Stockholm CHP potential - An opportunity for CO2 reductions?

International Nuclear Information System (INIS)

Danestig, Maria; Gebremehdin, Alemayehu; Karlsson, Bjoern

2007-01-01

The potential for combined heat and power (CHP) generation in Stockholm is large and a total heat demand of about 10 TWh/year can be met in a renewed large district heating system. This model of the Stockholm district heating system shows that CHP generation can increase from 8% in 2004 to 15.5% of the total electricity generation in Sweden. Increased electricity costs in recent years have awakened an interest to invest in new electricity generation. Since renewable alternatives are favoured by green certificates, bio-fuelled CHP is most profitable at low electricity prices. Since heat demand in the district heating network sets the limit for possible electricity generation, a CHP alternative with a high electricity to heat ratio will be more profitable at when electricity prices are high. The efficient energy use in CHP has the potential to contribute to reductions in carbon dioxide emissions in Europe, when they are required and the European electricity market is working perfectly. The potential in Stockholm exceeds Sweden's undertakings under the Kyoto protocol and national reduction goals. (author)

Epidemiology, risk factors, and outcome of Clostridium difficile infection in heart and heart-lung transplant recipients.

Science.gov (United States)

Bruminhent, Jackrapong; Cawcutt, Kelly A; Thongprayoon, Charat; Petterson, Tanya M; Kremers, Walter K; Razonable, Raymund R

2017-06-01

Clostridium difficile is a major cause of diarrhea in thoracic organ transplant recipients. We investigated the epidemiology, risk factors, and outcome of Clostridium difficile infection (CDI) in heart and heart-lung transplant (HT) recipients. This is a retrospective study from 2004 to 2013. CDI was defined by diarrhea and a positive toxigenic C. difficile in stool measured by toxin enzyme immunoassay (2004-2006) or polymerase chain reaction (2007-2013). Cox proportional hazards regression was used to model the association of risk factors with time to CDI and survival with CDI following transplantation. There were 254 HT recipients, with a median age of 53 years (IQR, 45-60); 34% were female. During the median follow-up of 3.1 years (IQR, 1.3-6.1), 22 (8.7%) patients developed CDI. In multivariable analysis, risk factors for CDI were combined heart-lung transplant (HR 4.70; 95% CI, 1.30-17.01 [P=.02]) and retransplantation (HR 7.19; 95% CI, 1.61-32.12 [P=.01]). Acute cellular rejection was associated with a lower risk of CDI (HR 0.34; 95% CI, 0.11-0.94 [P=.04]). CDI was found to be an independent risk factor for mortality (HR 7.66; 95% CI, 3.41-17.21 [PClostridium difficile infection after HT is more common among patients with combined heart-lung and those undergoing retransplantation. CDI was associated with a higher risk of mortality in HT recipients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Contesting lifestyle risk and gendering coronary candidacy: lay epidemiology of heart disease in Finland in the 1970s.

Science.gov (United States)

Jauho, Mikko

2017-09-01

This study addresses two issues currently under critical discussion in the epidemiology of cardiovascular diseases (CVD), the relative neglect of women and the individualised nature of key risk factors. It focuses on the North Karelia project (NKP), a community programme aimed at coronary heart disease (CHD) prevention in a predominantly rural Finnish region in the early 1970s, that is, during a period when the epidemiological understanding of CVD still was relatively new and actively promoted. Adopting the notions of lay epidemiology and coronary candidacy, culturally mediated explanatory models lay people use to assess who is likely to develop heart disease and why, the study shows that locals targeted by the project critically engaged with both of these bias. Based on the rich materials resulting from project activities the study shows, first, how many locals subsumed the individualised and lifestyle-based approach to CHD prevention promoted by NKP under a more general framework emphasising the health effects of ongoing structural changes in the area, and second, how women constructed themselves as viable coronary candidates. The case supports the position in the current discussions on lay expertise that wants to integrate lay experiences more firmly into epidemiological studies and public health. © 2017 Foundation for the Sociology of Health & Illness.

Erik Gunnar Asplund’s Stockholm Public Library

DEFF Research Database (Denmark)

Andersen, Michael Asgaard

2017-01-01

Stockholm Public Library, which opened on March 31, 1928, was in many ways an innovation in the Nordic countries. Most striking was the fact that lenders could now take books off the shelves themselves, but the central placement of the lending room and the secondary placement of the reading rooms...... also indicated a new way to do libraries. The thoughts embodied in the building became a model for many later libraries. The building is not only testimony to an important period of Nordic architectural history and a recognized masterpiece by the Swedish architect Erik Gunnar Asplund (1885......–1940), it is also part of the history of the Nordic social model that was taking shape in the interwar years. By its function as a public institution and its unique architectural qualities, Stockholm Public Library today stands as an important work of Nordic welfare building....

Substance Flow Analyses of Organic Pollutants in Stockholm

International Nuclear Information System (INIS)

Jonsson, A.; Friden, U.; Thuresson, K.; Soerme, L.

2008-01-01

This paper summarizes substance flow analyses for four organic substances in the City of Stockholm, Sweden: diethylhexyl phthalate (DEHP), alkylphenolethoxylates (APEO), polybrominated diphenylethers (PBDE) and chlorinated paraffins (CP). The results indicate that the stocks of APEO, PBDE and CP all are approximately 200-250 tonnes, whereas the DEHP stock is two orders of magnitude larger. Emissions can be linked to imported consumer goods such as electronics (PBDE) and textiles (APEO), and to construction materials (DEHP, CP). For several of the substances considerable amounts remain in the technosphere for a long time, even after use of the substance in new products has been eliminated. For example, the use of DEHP as plasticizer for PVC plastics in cables and floorings has more or less been phased-out, but still these applications make up a stock of some 20,000 tonnes (85% of the total DEHP stock in Stockholm) and emit 28 tonnes of DEHP annually (93% of overall emissions). Likewise, the use of chlorinated paraffins in sealants has been radically reduced, but there are 170 tonnes of CP in sealants in Stockholm making up 75% of the stock, and causing half of the emissions to water and air. These emissions are likely to continue for decades, and the stocks therefore have to be considered when analysing and managing the impact of urban substance flows on the environment

EMS – Elektron Musik Studion in Stockholm

DEFF Research Database (Denmark)

Groth, Sanne Krogh

2016-01-01

In 1964 the electronic music studio EMS, Stockholm opened as a conventional analogue studio. The primary intension with the institution was to build the world’s most advanced hybrid studio and to conduct an international research program into sound and sound perception. With financial support from...

Comparison between RFLP and MIRU-VNTR genotyping of Mycobacterium tuberculosis strains isolated in Stockholm 2009 to 2011.

