972 and incorporated as a not-for-profit charitable organization in 2004. It has become the face and voice of congenital heart surgery in North America. In 1985, the Society established a data center for multicenter clinical research studies to encourage congenital heart professionals to participate in improving outcomes for our patients. The goals of the Congenital Heart Surgeons' Society are to stimulate the study of congenital cardiac physiology, pathology, and management options which are instantiated in data collection, multi-institutional studies, and scientific meetings. Honest and open discussion of problems with possible solutions to the challenges facing congenital heart professionals have been the strength of the Congenital Heart Surgeons' Society. It is imperative for the growth of an organization to know from where it came in order to know to where it is going. The purpose of this article is to review the history of the Congenital Heart Surgeons' Society. © The Author(s) 2015.

  19. The prevalence and significance of abnormal vital signs prior to in-hospital cardiac arrest.

    Science.gov (United States)

    Andersen, Lars W; Kim, Won Young; Chase, Maureen; Berg, Katherine M; Mortensen, Sharri J; Moskowitz, Ari; Novack, Victor; Cocchi, Michael N; Donnino, Michael W

    2016-01-01

    Patients suffering in-hospital cardiac arrest often show signs of physiological deterioration before the event. The purpose of this study was to determine the prevalence of abnormal vital signs 1-4h before cardiac arrest, and to evaluate the association between these vital sign abnormalities and in-hospital mortality. We included adults from the Get With the Guidelines(®)- Resuscitation registry with an in-hospital cardiac arrest. We used two a priori definitions for vital signs: abnormal (heart rate (HR) ≤ 60 or ≥ 100 min(-1), respiratory rate (RR) ≤ 10 or >20 min(-1) and systolic blood pressure (SBP) ≤ 90 mm Hg) and severely abnormal (HR ≤ 50 or ≥ 130 min(-1), RR ≤ 8 or ≥ 30 min(-1) and SBP ≤ 80 mm Hg). We evaluated the association between the number of abnormal vital signs and in-hospital mortality using a multivariable logistic regression model. 7851 patients were included. Individual vital signs were associated with in-hospital mortality. The majority of patients (59.4%) had at least one abnormal vital sign 1-4h before the arrest and 13.4% had at least one severely abnormal sign. We found a step-wise increase in mortality with increasing number of abnormal vital signs within the abnormal (odds ratio (OR) 1.53 (CI: 1.42-1.64) and severely abnormal groups (OR 1.62 (CI: 1.38-1.90)). This remained in multivariable analysis (abnormal: OR 1.38 (CI: 1.28-1.48), and severely abnormal: OR 1.40 (CI: 1.18-1.65)). Abnormal vital signs are prevalent 1-4h before in-hospital cardiac arrest on hospital wards. In-hospital mortality increases with increasing number of pre-arrest abnormal vital signs as well as increased severity of vital sign derangements. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Postnatal Cardiac Autonomic Nervous Control in Pediatric Congenital Heart Disease

    NARCIS (Netherlands)

    Nederend, I.; Jongbloed, M.R.M.; de Geus, J.C.N.; Blom, N.A.; ten Harkel, A.D.J.

    2016-01-01

    Congenital heart disease is the most common congenital defect. During childhood, survival is generally good but, in adulthood, late complications are not uncommon. Abnormal autonomic control in children with congenital heart disease may contribute considerably to the pathophysiology of these long

  1. Cardiac development : the posterior heart field and atrioventricular reentry tachycardia

    NARCIS (Netherlands)

    Hahurij, Nathan Dominggus

    2011-01-01

    This thesis is separated in two parts (Part I and Part II) in which normal and abnormal heart development are studied and related to congenital heart disease, in particular to the etiology of supraventricular arrhythmias in fetuses and neonates. Part I describes the development of the posterior

  2. Mitochondrial function as a therapeutic target in heart failure

    Science.gov (United States)

    Brown, David A.; Perry, Justin B.; Allen, Mitchell E.; Sabbah, Hani N.; Stauffer, Brian L.; Shaikh, Saame Raza; Cleland, John G. F.; Colucci, Wilson S.; Butler, Javed; Voors, Adriaan A.; Anker, Stefan D.; Pitt, Bertram; Pieske, Burkert; Filippatos, Gerasimos; Greene, Stephen J.; Gheorghiade, Mihai

    2017-01-01

    Heart failure is a pressing worldwide public-health problem with millions of patients having worsening heart failure. Despite all the available therapies, the condition carries a very poor prognosis. Existing therapies provide symptomatic and clinical benefit, but do not fully address molecular abnormalities that occur in cardiomyocytes. This shortcoming is particularly important given that most patients with heart failure have viable dysfunctional myocardium, in which an improvement or normalization of function might be possible. Although the pathophysiology of heart failure is complex, mitochondrial dysfunction seems to be an important target for therapy to improve cardiac function directly. Mitochondrial abnormalities include impaired mitochondrial electron transport chain activity, increased formation of reactive oxygen species, shifted metabolic substrate utilization, aberrant mitochondrial dynamics, and altered ion homeostasis. In this Consensus Statement, insights into the mechanisms of mitochondrial dysfunction in heart failure are presented, along with an overview of emerging treatments with the potential to improve the function of the failing heart by targeting mitochondria. PMID:28004807

  3. Differences in Preseason Aerobic Fitness Screening in Professional and Pre-professional Modern Dancers.

    Science.gov (United States)

    Bronner, Shaw; Codman, Emma; Hash-Campbell, Dana; Ojofeitimi, Sheyi

    2016-03-01

    The aerobic demands of today's dance repertoire warrant understanding of the current cardiorespiratory fitness of dancers. The purpose of this study was to compare aerobic fitness levels of professional and pre-professional modern dancers and determine change over time. A retrospective analysis of four groups, two professional, and two pre-professional, was conducted in preseason annual screens, occurring before the professional dancers' rehearsal period and the students' academic training. Resting (HRrest), peak (HRpeak), and recovery (HRrecov) heart rate, and blood pressure (BP) were compared in 577 dancers, using an accelerated 3-minute step test. Smoking, asthma, and aerobic and cross training rates between groups were also compared. A 4 (group) X 2 (gender) MANOVA design determined differences between groups and genders in all dependent variables (p dance students over time. Additional aerobic training is recommended for pre-professional modern dance students to prepare them for the performance demands of a professional career.

  4. Lentiginosis, Deafness and Cardiac Abnormalities*

    African Journals Online (AJOL)

    1973-01-06

    Jan 6, 1973 ... The familia:l form is milder. The cardiac lesion commonly consists of hypertrophic obstructive cardiomyopathy of either ventricle or abnor- malities of the ECG.' The obstructive lesion may be pro- gressive and cause cardiac failure. The ECG features include conduction abnormalities, such as left hemiblock,.

  5. Chromosomal Abnormalities Associated With Omphalocele

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2007-03-01

    Full Text Available Fetuses with omphalocele have an increased risk for chromosomal abnormalities. The risk varies with maternal age, gestational age at diagnosis, association with umbilical cord cysts, complexity of associated anomalies, and the contents of omphalocele. There is considerable evidence that genetics contributes to the etiology of omphalocele. This article provides an overview of chromosomal abnormalities associated with omphalocele and a comprehensive review of associated full aneuploidy such as trisomy 18, trisomy 13, triploidy, trisomy 21, 45,X, 47,XXY, and 47,XXX, partial aneuploidy such as dup(3q, dup(11p, inv(11, dup(1q, del(1q, dup(4q, dup(5p, dup(6q, del(9p, dup(15q, dup(17q, Pallister-Killian syndrome with mosaic tetrasomy 12p and Miller-Dieker lissencephaly syndrome with deletion of 17p13.3, and uniparental disomy (UPD such as UPD 11 and UPD 14. Omphalocele is a prominent marker for chromosomal abnormalities. Perinatal identification of omphalocele should alert chromosomal abnormalities and familial unbalanced translocations, and prompt thorough cytogenetic investigations and genetic counseling.

  6. Interpreting chromosomal abnormalities using Prolog.

    Science.gov (United States)

    Cooper, G; Friedman, J M

    1990-04-01

    This paper describes an expert system for interpreting the standard notation used to represent human chromosomal abnormalities, namely, the International System for Human Cytogenetic Nomenclature. Written in Prolog, this program is very powerful, easy to maintain, and portable. The system can be used as a front end to any database that employs cytogenetic notation, such as a patient registry.

  7. Admission haematological abnormalities and postoperative ...

    African Journals Online (AJOL)

    Admission haematological abnormalities and postoperative outcomes in neonates with acute surgical conditions in Alexandria, Egypt. HL Wella, SMM Farahat. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

  8. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Demaerschalk, Bart M; Kleindorfer, Dawn O; Adeoye, Opeolu M; Demchuk, Andrew M; Fugate, Jennifer E; Grotta, James C; Khalessi, Alexander A; Levy, Elad I; Palesch, Yuko Y; Prabhakaran, Shyam; Saposnik, Gustavo; Saver, Jeffrey L; Smith, Eric E

    2016-02-01

    To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. After a review of the current literature, it was clearly evident that the levels of evidence supporting individual exclusion criteria for intravenous alteplase vary widely. Several exclusionary criteria have already undergone

  9. Professional development

    Science.gov (United States)

    Yoon, Jin Hee; Hartline, Beverly Karplus; Milner-Bolotin, Marina

    2013-03-01

    The three sessions of the professional development workshop series were each designed for a different audience. The purpose of the first session was to help mid-career physicists aspire for and achieve leadership roles. The second session brought together students, postdoctoral fellows, and early-career physicists to help them plan their career goals and navigate the steps important to launching a successful career. The final session sought to increase awareness of the results of physics education research, and how to use them to help students-especially women-learn physics better. The presentations and discussions were valuable for both female and male physicists.

  10. Professional C++

    CERN Document Server

    Gregoire, Marc

    2014-01-01

    Master complex C++ programming with this helpful, in-depth resource From game programming to major commercial software applications, C++ is the language of choice. It is also one of the most difficult programming languages to master. While most competing books are geared toward beginners, Professional C++, Third Edition, shows experienced developers how to master the latest release of C++, explaining little known features with detailed code examples users can plug into their own codes. More advanced language features and programming techniques are presented in this newest edition of the book,

  11. Congenital heart disease and chromossomopathies detected by the karyotype

    OpenAIRE

    Trevisan, Patrícia; Rosa, Rafael Fabiano M.; Koshiyama, Dayane Bohn; Zen, Tatiana Diehl; Paskulin, Giorgio Adriano; Zen, Paulo Ricardo G.

    2014-01-01

    OBJECTIVE: To review the relationship between congenital heart defects and chromosomal abnormalities detected by the karyotype.DATA SOURCES: Scientific articles were searched in MEDLINE database, using the descriptors "karyotype" OR "chromosomal" OR "chromosome" AND "heart defects, congenital". The research was limited to articles published in English from 1980 on.DATA SYNTHESIS: Congenital heart disease is characterized by an etiologically heterogeneous and not well understood group of lesio...

  12. Role and Value of Clinical Pharmacy in Heart Failure Management.

    Science.gov (United States)

    Stough, W G; Patterson, J H

    2017-08-01

    Effectively managing heart failure requires a multidisciplinary, holistic approach attuned to many factors: diagnosis of structural and functional cardiac abnormalities; medication, device, or surgical management; concomitant treatment of comorbidities; physical rehabilitation; dietary considerations; and social factors. This practice paper highlights the pharmacist's role in the management of patients with heart failure, the evidence supporting their functions, and steps to ensure the pharmacist resource is available to the broad population of patients with heart failure. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  13. Echocardiographic Evaluation of the Right Heart

    Science.gov (United States)

    Markley, Roshanak R; Potfay, Jonathan; Paulsen, Walter; Jovin, Ion S

    2016-01-01

    The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function. PMID:27721944

  14. Vagal enhancement linking abnormal blood pressure response and subendocardial ischemia in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kawasaki, Tatsuya; Sugihara, Hiroki

    2014-01-01

    An abnormal blood pressure response to exercise has been reported to be associated with left ventricular subendocardial ischemia in patients with hypertrophic cardiomyopathy (HCM), but the underlying mechanism remains unclear. We report a case of HCM with an abnormal blood pressure response and subendocardial ischemia, in which the analysis of heart rate variability revealed exercise-induced vagal enhancement. The present case highlights the possible mechanism linking abnormal blood pressure response and left ventricular subendocardial ischemia in patients with HCM. ©2013 Wiley Periodicals, Inc.

  15. Signs and symptoms of developmental abnormalities of the genitourinary tract

    Directory of Open Access Journals (Sweden)

    Paulo Cesar Koch Nogueira

    2016-06-01

    Full Text Available Abstract Objective: The abnormalities of the genitourinary tract development are the leading cause of chronic kidney disease (CKD in children. The diagnosis of this disease in Brazil is late and incomplete, which results in increased morbidity and mortality in this age group. Early diagnosis of this condition is the prerogative of generalist pediatricians, and the aim of this study was to review the clinical signs and symptoms associated with developmental abnormalities of the genitourinary tract. Data sources: Based on the description of a symbolic clinical case, the authors conducted a non-systematic review of medical literature. Data synthesis: The results suggest that the following data should be used as a warning for early diagnosis of affected children: (a combined urinary tract abnormalities (chromosomal abnormalities; sequence of malformations [VACTERLand Prune-Belly]; and musculoskeletal, digestive tract, heart, and nervous system malformations; (b previous history (congenital anomalies of the kidney and urinary tract [CAKUT] in the family, low birth weight, and oligoamnios; (c clinical signs (polyuria/nocturia, urinary tract infection, systemic arterial hypertension, failure to thrive, weak urinary stream, difficulty to start urination, distended bladder, non-monosymptomatic enuresis, urinary/urge incontinence, and bowel and bladder dysfunction; and (d pre- and postnatal ultrasonographic alterations (increased anteroposterior diameter of the renal pelvis, mainly in the third trimester of pregnancy; single kidney; hydronephrosis associated with other abnormalities; and hydronephrosis with parenchymal involvement in the post-neonatal assessment. Conclusion: The suggestions shown here can help the pediatrician to establish clinical hypotheses for the early diagnosis of developmental abnormalities of the genitourinary tract without resorting to expensive and invasive procedures.

  16. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...

  17. Heart attack - discharge

    Science.gov (United States)

    ... attack Heart bypass surgery Heart bypass surgery - minimally invasive Heart pacemaker High blood cholesterol levels High blood pressure Implantable cardioverter-defibrillator Smoking - tips on how to ...

  18. Thyrotoxicosis and the Heart – A Review of the Literature | Ogbera ...

    African Journals Online (AJOL)

    Thyrotoxicosis is a common endocrine disorder affecting more females than males. It is well known that one of the main complications of thyrotoxicosis is heart disease, including heart rhythm abnormalities. Studies have clearly shown that patients with hyperthyroidism are more likely to die from heart disease or stroke, ...

  19. The Prevalence of Clinical and Electrocardiographic Risk Factors of Cardiovascular Death among On-Duty Professional Firefighters

    Science.gov (United States)

    Al-Zaiti, Salah S.; Carey, Mary G.

    2014-01-01

    Background Firefighters have twice as many cardiovascular deaths as police officers and four times as many as emergency medical responders. The etiology for this high prevalence remains unknown. The electrocardiogram (ECG) is a widely used tool to screen populations at risk, but yet there are no available on-duty, high-resolution electrocardiographic (ECG) recordings. Objective We sought to evaluate the prevalence of clinical and ECG risk factors among on-duty professional firefighters during 12-lead ECG holter monitoring and exercise stress testing. Methods Firefighters were recruited from Surveying and Assessing Firefighters Fitness and ECG (SAFFE) study. This descriptive study recruited firefighters from 7 firehouses across Western New York area, who all completed on-duty, 24-hour Holter ECG monitoring and a standard exercise stress test. All analyses were completed by a reviewer blinded to all clinical data. Results 112 firefighters (age 44±8 years, mostly white males) completed the study. Even though all firefighters were in normal sinus rhythm, over half of them had at least one high risk ECG risk factor present, including abnormal sympathetic tone (elevated heart rate, 54%), abnormal repolarization (wide QRS-T angle, 25%), myocardial scaring (fragmented QRS, 24%), and myocardial ischemia (ST depression, 24%). In addition, most firefighters tolerated the treadmill exercise stress test well (metabolic equivalent tasks 11.8+2.5), however, almost one third had abnormal stress tests that require further evaluation to rule out subclinical coronary artery disease. Conclusion Among on-duty professional firefighters, high risk ECG markers of fatal cardiac events and abnormal stress test results that warrant further evaluation are prevalent. Annual physical checkups with routine 12-lead ECG can identify those who might benefit from preventive cardiovascular services. PMID:24874885

  20. Professional socialisation: an influence on professional ...

    African Journals Online (AJOL)

    Professional socialisation refers to the acquisition of values, attitudes, skills and knowledge pertaining to a profession. This article reviews the definition and conceptualisation of professional socialisation through anticipatory and formal professional socialisation processes. It describes the core elements of professional ...

  1. Surrogate Motherhood and Abortion for Fetal Abnormality.

    Science.gov (United States)

    Walker, Ruth; van Zyl, Liezl

    2015-10-01

    A diagnosis of fetal abnormality presents parents with a difficult - even tragic - moral dilemma. Where this diagnosis is made in the context of surrogate motherhood there is an added difficulty, namely that it is not obvious who should be involved in making decisions about abortion, for the person who would normally have the right to decide - the pregnant woman - does not intend to raise the child. This raises the question: To what extent, if at all, should the intended parents be involved in decision-making? In commercial surrogacy it is thought that as part of the contractual agreement the intended parents acquire the right to make this decision. By contrast, in altruistic surrogacy the pregnant woman retains the right to make these decisions, but the intended parents are free to decide not to adopt the child. We argue that both these strategies are morally unsound, and that the problems encountered serve to highlight more fundamental defects within the commercial and altruistic models, as well as in the legal and institutional frameworks that support them. We argue in favour of the professional model, which acknowledges the rights and responsibilities of both parties and provides a legal and institutional framework that supports good decision-making. In particular, the professional model acknowledges the surrogate's right to decide whether to undergo an abortion, and the intended parents' obligation to accept legal custody of the child. While not solving all the problems that arise in surrogacy, the model provides a framework that supports good decision-making. © 2015 John Wiley & Sons Ltd.

  2. Mastoid abnormalities in Down syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Glass, R.B.J.; Yousefzadeh, D.K.; Roizen, N.J.

    1989-06-01

    Hearing loss and otitis media are commonly associated with Down syndrome. Hypoplasia of the mastoids is seen in many affected children and sclerosis of mastoid bones is not uncommon in Down syndrome. Awareness and early recognition of mastoid abnormality may lead to appropriate and timely therapy, thereby preserving the child's hearing or compensating for hearing loss; factors which are important for learning and maximum development.

  3. Normal and abnormal skin color.

    Science.gov (United States)

    Ortonne, J P

    2012-12-01

    The varieties of normal skin color in humans range from people of "no color" (pale white) to "people of color" (light brown, dark brown, and black). Skin color is a blend resulting from the skin chromophores red (oxyhaemoglobin), blue (deoxygenated haemoglobin), yellow-orange (carotene, an exogenous pigment), and brown (melanin). Melanin, however, is the major component of skin color ; it is the presence or absence of melanin in the melanosomes in melanocytes and melanin in keratinocytes that is responsible for epidermal pigmentation, and the presence of melanin in macrophages or melanocytes in the dermis that is responsible for dermal pigmentation. Two groups of pigmentary disorders are commonly distinguished: the disorders of the quantitative and qualitative distribution of normal pigment and the abnormal presence of exogenous or endogenous pigments in the skin. The first group includes hyperpigmentations, which clinically manifest by darkening of the skin color, and leukodermia, which is characterized by lightening of the skin. Hypermelanosis corresponds to an overload of melanin or an abnormal distribution of melanin in the skin. Depending on the color, melanodermia (brown/black) and ceruloderma (blue/grey) are distinguished. Melanodermia correspond to epidermal hypermelanocytosis (an increased number of melanocytes) or epidermal hypermelanosis (an increase in the quantity of melanin in the epidermis with no modification of the number of melanocytes). Ceruloderma corresponds to dermal hypermelanocytosis (abnormal presence in the dermis of cells synthesizing melanins) ; leakage in the dermis of epidermal melanin also exists, a form of dermal hypermelanosis called pigmentary incontinence. Finally, dyschromia can be related to the abnormal presence in the skin of a pigment of exogenous or endogenous origin. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. [Normal and abnormal skin color].