Science.gov (United States)

Jonsson, Jerker; Hoffner, Sven; Berggren, Ingela; Bruchfeld, Judith; Ghebremichael, Solomon; Pennhag, Alexandra; Groenheit, Ramona

2014-01-01

Our aim was to analyze the difference between methods for genotyping of Mycobacterium tuberculosis complex isolates. We collected genotyping results from Restriction Fragment Length Polymorphism (RFLP) and Mycobacterial Interspersed Repetitive Units-Variable Numbers of Tandem Repeat (MIRU-VNTR) in a geographically limited area (Stockholm) during a period of three years. The number and proportion of isolates belonging to clusters was reduced by 45 and 35% respectively when combining the two methods compared with using RFLP or MIRU-VNTR only. The mean size of the clusters was smaller when combining methods and smaller with RFLP compared to MIRU-VNTR. In clusters with confirmed epidemiological links RFLP coincided slightly better than MIRU-VNTR but where there was a difference, the variation in MIRU-VNTR pattern was only in a single locus. In isolates with few IS6110 bands in RFLP, MIRU-VNTR differentiated the isolates more, dividing the RFLP clusters. Since MIRU-VNTR is faster and less labour-intensive it is the method of choice for routine genotyping. In most cases it will be sufficient for epidemiological purposes but true clustering might still be considered if there are epidemiological links and the MIRU-VNTR results differ in only one of its 24 loci.

Abundance and composition of near surface microplastics and plastic debris in the Stockholm Archipelago, Baltic Sea.

Science.gov (United States)

Gewert, Berit; Ogonowski, Martin; Barth, Andreas; MacLeod, Matthew

2017-07-15

We collected plastic debris in the Stockholm Archipelago using a manta trawl, and additionally along a transect in the Baltic Sea from the island of Gotland to Stockholm in a citizen science study. The samples were concentrated by filtration and organic material was digested using hydrogen peroxide. Suspected plastic material was isolated by visual sorting and 59 of these were selected to be characterized with Fourier transform infrared spectroscopy. Polypropylene and polyethylene were the most abundant plastics identified among the samples (53% and 24% respectively). We found nearly ten times higher abundance of plastics near central Stockholm than in offshore areas (4.2×10 5 plastics km -2 compared to 4.7×10 4 plastics km -2 ). The abundance of plastic debris near Stockholm was similar to urban areas in California, USA, and the overall abundance in the Stockholm Archipelago was similar to plastic abundance reported in the northwestern Mediterranean Sea. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Individual exposure to NO2 in relation to spatial and temporal exposure indices in Stockholm, Sweden: the INDEX study.

Directory of Open Access Journals (Sweden)

Tom Bellander

Full Text Available Epidemiology studies of health effects from air pollution, as well as impact assessments, typically rely on ambient monitoring data or modelled residential levels. The relationship between these and personal exposure is not clear. To investigate personal exposure to NO(2 and its relationship with other exposure metrics and time-activity patterns in a randomly selected sample of healthy working adults (20-59 years living and working in Stockholm. Personal exposure to NO(2 was measured with diffusive samplers in sample of 247 individuals. The 7-day average personal exposure was 14.3 µg/m(3 and 12.5 µg/m(3 for the study population and the inhabitants of Stockholm County, respectively. The personal exposure was significantly lower than the urban background level (20.3 µg/m(3. In the univariate analyses the most influential determinants of individual exposure were long-term high-resolution dispersion-modelled levels of NO(2 outdoors at home and work, and concurrent NO(2 levels measured at a rural location, difference between those measured at an urban background and rural location and difference between those measured in busy street and at an urban background location, explaining 20, 16, 1, 2 and 4% (R(2 of the 7-day personal NO(2 variation, respectively. A regression model including these variables explained 38% of the variation in personal NO(2 exposure. We found a small improvement by adding time-activity variables to the latter model (R(2 = 0.44. The results adds credibility primarily to long-term epidemiology studies that utilise long-term indices of NO(2 exposure at home or work, but also indicates that such studies may still suffer from exposure misclassification and dilution of any true effects. In contrast, urban background levels of NO(2 are poorly related to individual exposure.

Raid, Kaljo: Symphony No. 2, "Stockholm" / Guy S. Rickards

Index Scriptorium Estoniae

Rickards, Guy S.

1996-01-01

Uuest heliplaadist "Raid, Kaljo: Symphony No. 2, "Stockholm"; Tubin, Eduard: Elegy for Strings (arr. Raid). Symphony No. 11 (orch. Raid). Estonian State Symphony Orchestra, Arvo Volmer". Koch International Classics 37291-2 (48 minutes:DDD)

Fluxes of 13 selected pharmaceuticals in the water cycle of Stockholm, Sweden.

Science.gov (United States)

Wahlberg, C; Björlenius, B; Paxéus, N

2011-01-01

Mass flows of 13 pharmaceutical active ingredients (APIS) found in drinking water were studied in the water cycle of Stockholm. Data were collected by analyzing samples of surface water, raw water and drinking water as well as influents, effluents and sludges from waste water treatment plants (WWTPs) in Stockholm area. A mass balance was performed, based on sold amounts of pharmaceuticals and the measured concentrations in water and sludge. The selected APls were all present in WWTP effluents and the removal rates for many of them were poor. Mass balance calculations showed that the three studied WWTPs in Stockholm release considerable amounts of the selected APIs into the Baltic Sea while the portions ending up in WWTP sludge were significantly lower. The levels of APIs found in drinking water are low at present, but may increase in the future unless the releases from WWTPs in the catchment of Lake Mälären are mitigated.

A critical appraisal of the phene-plate biochemical fingerprinting system for epidemiological subtyping of Salmonella typhimurium

DEFF Research Database (Denmark)

On, S.L.W.; Baggesen, Dorte Lau

1996-01-01

The efficacy and reproducibility of the Phene-Plate (PhP) system (Biosys Inova, Stockholm, Sweden) for biochemical fingerprinting of Salmonella typhimurium was investigated. Duplicate and replicate assays on 40 epidemiologically related and unrelated strains were performed in two batches of PhP-48......P-types which are epidemiologically unjustified, (ii) tests currently recommended for PhP-typing S. typhimurium may be somewhat unstable and not satisfactory for fingerprinting purposes, (iii) caution must be exercised when comparing data from different batches of PhP-48 plates, and (iv) best results...

Stockholm Shines (Editorial

Directory of Open Access Journals (Sweden)

Denise Koufogiannakis

2009-09-01

Full Text Available I didn’t sleep much in Stockholm. The eight hour time difference and the jet lag completely messed me up, not to mention the 19 hours of daylight! But during the day when I was so tired, the content being presented at the conference and the people I met kept me buzzing and wide awake! It is always nice to find a group of people who are interested in the same things as you are, and to do so in a beautiful setting with great food and a friendly environment is all the better. In my opinion, the 5th EBLIP conference was the best yet! I returned to Canada inspired and intellectually stimulated.The EBLIP conference is one of the few times that those of us who work on the EBLIP journal have a chance to get together and talk in person. Our journal editors are situated in the U.K., Canada, and the United States, so our work is done primarily via e‐mail and the occasional conference call. Three of us made it to Stockholm (Alison, Lorie and myself, so it was great to touch base in person and have a drink or two together! We also got to see several members of the Editorial Advisory board, as well as those who write evidence summaries for us, or are involved in some other way. Meeting some of these people in person for the first time after a lengthy e‐mail relationship is quite a treat! The Editors took the opportunity at the conference to hold a user group meeting, inviting anyone who was interested to attend and provide us with feedback about the journal. To start we provided an update, which included the fact that the journal has over 2000 registered readers. Did you know that in just one month (May 25 – June 24, 2009 we had 4649 site visits; 3,678 of them unique? Most visits to the journal are from the United States, followed by Canada, Australia, and the U.K. But we have people accessing the journal from all over world, and now that we are tracking site traffic via Google Analytics, it is easy to see on a map where our readers reside. There was

MARITICIDE AND THE STOCKHOLM SYNDROME. THE PROFILE OF WOMAN IMPRISONED FOR MARITICIDE

Directory of Open Access Journals (Sweden)

RALUCA PAVEL

2016-01-01

Full Text Available This study analyzes the correlation between female crime and Stockholm syndrome. Due to the fact that researchers focused in their studies on crimes committed by men, criminologists, sociologists and psychologists concentrated little time and attention to the female crime phenomenon. In this article I focused on the sociological interpretation of the results obtained by participant observation, an interview and a questionnaire on the Stockholm syndrome, applied to a number of 25 women imprisoned in Târgşor Prison for the murdering of their partner

Niewydolność serca - definicja, klasyfikacja, epidemiologia, objawy i leczenie = Heart failure - definition, classification, epidemiology, symptoms and treatment

Directory of Open Access Journals (Sweden)

Beata Kowalczyk

2017-02-01

, classification, epidemiology, symptoms and treatment of heart failure.   Key words: heart failure, definition, classification, epidemiology, treatment.

Letter from Stockholm.

Science.gov (United States)

Johansson, Per Magnus

2015-04-01

Some of the ideas of Sigmund Freud were preceded in a literary form by the Swedish writer August Strindberg in the late 19th century. Psychoanalysis itself was introduced in Sweden about a decade into the 20th century by two rivalling pioneers, the doctors Emanuel af Geijerstam and Poul Bjerre. After a slow start, the Danish-Norwegian Psychoanalytical Society and the Finnish-Swedish Psychoanalytical Society were formed in 1934 in Stockholm. The same year, Ericastiftelsen [The Erica Foundation], a psychotherapeutic clinic for children, was founded by Hanna Bratt. Five years later, in 1939, also in Stockholm, the organization that was to become St. Lukasstiftelsen [The Saint Luke's Foundation] was founded. It has been, and still is, an association that has trained psychodynamic psychotherapists, with a focus on existential, religious and philosophical questions. Today, St. Luke's tries to be up-dated from an academic standpoint. During the Second World War, several important psychoanalysts came to Sweden, for example René de Monchy, Lajos and Edith Székely, and Stefi Pedersen. Ola Andersson's doctoral dissertation ("Studies in the Prehistory of Psychoanalysis", 1962) and the historian Gunnar Brandell's essay ("Freud, a Man of His Century", 1961) have had an international impact. In the last two decades, an authorized and carefully edited translation of Freud's collected works has been published by Natur och Kultur, and the history of psychoanalysis in Sweden has been written at the University of Gothenburg. As a result of a recent interest in the work of Jacques Lacan, and French psychoanalysis, philosophy and literature, the journal Psykoanalytisk Tid/Skrift was founded in 2002, in Gothenburg. Since 2011 the journal is called Arche. The largest organized group of psychoanalysts in Sweden today is the Swedish Psychoanalytical Association (SPAF), which has around 225 members. Since 2008, it no longer has the right to license psychotherapists, a situation which

Epidemiology of acquired valvular heart disease.

Science.gov (United States)

Iung, Bernard; Vahanian, Alec

2014-09-01

Population-based studies including systematic echocardiographic examinations are required to assess the prevalence of valvular heart disease. In industrialized countries, the prevalence of valvular heart disease is estimated at 2.5%. Because of the predominance of degenerative etiologies, the prevalence of valvular disease increases markedly after the age of 65 years, in particular with regard to aortic stenosis and mitral regurgitation, which accounts for 3 in 4 cases of valvular disease. Rheumatic heart disease still represents 22% of valvular heart disease in Europe. The prevalence of secondary mitral regurgitation cannot be assessed reliably but it seems to be a frequent disease. The incidence of infective endocarditis is approximately 30 cases per million individiuals per year. Its stability is associated with marked changes in its presentation. Patients are getting older and staphylococcus is now becoming the microorganism most frequently responsible. Heath care-associated infections are the most likely explanation of changes in the microbiology of infective endocarditis. In developing countries, rheumatic heart disease remains the leading cause of valvular heart disease. Its prevalence is high, between 20 and 30 cases per 1000 subjects when using systematic echocardiographic screening. In conclusion, the temporal and geographical heterogeneity illustrates the effect of socioeconomic status and changes in life expectancy on the frequency and presentation of valvular heart disease. A decreased burden of valvular disease would require the elaboration of preventive strategies in industrialized countries and an improvement in the socioeconomic environment in developing countries. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Urban Metal Flows - A Case Study of Stockholm. Review and Conclusions

International Nuclear Information System (INIS)

Bergbaeck, B.; Johansson, K.; Mohlander, U.