    Science.gov (United States)

    Ortonne, J-P

    2012-11-01

    The varieties of normal skin color in humans range from people of "no color" (pale white) to "people of color" (light brown, dark brown, and black). Skin color is a blend resulting from the skin chromophores red (oxyhaemoglobin), blue (deoxygenated haemoglobin), yellow-orange (carotene, an exogenous pigment), and brown (melanin). Melanin, however, is the major component of skin color ; it is the presence or absence of melanin in the melanosomes in melanocytes and melanin in keratinocytes that is responsible for epidermal pigmentation, and the presence of melanin in macrophages or melanocytes in the dermis that is responsible for dermal pigmentation. Two groups of pigmentary disorders are commonly distinguished: the disorders of the quantitative and qualitative distribution of normal pigment and the abnormal presence of exogenous or endogenous pigments in the skin. The first group includes hyperpigmentations, which clinically manifest by darkening of the skin color, and leukodermia, which is characterized by lightening of the skin. Hypermelanosis corresponds to an overload of melanin or an abnormal distribution of melanin in the skin. Depending on the color, melanodermia (brown/black) and ceruloderma (blue/grey) are distinguished. Melanodermia correspond to epidermal hypermelanocytosis (an increased number of melanocytes) or epidermal hypermelanosis (an increase in the quantity of melanin in the epidermis with no modification of the number of melanocytes). Ceruloderma correspond to dermal hypermelanocytosis (abnormal presence in the dermis of cells synthesizing melanins) ; leakage in the dermis of epidermal melanin also exists, a form of dermal hypermelanosis called pigmentary incontinence. Finally, dyschromia can be related to the abnormal presence in the skin of a pigment of exogenous or endogenous origin. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  5. Goldenhar syndrome and urogenital abnormalities

    Directory of Open Access Journals (Sweden)

    Mohan Marulaiah

    2003-01-01

    Full Text Available The Goldenhar syndrome (oculo-auriculo-vertebral syn-drome or 1st and 2nd branchial arch syndrome is a com-plex of craniofacial anomalies. It has been associated with anomalies in other systems and with abnormalities of the urogenital system. We present a case of Goldenhar syn-drome with multiple renal anomalies and a urogenital si-nus, which has not been reported before.

  6. Heart failure in children - overview

    Science.gov (United States)

    Congestive heart failure - children; Cor pulmonale - children; Cardiomyopathy - children; CHF - children; Congenital heart defect - heart failure in children; Cyanotic heart disease - heart failure in children; Birth defect of the heart - heart ...

  7. Heart Health: The Heart Truth Campaign 2009

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table ... one of the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) ...

  8. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  9. Women's Heart Disease: Heart Attack Symptoms

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter 2014 Table ... NHLBI has uncovered some of the causes of heart diseases and conditions, as well as ways to prevent ...

  10. Revealing Hearts

    DEFF Research Database (Denmark)

    Saghaug, Kristin Falck; Pattison, George; Lindgren, Peter

    2014-01-01

    Some small business owners want to balance personal values as well as economic values. “I have to follow my heart” or “it must be meaningful” some of them say. But how might they be able to know what gives meaning to the heart? The philosophical theologian Paul Tillich finds that the problem...

  11. Communicating with Professionals

    Medline Plus

    Full Text Available Skip to Content American Heart Association Learn and Live Local Info Languages Careers Volunteer Donate Search Heart. ... sheets: What is Cardiac Rehab? How Can I Live With Heart Failure? Medication Chart | Spanish Medical Contact ...

  12. Heart monitoring using left ventricle impedance and ventricular electrocardiography in left ventricular assist device patients.

    Science.gov (United States)

    Her, Keun; Ahn, Chi Bum; Park, Sung Min; Choi, Seong Wook

    2015-03-21

    Patients who develop critical arrhythmia during left ventricular assist device (LVAD) perfusion have a low survival rate. For diagnosis of unexpected heart abnormalities, new heart-monitoring methods are required for patients supported by LVAD perfusion. Ventricular electrocardiography using electrodes implanted in the ventricle to detect heart contractions is unsuitable if the heart is abnormal. Left ventricular impedance (LVI) is useful for monitoring heart movement but does not show abnormal action potential in the heart muscle. To detect detailed abnormal heart conditions, we obtained ventricular electrocardiograms (v-ECGs) and LVI simultaneously in porcine models connected to LVADs. In the porcine models, electrodes were set on the heart apex and ascending aorta for real-time measurements of v-ECGs and LVI. As the carrier current frequency of the LVI was adjusted to 30 kHz, it was easily derived from the original v-ECG signal by using a high-pass filter (cutoff: 10 kHz). In addition, v-ECGs with a frequency band of 0.1 - 120 Hz were easily derived using a low-pass filter. Simultaneous v-ECG and LVI data were compared to detect heart volume changes during the Q-T period when the heart contracted. A new real-time algorithm for comparison of v-ECGs and LVI determined whether the porcine heartbeats were normal or abnormal. Several abnormal heartbeats were detected using the LVADs operating in asynchronous mode, most of which were premature ventricle contractions (PVCs). To evaluate the accuracy of the new method, the results obtained were compared to normal ECG data and cardiac output measured simultaneously using commercial devices. The new method provided more accurate detection of abnormal heart movements. This method can be used for various heart diseases, even those in which the cardiac output is heavily affected by LVAD operation.

  13. Heart Disease and Stroke

    Science.gov (United States)

    ... email updates Enter email Submit Heart Disease and Stroke Heart disease and stroke are important health issues ... Stroke risk factors View more Heart Disease and Stroke resources Related information Heart-healthy eating Stress and ...

  14. Heart failure - overview

    Science.gov (United States)

    ... heart failure; Right-sided heart failure - cor pulmonale; Cardiomyopathy - heart failure; HF ... Disease Section. Heart Failure as a newly approved diagnosis for cardiac rehabilitation: challenges and opportunities. J Am ...

  15. Pericarditis - after heart attack

    Science.gov (United States)

    ... include: A previous heart attack Open heart surgery Chest trauma A heart attack that has affected the thickness of your heart muscle Symptoms Symptoms include: Anxiety Chest pain from the swollen pericardium rubbing on the ...

  16. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  17. Heart disease - risk factors

    Science.gov (United States)

    ... disease Heart bypass surgery Heart bypass surgery - minimally invasive Heart failure - overview Heart pacemaker High blood cholesterol levels High blood pressure Implantable cardioverter-defibrillator Smoking - tips on how to ...

  18. Getting a New Heart

    Science.gov (United States)

    ... a procedure that opens clogged arteries. Repair the heart valve . This procedure can often make your heart function ... heart muscle. Ventricular assist devices (VAD) . These are mechanical pumps that surgeons insert to help the heart ...

  19. Communicating with Professionals

    Medline Plus

    Full Text Available ... Prevention & Treatment of High Cholesterol Cholesterol Tools & Resources Congenital Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects ...

  20. PLASMA-LIPOPROTEIN ABNORMALITIES IN TYPE-1 (INSULIN-DEPENDENT) DIABETES-MELLITUS

    NARCIS (Netherlands)

    DULLAART, RPF

    Lipoprotein abnormalities may well contribute to the increased risk of coronary heart disease, cerebrovascular disease and peripheral vascular disease observed in type 1 (insulin-dependent) diabetes mellitus. The spectrum of diabetes-associated changes in lipoprotein metabolism is discussed. The

  1. ST-T Abnormalities on ECG in Relation to Cardiovascular Risk Factors

    Directory of Open Access Journals (Sweden)

    Yuko Chinushi, MD

    2011-01-01

    Conclusions: ST-T abnormalities without apparent heart diseas may be considered to be nonspecific but this cross-sectional study showed that they are related to CVRs and may be used as an early marker of preclinical cardiac damage by CVRs.

  2. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  3. Professional stress

    Directory of Open Access Journals (Sweden)

    Stanojević Dragana Z.

    2011-01-01

    Full Text Available Job stress is a line, for the person at work hired adverse physiological, psychological and behavioral reactions to situations in which job requirements are not in accordance with its capabilities, abilities and needs. Sources of stress at work are numerous. Personal factors: personality types have been most studied so far, environmental changes and demographic characteristics as well. Interpersonal stress inducing factors act and influence to the occurrence of many psychosomatic diseases. Psychosocial climate and relationships which are prevented or encouraged such as: cooperation and competition, trust and suspicion certainly affect to the appearance of professional stress. The way of leadership is very important. Organizational factors are the type of work, work time, noncompliance of the job, the introduction of new ethnologies, the conflict of personal roles, fear of job loss, bad physical conditions of working environment. The consequences of stress at work are numerous: at the cognitive level, the emotional level, the production plan, the health, plan reduces the immune system that cause a variety of psychosomatic illnesses and accidents at work.

  4. The Prevalence of Chagas Heart Disease in a Central Bolivian Community Endemic for Trypanosoma Cruzi

    Science.gov (United States)

    Yager, Jessica E.; Lozano Beltran, Daniel F.; Torrico, Faustino; Gilman, Robert H.; Bern, Caryn

    2015-01-01

    Background Though the incidence of new Trypanosoma cruzi infections has decreased significantly in endemic regions in the Americas, medical professionals continue to encounter a high burden of resulting Chagas disease among infected adults. The current prevalence of Chagas heart disease in a community setting is not known; nor is it known how recent insecticide vector control measures may have impacted the progression of cardiac disease in an infected population. Objectives and Methods Nested within a community serosurvey in rural and periurban communities in central Bolivia, we performed a cross-sectional cardiac substudy to evaluate adults for historical, clinical, and electrocardiographic evidence of cardiac disease. All adults between the ages of 20 and 60 years old with T. cruzi infection and those with a clinical history, physical exam, or ECG consistent with cardiac abnormalities were also scheduled for echocardiography. Results and conclusions Of the 604 cardiac substudy participants with definitive serology results, 183 were seropositive for infection with T. cruzi (30.3%). Participants who were seropositive for T. cruzi infection were more likely to have conduction system defects (1.6% versus 0 for complete right bundle branch block and 10.4% versus 1.9% for any bundle branch block; p=0.008 and p<0.001, respectively). However, there was no statistically significant difference in the prevalence of bradycardia among seropositive versus seronegative participants. Echocardiogram findings were not consistent with a high burden of Chagas cardiomyopathy: valvulopathies were the most common abnormality, and few participants were found to have low ejection fraction or left ventricular dilatation. No participants had significant heart failure. Though almost one third of adults in the community were seropositive for T. cruzi infection, few had evidence of Chagas heart disease. PMID:26407509

  5. 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

    Science.gov (United States)

    Powers, William J; Derdeyn, Colin P; Biller, José; Coffey, Christopher S; Hoh, Brian L; Jauch, Edward C; Johnston, Karen C; Johnston, S Claiborne; Khalessi, Alexander A; Kidwell, Chelsea S; Meschia, James F; Ovbiagele, Bruce; Yavagal, Dileep R

    2015-10-01

    The aim of this guideline is to provide a focused update of the current recommendations for the endovascular treatment of acute ischemic stroke. When there is overlap, the recommendations made here supersede those of previous guidelines. This focused update analyzes results from 8 randomized, clinical trials of endovascular treatment and other relevant data published since 2013. It is not intended to be a complete literature review from the date of the previous guideline publication but rather to include pivotal new evidence that justifies changes in current recommendations. Members of the writing committee were appointed by the American Heart Association/American Stroke Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association/American Stroke Association Manuscript Oversight Committee. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Statement Oversight Committee and Stroke Council Leadership Committee. Evidence-based guidelines are presented for the selection of patients with acute ischemic stroke for endovascular treatment, for the endovascular procedure, and for systems of care to facilitate endovascular treatment. Certain endovascular procedures have been demonstrated to provide clinical benefit in selected patients with acute ischemic stroke. Systems of care should be organized to facilitate the delivery of this care. © 2015 American Heart Association, Inc.

  6. Abnormal thermography in Parkinson's disease.

    Science.gov (United States)

    Antonio-Rubio, I; Madrid-Navarro, C J; Salazar-López, E; Pérez-Navarro, M J; Sáez-Zea, C; Gómez-Milán, E; Mínguez-Castellanos, A; Escamilla-Sevilla, F

    2015-08-01

    An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test. A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min. Continuous thermography was performed in: non-immersed hand (right or with lesser motor involvement) during immersion of the contralateral hand and for 6 min afterward; and contralateral immersed hand for 6 min post-immersion. The region of interest was the dorsal skin of the third finger, distal phalanx. PD patients showed a lower mean baseline hand temperature (p = 0.037) and greater thermal difference between dorsum of wrist and third finger (p = 0.036) and between hands (p = 0.0001) versus controls, regardless of the motor laterality. Both tests evidenced an adequate capacity to differentiate between groups: in the non-immersed hand, the PD patients did not show the normal cooling pattern or final thermal overshoot observed in controls (F = 5.29; p = 0.001), and there was an AUC of 0.897 (95%CI 0.796-0.998) for this cooling; in the immersed hand, thermal recovery at 6 min post-immersion was lesser in patients (29 ± 17% vs. 55 ± 28%, p = 0.002), with an AUC of 0.810 (95%CI 0.662-0.958). PD patients reveal abnormal skin thermal responses in thermography with cold stress test, suggesting cutaneous autonomic dysfunction. This simple technique may be useful to evaluate autonomic dysfunction in PD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Scn3b knockout mice exhibit abnormal sino-atrial and cardiac conduction properties

    Science.gov (United States)

    Hakim, P; Brice, N; Thresher, R; Lawrence, J; Zhang, Y; Jackson, A P; Grace, A A; Huang, C L-H

    2010-01-01

    Aim In contrast to extensive reports on the roles of Nav1.5 α-subunits, there have been few studies associating the β-subunits with cardiac arrhythmogenesis. We investigated the sino-atrial and conduction properties in the hearts of Scn3b−/− mice. Methods The following properties were compared in the hearts of wild-type (WT) and Scn3b−/− mice: (1) mRNA expression levels of Scn3b, Scn1b and Scn5a in atrial tissue. (2) Expression of the β3 protein in isolated cardiac myocytes. (3) Electrocardiographic recordings in intact anaesthetized preparations. (4) Bipolar electrogram recordings from the atria of spontaneously beating and electrically stimulated Langendorff-perfused hearts. Results Scn3b mRNA was expressed in the atria of WT but not Scn3b−/− hearts. This was in contrast to similar expression levels of Scn1b and Scn5a mRNA. Immunofluorescence experiments confirmed that the β3 protein was expressed in WT and absent in Scn3b−/− cardiac myocytes. Lead I electrocardiograms from Scn3b−/− mice showed slower heart rates, longer P wave durations and prolonged PR intervals than WT hearts. Spontaneously beating Langendorff-perfused Scn3b−/− hearts demonstrated both abnormal atrial electrophysiological properties and evidence of partial or complete dissociation of atrial and ventricular activity. Atrial burst pacing protocols induced atrial tachycardia and fibrillation in all Scn3b−/− but hardly any WT hearts. Scn3b−/− hearts also demonstrated significantly longer sinus node recovery times than WT hearts. Conclusion These findings demonstrate, for the first time, that a deficiency in Scn3b results in significant atrial electrophysiological and intracardiac conduction abnormalities, complementing the changes in ventricular electrophysiology reported on an earlier occasion. PMID:19796257

  8. QRS Complex Detection and Analysis of Cardiovascular Abnormalities: A Review

    Directory of Open Access Journals (Sweden)

    Akash Kumar Bhoi

    2014-09-01

    Full Text Available The ability to evaluate various Electrocardiogram (ECG waveforms is an important skill for many health care professionals including nurses, doctors, and medical assistants. The QRS complex is a vital wave in any ECG beat. It corresponds to the depolarization of ventricles. The duration, the amplitude and the complex QRS morphology are used for the purpose of cardiac arrhythmias diagnosis, conduction abnormalities, ventricular hypertrophy, myocardial infarction, electrolyte derangements etc. In this review, the different algorithms and methods for QRS complex detection have been discussed. Moreover, this review conceptualizes the challenge by discussing the effect of QRS complex on various critical cardiovascular conditions.

  9. Abnormal visuomotor processing in schizophrenia

    Directory of Open Access Journals (Sweden)

    Siân E. Robson

    2016-01-01

    Full Text Available Subtle disturbances of visual and motor function are known features of schizophrenia and can greatly impact quality of life; however, few studies investigate these abnormalities using simple visuomotor stimuli. In healthy people, electrophysiological data show that beta band oscillations in sensorimotor cortex decrease during movement execution (event-related beta desynchronisation (ERBD, then increase above baseline for a short time after the movement (post-movement beta rebound (PMBR; whilst in visual cortex, gamma oscillations are increased throughout stimulus presentation. In this study, we used a self-paced visuomotor paradigm and magnetoencephalography (MEG to contrast these responses in patients with schizophrenia and control volunteers. We found significant reductions in the peak-to-peak change in amplitude from ERBD to PMBR in schizophrenia compared with controls. This effect was strongest in patients who made fewer movements, whereas beta was not modulated by movement in controls. There was no significant difference in the amplitude of visual gamma between patients and controls. These data demonstrate that clear abnormalities in basic sensorimotor processing in schizophrenia can be observed using a very simple MEG paradigm.

  10. Lower Extremity Abnormalities in Children.

    Science.gov (United States)

    Rerucha, Caitlyn M; Dickison, Caleb; Baird, Drew C

    2017-08-15

    Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing is less common than intoeing and occurs more often in older children. Out-toeing is caused by external tibial torsion and femoral retroversion. Angular problems include genu varum (bowleg) and genu valgum (knock knee). With pes planus (flatfoot), the arch of the foot is usually flexible rather than rigid. A history and physical examination that include torsional profile tests and angular measurements are usually sufficient to evaluate patients with lower extremity abnormalities. Most children who present with lower extremity problems have normal rotational and angular findings (i.e., within two standard deviations of the mean). Lower extremity abnormalities that are within normal measurements resolve spontaneously as the child grows. Radiologic studies are not routinely required, except to exclude pathologic conditions. Orthotics are not beneficial. Orthopedic referral is often not necessary. Rarely, surgery is required in patients older than eight years who have severe deformities that cause dysfunction.

  11. Communicating with Professionals

    Medline Plus

    Full Text Available ... ECC for Heart.org Shop for Heart.org Causes for Heart.org Advocate for Heart.org Giving ... Tools & Resources Cholesterol About Cholesterol HDL, LDL & Triglycerides Causes of High Cholesterol How To Get Your Cholesterol ...