2001-01-01

Metals have rapidly accumulated in the anthroposphere, especially in urban areas, indicating possible environmental and resource problems. Here, Stockholm City was chosen for a case study of urban metal flows, i.e. metal inflow to, metals in the stock of,and metal outflow from the anthroposphere to the biosphere. The metal stock of Stockholm is large and still growing. The large amounts of metals in the solid waste fraction totally dominate the outflow from the city. For major parts of the stock, the emissions from goods in use are negligible. There are, however,goods applications corresponding to significant emissions: e.g. the traffic sector (Cu, Zn, Cr, Ni, Pb), the tapwater system (Cu), roofs/fronts or other metal surfaces (Cu, Zn). Today's known metal flows from the anthroposphere of Stockholm to the biosphere and sewage sludge are quantitatively dominated by Zn(34 ton y -1 ) and Cu (14 ton y -1 ). Historical and present emissions have resulted in high metal concentrations in sediments (especially Cd, Hg and Pb, but also Cu and Zn), groundwater (Cu, Hg) and in soils (Hg, Cu, Pb). At present the annual median concentrations are below the Swedish limits for metals in sewage sludge, even if the safety margins are small for Cd, Hg and to some extent Cu. The flows of Cu and Zn to Stockholm soils are high with a significant accumulation indicating an environmental impact in a longer time perspective.High levels of metals in surface sediments in the water environments reflects an ongoing input where these metals are transported from known (Cu, Zn) and or partly unknown (Cd, Hg, Pb) sources. In future urban areas, monitoring of metal flows must be performed both in the anthroposphere and the biospherein order to have a pro active approach to urban environmental problems and to get prompt answers to measures taken

PERSISTENT ORGANIC POLLUTANS (POPS DAN KONVENSI STOCKHOLM

Directory of Open Access Journals (Sweden)

Lina Warlina

2010-07-01

Full Text Available Persistent organic pollutants (POPs are toxic chemicals that adversely affect human health and the environment around the world. Because they can be transported by wind and water, most POPs generated in one country can affect people and wildlife far from where they are used and released. They persist for long periods of time in the environment and can accumulate and pass from one species to the next through the food chain. To address this global concern, many countries in the world joined forces with 90 other countries and the European Community to sign a groundbreaking United Nations treaty in Stockholm, Sweden, in May 2001, known as the Stockholm Convention. One of important agreement is all countries agreed to reduce or eliminate the production, use, and/or release of 12 key POPs. The Convention specifies a scientific review process that could lead to the addition of other POPs chemicals of global concern. POPs include a range of substances that include intentionally produced chemicals currently or once used in agriculture, disease control, manufacturing, or industrial processes. Also it can be produced by unintentionally produced chemicals, such as dioxins, that result from some industrial processes and from combustion (for example, municipal and medical waste incineration and backyard burning of trash.

Hammarby Sjöstad in Stockholm a model case?

DEFF Research Database (Denmark)

Grønlund, Bo

2010-01-01

central government agencies have contributed to put these guidelines in practice. Representatives have also taken part in similar work at CEN in Brussels. In Sweden, the Stockholm Police started to work out guidelines and give advice - with the mixed new urban district Ärvinge near Kista as their primary...

The Data Acquisition System of the Stockholm Educational Air Shower Array

Science.gov (United States)

Hofverberg, P.; Johansson, H.; Pearce, M.; Rydstrom, S.; Wikstrom, C.

2005-12-01

The Stockholm Educational Air Shower Array (SEASA) project is deploying an array of plastic scintillator detector stations on school roofs in the Stockholm area. Signals from GPS satellites are used to time synchronise signals from the widely separated detector stations, allowing cosmic ray air showers to be identified and studied. A low-cost and highly scalable data acquisition system has been produced using embedded Linux processors which communicate station data to a central server running a MySQL database. Air shower data can be visualised in real-time using a Java-applet client. It is also possible to query the database and manage detector stations from the client. In this paper, the design and performance of the system are described

Monitoring of air pollution in Stockholm county. Results up to September 1999; Oevervakning av luftfoeroreningar i Stockholms laen. Resultat till och med september 1999

Energy Technology Data Exchange (ETDEWEB)

Akselsson, Cecilia [ed.

2000-05-01

Swedish Environmental Research Inst. have measured deposition of air pollutants, soil water quality, and air pollution levels in forested areas in different parts of Sweden. This report treats Stockholm county and the compilation covers the period 1992-1999, with more detailed monitoring for 1998-1999.

Is the association between short stature and myocardial infarction explained by childhood exposures--a population-based case referent study (SHEEP)

DEFF Research Database (Denmark)

Lundberg, Michael; Diderichsen, Finn; Hallqvist, Johan

2002-01-01

AIMS: This study was undertaken to examine the association between short stature and acute non-fatal myocardial infarction and to analyse causal mechanisms related to height with a focus on childhood risk factors. METHOD: The SHEEP (Stockholm Heart Epidemiology Program) is a population-based case......-referent study. The outcome was incident first events of myocardial infarction. The study base included all Swedish citizens aged 45 to 70, who lived in Stockholm County during 1992-94. This analysis is based on 967 male cases, 412 female cases and 1696 referents. Exposure information was obtained through...... questionnaires, interviews, health examinations, and obstetric records. RESULTS: Adult height was inversely related to myocardial infarction. The odds ratio for men in the shortest quartile (

Epidemiology of Left Ventricular Systolic Dysfunction and Heart Failure in the Framingham Study

DEFF Research Database (Denmark)

Vasan, Ramachandran S; Xanthakis, Vanessa; Lyass, Asya

2018-01-01

OBJECTIVES: The purpose of this study was to describe the temporal trends in prevalence of left ventricular systolic dysfunction (LVSD) in individuals without and with heart failure (HF) in the community over a 3-decade period of observation. BACKGROUND: Temporal trends in the prevalence and mana......OBJECTIVES: The purpose of this study was to describe the temporal trends in prevalence of left ventricular systolic dysfunction (LVSD) in individuals without and with heart failure (HF) in the community over a 3-decade period of observation. BACKGROUND: Temporal trends in the prevalence...... and management of major risk factors may affect the epidemiology of HF. METHODS: We compared the frequency, correlates, and prognosis of LVSD (left ventricular ejection fraction [LVEF] ... with LVSD (∼2- to 4-fold risk of HF or death) remained unchanged over time. Among participants with new-onset HF (n = 894, mean age 75 years, 52% women), the frequency of heart failure with preserved ejection fraction (HFpEF) increased (preserved LVEF ≥50%: 41.0% in 1985 to 1994 vs. 56.17% in 2005 to 2014...

Epidemiology and Prognosis of Heart Failure

Directory of Open Access Journals (Sweden)

Ilaria Spoletini

2017-01-01

Full Text Available In this article the state of the art of prevalence, incidence and prognosis of heart failure is discussed. Prevalence and incidence are two measures of disease occurrence. Briefly, prevalence is the proportion of the population affected by the disease at a certain point in time. Incidence indicates the number of new cases within a given time period in a population at risk for the disease (for example, elderly people. A related, prognostic measure is mortality, i.e. the incidence of death from the disease occurring in a period of time. In the case of chronic, steady- state disease such as heart failure, disease duration is directly affected by mortality, and prevalence may correspond to the incidence of disease multiplied by the average duration of disease . Prevalence rates of heart failure may, therefore, vary across studies depending on the variability in incidence as well as in survival between population samples. Also, given that heart failure is a complex syndrome with different phenotypes (see article 1, each with specific clinical characteristics and associated risk factors, prevalence and incidence rates may vary according to the definition of the heart failure subtype. Finally, rates may vary on the basis of the method of collecting data and the criterion for defining left ventricular systolic dysfunction that is applied in the study.