  12. Prenatal chromosomal microarray analysis in fetuses with congenital heart disease: a prospective cohort study.

    Science.gov (United States)

    Wang, Yan; Cao, Li; Liang, Dong; Meng, Lulu; Wu, Yun; Qiao, Fengchang; Ji, Xiuqing; Luo, Chunyu; Zhang, Jingjing; Xu, Tianhui; Yu, Bin; Wang, Leilei; Wang, Ting; Pan, Qiong; Ma, Dingyuan; Hu, Ping; Xu, Zhengfeng

    2018-02-01

    Currently, chromosomal microarray analysis is considered the first-tier test in pediatric care and prenatal diagnosis. However, the diagnostic yield of chromosomal microarray analysis for prenatal diagnosis of congenital heart disease has not been evaluated based on a large cohort. Our aim was to evaluate the clinical utility of chromosomal microarray as the first-tier test for chromosomal abnormalities in fetuses with congenital heart disease. In this prospective study, 602 prenatal cases of congenital heart disease were investigated using single nucleotide polymorphism array over a 5-year period. Overall, pathogenic chromosomal abnormalities were identified in 125 (20.8%) of 602 prenatal cases of congenital heart disease, with 52.0% of them being numerical chromosomal abnormalities. The detection rates of likely pathogenic copy number variations and variants of uncertain significance were 1.3% and 6.0%, respectively. The detection rate of pathogenic chromosomal abnormalities in congenital heart disease plus additional structural anomalies (48.9% vs 14.3%, P heart disease group. Additionally, the detection rate in congenital heart disease with additional structural anomalies group was significantly higher than that in congenital heart disease with soft markers group (48.9% vs 19.8%, P heart disease with additional structural anomalies and congenital heart disease with intrauterine growth retardation groups (48.9% vs 50.0%), congenital heart disease with soft markers and congenital heart disease with intrauterine growth retardation groups (19.8% vs 50.0%), or congenital heart disease with soft markers and isolated congenital heart disease groups (19.8% vs 14.3%). The detection rate in fetuses with congenital heart disease plus mild ventriculomegaly was significantly higher than in those with other types of soft markers (50.0% vs 15.6%, P heart disease in clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Living with Diabetic Heart Disease

    Science.gov (United States)

    ... Home / Diabetic Heart Disease Diabetic Heart Disease What Is The term "diabetic heart ... Web page. What Heart Diseases Are Involved in Diabetic Heart Disease? DHD may include coronary heart disease ( ...

  14. Heart failure - surgeries and devices

    Science.gov (United States)

    ... surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure ... problem may cause heart failure or make heart failure worse. Heart valve surgery may be needed to repair or ...

  15. CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH RECURRENT MISCARRIAGE

    Directory of Open Access Journals (Sweden)

    Daniela Mierla

    2012-06-01

    Full Text Available Chromosomal abnormalities are involved in the etiology of recurrent spontaneous pregnancy loss and sub-fertility. The purpose of this study was to determine the frequency and contribution of chromosomal abnormalities in recurrent miscarriages. The results obtained and literature review are helpful in understanding the importance of cytogenetics analysis of female infertility. To investigate the distribution of chromosomal abnormalities in the Romanian population with recurrent miscarriage, karyotype analysis by G-banding was performed from peripheral blood in 967 women infertility. Results: Chromosomal abnormalities were found to 79 women (8,17%. The percentage of chromosomal abnormalities in the studied population correlates with the data in the literature. Chromosomal abnormalities could play the important role in etiology of infertility and are more frequently detected in this group of patients compared to general population. In the infertile couples balanced chromosomal abnormalities are the main cause of spontaneous abortions.

  16. The professional perspective on patient involvement in the development of quality indicators: a qualitative analysis using the example of chronic heart failure in the German health care setting

    Directory of Open Access Journals (Sweden)

    Pohontsch NJ

    2015-01-01

    Full Text Available Nadine Janis Pohontsch,1 Heidrun Herzberg,2 Stefanie Joos,3 Felix Welti,4 Martin Scherer,1 Eva Blozik1 1Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamberg, Germany; 2Faculty of Health, Nursing, Management, Neubrandenburg University of Applied Sciences, Neubrandenburg, Germany; 3Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany; 4Faculty of Human Sciences, University of Kassel, Kassel, Germany Purpose: There is an international consensus that quality indicators (QIs of health care ought to represent patient-relevant aspects. Therefore, patient involvement in the development process is essential. However, there is no methodological gold standard for involving patients in QI development. The aim of this study is to explore experts’ views on the representation of patient-relevant aspects in the QI development process using the QIs developed in the context of the German National Disease Management Guideline for Heart Failure as an example. Methods: Semi-structured, open telephone interviews were conducted with 15 German experts (patient representatives, physicians, researchers, and methodologists involved in guideline development or quality assessment. Interview themes were the relevance of the exemplary set of QIs for patients, as well as the legitimacy of, competence of, and collaboration with the patient representative who participated in the development process. Interviews were fully transcribed and content analyzed. Deductive categories derived from the research questions were supplemented by inductively formed categories during the review of the interview material.Results: The qualitative analysis suggests a discrepancy between the guidelines’ QIs and those relevant to patients from an expert’s point of view, such as physician-patient communication and quality of counseling. Experts reported only minor communication and cooperation

  17. Identity, Authority, and the Heart of Supervision.

    Science.gov (United States)

    Waite, Duncan

    2000-01-01

    Discusses types of authority (bureaucratic, personal, technical-rational, professional, moral, cultural, and ideological) and their implications for teacher supervision. Supervision is a helping profession, in service of the teacher. The heart of supervision lies in its relationships and its mission to improve the total teaching/learning…

  18. Adverse pregnancy outcomes after abnormal first-trimester screening for aneuploidy.

    Science.gov (United States)

    Goetzl, Laura

    2010-09-01

    Women with abnormal results of first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency of greater than 3.5 mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities, and other structural abnormalities. Abnormal levels of first trimester analytes are also associated with adverse pregnancy outcomes, but the predictive value is less impressive. As a single marker, pregnancy-associated plasma protein (PAPP)-A level less than 1st percentile has a good predictive value for subsequent fetal growth restriction. Women with PAPP-A level less than 5th percentile should undergo subsequent risk assessment with routine maternal serum afetoprotein screening with the possible addition of uterine artery pulsatility index assessment in the midtrimester. Copyright 2010 Elsevier Inc. All rights reserved.

  19. Congenital heart disease and chromossomopathies detected by the karyotype.

    Science.gov (United States)

    Trevisan, Patrícia; Rosa, Rafael Fabiano M; Koshiyama, Dayane Bohn; Zen, Tatiana Diehl; Paskulin, Giorgio Adriano; Zen, Paulo Ricardo G

    2014-06-01

    To review the relationship between congenital heart defects and chromosomal abnormalities detected by the karyotype. Scientific articles were searched in MEDLINE database, using the descriptors "karyotype" OR "chromosomal" OR "chromosome" AND "heart defects, congenital". The research was limited to articles published in English from 1980 on. Congenital heart disease is characterized by an etiologically heterogeneous and not well understood group of lesions. Several researchers have evaluated the presence of chromosomal abnormalities detected by the karyotype in patients with congenital heart disease. However, most of the articles were retrospective studies developed in Europe and only some of the studied patients had a karyotype exam. In this review, only one study was conducted in Latin America, in Brazil. It is known that chromosomal abnormalities are frequent, being present in about one in every ten patients with congenital heart disease. Among the karyotype alterations in these patients, the most important is the trisomy 21 (Down syndrome). These patients often have associated extra-cardiac malformations, with a higher risk of morbidity and mortality, which makes heart surgery even more risky. Despite all the progress made in recent decades in the field of cytogenetic, the karyotype remains an essential tool in order to evaluate patients with congenital heart disease. The detailed dysmorphological physical examination is of great importance to indicate the need of a karyotype.

  20. Congenital heart disease and chromossomopathies detected by the karyotype

    Directory of Open Access Journals (Sweden)

    Patrícia Trevisan

    2014-06-01

    Full Text Available OBJECTIVE: To review the relationship between congenital heart defects and chromosomal abnormalities detected by the karyotype.DATA SOURCES: Scientific articles were searched in MEDLINE database, using the descriptors "karyotype" OR "chromosomal" OR "chromosome" AND "heart defects, congenital". The research was limited to articles published in English from 1980 on.DATA SYNTHESIS: Congenital heart disease is characterized by an etiologically heterogeneous and not well understood group of lesions. Several researchers have evaluated the presence of chromosomal abnormalities detected by the karyotype in patients with congenital heart disease. However, most of the articles were retrospective studies developed in Europe and only some of the studied patients had a karyotype exam. In this review, only one study was conducted in Latin America, in Brazil. It is known that chromosomal abnormalities are frequent, being present in about one in every ten patients with congenital heart disease. Among the karyotype alterations in these patients, the most important is the trisomy 21 (Down syndrome. These patients often have associated extra-cardiac malformations, with a higher risk of morbidity and mortality, which makes heart surgery even more risky.CONCLUSIONS: Despite all the progress made in recent decades in the field of cytogenetic, the karyotype remains an essential tool in order to evaluate patients with congenital heart disease. The detailed dysmorphological physical examination is of great importance to indicate the need of a karyotype.

  1. Types of Heart Block

    Science.gov (United States)

    ... defects. Acquired heart block is more common than congenital heart block. Damage to the heart muscle or its electrical system causes acquired heart block. Diseases, surgery, or medicines can cause this damage. The three types of heart block are first degree, second degree, ...

  2. What Causes Heart Block?

    Science.gov (United States)

    ... defects. Acquired heart block is more common than congenital heart block. Damage to the heart muscle or its electrical system causes acquired heart block. Diseases, surgery, or medicines can cause this damage. The three types of heart block are first degree, second degree, ...

  3. Living with Heart Block

    Science.gov (United States)

    ... defects. Acquired heart block is more common than congenital heart block. Damage to the heart muscle or its electrical system causes acquired heart block. Diseases, surgery, or medicines can cause this damage. The three types of heart block are first degree, second degree, ...

  4. Electronic fetal heart rate monitoring: where are we now?

    Science.gov (United States)

    Chez, Bonnie Flood; Baird, Suzanne McMurtry

    2011-01-01

    Electronic fetal heart rate monitoring (EFM) continues to be the primary method utilized for fetal assessment in the United States. Standardization of nomenclature associated with this perinatal technology has evolved over the past 40 years such that the current nomenclature recommended by the National Institute of Child Health and Human Development (NICHD) has been adopted by professional perinatal organizations as the agreed-upon method for professional communication and documentation. Current research continues to focus on the optimal management of intrapartum fetal heart rate tracings. The clinical controversies and challenges related to electronic fetal heart rate monitoring continue to evolve.

  5. Assessment of electrocardiography, echocardiography, and heart rate variability in dynamic and static type athletes

    Directory of Open Access Journals (Sweden)

    Ataei A

    2012-07-01

    Full Text Available Mehrnoush Toufan,1 Babak Kazemi,1 Fariborz Akbarzadeh,1 Amin Ataei,1 Majid Khalili21Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Azerbaijan National Academy of Sciences, Baku, AzerbaijanBackground: Over the last two decades, morphological cardiac changes induced by athletic conditioning have been of great interest. Therefore, several studies have been orchestrated to delineate electrocardiography (ECG, echocardiography, and heart rate variability (HRV findings in athletes.Purpose: To assess the ECG, echocardiography, and HRV in a group of dynamic and static type athletes.Methods: Fifty professional athletes (20 static and 30 dynamic exercise athletes and 50 healthy nonathletes (control group were recruited. Standard 12-lead ECG and transthoracic echocardiography was performed on all athletes and the control group. Through echocardiography, variables including left ventricular (LV end-diastolic/systolic diameter, LV mass, and left atrial volume index were measured. In addition, both the athletes and the control group underwent ECG Holter monitoring for 15 minutes and several parameters related to HRV (time and frequency domain were recorded.Results: The most common ECG abnormalities among the athletes were sinus bradycardia and incomplete right bundle branch block. LV end-diastolic diameter and left atrial volume index were significantly greater in the dynamic athletes (P < 0.001. LV end-systolic diameter was significantly lower in the static group (P < 0.001. LV mass of the dynamic and static athletes was significantly greater than that of the controls (P < 0.001. Among the ECG Holter monitoring findings, the dynamic athletes had lower systolic blood pressure than the controls (P = 0.01. Heart rate was lowest in the control group (P < 0.001.Conclusion: The most common ECG abnormalities among adolescent Iranian athletes were sinus bradycardia and incomplete right bundle branch block. Static exercise seemed

  6. [Usefulness of enalapril in congestive heart failure].

    Science.gov (United States)

    Escudero, J; Necoechea, J C; Navarro, J

    1987-01-01

    The usefulness of vasodilating agents in congestive heart failure depends on their ability to diminish left ventricular afterload; this effect does not necessarily persist with long-term treatment. The present study reports the clinical response of 16 patients in heart failure; the trial was double blind with enalapril and/or placebo during 24 weeks. Diagnoses were dilated cardiomyopathy in six, rheumatic heart disease in five, ischemic heart disease in four und hypertensive heart disease in one. Two patients on enalapril died of non cardiac causes and one was withdrawn from the study due to pregnancy. In those patients treated with enalapril the NYHA functional class improved from 2.9/0.8 to 1.1/0.4 (p less than 0.001), and the effort capacity increased from 545/171 to 888/160 seconds (p less than 0.01). Left ventricular systolic function evaluated by echocardiogram and Tc 99 m ventriculogram, radiologic size of the heart and echocardiographic left ventricular diameters showed no significant changes. There were no adverse clinical effects nor laboratory abnormalities. It is concluded that in this study, enalapril produced sustained clinical improvement in patients with heart failure and it was well tolerated during long-term treatment.

  7. Acute coronary care in the elderly, part I: Non-ST-segment-elevation acute coronary syndromes: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology.

    Science.gov (United States)

    Alexander, Karen P; Newby, L Kristin; Cannon, Christopher P; Armstrong, Paul W; Gibler, W Brian; Rich, Michael W; Van de Werf, Frans; White, Harvey D; Weaver, W Douglas; Naylor, Mary D; Gore, Joel M; Krumholz, Harlan M; Ohman, E Magnus

    2007-05-15

    Age is an important determinant of outcomes for patients with acute coronary syndromes (ACS); however, community practice reveals a disproportionately lower use of cardiovascular medications and invasive treatment even among elderly patients with ACS who would stand to benefit. Reasons include limited trial data to guide the care of older adults and uncertainty about benefits and risks, particularly with newer medications or invasive treatments and in the setting of advanced age or complex health status. This 2-part American Heart Association scientific statement summarizes evidence on patient heterogeneity, clinical presentation, and treatment of non-ST-elevation ACS in relation to age ( or = 85 years). In addition, we review methodological issues that influence the acquisition and application of evidence to the elderly patients treated in community practice. A writing group combining international cardiovascular and geriatric perspectives convened to summarize available data from trials (5 combined Virtual Coordinating Center for Global Collaborative Cardiovascular Research [VIGOUR] trials) and 3 registries (Global Registry of Acute Coronary Events, National Registry of Myocardial Infarction, and the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the American College of Cardiology/American Heart Association guidelines national quality improvement initiative [CRUSADE]) to provide a conceptual framework for future work in the care of the elderly with acute cardiac disease. Treatment for non-ST-segment-elevation ACS (Part I) and ST-segment-elevation myocardial infarction (Part II) are reviewed. In addition, ethical considerations pertaining to acute care and secondary prevention are considered (Part II). The primary goal is to identify the areas in which sufficient evidence is available to guide practice, as well as to determine areas that warrant further study. Although treatment-related benefits

  8. A Fatal, Systemic Mitochondrial Disease with Decreased Mitochondrial Enzyme Activities, Abnormal Ultrastructure of the Mitochondria and Deficiency of Heat Shock Protein 60

    NARCIS (Netherlands)

    Agsteribbe, Etienne; Huckriede, Anke; Veenhuis, Marten; Ruiters, Marcel H.J.; Niezen-Koning, Klaziena; Skjeldal, Ola H.; Skullerud, Kari; Gupta, Radhey S.; Hallberg, Richard; Diggelen, Otto P. van; Scholte, Hans R.

    1993-01-01

    We report on a girl presenting with facial dysmorphic features and breathing difficulties upon birth. She was hypotonic, developed a metabolic acidosis, and died two days old of heart failure. Post-mortem examination revealed abnormalities of brain, lungs, heart and liver. In cultured skin

  9. Electrocardiography-inclusive screening strategies for detection of cardiovascular abnormalities in high school athletes.

    Science.gov (United States)

    Price, David E; McWilliams, Andrew; Asif, Irfan M; Martin, Anthony; Elliott, Spencer D; Dulin, Michael; Drezner, Jonathan A

    2014-03-01

    The best protocol for cardiovascular preparticipation screening (PPS) in young athletes is uncertain. The purpose of this study was to determine the value of integrating electrocardiographic (ECG) testing with standard history and physical examination during PPS to identify potentially serious cardiovascular abnormalities in young athletes. A total of 2017 high school athletes seeking clearance for competitive sports were prospectively evaluated using a standardized history and physical examination, 12-lead ECG, and two-dimensional echocardiogram (echo). Primary outcome measures included the identification of cardiac disorders associated with sudden cardiac death. Secondary outcome measures included identification of abnormal, but nonlethal, cardiac conditions that required medical follow-up. Of these athletes, 14.7% had an abnormal history or physical examination and 3.1% had an abnormal ECG based on modern ECG interpretation criteria. Five primary outcomes (1 hypertrophic cardiomyopathy, 4 Wolff-Parkinson-White syndrome) and four secondary outcomes were identified. History and physical examination detected 40% of primary and 50% of secondary abnormalities. ECG detected all five primary abnormalities but none of the secondary abnormalities. Echo was abnormal in 1.2% and detected one primary and four secondary abnormalities. The false-positive rates for primary and secondary outcomes for history and physical examination and ECG were 14.5% and 2.8%, respectively. ECG adds value to PPS through increased detection of arrhythmogenic and structural cardiovascular conditions associated with sudden cardiac death. Use of modern ECG interpretation standards allows a low false-positive rate. Routine echo may detect other clinically important cardiac abnormalities, but its role in PPS remains uncertain. Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  10. Low Vital Capacity and Electrocardiographic ST-T Abnormalities in Asymptomatic Adults

    Directory of Open Access Journals (Sweden)

    Kei Nakajima

    2012-01-01

    Full Text Available Studies have shown that low forced vital capacity (LFVC is associated with atherosclerosis. However, it is unclear whether LFVC is associated with resting electrocardiographic ST-T abnormalities, a common finding that is prognostic for cardiovascular events. Therefore, pulmonary functions, ST-T abnormalities defined with Minnesota Code, and cardiometabolic risk factors were examined in a cross-sectional study of 1,653 asymptomatic adults without past history of coronary heart diseases. The prevalence of diabetes, metabolic syndrome, and ST-T abnormalities significantly increased with decreasing percent of predicted forced vital capacity (%PFVC. ST-T abnormalities were observed in 73 subjects (4.4% in total. Multiple logistic regression analysis showed that, compared with the highest quartile of %PFVC (≥99.7%, the lowest quartile of %PFVC (≤84.2% was persistently associated with ST-T abnormalities even after further adjustment for diabetes or metabolic syndrome (odds ratio (95%CI: 2.44 (1.16–5.14 and 2.42 (1.15–5.10, resp.. Similar trends were observed when subjects were divided into quartiles according to percent of predicted forced expiratory volume in 1 second (FEV1, but not the ratio of FEV1/FVC. In conclusion, LFVC may be associated with ST-T abnormalities independent of metabolic abnormalities in asymptomatic adults, suggesting a plausible link between impaired pulmonary defects and cardiovascular diseases.

  11. Low Vital Capacity and Electrocardiographic ST-T Abnormalities in Asymptomatic Adults

    Science.gov (United States)

    Nakajima, Kei; Li, Yulan; Fuchigami, Hiroshi; Munakata, Hiromi

    2012-01-01

    Studies have shown that low forced vital capacity (LFVC) is associated with atherosclerosis. However, it is unclear whether LFVC is associated with resting electrocardiographic ST-T abnormalities, a common finding that is prognostic for cardiovascular events. Therefore, pulmonary functions, ST-T abnormalities defined with Minnesota Code, and cardiometabolic risk factors were examined in a cross-sectional study of 1,653 asymptomatic adults without past history of coronary heart diseases. The prevalence of diabetes, metabolic syndrome, and ST-T abnormalities significantly increased with decreasing percent of predicted forced vital capacity (%PFVC). ST-T abnormalities were observed in 73 subjects (4.4% in total). Multiple logistic regression analysis showed that, compared with the highest quartile of %PFVC (≥99.7%), the lowest quartile of %PFVC (≤84.2%) was persistently associated with ST-T abnormalities even after further adjustment for diabetes or metabolic syndrome (odds ratio (95%CI): 2.44 (1.16–5.14) and 2.42 (1.15–5.10), resp.). Similar trends were observed when subjects were divided into quartiles according to percent of predicted forced expiratory volume in 1 second (FEV1), but not the ratio of FEV1/FVC. In conclusion, LFVC may be associated with ST-T abnormalities independent of metabolic abnormalities in asymptomatic adults, suggesting a plausible link between impaired pulmonary defects and cardiovascular diseases. PMID:22685652

  12. Neuroimaging and Correlates of Cognitive Function among Patients with Heart Failure

    NARCIS (Netherlands)

    Vogels, R.L.C.; Oosterman, J.M.; Harten, B. van; Gouw, A.A.; Schroeder-Tanka, J.M.; Scheltens, P.; Flier, W.M. van der; Weinstein, H.C.