Shift work and the risk of ischemic heart disease - a systematic review of the epidemiologic evidence

DEFF Research Database (Denmark)

Frost, P.; Kolstad, H.A.; Bonde, Jens Peter

2009-01-01

Objective The objective of this review was to evaluate the epidemiologic evidence for a causal relation between shift work and ischemic heart disease. Methods We conducted a systematic search until the end of March 2008 for studies providing information on the relative risk of ischemic heart...... disease in relation to shift work. The quality of included papers was evaluated with respect to design, exposure and outcome information, bias, and exposure response assessment. Results Of the 16 studies examined, relevant information was retrieved from 14. Seven of these analyzed fatal events, six......-fatal events showed modest positive associations. In a majority of studies, we could not reasonably rule out negative or positive bias due to the quality of outcome or exposure information, or confounder control. Five studies used years in shift work for exposure response analysis and no consistent pattern...

Real world heart failure epidemiology and outcome: A population-based analysis of 88,195 patients.

Science.gov (United States)

Farré, Núria; Vela, Emili; Clèries, Montse; Bustins, Montse; Cainzos-Achirica, Miguel; Enjuanes, Cristina; Moliner, Pedro; Ruiz, Sonia; Verdú-Rotellar, José María; Comín-Colet, Josep

2017-01-01

Heart failure (HF) is frequent and its prevalence is increasing. We aimed to evaluate the epidemiologic features of HF patients, the 1-year follow-up outcomes and the independent predictors of those outcomes at a population level. Population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on December 31st, 2012. Patients were divided in 3 groups: patients without a previous HF hospitalization, patients with a remote (>1 year) HF hospitalization and patients with a recent (population studied. Some comorbidity, an all-cause hospitalization or emergency department visit the previous year were associated with a worse outcome.

The changing epidemiology of congenital heart disease

NARCIS (Netherlands)

van der Bom, Teun; Zomer, A. Carla; Zwinderman, Aeilko H.; Meijboom, Folkert J.; Bouma, Berto J.; Mulder, Barbara J. M.

2011-01-01

Congenital heart disease is the most common congenital disorder in newborns. Advances in cardiovascular medicine and surgery have enabled most patients to reach adulthood. Unfortunately, prolonged survival has been achieved at a cost, as many patients suffer late complications, of which heart

Temporal and spatial patterns of suicides in Stockholm's subway stations.

Science.gov (United States)

Uittenbogaard, Adriaan; Ceccato, Vania

2015-08-01

This paper investigates the potential temporal and spatial variations of suicides in subway stations in Stockholm, Sweden. The study also assesses whether the variation in suicide rates is related to the station environments by controlling for each station's location and a number of contextual factors using regression models and geographical information systems (GIS). Data on accidents are used as references for the analysis of suicides. Findings show that suicides tend to occur during the day and in the spring. They are concentrated in the main transportation hubs but, interestingly, during off-peak hours. However, the highest rates of suicides per passenger are found in Stockholm's subway stations located in the Southern outskirts. More than half of the variation in suicide rates is associated with stations that have walls between the two sides of the platform but still allow some visibility from passers-by. The surrounding environment and socioeconomic context show little effect on suicide rates, but stations embedded in areas with high drug-related crime rates tend to show higher suicide rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Child mortality in Stockholm during 1885-1910

DEFF Research Database (Denmark)

Burström, B; Diderichsen, Finn; Smedman, L

1999-01-01

on the risk of measles death. Individual entries in a population-based register and on death certificates for children aged 0-15 years living in one parish in Stockholm in 1885, 1891, and 1910 (n = 36,718) were used to analyze cause-specific and overall death rates in relation to household size and the number...... crowding and the risk of death from pneumonia and bronchitis disappeared when controlling for other risk factors. A negative association between the risk of overall death and large household size became significantly positive when controlling for other risk factors. The increased risk of death from measles...

[Coronary heart disease: epidemiologic-genetic aspects].

Science.gov (United States)

Epstein, F H

1985-01-01

Coronary heart disease and the risk factors which predispose to it aggregate in families. How much of this clustering of disease is "explained" by the familial resemblance in predisposing factors? The published reports which bear on this question fall into six distinct study designs: prospective studies, persons at high or low risk or persons with and without a positive family history as points of departure, case-control studies, studies of patients who had a coronary angiogram and studies in different ethnic groups. The findings of the 16 investigations reviewed suggest that there are as yet unidentified factors - genetic, environmental or both - which are responsible for familial clustering of coronary heart disease, apart from the three main risk factors (serum lipids, blood pressure, smoking) and diabetes. Future research must put greater emphasis on studies of families rather than individuals and on closer collaboration between epidemiologists and geneticists, in order to fill these gaps in knowledge. It is likely that the individual predisposition to coronary heart disease is due in part to genetic influences which remain to be discovered in the course of such studies. They would help in identifying susceptible person in the population with greater precision than is now possible. The "high-risk strategy" of coronary heart disease prevention will become more efficient as more specific and sensitive tests of disease prediction are developed. In the meantime, preventive programmes must be put into action on the basis of what is already known, on the level of both the high-risk and the community-wide mass strategy.

Vitamin C and Heart Health: A Review Based on Findings from Epidemiologic Studies

Directory of Open Access Journals (Sweden)

Melissa A. Moser

2016-08-01

Full Text Available Vitamin C is a powerful dietary antioxidant that has received considerable attention in the literature related to its possible role in heart health. Although classical vitamin C deficiency, marked by scurvy, is rare in most parts of the world, some research has shown variable heart disease risks depending on plasma vitamin C concentration, even within the normal range. Furthermore, other studies have suggested possible heart-related benefits to vitamin C taken in doses beyond the minimal amounts required to prevent classically defined deficiency. The objective of this review is to systematically review the findings of existing epidemiologic research on vitamin C and its potential role in cardiovascular disease (CVD. It is well established that vitamin C inhibits oxidation of LDL-protein, thereby reducing atherosclerosis, but the cardiovascular outcomes related to this action and other actions of vitamin C are not fully understood. Randomized controlled trials as well as observational cohort studies have investigated this topic with varying results. Vitamin C has been linked in some work to improvements in lipid profiles, arterial stiffness, and endothelial function. However, other studies have failed to confirm these results, and observational cohort studies are varied in their findings on the vitamin’s effect on CVD risk and mortality. Overall, current research suggests that vitamin C deficiency is associated with a higher risk of mortality from CVD and that vitamin C may slightly improve endothelial function and lipid profiles in some groups, especially those with low plasma vitamin C levels. However, the current literature provides little support for the widespread use of vitamin C supplementation to reduce CVD risk or mortality.