    2007-01-01

    Background/Aims: We purposed to investigate the relationship between cerebral abnormalities detected by magnetic resonance imaging (MRI) and cognitive performance in nondemented outpatients with heart failure (HF). Methods: In 58 patients with HF neuropsychological assessment was performed including

  13. Evaluating your professionalism.

    Science.gov (United States)

    Burr, Steven; Neve, Hilary; Leung, Yee

    2016-11-02

    What does being professional look like? Does it mean that you do the 'right' thing, even when no-one is looking? How do you evaluate your professionalism knowledge, values and behaviour? How do you identify and address underperformance in professionalism? How can you transfer your professionalism to different circumstances?

  14. Diabetic Heart Disease

    Science.gov (United States)

    ... about other tests and procedures, go to the diagnosis sections of the Health Topics Coronary Heart Disease , Heart Failure , and Cardiomyopathy articles. Treatment Diabetic heart disease (DHD) is treated ...

  15. Classes of Heart Failure

    Science.gov (United States)

    ... second installment explains heart failure with muscle intact. Queen Latifah and her mom, Rita, share their personal ... a Heart Attack 10 Tachycardia | Fast Heart Rate *Red Dress ™ DHHS, Go Red ™ AHA ; National Wear Red ...

  16. Types of Heart Failure

    Science.gov (United States)

    ... second installment explains heart failure with muscle intact. Queen Latifah and her mom, Rita, share their personal ... a Heart Attack 10 Tachycardia | Fast Heart Rate *Red Dress ™ DHHS, Go Red ™ AHA ; National Wear Red ...

  17. Heart failure - home monitoring

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000113.htm Heart failure - home monitoring To use the sharing features on this page, please enable JavaScript. Heart failure is a condition in which the heart is ...

  18. Heart disease and depression

    Science.gov (United States)

    ... gov/ency/patientinstructions/000790.htm Heart disease and depression To use the sharing features on this page, ... a heart attack or heart surgery Signs of Depression It is pretty common to feel down or ...

  19. Who Needs Heart Surgery?

    Science.gov (United States)

    ... children, go to the Health Topics articles about congenital heart defects , holes in the heart , and tetralogy of Fallot . Overview The most common type of heart surgery for adults is coronary artery ...

  20. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  1. Heart Health Tests

    Science.gov (United States)

    ... is easier to treat. Blood tests and heart health tests can help find heart diseases or identify ... diseases. There are several different types of heart health tests. Your doctor will decide which test or ...

  2. Hypertensive heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000163.htm Hypertensive heart disease To use the sharing features on this page, please enable JavaScript. Hypertensive heart disease refers to heart problems that occur because of ...

  3. Congenital Heart Information Network

    Science.gov (United States)

    ... heart defects. Important Notice The Congenital Heart Information Network website is temporarily out of service. Please join ... and Uwe Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright © ...

  4. Sodium valproate-induced congenital cardiac abnormalities in mice are associated with the inhibition of histone deacetylase

    Science.gov (United States)

    2010-01-01

    Background Valproic acid, a widely used anticonvulsant drug, is a potent teratogen resulting in various congenital abnormalities. However, the mechanisms underlying valproic acid induced teratogenesis are nor clear. Recent studies indicate that histone deacetylase is a direct target of valproic acid. Methods In the present study, we have used histological analysis and RT-PCR assays to examine the cardiac abnormalities in mice treated with sodium valproate (NaVP) and determined the effects of NaVP on histone deacetylase activity and the expression of heart development-related genes in mouse myocardial cells. Results The experimental data show that NaVP can induce cardiac abnormalities in fetal mice in a dose-dependent manner. NaVP causes a dose-dependent inhibition of hitone deacetylase (HDAC) activity in mouse myocardial cells. However, the expression levels of HDAC (both HDAC1 and HDAC2) are not significantly changed in fetal mouse hearts after administration of NaVP in pregnant mice. The transcriptional levels of other heart development-related genes, such as CHF1, Tbx5 and MEF2, are significantly increased in fetal mouse hearts treated with NaVP. Conclusions The study indicates that administration of NaVP in pregnant mice can result in various cardiac abnormalities in fetal hearts, which is associated with an inhibition of histone deacetylase without altering the transcription of this enzyme. PMID:20219112

  5. Sodium valproate-induced congenital cardiac abnormalities in mice are associated with the inhibition of histone deacetylase

    Directory of Open Access Journals (Sweden)

    Rollo Johnathon C

    2010-03-01

    Full Text Available Abstract Background Valproic acid, a widely used anticonvulsant drug, is a potent teratogen resulting in various congenital abnormalities. However, the mechanisms underlying valproic acid induced teratogenesis are nor clear. Recent studies indicate that histone deacetylase is a direct target of valproic acid. Methods In the present study, we have used histological analysis and RT-PCR assays to examine the cardiac abnormalities in mice treated with sodium valproate (NaVP and determined the effects of NaVP on histone deacetylase activity and the expression of heart development-related genes in mouse myocardial cells. Results The experimental data show that NaVP can induce cardiac abnormalities in fetal mice in a dose-dependent manner. NaVP causes a dose-dependent inhibition of hitone deacetylase (HDAC activity in mouse myocardial cells. However, the expression levels of HDAC (both HDAC1 and HDAC2 are not significantly changed in fetal mouse hearts after administration of NaVP in pregnant mice. The transcriptional levels of other heart development-related genes, such as CHF1, Tbx5 and MEF2, are significantly increased in fetal mouse hearts treated with NaVP. Conclusions The study indicates that administration of NaVP in pregnant mice can result in various cardiac abnormalities in fetal hearts, which is associated with an inhibition of histone deacetylase without altering the transcription of this enzyme.

  6. Heart rate recovery in patients with obstructive sleep apnea syndrome

    OpenAIRE

    Karaşen, Rıza Murat; ÇİFTÇİ, Bülent; Acar, Baran; YALÇIN, Ahmet Arif; GÜVEN, Selma FIRAT

    2014-01-01

    To demonstrate the effects of obstructive sleep apnea syndrome (OSAS) on baroregulatory function by using heart rate recovery (HRR) parameters. Materials and methods: Fifty-four moderate and severe OSAS patients were included in the study. HRR was defined as the difference in heart rate between peak exercise and 1 min later; a value of 18 beats/min was considered abnormal. OSAS patients were enrolled in the study as group 1 (normal HRR; n = 12) and group 2 (abnormal HRR, n = 42). Left ventr...

  7. Chromosomal abnormalities in child psychiatric patients.

    OpenAIRE

    Hong, K. E.; Kim, J. H.; Moon, S. Y.; Oh, S. K.

    1999-01-01

    To determine the frequency of chromosomal abnormalities in a child psychiatric population, and to evaluate possible associations between types of abnormalities and patient's clinical characteristics, cytogenetic examination was performed on 604 patients. Demographic data, reasons for karyotyping, clinical signs, and other patient characteristics were assessed and correlated with the results from karyotyping. Chromosomal abnormalities were found in 69 patients (11.3%); these were structural in...

  8. Cardiac sympathetic nerve abnormality predicts ventricular tachyarrhythmic events in patients without conventional risk of sudden death

    Energy Technology Data Exchange (ETDEWEB)

    Akutsu, Yasushi; Kaneko, Kyouichi; Kodama, Yusuke; Li, Hui-Ling; Kawamura, Mitsuharu; Asano, Taku; Tanno, Kaoru; Kobayashi, Youichi [Showa University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo (Japan); Shinozuka, Akira; Gokan, Takehiko [Showa University School of Medicine, Department of Radiology, Tokyo (Japan)

    2008-11-15

    Patients with structural heart disease, severe left ventricular dysfunction, or history of cardiac arrest are at increased risk of sudden cardiac death. However, a useful marker for predicting sudden cardiac death is not clarified in low-risk patients without those conventional risks. We hypothesized that cardiac sympathetic nerve system (SNS) abnormality would be associated with ventricular tachyarrhythmic events in low-risk patients with ventricular tachycardia (VT). Iodine-123 metaiodobenzylguanidine ({sup 123}I-MIBG) scintigraphy was performed in 50 patients (mean{+-}standard deviation, age 54 {+-} 16 years, 52% males) with VT who did not have structural heart disease, severe left ventricular dysfunction, or history of cardiac arrest, and SNS activity was assessed from heart/mediastinal (H/M) ratio on delayed images. Over 11 years of follow-up, three patients had sudden deaths (6%) and nine patients had sustained ventricular tachyarrhythmic events (18%). SNS abnormality, defined as H/M ratio <2.8, was predictive of sudden death or ventricular tachyarrhythmic events (45% in nine of 20 patients with SNS abnormality vs 16.7% in three of 30 patients without SNS abnormality, p = 0.005). After adjustment for potential confounding variables including slight left ventricular dysfunction, SNS abnormality remained independently predictive of ventricular tachyarrhythmic events with a hazard ratio of 5.3 (95% confidence interval = 1.4 to 20.8, p = 0.016). SNS abnormality is a readily available and powerful predictor of recurrent ventricular tachyarrhythmic events in patients with VT who did not have conventional risk of sudden cardiac death. {sup 123}I-MIBG scintigraphy can provide prognostic information of VT patients without conventional risk. (orig.)

  9. EXPLORATORY-STUDY OF THE EFFECTS OF SINGLE DOSES OF ISOMAZOLE AN HEMODYNAMICS AND HEART-RATE-VARIABILITY PARAMETERS IN CHRONIC HEART-FAILURE

    NARCIS (Netherlands)

    TUININGA, YS; VANVELDHUISEN, DJ; CRIJNS, HJGM; VANDENBROEK, SAJ; BROUWER, J; HAAKSMA, J; MANINTVELD, AJ; LIE, KI

    Ventricular arrhythmias and disturbed autonomic control, as reflected by abnormal heart rate variability (HRV), are related to hemodynamic impairment in chronic heart failure (CHF). We investigated the effects of orally (p.o.) administered isomazole, a new phosphodiesterase (PDE) inhibitor with

  10. Congenital and Acquired Valvular Heart Disease in Pregnancy.

    Science.gov (United States)

    Goldstein, Sarah A; Ward, Cary C

    2017-08-24

    The number of pregnancies complicated by valvular heart disease is increasing. This review describes the hemodynamic effects of clinically important valvular abnormalities during pregnancy and reviews current guideline-driven management strategies. Valvular heart disease in women of childbearing age is most commonly caused by congenital abnormalities and rheumatic heart disease. Regurgitant lesions are well tolerated, while stenotic lesions are associated with a higher risk of pregnancy-related complications. Management of symptomatic disease during pregnancy is primarily medical, with percutaneous interventions considered for refractory symptoms. Most guidelines addressing the management of valvular heart disease during pregnancy are based on case reports and observational studies. Additional investigation is required to further advance the care of this growing patient population.

  11. Tackling heart disease and poverty.

    Science.gov (United States)

    Lee, Geraldine; Carrington, Melinda

    2007-12-01

    Cardiovascular disease is the leading cause of death worldwide, with a projected increase in incidence in developed and developing countries. This paper will review the literature on the role of poverty and socioeconomic deprivation in cardiovascular disease and outline ways to tackle poverty. The literature acknowledges the individual risk factors for cardiovascular disease, but highlights the negative effects of neighborhood deprivation on the incidence of cardiovascular disease and its mortality rates. The studies show that equitable access to health care is not evident and those in less affluent neighborhoods have greater disease incidence and increased mortality and morbidity rates, particularly for angina, myocardial infarction, and heart failure. The approach to reducing disease rates needs to be conducted from an individual level to the societal level and needs to prevent and treat heart disease (particularly in deprived neighborhoods). Nurses and health professionals must drive health policy so that progress can be achieved in reducing the disease rates.

  12. Semen abnormalities with SSRI antidepressants.

    Science.gov (United States)

    2015-01-01

    Despite decades of widespread use, the adverse effect profile of "selective" serotonin reuptake inhibitor (SSRI) antidepressants has still not been fully elucidated. Studies in male animals have shown delayed sexual development and reduced fertility. Three prospective cohort studies conducted in over one hundred patients exposed to an SSRI for periods ranging from 5 weeks to 24 months found altered semen param-eters after as little as 3 months of exposure: reduced sperm concentration, reduced sperm motility, a higher percentage of abnormal spermatozoa, and increased levels of sperm DNA fragmentation. One clinical trial showed growth retardation in children considered depressed who were exposed to SSRls. SSRls may have endocrine disrupting properties. Dapoxetine is a short-acting serotonin reuptake inhibitor that is chemically related to fluoxetine and marketed in the European Union for men complaining of premature ejaculation. But the corresponding European summary of product characteristics does not mention any effects on fertility. In practice, based on the data available as of mid-2014, the effects of SSRI exposure on male fertility are unclear. However, it is a risk that should be taken into account and pointed out to male patients who would like to father a child or who are experiencing fertility problems.

  13. [Cognitive abnormalities and cannabis use].

    Science.gov (United States)

    Solowij, Nadia; Pesa, Nicole

    2010-05-01

    Evidence that cannabis use impairs cognitive function in humans has been accumulating in recent decades. The purpose of this overview is to update knowledge in this area with new findings from the most recent literature. Literature searches were conducted using the Web of Science database up to February 2010. The terms searched were: "cannabi*" or "marijuana", and "cogniti*" or "memory" or "attention" or "executive function", and human studies were reviewed preferentially over the animal literature. Cannabis use impairs memory, attention, inhibitory control, executive functions and decision making, both during the period of acute intoxication and beyond, persisting for hours, days, weeks or more after the last use of cannabis. Pharmacological challenge studies in humans are elucidating the nature and neural substrates of cognitive changes associated with various cannabinoids. Long-term or heavy cannabis use appears to result in longer-lasting cognitive abnormalities and possibly structural brain alterations. Greater adverse cognitive effects are associated with cannabis use commencing in early adolescence. The endogenous cannabinoid system is involved in regulatory neural mechanisms that modulate processes underlying a range of cognitive functions that are impaired by cannabis. Deficits in human users most likely therefore reflect neuroadaptations and altered functioning of the endogenous cannabinoid system.

  14. Red cell membrane transport abnormalities.

    Science.gov (United States)

    Bruce, Lesley J

    2008-05-01

    The present review describes the red cell transport abnormalities of proteins of the band 3 macrocomplex. The macrocomplex is involved in red cell gas exchange and recent findings have furthered our understanding of this process. Study of a novel band 3 hereditary spherocytosis variant suggests that expression of mutant band 3 protein can be rescued by wild-type band 3. Other studies show that some mutant band 3 protein can mediate a cation conductance. Recent work suggests both Rh-associated glycoprotein and aquaporin act as gas channels confirming the integrated function of the macrocomplex and the importance of its role in red cell gas transport. The most recent studies on band 3-induced hereditary spherocytosis are reviewed and an explanation for the mild phenotype of heterozygous hereditary spherocytosis is discussed. A number of red cell conditions (hereditary stomatocytosis, south-east Asian ovalocytosis, distal renal tubular acidosis, Rhnull), associated with both stomatocytosis and a cation leak, are described. The evidence that Rh-associated glycoprotein forms a gas channel that transports CO2 and/or NH3 is reviewed and discussed, together with recent studies that show that aquaporin 1 transports both CO2 and O2.

  15. Heart Failure Association of the European Society of Cardiology Specialist Heart Failure Curriculum

    DEFF Research Database (Denmark)

    McDonagh, Theresa A; Gardner, Roy S; Lainscak, Mitja

    2014-01-01

    It is well established that organized care of heart failure patients, including specialist management by cardiologists, improves patient outcomes. In response to this, other national training bodies (the UK and the USA) have developed heart failure subspecialty curricula within their Cardiology...... Training Curricula. In addition, European Society of Cardiology (ESC) subspecialty curricula exist for Interventional Cardiology and Heart Rhythm Management. The purpose of this heart failure curriculum is to provide a framework which can be used as a blueprint for training across Europe. This blueprint...... mirrors other ESC curricula. Each section has three components: the knowledge required, the skills which are necessary, and the professionalism (attitudes and behaviours) which should be attained. The programme is designed to last 2 years. The first year is devoted to the specialist heart failure module...

  16. Communicating with Professionals

    Medline Plus

    Full Text Available Skip to Content American Heart Association Learn and Live Local Info Languages Careers Volunteer Donate Search Heart.org Search Get Your Local Info Find out what is happening at ...

  17. Communicating with Professionals

    Medline Plus

    Full Text Available ... Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Target Heart Rates 4 Heart Attack Symptoms ... site complies with the HONcode standard for trustworthy health information: verify here.

  18. Communicating with Professionals

    Medline Plus

    Full Text Available ... Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for ... Care of Yourself - Introduction - Coping With Feelings - Reducing Stress - Quitting Smoking - Eating Well and Losing Weight • Tools & ...

  19. Communicating with Professionals

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    Full Text Available ... tips from others who have successfully recovered from heart surgery, including how to maximize your recovery at home. Cardiac Rehab Tools & Resources Cardiac Rehab Referral Card | Spanish Heart Attack Discharge Worksheet | Spanish Fact sheets: What is ...

  20. Communicating with Professionals

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    Full Text Available ... Target Heart Rates 4 Heart Attack Symptoms in Women 5 How to Eat Healthy 6 What are ... site complies with the HONcode standard for trustworthy health information: verify here.

  1. Communicating with Professionals

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    Full Text Available ... Defects Children & Adults About Congenital Heart Defects The Impact of Congenital Heart Defects Understand Your Risk for ... are the Symptoms of High Blood Pressure? 7 Low Blood Pressure - When Blood Pressure Is Too Low ...

  2. Communicating with Professionals

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    Full Text Available ... Taking Control of Your Medicines - Medicine Assistance Programs - Medicine Checklist - ... 3 Target Heart Rates 4 Heart Attack Symptoms in Women 5 How to Eat Healthy 6 What are ...

  3. Communicating with Professionals

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    Full Text Available ... Arrhythmia About Arrhythmia Why Arrhythmia Matters Understand Your Risk for Arrhythmia Symptoms, Diagnosis & Monitoring of Arrhythmia Prevention & ... The Impact of Congenital Heart Defects Understand Your Risk for Congenital Heart Defects Symptoms & Diagnosis of Congenital ...

  4. Communicating with Professionals

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    Full Text Available ... Arrhythmia Matters Understand Your Risk for Arrhythmia Symptoms, Diagnosis & Monitoring of Arrhythmia Prevention & Treatment of Arrhythmia Arrhythmia ... Understand Your Risk for Congenital Heart Defects Symptoms & Diagnosis of Congenital Heart Defects Care & Treatment for Congenital ...

  5. Communicating with Professionals

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    Full Text Available ... and Live Local Info Languages Careers Volunteer Donate Search Heart.org Search Get Your Local Info Find out what is happening at your local American Heart area Search By Zipcode Search by State SELECT YOUR LANGUAGE ...

  6. Heart bypass surgery - discharge

    Science.gov (United States)

    Off-pump coronary artery bypass - discharge; OPCAB - discharge; Beating heart surgery - discharge; Bypass surgery - heart - discharge; CABG - discharge; Coronary artery bypass graft - discharge; Coronary artery ...

  7. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken once ...

  8. Diagnostic accuracy of plasma NT-proBNP levels for excluding cardiac abnormalities in the very elderly

    Directory of Open Access Journals (Sweden)

    Westendorp Rudi GJ

    2010-11-01

    Full Text Available Abstract Background In the elderly the diagnosis of chronic heart failure is often challenging and the availability of echocardiography can be limited. Plasma levels of NT-proBNP are valuable tools to diagnose patients with heart failure. However, the performance of this biomarker to detect cardiac abnormalities in the very elderly remains unclear. The aims of this study were to investigate the relation between NT-proBNP and cardiac abnormalities and to evaluate the use of NT-proBNP to exclude structural and functional cardiac abnormalities in a community-based sample of "well-functioning" nonagenarians. Methods A diagnostic cross-sectional study embedded within the Leiden 85-plus Study in the municipality of Leiden, the Netherlands. Plasma NT-proBNP levels were measured and 2-dimensional echocardiography was performed in a subgroup of 80 well-functioning nonagenarians. Linear regression analysis was used to explore the relation between NT-proBNP and cardiac abnormalities and ROC curve analysis was used to assess the performance of NT-proBNP to exclude cardiac abnormalities. The upper limit of the lowest tertile of NT-proBNP was used as a cut-off value. Results NT-proBNP levels were associated with abnormal left ventricular (LV dimensions, LV systolic and diastolic function, left atrial enlargement and valvular heart disease. LV mass, E/A ratio and degree of aortic regurgitation were identified as independent predictors of NT-proBNP. NT-proBNP levels were higher with greater number of echocardiographic abnormalities (P Conclusions In this convenience sample of well-functioning nonagenarians NT-proBNP was related to a wide variety of functional and structural echocardiographic abnormalities. Moreover, NT-proBNP could be used to exclude echocardiographic abnormalities in well-functioning nonagenarians and might be used to indicate who needs to be referred for further cardiovascular examination.

  9. Physical activity recommendations for patients with electrophysiologic and structural congenital heart disease: a survey of Canadian health care providers.

    Science.gov (United States)

    Roston, Thomas M; De Souza, Astrid M; Sandor, George G S; Sanatani, Shubhayan; Potts, James E

    2013-08-01

    Determining safe levels of physical activity for children and adolescents with electrophysiologic and structural congenital heart disease is a challenging clinical problem. The body of evidence for making these recommendations is limited and likely based on expert opinion, medicolegal concerns, and perceived risks of sudden cardiac death (SCD) with activity. The Bethesda Conference has established consensus guidelines for determining the eligibility of athletes with cardiovascular abnormalities for competitive sports and their disqualification from them. However, literature on guidelines for noncompetitive physical activity is not available. A survey was designed to determine practice patterns for patients with electrophysiologic and structural congenital heart disease. Between July 2011 and December 2011, approximately 350 health care providers working with this group of patients were recruited by email or while attending professional meetings. The survey received 81 responses, primarily from pediatric cardiologists (70 %). The findings indicate that the majority of Canadian cardiac care providers surveyed are only partially implementing current recommendations. Areas of variance included physical activity recommendations for hypertrophic cardiomyopathy, long QT syndrome, catecholaminergic polymorphic ventricular tachycardia, and heart transplantation, among others. The development of comprehensive consensus guidelines for activity recommendations was supported by 96 % of the respondents. The heterogeneity of responses may be attributable to conflicting and poorly evidenced information in the literature, a lack of emphasis on recreational activity, an entrenched tendency toward bed rest in the cardiology community, and a lack of awareness by cardiac care providers regarding the actual risk associated with physical activity in electrophysiologic and structural congenital heart disease. A balanced discussion is required in considering both the significant benefit of

  10. Nitric Oxide Synthases in Heart Failure

    Science.gov (United States)

    Carnicer, Ricardo; Crabtree, Mark J.; Sivakumaran, Vidhya

    2013-01-01

    Abstract Significance: The regulation of myocardial function by constitutive nitric oxide synthases (NOS) is important for the maintenance of myocardial Ca2+ homeostasis, relaxation and distensibility, and protection from arrhythmia and abnormal stress stimuli. However, sustained insults such as diabetes, hypertension, hemodynamic overload, and atrial fibrillation lead to dysfunctional NOS activity with superoxide produced instead of NO and worse pathophysiology. Recent Advances: Major strides in understanding the role of normal and abnormal constitutive NOS in the heart have revealed molecular targets by which NO modulates myocyte function and morphology, the role and nature of post-translational modifications of NOS, and factors controlling nitroso-redox balance. Localized and differential signaling from NOS1 (neuronal) versus NOS3 (endothelial) isoforms are being identified, as are methods to restore NOS function in heart disease. Critical Issues: Abnormal NOS signaling plays a key role in many cardiac disorders, while targeted modulation may potentially reverse this pathogenic source of oxidative stress. Future Directions: Improvements in the clinical translation of potent modulators of NOS function/dysfunction may ultimately provide a powerful new treatment for many hearts diseases that are fueled by nitroso-redox imbalance. Antioxid. Redox Signal. 18, 1078–1099. PMID:22871241

  11. Nutritional Approach of Pediatric Patients Diagnosed with Congenital Heart Disease

    OpenAIRE

    Togănel Rodica

    2013-01-01

    Congenital heart defects are among the most frequent anomalies present at birth, representing a heterogeneous group of malformations, both in terms of pathogenesis and clinical significance of the lesion. Failure to grow is well documented in infants with complex congenital heart defects; the presence of associated chromosomal abnormalities, cyanosis, and cardiac failure adds to the complexity and challenge. Malnutrition etiology can be grouped into the following three categories: inadequate ...

  12. Comprehensive Approach to Heart Failure: an Urgent Need

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2015-11-01

    Full Text Available Heart failure leads to the activation of a neurohormonal response that interacts with the hemodynamic changes, which are joined by functional and structural myocardial abnormalities, that may exist. This paper addresses the role of the renin-angiotensin system in the pathophysiology of heart failure and the use of non-invasive complementary methods that provide additional information necessary for the assessment and comprehensive management of patients, without losing the essential connection between the doctor and the patient.

  13. Determinants of heart rate turbulence in individuals without apparent heart disease and in patients with stable coronary artery disease.

    Science.gov (United States)

    Pinnacchio, Gaetano; Lanza, Gaetano Antonio; Stazi, Alessandra; Careri, Giulia; Coviello, Ilaria; Mollo, Roberto; Crea, Filippo

    2015-12-01

    To assess the characteristics and determinants of heart rate turbulence (HRT) in individuals without any apparent heart disease and in patients with coronary artery disease (CAD). Heart rate turbulence parameters, turbulence onset (TO), and turbulence slope (TS) were calculated on 24 h electrocardiogram recordings in 209 individuals without any heart disease (group 1) and in 157 CAD patients (group 2). In group 1, only age independently predicted abnormal TO (≥0%) [odds ratio (OR), 1.05; PCoronary artery disease group, however, did not predict abnormal HRT parameters in multivariable analyses, both in the whole population and when comparing two subgroups matched for age and gender. Age and (for TS) LVEF, indeed, were the only independent predictors of abnormal HRT. Age is a major HRT determinant both in subjects without any apparent heart disease and in stable CAD patients. Hypertension and LVEF contribute independently to HRT in these two groups, respectively. Coronary artery disease group was not by itself associated with abnormal HRT parameters in multivariable analyses. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  14. Communicating with Professionals

    Medline Plus

    Full Text Available ... Search By Zipcode Search by State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) ... Tools & Resources Heart Attack About Heart Attacks Warning Signs of a Heart Attack Understand Your Risks to ...

  15. [Spectral analysis and LDB based classification of heart sounds with mechanical prosthetic heart valves].

    Science.gov (United States)

    Zhang, Di; Wu, Yuequan; Yao, Jianping; Yang, Song; Du, Minghui

    2011-12-01

    Auscultation, the act of listening for heart sounds to aid in the diagnosis of various heart diseases, is a widely used efficient technique by cardiologists. Since the mechanical prosthetic heart valves are widely used today, it is important to develop a simple and efficient method to detect abnormal mechanical valves. The study on five different mechanical valves showed that only the case of perivalvular leakage could be detected by spectral estimation. Though it is possible to classify different mechanical valves by using time-frequency components of the signal directly, the recognition rate is merely 84%. However, with the improved local discriminant bases (LDB) algorithm to extract features from heart sounds, the recognition rate is 97.3%. Experimental results demonstrated that the improved LDB algorithm could improve classification rate and reduce computational complexity in comparison with original LDB algorithm.

  16. Altered fetal growth, placental abnormalities, and stillbirth.

    Science.gov (United States)

    Bukowski, Radek; Hansen, Nellie I; Pinar, Halit; Willinger, Marian; Reddy, Uma M; Parker, Corette B; Silver, Robert M; Dudley, Donald J; Stoll, Barbara J; Saade, George R; Koch, Matthew A; Hogue, Carol; Varner, Michael W; Conway, Deborah L; Coustan, Donald; Goldenberg, Robert L

    2017-01-01

    Worldwide, stillbirth is one of the leading causes of death. Altered fetal growth and placental abnormalities are the strongest and most prevalent known risk factors for stillbirth. The aim of this study was to identify patterns of association between placental abnormalities, fetal growth, and stillbirth. Population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in 5 geographic areas in the U.S. Fetal growth abnormalities were categorized as small (90th percentile) for gestational age at death (stillbirth) or delivery (live birth) using a published algorithm. Placental examination by perinatal pathologists was performed using a standardized protocol. Data were weighted to account for the sampling design. Among 319 singleton stillbirths and 1119 singleton live births at ≥24 weeks at death or delivery respectively, 25 placental findings were investigated. Fifteen findings were significantly associated with stillbirth. Ten of the 15 were also associated with fetal growth abnormalities (single umbilical artery; velamentous insertion; terminal villous immaturity; retroplacental hematoma; parenchymal infarction; intraparenchymal thrombus; avascular villi; placental edema; placental weight; ratio birth weight/placental weight) while 5 of the 15 associated with stillbirth were not associated with fetal growth abnormalities (acute chorioamnionitis of placental membranes; acute chorioamionitis of chorionic plate; chorionic plate vascular degenerative changes; perivillous, intervillous fibrin, fibrinoid deposition; fetal vascular thrombi in the chorionic plate). Five patterns were observed: placental findings associated with (1) stillbirth but not fetal growth abnormalities; (2) fetal growth abnormalities in stillbirths only; (3) fetal growth abnormalities in live births only; (4) fetal growth abnormalities in stillbirths and live births in a similar manner; (5) a different pattern of fetal growth abnormalities in

  17. Altered fetal growth, placental abnormalities, and stillbirth.

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    Full Text Available Worldwide, stillbirth is one of the leading causes of death. Altered fetal growth and placental abnormalities are the strongest and most prevalent known risk factors for stillbirth. The aim of this study was to identify patterns of association between placental abnormalities, fetal growth, and stillbirth.Population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in 5 geographic areas in the U.S. Fetal growth abnormalities were categorized as small (90th percentile for gestational age at death (stillbirth or delivery (live birth using a published algorithm. Placental examination by perinatal pathologists was performed using a standardized protocol. Data were weighted to account for the sampling design. Among 319 singleton stillbirths and 1119 singleton live births at ≥24 weeks at death or delivery respectively, 25 placental findings were investigated. Fifteen findings were significantly associated with stillbirth. Ten of the 15 were also associated with fetal growth abnormalities (single umbilical artery; velamentous insertion; terminal villous immaturity; retroplacental hematoma; parenchymal infarction; intraparenchymal thrombus; avascular villi; placental edema; placental weight; ratio birth weight/placental weight while 5 of the 15 associated with stillbirth were not associated with fetal growth abnormalities (acute chorioamnionitis of placental membranes; acute chorioamionitis of chorionic plate; chorionic plate vascular degenerative changes; perivillous, intervillous fibrin, fibrinoid deposition; fetal vascular thrombi in the chorionic plate. Five patterns were observed: placental findings associated with (1 stillbirth but not fetal growth abnormalities; (2 fetal growth abnormalities in stillbirths only; (3 fetal growth abnormalities in live births only; (4 fetal growth abnormalities in stillbirths and live births in a similar manner; (5 a different pattern of fetal growth

  18. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. Copyright © 2011 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  19. Impact of Heart Transplantation on the Functional Status of US Children With End-Stage Heart Failure.

    Science.gov (United States)

    Peng, David M; Zhang, Yulin; Rosenthal, David N; Palmon, Michal; Chen, Sharon; Kaufman, Beth D; Maeda, Katsuhide; Hollander, Seth A; McDonald, Nancy; Smoot, Leslie B; Bernstein, Daniel; Almond, Christopher S

    2017-03-07

    There are limited data describing the functional status (FS) of children after heart transplant (HT). We sought to describe the FS of children surviving at least 1 year after HT, to evaluate the impact of HT on FS, and to identify factors associated with abnormal FS post-HT. Organ Procurement and Transplantation Network data were used to identify all US children Heart Association, Inc.

  20. Symptoms associated with an abnormal echocardiogram in elderly primary care hypertension patients

    DEFF Research Database (Denmark)

    Ringoir, L.; Widdershoven, J. W.; Pedersen, S. S.

    2014-01-01

    Background The prevalence and diagnostic value of heart failure symptoms in elderly primary care patients with hypertension is unknown. Aim To assess the prevalence, sensitivity, specificity, positive and negative predictive value of symptoms in association with an abnormal echocardiogram. Design...... and setting Cross-sectional screening study in five general practices in the south-east of the Netherlands. Method Between June 2010 and January 2013, 591 primary care hypertension patients aged between 60 and 85 years were included, without known heart failure and not treated by a cardiologist. All patients...

  1. Towards professionalism in agricultural extension: The professional ...

    African Journals Online (AJOL)

    Towards professionalism in agricultural extension: The professional registration of Extensionists in South Africa – A dream or a reality? The role of the South African Society of Extensionists in South Africa – A dream or a reality? The role of the South African Society of Agricultural Extension (SASAE)

  2. Professional development of distance education professionals ...

    African Journals Online (AJOL)

    Erna Kinsey

    Professional development of distance education professionals (DEPs) at TSA: a profile of functions. J.F. van Koller. Institute for Staff Development, Technikon SA, Private Bag X6, Florida, 1710 South Africa jvcoller@tsa.ac.za. This article deals with the development of a profile of the functions and required competencies of ...

  3. Teacher Professionalism: Analysis of Professionalism Phases

    Science.gov (United States)

    Wardoyo, Cipto; Herdiani, Aulia; Sulikah

    2017-01-01

    Teacher professionalism has become a distinctive concern in educational discussions. Based on Teacher and Lecturer Act No.14 2005 carried out by Indonesian Government, teacher professionalism, considered as an assessment aspect of teacher quality, could be drawn by four competences, pedagogical competence, personal, competence, social competence,…

  4. Transforming Professional Development to Professional Learning

    Science.gov (United States)

    Stewart, Chelsea

    2014-01-01

    This article reviews teacher professional development norms as they are shifting toward collaborative practice. It is posed that passive and individual practices are inadequate to prepare teachers to integrate the academic skills that learners need for both workforce and college readiness. Promising practices in professional development are…

  5. Professional Development Plus: Rethinking Professional Learning

    Science.gov (United States)

    Hudak, Michele

    2013-01-01

    The purpose of professional development is to enhance educator practices so that students may achieve at high levels. Too often, professional development tends to be too broad, general, or unrelated to problems of practice that teachers face in their own classrooms. This action research project builds upon the scholarly research that recognizes…

  6. Prevalence of biochemical and immunological abnormalities in ...

    African Journals Online (AJOL)

    Tile prevalence of biochemical and immunological abnormalities was studied in a group of 256 patients with rheumatoid arthritis (104 coloureds, 100 whites and 52 blacks). The most common biochemical abnormalities detected were a reduction in the serum creatinine value (43,4%), raised globulins (39,7%), raised serum ...

  7. The prevalence of electroencephalographic abnormalities and ...

    African Journals Online (AJOL)

    Adele

    2004-05-20

    May 20, 2004 ... premorbid organic insult. Both would likely have increased the probability of an abnormal EEG. The high prevalence of abnormal EEGs, particularly of EEGs supporting a diagnosis of epilepsy may reflect a high prevalence in the study popula- tion, but more likely reflects the careful selection of patients.

  8. Relationship among sera lipoprotein abnormalities in healthy ...

    African Journals Online (AJOL)

    As the prevalence of lipoprotein abnormalities in adolescents is increasing dramatically, the identification of relevant risk factors is a major public health challenge. The aim of this study was to investigate whether a family history of diabetes could be a risk factor for lipid abnormalities in healthy individuals. This study is a ...

  9. Sex chromosomes and sex chromosome abnormalities.

    Science.gov (United States)

    Li, Xu

    2011-12-01

    This article focuses on constitutional sex chromosome abnormalities detected by conventional cytogenetics and fluorescence in situ hybridization. The author discusses the two general classifications of abnormalities: numerical and structural. Also included are descriptions of unique aspects of X and Y chromosomes, technological advances in detection, and future perspectives.

  10. [CHROMOSOMAL ABNORMALITIES IN PATIENTS WITH INFERTILITY].

    Science.gov (United States)

    Pylyp, L Y; Spinenko, L O; Verhoglyad, N V; Kashevarova, O O; Zukin, V D

    2015-01-01

    To assess the frequency and structure of chromosomal abnormalities in patients with infertility, a retrospective analysis of cytogenetic studies of 3414 patients (1741 females and 1673 males), referred to the Clinic of reproductive medicine "Nadiya" from 2007 to 2012, was performed. Chromosomal abnormalities were detected in 2.37% patients: 2.79% in males and 1.95% in females. Balanced structural chromosomal abnormalities prevailed over numerical abnormalities and corresponded to 80.2% of all chromosomal abnormalities detected in the studied group. Sex chromosome abnormalities made up 23.5% of chromosomal pathology (19/81) and included gonosomal aneuploidies in 84% of cases (16/19) and structural abnormalities of chromosome Y in 16% of cases (3/19). The low level sex chromosome mosaicism was detected with the frequency of 0.55%. Our results highlight the importance of cytogenetic studies in patients seeking infertility treatment by assisted reproductive technologies, since an abnormal finding not only provide a firm diagnosis to couples with infertility, but also influences significantly the approach to infertility treatment in such patients.

  11. Multiparametric tissue abnormality characterization using manifold regularization

    Science.gov (United States)

    Batmanghelich, Kayhan; Wu, Xiaoying; Zacharaki, Evangelia; Markowitz, Clyde E.; Davatzikos, Christos; Verma, Ragini

    2008-03-01

    Tissue abnormality characterization is a generalized segmentation problem which aims at determining a continuous score that can be assigned to the tissue which characterizes the extent of tissue deterioration, with completely healthy tissue being one end of the spectrum and fully abnormal tissue such as lesions, being on the other end. Our method is based on the assumptions that there is some tissue that is neither fully healthy or nor completely abnormal but lies in between the two in terms of abnormality; and that the voxel-wise score of tissue abnormality lies on a spatially and temporally smooth manifold of abnormality. Unlike in a pure classification problem which associates an independent label with each voxel without considering correlation with neighbors, or an absolute clustering problem which does not consider a priori knowledge of tissue type, we assume that diseased and healthy tissue lie on a manifold that encompasses the healthy tissue and diseased tissue, stretching from one to the other. We propose a semi-supervised method for determining such as abnormality manifold, using multi-parametric features incorporated into a support vector machine framework in combination with manifold regularization. We apply the framework towards the characterization of tissue abnormality to brains of multiple sclerosis patients.

  12. Effects of theophylline administration and intracranial abnormalities ...

    African Journals Online (AJOL)

    Objective: To determine effects of theophylline therapy for recurrent apnoea of prematurity and abnormal early (within the first 24 hours) cranial ultrasound abnormalities on protective neck turning response in preterm infants. Design: A cross sectional descriptive study. Setting: The Neonatal Unit of Hammersmith Hospital, ...

  13. Relationship among sera lipoprotein abnormalities in healthy ...

    African Journals Online (AJOL)

    Jane

    2011-08-29

    Aug 29, 2011 ... As the prevalence of lipoprotein abnormalities in adolescents is increasing dramatically, the identification of relevant ... investigate whether a family history of diabetes could be a risk factor for lipid abnormalities in healthy individuals. This study is a ..... thickness in children with type 1 diabetes. Diabetes, 51: ...