Association between job characteristics and plasma fibrinogen in a normal working population: a cross sectional analysis in referents of the SHEEP Study. Stockholm Heart Epidemiology Program.

Science.gov (United States)

Tsutsumi, A; Theorell, T; Hallqvist, J; Reuterwall, C; de Faire, U

1999-06-01

To explore the association between job characteristics and plasma fibrinogen concentrations. Cross sectional design. The Greater Stockholm area. A total of 1018 men and 490 women aged 45-70 who were randomly selected from the general population during 1992-1994. They were all employed and had no history of myocardial infarction. The self reported job characteristics were measured by a Swedish version of the Karasek demand-control questionnaire. For inferred scoring of job characteristics, psychosocial exposure categories (job control and psychological demands) were assigned by linking each subject's occupational history with a work organisation exposure matrix. Job strain was defined as the ratio between demands and control. In univariate analyses, expected linear trends were found in three of four tests of association between high plasma fibrinogen and low control (the self reported score for women and the inferred score for both sexes), in one of four tests of association between high plasma fibrinogen and high demands (the inferred score for women) and in two of four tests of association between high plasma fibrinogen and job strain (the inferred score for both sexes). Multiple logistic regression analyses showed that men in the inferred job strain group have an increased risk of falling into the increased plasma fibrinogen concentration group (above median level of the distribution) (odds ratio (OR) 1.2; 95% CI 1.0, 1.5) after adjustment for the variables that were associated with plasma fibrinogen in the univariate analyses. In women, low self reported control, high inferred demand, and inferred job strain were significantly associated with increased plasma fibrinogen concentration (OR 1.3; 95% CI 1.0, 1.8, OR 1.5; 95% CI 1.0, 2.2, OR 1.5; 95% CI 1.1, 2.2, respectively). These results indicate that adverse job characteristics may be related to plasma fibrinogen concentrations and this relation is more relevant in female workers. The clearest evidence for

Recent trends in coronary heart disease epidemiology in India.

Science.gov (United States)

Gupta, Rajeev

2008-01-01

Coronary heart disease (CHD) is epidemic in India and one of the major causes of disease-burden and deaths. Mortality data from the Registrar General of India shows that cardiovascular diseases are a major cause of death in India now. Studies to determine the precise causes of death in urban Chennai and rural areas of Andhra Pradesh have revealed that cardiovascular diseases cause about 40% of the deaths in urban areas and 30% in rural areas. Analysis of cross-sectional CHD epidemiological studies performed over the past 50 years reveals that this condition is increasing in both urban and rural areas. The adult prevalence has increased in urban areas from about 2% in 1960 to 6.5% in 1970, 7.0% in 1980, 9.7% in 1990 and 10.5% in 2000; while in rural areas, it increased from 2% in 1970, to 2.5% in 1980, 4% in 1990, and 4.5% in 2000. In terms of absolute numbers this translates into 30 million CHD patients in the country. The disease occurs at a much younger age in Indians as compared to those in North America and Western Europe. Rural-urban differences reveal that risk factors like obesity, truncal obesity, hypertension, high cholesterol, low HDL cholesterol and diabetes are more in urban areas. Case-control studies also confirm the importance of these risk factors. The INTERHEART-South Asia study identified that eight established coronary risk factors--abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable consumption, and lack of physical activity--accounted for 89% of the cases of acute myocardial infarction in Indians. There is epidemiological evidence that all these risk factors are increasing. Over the past fifty years prevalence of obesity, hypertension, hypercholesterolemia, and diabetes have increased significantly in urban (R2 0.45-0.74) and slowly in rural areas (R2 0.19-0.29). There is an urgent need for development and implementation of suitable primordial, primary, and secondary prevention

A liquidity study on the Nasdaq OMX Stockholm exchange

OpenAIRE

Leffler, Fredrik; Dworsky Nylander, Adam

2012-01-01

As the demand for liquidity risk management has increased, the importance of comprehensive liquidity assessments of exchanges has been highlighted. This thesis investigates the liquidity on the Nasdaq OMX Stockholm exchange by using daily end of day data. The transaction cost is evaluated using the Holden model and the price impact from trading is evaluated using the Illiq model. Considering the three segments; small cap, mid cap, and large cap, the results suggest that both the transaction c...

Food redistribution in Stockholm : A comparative analysis of two scenarios – with and without a food bank

OpenAIRE

Persson, Anna

2016-01-01

Food waste is a serious problem in today’s society. Functional food waste is going to waste treatment while people are suffering from food insecurity. Food redistribution in form of a central food bank which collects food waste at food companies and delivers it to social organizations is a measure to deal with this issue. Stockholm City Mission plans to start up a central food bank in Stockholm and it is this implementation that is of focus in this report. The purpose of this study is to comp...

School Performance, School Segregation, and Stress-Related Symptoms: Comparing Helsinki and Stockholm

Science.gov (United States)

Modin, Bitte; Karvonen, Sakari; Rahkonen, Ossi; Östberg, Viveca

2015-01-01

This study investigates cross-cultural differences in the interrelation between school performance, school segregation, and stress-related health among 9th-grade students in the greater Stockholm and Helsinki areas. Contrary to the Swedish case, it has been proposed that school performance in Finland is largely independent of the specific school…

Race and ethnic differences in the epidemiology and risk factors for graft failure after heart transplantation.

Science.gov (United States)

Morris, Alanna A; Kalogeropoulos, Andreas P; Zhao, Liping; Owen, Melissa; Raja Laskar, S; David Vega, J; Smith, Andrew; Butler, Javed

2015-06-01

Contemporary epidemiology of chronic graft failure (GF) after heart transplantation (HT) is not well described. Moreover, differences in the epidemiology of GF based on race/ethnicity remain poorly understood, despite clear evidence of inferior survival of ethnic minorities after HT. The incidence of GF and the population-attributable risk (PAR) of independent risk factors for GF were assessed in 15,255 patients (76% men; mean age 52 ± 12 years) who underwent primary HT from 2004 to 2012. During a median follow-up of 4.7 years (interquartile range, 2.3-7.1 years), GF developed in 2,926 patients (19.2%), corresponding to an incidence rate of 39.8/1,000 person-years (95% confidence interval, 38.4-41.3). Blacks were more likely to develop GF than Hispanics or whites, with incidence rates of 55.1, 42.2, and 36.5/1,000 person-years, respectively. After multivariable adjustment, black race was associated with a higher risk of GF (hazard ratio, 1.4; 95% confidence interval, 1.2-1.6; p differences in risk factors for GF after HT require further study. Published by Elsevier Inc.

Bullying in Context: An Analysis of Psychosomatic Complaints among Adolescents in Stockholm

Science.gov (United States)

Modin, Bitte; Låftman, Sara Brolin; Östberg, Viveca

2015-01-01

Using multilevel modeling, this study examined how different types of bullying, involving both peers and teachers, relate to psychosomatic health complaints. Data were obtained via the Stockholm School Survey from 41,032 ninth- and eleventh-grade students in the years 2004, 2006, 2008, and 2010. Results showed that students involved in bullying as…

Effect of air pollution on the epiphytic flora of conifers in the Stockholm region

Energy Technology Data Exchange (ETDEWEB)

Lundstroem, H

1968-01-01

Epiphytic flora (especially lichens) have been investigated in order to see how they respond to air pollution. The study was restricted to those occurring up to a height of 2.3 m from the ground, on trunks of the conifers Picea abies and Pinus silvestries. The area of investigation lies north of Stockholm. Wind diagrams show a slight predominance of winds from Stockholm. This means that polluted air is spread out over the area of investigation. All epiphytic vegetation on the station-trees for which the species were determined are listed. The distribution of lichen species is discussed, especially how air pollution has affected the distributions of the three lichens, Hypogymnia physodes (L.) Zopf (syn. Parmelia physodes (L.) Ach.) Parmeliopsis ambigua (Wulf) Nyl. Pseudevernia furfuraceae (L.) Zopf (syn. Parmelia furfuraceae (L.) Ach.). Maps of distributions have been made for the most common epiphytes.

Framing the role of Decision Support in the case of Stockholm Congestion Charging Trial

DEFF Research Database (Denmark)

Gudmundsson, Henrik; Ericsson, Eva; Hugosson, Muriel Besser

2009-01-01

the way for investigating the use and role of ‘Decision Support’ in the Stockholm Congestion Charging experiment. We adopt a definition of Decision Support as the systematic application of externally produced knowledge in transport planning and policy making processes. We then derive an analytical...... framework from the research literature on ‘knowledge utilization’ in policy making. This research has generally found that both ‘technical’, ‘communicative’, and ‘institutional’ aspects of the Decision Support matter for its influence on actual policy making processes and results. In our analysis we find...... in a Swedish context, and the introduction of the Stockholm system has been highly controversial. Considerable efforts have therefore been undertaken to provide information that could serve as ‘Decision Support’ along the way. This has included e.g. modelling and forecasts before the Trial, a comprehensive...

Incentives for environmentally friendly vehicles. A report from the Environment and Health Protection Administration in Stockholm

Energy Technology Data Exchange (ETDEWEB)

Henriksson, Cecilia; Paedam, S. [Inregia AB, Stockholm (Sweden)

1999-11-01

This report deals with incentives for environmentally friendly vehicles. The report includes a description of the current status of these vehicles in Sweden, Stockholm County Council, and the City of Stockholm. A forecast of possible development of zero and low emission vehicles is carried out. The major obstacles which currently hinder a market for these vehicles are noted. In order to determine market readiness and factors which affect these firms' purchase of vehicles, interviews were carried out with private firms. This analysis indicates that institutional barriers in Sweden hinder zero and low emission vehicles, with laws and tax policies which offer conflicting signals. To follow international developments, these obstacles must be reduced. Therefore, it is important that Stockholm works to create a positive climate for environmentally friendly vehicles. This means that it is important that the policies recommended in this report are implemented with adequate intensity. Because knowledge about zero and low emission vehicles is limited, there is a need to produce factual information. Information can be spread to a larger group, but it is more cost effective to reach a group which is most likely to accept environmentally friendly vehicles. This could include companies with environmental profiles, or those who drive and use company cars. To increase the effectiveness of this information campaign, we suggest that the City also maintain a demonstration fleet with loaner cars for companies who wish to test these vehicles in daily operation before deciding whether or not to purchase them. The incentive package recommended for Stockholm includes offering parking rebates to various groups who park in the city centre; residents , commercial vehicles, and temporary visitors. For equity reasons, all groups should in practice be offered the rebate. To increase the positive effect of the incentive, environmentally friendly vehicles should also be allowed to drive in

The environmental fate of polybrominated diphenyl ethers in the centre of Stockholm - Assessment using a multimedia fugacity model

Energy Technology Data Exchange (ETDEWEB)

Palm, Anna

2001-01-01

A local-scale assessment of the environmental fate of three congeners of polybrominated diphenyl ethers (PBDEs) has been performed for the centre of Stockholm. The partitioning properties and main transport processes of these congeners in Stockholm are identified using a site-specific multimedia fugacity model, called CeStoc, that was developed and parameterized for the area of interest. CeStoc was based on level III and IV fugacity models. Five compartments were included: air, water, soil, sediment and an organic film covering the impervious surfaces in the city. The model was satisfactory calibrated with the PAH fluoranthene, before it was run for the compounds of interest. Validation with environmental levels of PBDEs was made where possible, showing reasonable agreement with model results. According to the CeStoc results, the majority of the PBDEs emitted are transported out of the region through air advection, implying that Stockholm may act as a source for chemical release to other regions. The largest sink for PBDEs in Stockholm is soil, closely followed by sediment, the two compartments together accounting for about 98 % of the total amount remaining in the system. The degree of bromination does not seem to have a large impact on the environmental distribution in this area, but further research on e.g. physical-chemical properties is necessary before this can be finally concluded. Predicted concentrations of individual PBDE congeners in sediment and water lie in the same range as measured levels of individual PCB-congeners, indicating that PBDEs could have an environmental impact of about the same size as the PCBs.

[INCIDENCE OF CORONARY HEART DISEASE IN COMBINATION WITH TYPE 2 DIABETES MELLITUS ESTIMATED FROM RESULTS OF AN EPIDEMIOLOGICAL STUDY OF 20-59 YEAR OLD WOMEN].

Science.gov (United States)

Sultanova, S S; Kasumova, E N; Mamedova, R N

2015-01-01

We report evaluation of the incidence of coronary heart disease (CHD) in combination with type 2 diabetes mellitus (DM2) estimated from results of an epidemiological study of 20-59 year old women. CPD was shown to occur twice more frequently in association with DM2 especilly in the age groups of 30-39 and 50-59 years.

Dental erosion, prevalence and risk factors among a group of adolescents in Stockholm County.