  14. Common echocardiographic abnormalities in Nigerians of different ...

    African Journals Online (AJOL)

    2012-09-17

    Sep 17, 2012 ... Degenerative valvular diseases, left ventricular diastolic dysfunction, and atrial septal defects were the commonest abnormalities in the elderly, middle-aged population and children, respectively. Key words: Different age groups, echocardiographic abnormalities, Nigerians. Date of Acceptance: 17-Sep- ...

  15. First Trimester Ultrasound Screening for Congenital Abnormalities ...

    African Journals Online (AJOL)

    approach used, especially with the introduction of first trimester ultrasound as a reliable screening method. Objective: To give a comprehensive review of the basis for first trimester ultrasound screening for congenital abnormalities, it's utilization in the prenatal screening for chromosomal, structural and genetic abnormalities ...

  16. Abnormal fat distribution in PMM2-CDG

    NARCIS (Netherlands)

    Wolthuis, D.F.; Asbeck, E.V. van; Kozicz, T.L.; Morava, E.

    2013-01-01

    We hypothesize that abnormal fat distribution, a common feature of PMM2-CDG, is associated with abnormal perinatal hormone regulation. We assessed 32 cases with PMM2-CDG, for the comorbidity of hypoglycemia/hyperinsulinism and fat pads. Ninety percent of patients with hypoketotic hypoglycemia and/or

  17. Valvular Abnormalities Detected by Echocardiography in 5-Year Survivors of Childhood Cancer: A Long-Term Follow-Up Study

    Energy Technology Data Exchange (ETDEWEB)

    Pal, Helena J. van der, E-mail: h.j.vanderpal@amc.uva.nl [Department of Medical Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Dijk, Irma W. van [Department of Radiation Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Geskus, Ronald B. [Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Kok, Wouter E. [Department of Cardiology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Koolen, Marianne; Sieswerda, Elske [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Oldenburger, Foppe; Koning, Caro C. [Department of Radiation Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Leeuwen, Flora E. van [Department of Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Caron, Huib N.; Kremer, Leontien C.; Dalen, Elvira C. van [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands)

    2015-01-01

    Purpose: To determine the prevalence of valvular abnormalities after radiation therapy involving the heart region and/or treatment with anthracyclines and to identify associated risk factors in a large cohort of 5-year childhood cancer survivors (CCS). Methods and Materials: The study cohort consisted of all 626 eligible 5-year CCS diagnosed with childhood cancer in the Emma Children's Hospital/Academic Medical Center between 1966 and 1996 and treated with radiation therapy involving the heart region and/or anthracyclines. We determined the presence of valvular abnormalities according to echocardiograms. Physical radiation dose was converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Using multivariable logistic regression analyses, we examined the associations between cancer treatment and valvular abnormalities. Results: We identified 225 mainly mild echocardiographic valvular abnormalities in 169 of 545 CCS (31%) with a cardiac assessment (median follow-up time, 14.9 years [range, 5.1-36.8 years]; median attained age 22.0 years [range, 7.0-49.7 years]). Twenty-four CCS (4.4%) had 31 moderate or higher-graded abnormalities. Most common abnormalities were tricuspid valve disorders (n=119; 21.8%) and mitral valve disorders (n=73; 13.4%). The risk of valvular abnormalities was associated with increasing radiation dose (using EQD{sub 2}) involving the heart region (odds ratio 1.33 per 10 Gy) and the presence of congenital heart disease (odds ratio 3.43). We found no statistically significant evidence that anthracyclines increase the risk. Conclusions: Almost one-third of CCS treated with potentially cardiotoxic therapy had 1 or more asymptomatic, mostly mild valvular abnormalities after a median follow-up of nearly 15 years. The most important risk factors are higher EQD{sub 2} to the heart region and congenital heart disease. Studies with longer follow-up are necessary to investigate the clinical course of asymptomatic valvular abnormalities

  18. Heart bypass surgery - minimally invasive

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass surgery - minimally invasive - discharge Heart disease - risk factors Heart pacemaker - discharge ...

  19. How Is Heart Failure Treated?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  20. How Is Heart Failure Diagnosed?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  1. How Is Heart Disease Diagnosed?

    Science.gov (United States)

    ... Back To Health Topics / Heart Disease in Women Heart Disease in Women Leer en español How Does Heart ... about coronary MVD and broken heart syndrome. Coronary Heart Disease CHD is a disease in which plaque (plak) ...

  2. Cyanotic Congenital Heart Defects – literature review

    Directory of Open Access Journals (Sweden)

    Vlad Drăgoi

    2017-11-01

    Full Text Available Congenital heart defects are one of the most interesting and important chapters regarding abnormal fetal growth pathology. The objective of this article is to present a literature review for the main cyanotic congenital heart defects. The ones presented in the article are: tetralogy of Fallot, transposition of the great vessels, double outlet right ventricle, truncus arteriosus, total anomalous pulmonary venous circulation and additional information regarding very rare malformations such as pentalogy of Cantrell and Uhl anomaly. An early and precise identification of congenital heart defects is an important step in an accurate follow-up of a potential problematic pregnancy. Knowing the sonographic aspect, associated pathology and the current available treatment procedures are vital for the fetal outcome and for the physician to adapt the right management in every situation that might appear during the pregnancy and in the neonatal period.

  3. American Heart Association

    Science.gov (United States)

    ... Giving for Heart.org Media for Heart.org American Heart Association Check out Scientific Sessions news — translated for you. ... with the Woman of Distinction Award at the American Heart Association's top science gathering. Nearly half of U.S. adults ...

  4. Advanced Heart Failure

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:May 9,2017 When heart failure (HF) ... Making This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  5. Congenital Heart Defects

    Science.gov (United States)

    ... of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the ... and heart transplants. The treatment depends on the type of the defect, how ... and general health. NIH: National Heart, Lung, and Blood Institute

  6. What Is Heart Surgery?

    Science.gov (United States)

    ... heart surgery that is becoming more common is robotic-assisted surgery. For this surgery, a surgeon uses a computer ... surgeon always is in total control of the robotic arms; they don't move on their own. Who Needs Heart Surgery? Heart surgery is used to treat many heart ...

  7. Chest wall abnormalities and their clinical significance in childhood.

    Science.gov (United States)

    Koumbourlis, Anastassios C

    2014-09-01

    The thorax consists of the rib cage and the respiratory muscles. It houses and protects the various intrathoracic organs such as the lungs, heart, vessels, esophagus, nerves etc. It also serves as the so-called "respiratory pump" that generates the movement of air into the lungs while it prevents their total collapse during exhalation. In order to be performed these functions depend on the structural and functional integrity of the rib cage and of the respiratory muscles. Any condition (congenital or acquired) that may affect either one of these components is going to have serious implications on the function of the other. Furthermore, when these abnormalities occur early in life, they may affect the growth of the lungs themselves. The following article reviews the physiology of the respiratory pump, provides a comprehensive list of conditions that affect the thorax and describes their effect(s) on lung growth and function. Copyright © 2014. Published by Elsevier Ltd.

  8. Chromosomal abnormalities in patients with sperm disorders

    Directory of Open Access Journals (Sweden)

    L. Y. Pylyp

    2013-02-01

    Full Text Available Chromosomal abnormalities are among the most common genetic causes of spermatogenic disruptions. Carriers of chromosomal abnormalities are at increased risk of infertility, miscarriage or birth of a child with unbalanced karyotype due to the production of unbalanced gametes. The natural selection against chromosomally abnormal sperm usually prevents fertilization with sperm barring in cases of serious chromosomal abnormalities. However, assisted reproductive technologies in general and intracytoplasmic sperm injection in particular, enable the transmission of chromosomal abnormalities to the progeny. Therefore, cytogenetic studies are important in patients with male factor infertility before assisted reproduction treatment. The purpose of the current study was to investigate the types and frequencies of chromosomal abnormalities in 724 patients with infertility and to estimate the risk of chromosomal abnormalities detection in subgroups of patients depending on the severity of spermatogenic disruption, aiming at identifying groups of patients in need of cytogenetic studies. Karyotype analysis was performed in 724 blood samples of men attending infertility clinic. Chromosomal preparation was performed by standard techniques. At least 20 GTG-banded metaphase plates with the resolution from 450 to 750 bands per haploid set were analysed in each case. When chromosomal mosaicism was suspected, this number was increased to 50. Abnormal karyotypes were observed in 48 (6.6% patients, including 67% of autosomal abnormalities and 33% of gonosomal abnormalities. Autosomal abnormalities were represented by structural rearrangements. Reciprocal translocations were the most common type of structural chromosomal abnormalities in the studied group, detected with the frequency of 2.6% (n = 19, followed by Robertsonian translocation, observed with the frequency of 1.2% (n = 9. The frequency of inversions was 0.6% (n = 4. Gonosomal abnormalities included 14 cases

  9. Communicating with Professionals

    Medline Plus

    Full Text Available ... with your healthcare team about your concerns, asking questions and getting the facts. Usually, office visits and ... or other healthcare professionals. Find a list of questions to ask at your next appointment . Healthcare professionals ...

  10. Professionalism in anesthesia.

    Science.gov (United States)

    Yang, Homer

    2017-02-01

    Is professionalism in medicine just another bureaucratic imposition on our practice or a fundamental concept for physicians at all stages in their career? In this review, the historical perspectives of professionalism are explored as well as the what, why, and how questions concerning this topic. The key words "professionalism" and "anesthesia" were used to conduct a search of the PubMed database, the policies and publications of relevant Canadian and international physician regulatory bodies and organizations, historical documents, and other internet publications. Professionalism in anesthesia has a long history. While there are many definitions for professionalism, some very dated, all are based on virtues, behaviour, or professional identity. Professionalism plays a central role in the balance between physician autonomy and social contract, and it has a significant impact on patient safety and medicolegal litigation. Considerable evidence exists to suggest that professionalism must be treated seriously, particularly in these times of social accountability and budgetary pressures.

  11. Communicating with Professionals

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Communicating with Professionals Updated:Oct 3,2016 After a cardiac event ... Medicines - Medicine Assistance Programs - Medicine Checklist - Medication Tracker ... with Professionals - Introduction - Preparing for Medical Visits - Questions To Ask ...

  12. Communicating with Healthcare Professionals

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Communicating with Professionals Updated:Oct 3,2016 After a cardiac event ... Medicines - Medicine Assistance Programs - Medicine Checklist - Medication Tracker ... with Professionals - Introduction - Preparing for Medical Visits - Questions To Ask ...

  13. Development of heart failure is independent of K+ channel-interacting protein 2 expression

    DEFF Research Database (Denmark)

    Speerschneider, Tobias; Grubb, Søren; Metoska, Artina

    2013-01-01

    Abstract  Abnormal ventricular repolarization in ion channelopathies and heart disease is a major cause of ventricular arrhythmias and sudden cardiac death. K(+) channel-interacting protein 2 (KChIP2) expression is significantly reduced in human heart failure (HF), contributing to a loss of the t...

  14. Forkhead box transcription factors in embryonic heart development and congenital heart disease.

    Science.gov (United States)

    Zhu, Hong

    2016-01-01

    Embryonic heart development is a very complicated process regulated precisely by a network composed of many genes and signaling pathways in time and space. Forkhead box (Fox, FOX) proteins are a family of transcription factors characterized by the presence of an evolutionary conserved "forkhead"or "winged-helix" DNA-binding domain and able to organize temporal and spatial gene expression during development. They are involved in a wide variety of cellular processes, such as cell cycle progression, proliferation, differentiation, migration, metabolism and DNA damage response. An abundance of studies in model organisms and systems has established that Foxa2, Foxc1/c2, Foxh1 and Foxm1, Foxos and Foxps are important components of the signaling pathways that instruct cardiogenesis and embryonic heart development, playing paramount roles in heart development. The previous studies also have demonstrated that mutations in some of the forkhead box genes and the aberrant expression of forkhead box gene are heavily implicated in the congenital heart disease (CHD) of humans. This review primarily focuses on the current understanding of heart development regulated by forkhead box transcription factors and molecular genetic mechanisms by which forkhead box factors modulate heart development during embryogenesis and organogenesis. This review also summarizes human CHD related mutations in forkhead box genes as well as the abnormal expression of forkhead box gene, and discusses additional possible regulatory mechanisms of the forkhead box genes during embryonic heart development that warrant further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Rare cytogenetic abnormalities in myelodysplastic syndromes.

    Science.gov (United States)

    Bacher, Ulrike; Schanz, Julie; Braulke, Friederike; Haase, Detlef

    2015-01-01

    The karyotype represents one of the main cornerstones for the International Prognostic Scoring System (IPSS) and the revised IPSS-R (IPSS-R) that are most widely used for prognostication in patients with myelodysplastic syndromes (MDS). The most frequent cytogenetic abnormalities in MDS, i.e. del(5q), -7/del(7q), +8, complex karyotypes, or -Y have been extensively explored for their prognostic impact. The IPSS-R also considers some less frequent abnormalities such as del(11q), isochromosome 17, +19, or 3q abnormalities. However, more than 600 different cytogenetic categories had been identified in a previous MDS study. This review aims to focus interest on selected rare cytogenetic abnormalities in patients with MDS. Examples are numerical gains of the chromosomes 11 (indicating rapid progression), of chromosome 14 or 14q (prognostically intermediate to favorable), -X (in females, with an intermediate prognosis), or numerical abnormalities of chromosome 21. Structural abnormalities are also considered, e.g. del(13q) that is associated with bone marrow failure syndromes and favorable response to immunosuppressive therapy. These and other rare cytogenetic abnormalities should be integrated into existing prognostication systems such as the IPSS-R. However, due to the very low number of cases, this is clearly dependent on international collaboration. Hopefully, this article will help to inaugurate this process.

  16. RARE CYTOGENETIC ABNORMALITIES IN MYELODYSPLASTIC SYNDROMES

    Directory of Open Access Journals (Sweden)

    Julie Schanz

    2015-04-01

    Full Text Available The karyotype represents one of the main cornerstones for the International Prognostic Scoring System (IPSS and the revised IPSS-R (IPSS-R that are most widely used for prognostication in patients with myelodysplastic syndromes (MDS. The most frequent cytogenetic abnormalities in MDS, i.e. del(5q, -7/del(7q, +8, complex karyotypes, or –Y have been extensively explored for their prognostic impact. The IPSS-R considers also some less frequent abnormalities such as del(11q, isochromosome 17, +19, or 3q abnormalities. However, more than 600 different cytogenetic categories had been identified in a previous MDS study. This review aims to focus interest on selected rare cytogenetic abnormalities in patients with MDS. Examples are numerical gains of the chromosomes 11 (indicating rapid progression, of chromosome 14 or 14q (prognostically intermediate to favorable, -X (in females, with an intermediate prognosis, or numerical abnormalities of chromosome 21. Structural abnormalities are also considered, e.g. del(13q that is associated with bone marrow failure syndromes and favorable response to immunosuppressive therapy. These and other rare cytogenetic abnormalities should be integrated into existing prognostication systems such as the IPSS-R. However, due to the very low number of cases, this is clearly dependent on international collaboration. Hopefully, this article will help to inaugurate this process.

  17. Nail abnormalities in patients with vitiligo.

    Science.gov (United States)

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (pvitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study.

  18. Oxidative and inflammatory signals in obesity-associated vascular abnormalities.

    Science.gov (United States)

    Reho, John J; Rahmouni, Kamal

    2017-07-15

    Obesity is associated with increased cardiovascular morbidity and mortality in part due to vascular abnormalities such as endothelial dysfunction and arterial stiffening. The hypertension and other health complications that arise from these vascular defects increase the risk of heart diseases and stroke. Prooxidant and proinflammatory signaling pathways as well as adipocyte-derived factors have emerged as critical mediators of obesity-associated vascular abnormalities. Designing treatments aimed specifically at improving the vascular dysfunction caused by obesity may provide an effective therapeutic approach to prevent the cardiovascular sequelae associated with excessive adiposity. In this review, we discuss the recent evidence supporting the role of oxidative stress and cytokines and inflammatory signals within the vasculature as well as the impact of the surrounding perivascular adipose tissue (PVAT) on the regulation of vascular function and arterial stiffening in obesity. In particular, we focus on the highly plastic nature of the vasculature in response to altered oxidant and inflammatory signaling and highlight how weight management can be an effective therapeutic approach to reduce the oxidative stress and inflammatory signaling and improve vascular function. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  19. Thoracic shock wave injury causes behavioral abnormalities in mice.

    Science.gov (United States)

    Miyazaki, Hiromi; Miyawaki, Hiroki; Satoh, Yasushi; Saiki, Takami; Kawauchi, Satoko; Sato, Shunichi; Saitoh, Daizoh

    2015-12-01

    Mild traumatic brain injury (mTBI) is caused by complex mechanisms of systemic, local and cerebral responses to blast exposure. However, the molecular mechanisms of cognitive impairment after exposure to blast waves are not clearly known. We tested the hypothesis that thoracic injury induced functional and morphological impairment in the brain, leading to behavioral abnormalities. Mice were exposed to laser-induced shock waves (LISWs) impacting the thorax and assessed for behavioral outcome at 7 and 28 days post injury. Hippocampus and lung were collected for histopathological analysis and gene expression profiling after injury. Thoracic injury transiently decreased the heart rate, blood pressure, peripheral oxyhemoglobin saturation and cerebral blood flow immediately after LISW exposure. Although LISWs exposure caused pulmonary contusions, hemorrhage was not apparent in the brain. At 7 and 28 days after, the injured mice exhibited impaired short-term memory and depression-like behavior compared with controls. Histological assessments showed an increase in neuronal cell death after shock wave exposure, especially in the CA3 region of the hippocampus. Moreover, shock wave exposure altered the expression of functionally relevant genes in the hippocampus at 1 h and 1 day post injury. Our findings indicate that the LISW-induced thoracic injury with no direct impact on the brain affected the hippocampal gene expression and led to morphological alterations, resulting in behavioral abnormalities. Therefore, body protection may be extremely important in the effective prevention against blast-induced alterations in brain function.

  20. [Cardiovascular disease and professional activities].

    Science.gov (United States)

    Gamberale, D; Pecora, A; Ardù, M

    2010-01-01

    Cardiovascular diseases occurrence in the industrial countries is very high and represents one of the major cause of invalidity and mortality. Studies show the close connection between cardiovascular diseases and other risk factors. In Italy heart diseases prevention is one of the main goals of the National Centre for Disease Prevention and Control. Coronary disease increased by 40% among shift-workers and those workers exposed to vibrations and microclimate; extra-auditory effects of noise have also proved to be relevant. Reintegration into labour market and work eligibility certificate can be a problem for patients with coronary diseases, after pathological events. A record of the cardiovascular system could be useful for a readmission to work, in particular after acute episodes. The PreSAL service on the basis of the 2009 data provided by qualified doctors did not show professional diseases but the undervalue may be due to the limited use of specific complementary tests.

  1. Professionalism in Dance Education

    Science.gov (United States)

    Koff, Susan R.; Mistry, Gianna Limone

    2012-01-01

    Professionalism in Dance Education is a complex construction. It can be imposed from the outside (degree completed, job status, salary) or can be identified from the professional herself. Seven graduate dance education students were interviewed with specific focus on the transition from student to professional and the feelings surrounding this…

  2. Professional Development. Issue Brief

    Science.gov (United States)

    Keleher, Julia

    2017-01-01

    In this professional development research brief, the author sets forth the overarching considerations that should be kept in mind when conceptualizing professional development for educators working with neglected or delinquent youth (N or D). The brief begins by defining professional development and demonstrating why it is a critical support for…

  3. Role of Multi-slice and Three-dimensional Computed Tomography in Delineating Extracardiac Vascular Abnormalities in Neonates

    Directory of Open Access Journals (Sweden)

    Yew Giin Long

    2010-08-01

    Conclusion: Based on clinical and surgical confirmation of the MSCT scan results from a multidisciplinary congenital heart disease specialist team, we concluded that adequate information on CHD, specifically that regarding extracardiac abnormalities of the anatomy, can be obtained and MSCT can be used to replace cardiac catheterization.

  4. [Fetal abnormalities and prognosis associated with increased nuchal translucency and abnormal karyotype].

    Science.gov (United States)

    Saldanha, Fátima Aparecida Targino; Brizot, Maria de Lourdes; Lopes, Lilian M; Liao, Adolfo Wenjaw; Zugaib, Marcelo

    2009-01-01

    This study aimed to evaluate the incidence of chromosomal abnormalities in fetuses with increased nuchal translucency (NT) measurement. Incidence of structural abnormalities and pregnancy outcome was also described in fetuses with increased NT and abnormal karyotype. This was a retrospective study involving 246 fetuses with increased NT and known karyotype followed at the Fetal Medicine Unit, Hospital das Clínicas, São Paulo University Medical School. Fetal karyotype was abnormal in 14.2% of the cases. Ultrasound anomaly scan and specialized echocardiographic studies in these cases showed fetal structural abnormalities in 80.8% and cardiac defects were found in 61.5% of the fetuses. Pregnancy outcome was abnormal in 76.5% of these women. Increased NT measurement at 11 to 13 weeks and 6 days is an important marker for fetal chromosomal and structural abnormalities, mainly fetal cardiac defects. This finding also indicates increased risk of spontaneous fetal and neonatal death.

  5. Numerically abnormal chromosome constitutions in humans

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 24, discusses numerically abnormal chromosome constitutions in humans. This involves abnormalities of human chromosome number, including polyploidy (when the number of sets of chromosomes increases) and aneuploidy (when the number of individual normal chromosomes changes). Chapter sections discuss the following chromosomal abnormalities: human triploids, imprinting and uniparental disomy, human tetraploids, hydatidiform moles, anomalies caused by chromosomal imbalance, 13 trisomy (D{sub 1} trisomy, Patau syndrome), 21 trisomy (Down syndrome), 18 trisomy syndrome (Edwards syndrome), other autosomal aneuploidy syndromes, and spontaneous abortions. The chapter concludes with remarks on the nonrandom participation of chromosomes in trisomy. 69 refs., 3 figs., 4 tabs.

  6. Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis

    DEFF Research Database (Denmark)

    Høfsten, Dan E; Løgstrup, Brian B; Møller, Jacob E

    2009-01-01

    to be particularly attributable to an increased incidence of post-infarction congestive heart failure. A relationship between glucose metabolism and LV function could potentially explain this excess mortality. METHODS: In patients without known diabetes, glucose metabolism was determined using an oral glucose......OBJECTIVES: We studied the influence of abnormal glucose metabolism on left ventricular (LV) function and prognosis in 203 patients with acute myocardial infarction. BACKGROUND: Abnormal glucose metabolism is associated with increased mortality after acute myocardial infarction. This appears...... atrial volume index) and by measuring plasma N-terminal pro-B-type natriuretic peptide levels. RESULTS: After adjustment for age and gender, a linear relationship between the degree of abnormal glucose metabolism was observed for each marker of LV dysfunction (p(trend)

  7. Congenital Heart Diseases in Adults: A Review of Echocardiogram ...

    African Journals Online (AJOL)

    Background: Congenital abnormalities of the heart and cardiovascular system are reported in almost 1% of live births, and about half of these children need medical or surgical help in infancy. In the first decade, a further 25% require surgery to maintain or improve their life. Only 10% survive to adolescence without treatment ...

  8. Electrophysiological Remodeling in Heart Failure Dyssynchrony vs. Resynchronization

    Directory of Open Access Journals (Sweden)

    Takeshi Aiba, MD PhD

    2010-01-01

    In conclusion, CRT partially restores DHF-induced ion channel remodeling, abnormal Ca homeostasis, blunted β-adrenergic response and regional heterogeneity of APD, thus may suppress ventricular arrhythmias and contribute to the mortality benefit of CRT as well as improve mechanical performance of the heart.

  9. [Heart arrest].

    Science.gov (United States)

    Chiarella, F; Giovannini, E; Bozzano, A; Caristo, G; Delise, P; Fedele, F; Fera, M S; Lavalle, C; Roghi, A; Valagussa, F

    2001-03-01

    Cardiac arrest is one of the leading causes of mortality in industrialized countries and is mainly due to ischemic heart disease. According to ISTAT estimates, approximately 45,000 sudden deaths occur annually in Italy whereas according to the World Health Organization, its incidence is 1 per 1000 persons. The most common cause of cardiac arrest is ventricular fibrillation due to an acute ischemic episode. During acute ischemia the onset of a ventricular tachyarrhythmia is sudden, unpredictable and often irreversible and lethal. Each minute that passes, the probability that the patient survives decreases by 10%. For this reason, the first 10 min are considered to be priceless for an efficacious first aid. The possibility of survival depends on the presence of witnesses, on the heart rhythm and on the resolution of the arrhythmia. In the majority of cases, the latter is possible by means of electrical defibrillation followed by the reestablishment of systolic function. An increase in equipment alone does not suffice for efficacious handling of cardiac arrest occurring outside the hospital premises. Above all, an adequate intervention strategy is required. Ambulance personnel must be well trained and capable of intervening rapidly, possibly within the first 5 min. The key to success lies in the diffusion and proper use of defibrillators. The availability of new generation instruments, the external automatic defibrillators, encourages their widespread use. On the territory, these emergencies are the responsibility of the 118 organization based, according to the characteristics specific to each country, on the regulated coordination between the operative command, the crews and the first-aid means. Strategies for the handling of these emergencies within hospitals have been proposed by the Conference of Bethesda and tend to guarantee an efficacious resuscitation with a maximum latency of 2 min between cardiac arrest and the first electric shock. The diffusion of external

  10. Single nucleotide polymorphisms associated with abnormal coronary microvascular function.

    Science.gov (United States)

    Yoshino, Satoshi; Cilluffo, Rebecca; Best, Patricia J M; Atkinson, Elizabeth J; Aoki, Tatsuo; Cunningham, Julie M; de Andrade, Mariza; Choi, Byoung-Joo; Lerman, Lilach O; Lerman, Amir

    2014-06-01

    Single nucleotide polymorphisms (SNPs) are the most common source of genetic variation. Although microvascular pathology is associated with cardiovascular events, genetic phenotypes causing microvascular disease remain largely unknown. This study identifies sex-specific SNPs associated with coronary microvascular dysfunction. Six hundred and forty-three patients without significant obstructive coronary heart disease were enrolled, referred for cardiac catheterization, and underwent invasive coronary microcirculatory assessment. Patient data were collected from 1529 autosomal SNPs and seven X chromosome SNPs, which were selected to represent the variability from 76 candidate genes with published associations with coronary vasoreactivity, angiogenesis, inflammation, vascular calcification, atherosclerosis risk factors, female hormones, blood coagulation, or coronary heart disease. Coronary flow reserve (CFR) was assessed by an intracoronary injection of adenosine. Patients were categorized according to a CFR above or below 2.5 and were stratified by sex.After adjusting for age, sex, and BMI, this study shows that SNPs within VEGFA and CDKN2B-AS1 are associated with abnormal CFR (Pcoronary microvascular dysfunction. Furthermore, sex-specific allelic variants within MYH15, VEGFA, and NT5E are associated with an increased risk of coronary microvascular dysfunction in men.

  11. Automated identification of abnormal respiratory ciliary motion in nasal biopsies.

    Science.gov (United States)

    Quinn, Shannon P; Zahid, Maliha J; Durkin, John R; Francis, Richard J; Lo, Cecilia W; Chennubhotla, S Chakra

    2015-08-05

    Motile cilia lining the nasal and bronchial passages beat synchronously to clear mucus and foreign matter from the respiratory tract. This mucociliary defense mechanism is essential for pulmonary health, because respiratory ciliary motion defects, such as those in patients with primary ciliary dyskinesia (PCD) or congenital heart disease, can cause severe sinopulmonary disease necessitating organ transplant. The visual examination of nasal or bronchial biopsies is critical for the diagnosis of ciliary motion defects, but these analyses are highly subjective and error-prone. Although ciliary beat frequency can be computed, this metric cannot sensitively characterize ciliary motion defects. Furthermore, PCD can present without any ultrastructural defects, limiting the use of other detection methods, such as electron microscopy. Therefore, an unbiased, computational method for analyzing ciliary motion is clinically compelling. We present a computational pipeline using algorithms from computer vision and machine learning to decompose ciliary motion into quantitative elemental components. Using this framework, we constructed digital signatures for ciliary motion recognition and quantified specific properties of the ciliary motion that allowed high-throughput classification of ciliary motion as normal or abnormal. We achieved >90% classification accuracy in two independent data cohorts composed of patients with congenital heart disease, PCD, or heterotaxy, as well as healthy controls. Clinicians without specialized knowledge in machine learning or computer vision can operate this pipeline as a "black box" toolkit to evaluate ciliary motion. Copyright © 2015, American Association for the Advancement of Science.

  12. Lyme Carditis: An Interesting Trip to Third-Degree Heart Block and Back

    Directory of Open Access Journals (Sweden)

    Maxwell Eyram Afari

    2016-01-01

    Full Text Available Carditis is an uncommon presentation of the early disseminated phase of Lyme disease. We present the case of a young female who presented with erythema migrans and was found to have first-degree heart block which progressed to complete heart block within hours. After receiving ceftriaxone, there was complete resolution of the heart block in sequential fashion. Our case illustrates the importance of early recognition and anticipation of progressive cardiac conduction abnormalities in patients presenting with Lyme disease.

  13. THE STUDY OF PREVALENCE AND CLINICAL PROFILE OF VALVULAR HEART DISEASES IN A TEACHING HOSPITAL

    OpenAIRE

    Radha Krishnan; Srinivas

    2015-01-01

    Valvular heart disease is still a common causes of mortality and morbidity in India and rheumatic heart disease is still far more frequent. AIMS AND OBJECTIVES: To study the prevalence and clinical profile of rheumatic and non - rheumatic valvular heart dise ase in patients attending to Government General Hospital, Kakinada. MATERIALS AND METHODS: 100 Adult patients with valvular abnormalities attending to the Medicine and Cardiol...

  14. Professionals' views of fetal monitoring during labour: a systematic review and thematic analysis

    National Research Council Canada - National Science Library

    Smith, Valerie; Begley, Cecily M; Clarke, Mike; Devane, Declan

    2012-01-01

    ... evidence-based maternity care. The aim of this paper is to offer insight and understanding, through systematic review and thematic analysis, of research into professionals' views on fetal heart rate monitoring during labour...

  15. MIBG scintigraphy of the heart; MIBG-Szintigrafie des Herzens

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M.; Weiss, M. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

    2009-03-15

    The sympathetic nervous system plays an important role in cardiovascular physiology. Planar MIBG with or without SPECT can be used to visualize the sympathetic innervation of the heart and the abnormalities in innervation caused by, for example, ischemia, heart failure, and arrhythmogenic disorders. Furthermore, cardiac neuronal imaging allows early detection of autonomic neuropathy in diabetes mellitus. Assessment of sympathetic nerve activity in patients with heart failure has been shown to provide important prognostic information, and cardiac neuronal imaging can potentially identify patients who are at increased risk of sudden death. Moreover, therapeutic effects of different treatment strategies can be evaluated by imaging. To establish the clinical utility of cardiac neuronal imaging, it will be necessary to determine the incremental value of innervation imaging to triage heart failure patients to medical therapy, CRT (with or without ICD), or heart transplantation. (orig.)

  16. Association of sympathovagal imbalance with obesity indices, and abnormal metabolic biomarkers and cardiovascular parameters.

    Science.gov (United States)

    Indumathy, J; Pal, G K; Pal, Pravati; Ananthanarayanan, P H; Parija, S C; Balachander, J; Dutta, T K

    2015-01-01

    Pathophysiological mechanisms contributing to abnormal cardiovascular (CV) parameters in obesity have not been fully elucidated. Role of sympathovagal imbalance (SVI) in the prediction of abnormalities in CV functions in obesity has not been studied. Anthropometric indices, CV parameters, autonomic function tests (AFTs) such as spectral heart rate variability (HRV) analysis, heart rate and blood pressure response to standing, deep breathing, and isometric-handgrip, and biochemical parameters like insulin resistance (HOMA-IR), lipid risk factors and inflammatory marker [high-sensitive C-reactive protein (hsCRP)] were assessed in control group (non-obese, n=43) and obese group (n=45). Association of anthropometric indices and abnormal CV parameters with low-frequency to high-frequency ratio (LF-HF) of HRV was performed by Pearson's correlation. Independent contribution of anthropometric indices and abnormal CV parameters to LF-HF was assessed by using a multiple regression analysis. LF-HF prediction of rate-pressure product (RPP), the indicator of CV dysfunction was assessed by logistic regression. LF-HF, the marker of SVI was more in obese group compared to control group. AFTs of sympathetic activity were increased and of parasympathetic activity were reduced in obese group. Anthropometric indices, HOMA-IR, lipid risk factors and hsCRP were correlated with LF-HF. These metabolic biomarkers had independent contribution to SVI. Among, anthropometric indices, waist-to-height ratio (WHtR) had maximum association with LF-HF. LF-HF had significant prediction of RPP in obese group. SVI in obesity is due to both increased sympathetic and decreased vagal activity. Abnormal CV parameters in obesity are linked to SVI, which is contributed by insulin resistance, dyslipidaemia and low-grade inflammation. LF-HF predicts abnormal CV parameters in obesity. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  17. Communicating with Professionals

    Medline Plus

    Full Text Available ... sheets: What is Cardiac Rehab? How Can I Live With Heart Failure? Medication Chart | ... Active - Stretching & Flexibility Exercises - Strength & Balance Exercises - Problems & ...

  18. Professional performance in school

    Directory of Open Access Journals (Sweden)

    Rubio, J. F.

    2012-01-01

    Full Text Available Professional performance in education is now calling the attention of researcher due to its role in the professionalizing process intended to increase international education standards. In this article the term professional performance is examined from the two socio-historic traditional roles involved in training the individuals as a bio-psychic and social entity: teachers and executive. By means of scientific methods, the author gives the theoretical grounds connecting professional performance, learning and individual capacity of using them in solving problem at his labor position. The professional performance is regarded as a human value that stimulates the activity. By predicting educational alternatives, the paper portraits a model of professional performance in education, referring the necessary actions needed for achieving the goals of education. Searching and discussing such alternatives leads to reinterpret professional problems and to find out ways of improving educational standards.

  19. On two abnormal sharks from Gujarat

    Digital Repository Service at National Institute of Oceanography (India)

    Gopalan, U.K.

    The description of the two abnormal sharks, Carchariaswalbeehmi and Eulamia dussumieri collected from Gujarat, India, is given Of these C walbeehmi was double-headed The other shark E dussumieri had thumb snouted albino...

  20. Low-set ears and pinna abnormalities

    Science.gov (United States)

    ... because they do not affect hearing. However, sometimes cosmetic surgery is recommended. Skin tags may be tied off, ... 5 years old. More severe abnormalities may require surgery for cosmetic reasons as well as for function. Surgery to ...

  1. Morphological abnormality among regenerated shoots of banana ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-11-02

    AAA), 'Rastali',. 'Nangka' (AAB) and 'Baka Baling' (ABB) were chosen to compare the effect of benzylaminopurine (BAP) and thidiazuron (TDZ) on multiplication efficiency in relation with frequency of abnormal shoot.

  2. Expression of the congenital heart disease 5/tryptophan rich basic protein homologue gene during heart development in medaka fish, Oryzias latipes.

    Science.gov (United States)

    Murata, Kenji; Degmetich, Sean; Kinoshita, Masato; Shimada, Eriko

    2009-02-01

    The congenital heart disease 5 (CHD5)/tryptophan rich basic protein (WRB) is a protein containing a tryptophan-rich carboxy-terminal region, which was discovered in the human fetal heart. In humans, this CHD5/WRB is located between the markers ACTL5-D21S268 within the Down syndrome (DS) Region-2 at chromosome 21. Congenital heart disease is commonly linked to DS patients. The functions of this gene product are unknown. To identify the functions of CHD5/WRB in heart formation during embryogenesis, the medaka CHD5 cDNA (mCHD5) was isolated and its gene expression pattern and the localization of its gene product were investigated. The obtained mCHD5 belongs to the CHD5 superfamily, whose members include coiled-coil proteins. The mCHD5 gene was found to be expressed in the developing heart after stage 28 at which the chamber (ventricle and atrium) differentiation in the heart tube is initiated in the embryo. Its gene product was also detected in the developing heart at embryonic stage 28 and 35. Knocking-down of mCHD5 function caused severe cardiac disorder, including abnormal chamber differentiation, abnormal looping and ocular abnormality such as Cyclops. Our results provide the mCHD5 gene expression pattern as well as its physiological role during heart formation in a vertebrate model system.

  3. Heart rate index

    DEFF Research Database (Denmark)

    Haedersdal, C; Pedersen, F H; Svendsen, J H

    1992-01-01

    after the myocardial infarction. A significant correlation (Spearman's correlation coefficient rs, p less than 0.05) was found between LVEF at rest and the following variables assessed at exercise test: 1) the heart rate at rest, 2) rise in heart rate, 3) ratio between maximal heart rate and heart rate...... at rest, 4) rise in systolic blood pressure, 5) rate pressure product at rest, 6) rise in rate pressure product, 7) ratio (rHR) between maximal rate pressure product and rate pressure product at rest, 8) total exercise time. The heart rate was corrected for effects caused by age (heart index (HR...

  4. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  5. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  6. Diagnosis and treatment of abnormal dental pain

    OpenAIRE

    Fukuda, Ken-ichi

    2016-01-01

    Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, ...

  7. Familial eccrine syringofibroadenomatosis with associated ophthalmologic abnormalities.

    Science.gov (United States)

    Chen, S; Palay, D; Templeton, S F

    1998-08-01

    Eccrine syringofibroadenoma (ESFA) is a rare benign adnexal tumor, generally with sporadic occurrence and not linked to other diseases. Only one familial occurrence of ESFA has been reported. We describe the familial occurrence of multiple ESFAs in a father and his two sons, all of whom also had similar eyelid abnormalities and progressive corneal scarring. This description of hereditary ESFA is the first to link ESFA with periocular and ocular abnormalities.

  8. Burn-induced subepicardial injury in frog heart: a simple model mimicking ST segment changes in ischemic heart disease.

    Science.gov (United States)

    Kazama, Itsuro

    2016-02-01

    To mimic ischemic heart disease in humans, several animal models have been created, mainly in rodents by surgically ligating their coronary arteries. In the present study, by simply inducing burn injuries on the bullfrog heart, we reproduced abnormal ST segment changes in the electrocardiogram (ECG), mimicking those observed in ischemic heart disease, such as acute myocardial infarction and angina pectoris. The "currents of injury" created by a voltage gradient between the intact and damaged areas of the myocardium, negatively deflected the ECG vector during the diastolic phase, making the ST segment appear elevated during the systolic phase. This frog model of heart injury would be suitable to explain the mechanisms of ST segment changes observed in ischemic heart disease.

  9. Disruption of Ah Receptor Signaling during Mouse Development Leads to Abnormal Cardiac Structure and Function in the Adult.

    Directory of Open Access Journals (Sweden)

    Vinicius S Carreira

    Full Text Available The Developmental Origins of Health and Disease (DOHaD Theory proposes that the environment encountered during fetal life and infancy permanently shapes tissue physiology and homeostasis such that damage resulting from maternal stress, poor nutrition or exposure to environmental agents may be at the heart of adult onset disease. Interference with endogenous developmental functions of the aryl hydrocarbon receptor (AHR, either by gene ablation or by exposure in utero to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, a potent AHR ligand, causes structural, molecular and functional cardiac abnormalities and altered heart physiology in mouse embryos. To test if embryonic effects progress into an adult phenotype, we investigated whether Ahr ablation or TCDD exposure in utero resulted in cardiac abnormalities in adult mice long after removal of the agent. Ten-months old adult Ahr-/- and in utero TCDD-exposed Ahr+/+ mice showed sexually dimorphic abnormal cardiovascular phenotypes characterized by echocardiographic findings of hypertrophy, ventricular dilation and increased heart weight, resting heart rate and systolic and mean blood pressure, and decreased exercise tolerance. Underlying these effects, genes in signaling networks related to cardiac hypertrophy and mitochondrial function were differentially expressed. Cardiac dysfunction in mouse embryos resulting from AHR signaling disruption seems to progress into abnormal cardiac structure and function that predispose adults to cardiac disease, but while embryonic dysfunction is equally robust in males and females, the adult abnormalities are more prevalent in females, with the highest severity in Ahr-/- females. The findings reported here underscore the conclusion that AHR signaling in the developing heart is one potential target of environmental factors associated with cardiovascular disease.

  10. Development of Healthcare Kiosk for Checking Heart Health

    Directory of Open Access Journals (Sweden)

    Riyanto Sigit

    2016-04-01

    Full Text Available The main problem encountered nowadays in the health field, especially in health care is the growing number of population and the decreasing health facilities. In this regard, healthcare kiosk is used as an alternative to the health care facilities. Heart disease is a dangerous one which could threaten human life. Many people have died due to heart disease and the surgery itself is still very expensive. To analyze heart diseases, doctor usually takes a video of the heart movement using ultrasound equipment to distinguish between normal and abnormal case. The results of analysis vary depending on the accuracy and experience of each doctor so it is difficult to determine the actual situation. Therefore, a method using healthcare kiosk to check the heart health is needed to help doctor and improve the health care facilities. The aim of this research is to develop healthcare kiosk which can be used to check the heart health. This research method is divided into three main parts: firstly, preprocessing to clarify the quality of the image.In this section, the writers propose a Median High Boost Filter method which is a combined method of Median Filtering and High Boost Filtering. Secondly, segmentation is used to obtain local cavities of the heart. In this part, the writers propose using Triangle Equation that is a new method to be developed. Thirdly, classification using Partial Monte Carlo method and artificial neural network method; these methods are used to measure the area of the heart cavity and discover the possibility of cardiac abnormalities. Methods for detecting heart health are placed in the kiosk. Therefore, it is expected to facilitate and improve the healthcare facilities. Keywords: Healthcare kiosk, heart health, reprocessing, segmentation, classification.

  11. Electromagnetic induction and radiation-induced abnormality of wave propagation in excitable media

    Science.gov (United States)

    Ma, Jun; Wu, Fuqiang; Hayat, Tasawar; Zhou, Ping; Tang, Jun

    2017-11-01

    Continuous wave emitting from sinus node of the heart plays an important role in wave propagating among cardiac tissue, while the heart beating can be terminated when the target wave is broken into turbulent states by electromagnetic radiation. In this investigation, local periodical forcing is applied on the media to induce continuous target wave in the improved cardiac model, which the effect of electromagnetic induction is considered by using magnetic flux, then external electromagnetic radiation is imposed on the media. It is found that target wave propagation can be blocked to stand in a local area and the excitability of media is suppressed to approach quiescent but homogeneous state when electromagnetic radiation is imposed on the media. The sampled time series for membrane potentials decrease to quiescent state due to the electromagnetic radiation. It could accounts for the mechanism of abnormality in heart failure exposed to continuous electromagnetic field.

  12. Effects of ankylosing spondylitis on the heart.

    Science.gov (United States)

    Gunes, Yilmaz; Tuncer, Mustafa; Guntekin, Unal; Sahin, Musa; Yazmalar, Levent

    2009-06-01

    Various cardiac pathologies have been linked to ankylosing spondylitis (AS) in various conflicting reports. A pilot exploration is done to search frequencies of structural heart involvement, arrhythmias and heart rate variability (HRV) in AS patients. Thirty-five AS patients and 25 healthy people were evaluated with 12-lead electrocardiography, echocardiography and 24-hour Holter monitoring. No patient had significant valvular heart disease except one. Ventricular and supraventricular premature beat counts were significantly higher in AS patients compared to the control group (P = 0.002 and 0.01). Frequency of ventricular premature beats was significantly correlated with isovolumetric relaxation time (IVRT) (r = 0.291 , P = 0.025). Abnormal ECG was defined in 4 AS patients; 2 incomplete right bundle-branch block (RBBB), one left axis deviation and one complete RBBB and left anterior hemiblock. QT and P wave dispersions were not significantly different between AS patients and the control group. Although mitral inflow deceleration time (DT) and IVRT were significantly longer in AS patients (P SDSD (day and night time) were significantly lower than the control group. There were weak to moderate but significant negative correlations of IVRT and DT with these parameters. In this small sample there is no significant increase in structural heart disease in patients with AS. Diastolic functions may be affected in the course of disease and this may be associated with increased frequency of premature beats. Day time heart rate variability is decreased and associated with diastolic function parameters of IVRT and DT in AS patients.

  13. Arrhythmias and sudden death in heart failure.

    Science.gov (United States)

    Stevenson, W G; Sweeney, M O

    1997-09-01

    Survival of patients with heart failure has improved over the past decade due to advances in medical therapy. Sudden death continues to cause 20 to 50% of deaths. Ventricular arrhythmias are common in patients with heart failure. Ventricular hypertrophy, scars from prior myocardial infarction, sympathetic activation, and electrolyte abnormalities contribute. Some sudden deaths are due to bradyarrhythmias and electromechanical dissociation rather than ventricular arrhythmias. The risks and benefits of antiarrhythmic therapies continue to be defined. Class I antiarrhythmic drugs should be avoided due to proarrhythmic and negative inotropic effects that may increase mortality. For patients resuscitated from sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) amiodarone or an implantable cardioverter defibrillator (ICD) should be considered. ICDs markedly reduce sudden death in VT/VF survivors, but in advanced heart failure, this may not markedly extend survival. Catheter or surgical ablation can be considered for selected patients with bundle branch reentry VT or difficult to control monomorphic VT. For patients who have not had sustained VT/VF antiarrhythmic therapy should generally be avoided, but may benefit some high risk patients. Amiodarone may be beneficial in patients with advanced heart failure and rapid resting heart rates. ICDs may improve survival in selected survivors of myocardial infarction who have inducible VT.

  14. The heart failure epidemic: a UK perspective

    Directory of Open Access Journals (Sweden)

    Martin R Cowie

    2017-03-01

    Full Text Available Heart failure is appropriately described as an epidemic, with 1–2% of health care expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE has issued guidance on the best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and access to this (with our without biochemical testing using natriuretic peptides is key to high-quality and speedy diagnosis. New models of care aim to speed up access to echocardiography, but a shortage of technically trained staff remains a limiting factor in improving standards of care. The NHS audits the quality of care and outcome for patients admitted to hospital with heart failure, and this continues to show wide variation in practice, particularly, where patients are not reviewed by the local heart failure multidisciplinary team. Recently, the All Party Parliamentary Group on Cardiac Disease issued 10 suggestions for improvement in care for patients with heart failure – access to echocardiography being one of the key suggestions. Time will tell as to whether this support from law makers will assist in the implementation of NICE-recommended standards of care consistently across the country.

  15. Clinical and Echocardiographic Characteristics and Cardiovascular Outcomes According to Diabetes Status in Patients With Heart Failure and Preserved Ejection Fraction

    DEFF Research Database (Denmark)

    Kristensen, Søren L; Mogensen, Ulrik M; Jhund, Pardeep S

    2017-01-01

    structural and functional echocardiographic abnormalities. Further investigation is needed to determine the mediators of the adverse impact of diabetes mellitus on outcomes in heart failure with preserved ejection fraction and whether they are modifiable. CLINICAL TRIAL REGISTRATION: URL: http...

  16. Heart Health: Learn the Truth About Your Heart

    Science.gov (United States)

    ... Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter ... minute. There are many ways that Americans can learn more about staying heart healthy and understanding heart ...

  17. Implantation of Total Artificial Heart in Congenital Heart Disease

    OpenAIRE

    Adachi, Iki; Morales, David S. L.

    2014-01-01

    In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation.

  18. El comportamiento de la frecuencia cardiaca del futbolista profesional en competición. ¿Es posible explicarlo a partir del contexto de las situaciones de juego? The behaviour of the heart rate of the professional football player in competition. Is possible to explain it from the context of the game situation?

    Directory of Open Access Journals (Sweden)

    A. Rial

    2010-09-01

    methodology, in which the utilization of the methodology observational in complemented with a selective methodology. For the analysis of information there were retained a whole of 153 cases, correspondents to a whole of 6 professional players belonging to the first team of the R.C. Celta de Vigo, classified to dispute the Champions League in the season 2003/04. The results seem to indicate that they are three criteria that they allow arrange of a model with a high explanatory capacity of more than 80% of the variance of the behaviour of the HR, measured by the marked increases and the decreases in the values: centre of game, role and opposition, specially the first of them turns out to be key at the moment of being able to explain or predict it.
    Key Words: soccer, heart rate, game situation, centre of game.

  19. Communicating with Professionals

    Medline Plus

    Full Text Available ... Traditional Chinese) 繁体中文 (Simplified Chinese) Tiếng Việt (Vietnamese) Healthy Living for Heart.org Conditions for Heart.org ... Attack Symptoms in Women 5 How to Eat Healthy 6 What are the Symptoms of High Blood ...

  20. Heart Attack Payment - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – state data. This data set includes state-level data for payments associated with a 30-day episode of care for heart...

  1. Heart Attack Payment - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – provider data. This data set includes provider data for payments associated with a 30-day episode of care for heart...

  2. Right heart ventriculography

    Science.gov (United States)

    Angiography - right heart ... The catheter will be moved forward into the right side of the heart. As the catheter is advanced, the doctor can record pressures from the right atrium and right ventricle. Contrast material ("dye") is ...

  3. Living with Heart Disease

    Science.gov (United States)

    ... Education Institute) Heart Attack: Interactive Tutorial (MedlinePlus—Patient Education Institute) RELATED NEWS March 13, 2017 | Research Feature NHLBI, nursing sorority team up to fight heart disease in ...

  4. What Causes Heart Disease?

    Science.gov (United States)

    ... Education Institute) Heart Attack: Interactive Tutorial (MedlinePlus—Patient Education Institute) RELATED NEWS March 13, 2017 | Research Feature NHLBI, nursing sorority team up to fight heart disease in ...

  5. Types of Heart Surgery

    Science.gov (United States)

    ... problems with the heart's function and valves. Cardiac Magnetic Resonance Imaging Magnetic resonance imaging (MRI) is a ... To Expect After Heart Surgery Recovery in the Hospital You may spend a day or more in ...

  6. Tachycardia | Fast Heart Rate

    Science.gov (United States)

    ... tachycardia occurs less commonly with: Heart attack Serious mitral valve disease Symptoms and Complications of Atrial or SVT Some ... tachycardia occurs less commonly with: Heart attack Serious mitral valve disease Symptoms and Complications of Atrial or SVT Some ...

  7. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  8. Heart disease and intimacy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000540.htm Heart disease and intimacy To use the sharing features on ... Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, ...

  9. Heart Information Center

    Science.gov (United States)

    ... Medical and Surgical Procedures A Heart Surgery Overview Aneurysm Repair Balloon Angioplasty and Stents Carotid Artery Angioplasty and Stents Carotid Endarterectomy Coronary Artery Bypass Heart Transplantation Implantable Cardioverter Defibrillator (ICD) ...

  10. Heart Attack Payment - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Payment for heart attack patients measure – national data. This data set includes national-level data for payments associated with a 30-day episode of care for heart...

  11. Diabetic Heart Disease

    Science.gov (United States)

    ... blood pressure and excess protein in the urine. Preeclampsia is linked to an increased lifetime risk of CHD, heart attack, heart failure , and high blood pressure. Screening and Prevention Taking action to control risk factors can help ...

  12. Heart valve surgery

    Science.gov (United States)

    Valve replacement; Valve repair; Heart valve prosthesis; Mechanical valves; Prosthetic valves ... can relieve your symptoms and prolong your life. Mechanical heart valves do not often fail. However, blood clots can ...

  13. Nutrition care for newborns with congenital heart disease.

    Science.gov (United States)

    Steltzer, Michelle; Rudd, Nancy; Pick, Barbara

    2005-12-01

    Those health care professionals entrusted with the care of infants with congenital heart disease require an understanding of the unique nutritional needs of this population. This article defines the congenital, physiologic, and nutritional variables encountered in this population. The nutritional needs, multi-factorial sources of undernutrition, and consequences of inadequate nutrition in infants with congenital heart disease are discussed, as well as medical and nutritional management strategies intended to optimize growth and reduce morbidity.

  14. Heart rate turbulence predicts all-cause mortality and sudden death in congestive heart failure patients.

    Science.gov (United States)

    Cygankiewicz, Iwona; Zareba, Wojciech; Vazquez, Rafael; Vallverdu, Montserrat; Gonzalez-Juanatey, Jose R; Valdes, Mariano; Almendral, Jesus; Cinca, Juan; Caminal, Pere; de Luna, Antoni Bayes

    2008-08-01

    Abnormal heart rate turbulence (HRT) has been documented as a strong predictor of total mortality and sudden death in postinfarction patients, but data in patients with congestive heart failure (CHF) are limited. The aim of this study was to evaluate the prognostic significance of HRT for predicting mortality in CHF patients in New York Heart Association (NYHA) class II-III. In 651 CHF patients with sinus rhythm enrolled into the MUSIC (Muerte Subita en Insuficiencia Cardiaca) study, the standard HRT parameters turbulence onset (TO) and slope (TS), as well as HRT categories, were assessed for predicting total mortality and sudden death. HRT was analyzable in 607 patients, mean age 63 years (434 male), 50% of ischemic etiology. During a median follow up of 44 months, 129 patients died, 52 from sudden death. Abnormal TS and HRT category 2 (HRT2) were independently associated with increased all-cause mortality (HR: 2.10, CI: 1.41 to 3.12, P 120 ms. HRT is a potent risk predictor for both heart failure and arrhythmic death in patients with class II and III CHF.

  15. Pediatric Patients Discharged from the Emergency Department with Abnormal Vital Signs.

    Science.gov (United States)

    Winter, Josephine; Waxman, Michael J; Waterman, George; Ata, Ashar; Frisch, Adam; Collins, Kevin P; King, Christopher

    2017-08-01

    Children often present to the emergency department (ED) with minor conditions such as fever and have persistently abnormal vital signs. We hypothesized that a significant portion of children discharged from the ED would have abnormal vital signs and that those discharged with abnormal vital signs would experience very few adverse events. We performed a retrospective chart review encompassing a 44-month period of all pediatric patients (aged two months to 17 years) who were discharged from the ED with an abnormal pulse rate, respiratory rate, temperature, or oxygen saturation. We used a local quality assurance database to identify pre-defined adverse events after discharge in this population. Our primary aim was to determine the proportion of children discharged with abnormal vital signs and the frequency and nature of adverse events. Additionally, we performed a sub-analysis comparing the rate of adverse events in children discharged with normal vs. abnormal vital signs, as well as a standardized review of the nature of each adverse event. Of 33,185 children discharged during the study period, 5,540 (17%) of these patients had at least one abnormal vital sign. There were 24/5,540 (0.43%) adverse events in the children with at least one abnormal vital sign vs. 47/27,645 (0.17%) adverse events in the children with normal vital signs [relative risk = 2.5 (95% confidence interval, 1.6 to 2.4)].However, upon review of each adverse event we found only one case that was related to the index visit, was potentially preventable by a 23-hour hospital observation, and caused permanent disability. In our study population, 17% of the children were discharged with at least one abnormal vital sign, and there were very few adverse (0.43%) events associated with this practice. Heart rate was the most common abnormal vital sign leading to an adverse event. Severe adverse events that were potentially related to the abnormal vital sign(s) were exceedingly rare. Additional research is

  16. Termination of pregnancy for fetal abnormality: a meta-ethnography of women's experiences.

    Science.gov (United States)

    Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

    2014-11-01

    Due to technological advances in antenatal diagnosis of fetal abnormalities, more women face the prospect of terminating pregnancies on these grounds. Much existing research focuses on women's psychological adaptation to this event. However, there is a lack of holistic understanding of women's experiences. This article reports a systematic review of qualitative studies into women's experiences of pregnancy termination for fetal abnormality. Eight databases were searched up to April 2014 for peer-reviewed studies, written in English, that reported primary or secondary data, used identifiable and interpretative qualitative methods, and offered a valuable contribution to the synthesis. Altogether, 4,281 records were screened; 14 met the inclusion criteria. The data were synthesised using meta-ethnography. Four themes were identified: a shattered world, losing and regaining control, the role of health professionals and the power of cultures. Pregnancy termination for fetal abnormality can be considered as a traumatic event that women experience as individuals, in their contact with the health professional community, and in the context of their politico-socio-legal environment. The range of emotions and experiences that pregnancy termination for fetal abnormality generates goes beyond the abortion paradigm and encompasses a bereavement model. Coordinated care pathways are needed that enable women to make their own decisions and receive supportive care. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  17. Ocular abnormalities in healthy Standardbred foals.

    Science.gov (United States)

    Barsotti, Giovanni; Sgorbini, Micaela; Marmorini, Paola; Corazza, Michele

    2013-07-01

    To determine the prevalence and describe ocular abnormalities in healthy Standardbred foals within 48 h of birth. One hundred and two neonatal foals. All foals had an unassisted delivery. On the basis of physical examination and the results of hematological and biochemical parameters, all foals were unaffected by systemic diseases. A complete ophthalmic examination was performed within 48 h of birth. Foals with ocular hemorrhages were re-examined weekly until the abnormalities were resolved. 65/102 (63.7%) foals did not show ocular abnormalities, while in 37/102 (36.3%) cases, ocular abnormalities were present. Retinal and subconjunctival hemorrhages were recorded in 19/102 (18.6%), and in 13/102 (12.7%), respectively. In 4/102 (3.9%) animals, an entropion of the lower eyelid was present. Only one foal (1%) showed a congenital nuclear unilateral cataract. No other ocular abnormalities were detected. However, all foals showed various degrees of remnants of hyaloid system. One week after the first ocular examination, retinal hemorrhages had resolved in 100% of the eyes, whereas subconjunctival hemorrhages had disappeared in all eyes by the second week following the first examination. The acquired ocular lesions observed with relatively high frequency in the examined healthy Standardbred foals were ocular hemorrhages, which always showed a good outcome. Although these abnormalities were present at birth, they were not considered strictly congenital but likely acquired during parturition. Instead, congenital ocular abnormalities were rarely diagnosed, and the entropion of the lower eyelid was the most common disease in the breed. © 2012 American College of Veterinary Ophthalmologists.

  18. Restoring medical professionalism.

    Science.gov (United States)

    Bernat, James L

    2012-08-21

    The essence of medical professionalism is placing dedication to the welfare of patients above physicians' personal or proprietary interests. Medicine has become deprofessionalized as a consequence of socioeconomic factors leading to increasing commercialization and perverse financial incentives converting it into a business, the presence of unmanaged conflicts of interest, challenges to medical authority by insurance companies and the consumerism movement, and by gradual changes in the attitudes of physicians. Organized medicine has responded by making explicit its standards of professionalism and its dedication to preserving them. Medical educators have studied the means to develop professional attitudes and behaviors among medical students and residents. Modeling the characteristics of professional behavior by virtuous physicians remains the most effective method to instill professional behaviors in trainees. Restoring professionalism may be abetted by changes in physicians' financial incentives through innovative models of health care delivery, by physicians reducing their conflicts of interest, and by medical societies rejecting a guild identity.

  19. Risks for Heart Valve Problems

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Risks for Heart Valve Problems Updated:Jan 18,2017 Who is at risk ... content was last reviewed May 2016. Heart Valve Problems and Disease • Home • About Heart Valves • Heart Valve ...

  20. What Happens After Heart Surgery?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Happens After Heart Surgery? What are the ICU and CCU? In a ... doctors. This is where patients go after open-heart surgery or a heart attack. You’re watched around ...