Science.gov (United States)

Skalsky Jarkander, M; Grindefjord, M; Carlstedt, K

2018-02-01

To investigate the prevalence and risk factors of dental erosion (DE) among a group of adolescents in Stockholm County. This cross sectional cohort study was conducted at three clinics of the Public Dental Service in Stockholm County. Fifteen and 17 year old adolescents (1335) who scheduled their regular dental health examination were asked to participate. After drop-outs a sample of 1071 individuals, 547 males and 524 females were enrolled in the study. Presence of erosive wear was diagnosed (yes/no) on marker teeth by trained dentists/dental hygienists and photographs were taken. The adolescents answered a questionnaire regarding oral symptoms, dietary and behavioural factors. Two calibrated specialist dentists performed evaluation of the photographs for severity of DE using a modified version of the Simplified Erosion Partial Recording System (SEPRS). DE was clinically diagnosed in 28.3% of 15 years old and 34.3% of 17 years old. Severe erosive wear (grade 3 and 4 according to SEPRS) was found in 18.3% of the adolescents based upon the intra-oral photographs. DE was more prevalent and severe among males than females. Clinically diagnosed erosive lesions correlated significantly with soft drink consumption (p < 0.001), the use of juice or sport drinks as a thirst quencher after exercise (p = 0.006) and tooth hypersensitivity when eating and drinking (p = 0.012). Furthermore, self-assessed gastric reflux was a factor strongly associated with DE (p < 0.001). The study indicated that DE was common among adolescents in Stockholm County and associated with both internal and external risk factors.

A systematic review of trends and patterns of congenital heart ...

African Journals Online (AJOL)

Background: Congenital heart diseases cause significant childhood morbidity and mortality. Several restricted studies have been conducted on the epidemiology in Nigeria. No truly nationwide data on patterns of congenital heart disease exists. Objectives: To determine the patterns of congenital heart disease in children in ...

Epidemiology of heart failure with preserved ejection fraction

DEFF Research Database (Denmark)

Andersson, Charlotte; Vasan, Ramachandran S

2014-01-01

Heart failure with preserved ejection fraction (HFPEF) is a common condition, and the prevalence is projected to increase further. Studies differ in the reported incidence and mortality associated with this condition, although there is agreement that between a third and one-half of all patients...... with heart failure have HFPEF. Although several consensus statements and guidelines have been published, some recent randomized clinical trials have reported low mortality, raising doubts about whether all patients diagnosed with HFPEF have HFPEF or whether the condition is heterogeneous in its cause...

[Heart failure patterns in Djibouti: epidemiologic transition].

Science.gov (United States)

Massoure, P L; Roche, N C; Lamblin, G; Topin, F; Dehan, C; Kaiser, E; Fourcade, L

2013-05-01

The features of heart failure (HF) in Djibouti have not been well described. We sought to document the current patterns of HF here. We prospectively included Djiboutian adults hospitalized for HF in the French Military Hospital (Djibouti) from August 2008 through December 2010. Of 1688 adults hospitalized in the medical department, 45 (2.7%) had symptomatic HF: 38 (84%) men, mean age 55.8 years (range 27-75). Twenty-five (56%) patients were initially hospitalized for acute pulmonary edema. The underlying diseases included coronary artery disease (CAD) (62%), hypertensive heart disease (18%), rheumatic valvular disease (13%), and primary dilated cardiomyopathy (7%). Their cardiovascular risk factors included tobacco use (53%), hypertension (69%), diabetes (47%), and hypercholesterolemia (51%). Patients in the CAD group were older, and had diabetes more often (p<0.01). All khat chewers (53%) were males and smokers. Mean left ventricular ejection fraction (LVEF) was 39 ± 14%. During follow-up (14.4 ± 9 months), 8 (18%) patients died, 9 (20%) were again hospitalized for HF, and 3 (7%) had ischemic strokes. One month after discharge, the New York Heart Association (NYHA) class was II for 40%, III for 44%, and IV for 16%. Higher NYHA classes and dilated cardiomyopathy were both associated with poorer outcomes (p<0.03). In hospitalized Djiboutians, most HF patterns are similar to those in industrialized countries. CAD is more prevalent than previously reported in African patients with HF.

Stockholm conference. Summary of the international conference on the security of material in Stockholm, Sweden

International Nuclear Information System (INIS)

Hoskins, Richard

2001-01-01

Preventing illicit uses of nuclear material and radioactive sources was a major international concern even before the spectre of nuclear terrorism was raised by terrorist attacks in September 2001. At an IAEA international conference in Stockholm, Sweden, convened in May 2001, international experts examined ways and means of strengthening systems for the protection of nuclear and radioactive material. The Conference - formally called 'Security of Material: Measures to Prevent, Intercept and Respond to Illicit Uses of Nuclear Material and Radioactive Sources' - was attended by more than 300 experts from around the world. It was organized by the IAEA in cooperation with the European Police Office (Europol), the International Criminal Police Organization - Interpol (ICPO-Interpol), and the World Customs Organization (WCO), and hosted by the Swedish Nuclear Power Inspectorate. In the Conference Summary Document, participants underscored the importance of establishing stronger systems for nuclear security, and they outlined a number of steps for the future in particular areas. Following are excerpts from the Document. More information on the Conference is accessible on the IAEA's WorldAtom Web site at http://www.iaea.org/ worldatom/Press/P r elease/2001/ prn0110.shtml

HCH contamination from former pesticide production in Brazil--a challenge for the Stockholm Convention implementation.

Science.gov (United States)

Torres, J P M; Fróes-Asmus, C I R; Weber, R; Vijgen, J M H

2013-04-01

Hexachlorocyclohexane (HCH) isomers (α-, β- and γ- HCH [lindane]) were recently added to the list of persistent organic pollutants regulated by the Stockholm Convention, and therefore, the legacy of HCH and lindane production has become an issue of global relevance. The production of lindane with the much larger quantities of associated waste isomers has generated large waste deposits and contaminated sites. This article presents an overview of HCH-polluted sites in Brazil as a basis for further activities related to the Stockholm Convention. The locations of HCH stockpiles and contaminated sites in Brazil arising from production and formulation have been compiled and mapped. This shows that the measures taken over the past 25 years have not resulted in remediation of the HCH pollution. An exposure risk study has been summarised for one major site and is included to demonstrate the contemporary relevance of the contamination. Major site remediation efforts are planned at one site but people live close to several other sites, and there is an urgent need of further assessments and remediation to ensure the protection of human health and the environment. The Stockholm Convention requires a systematic approach and should be adopted for the assessment of all sites and appropriate isolation/remediation measures should be facilitated. The appropriate planning of these activities for the production site in Rio de Janeiro could be a positive contribution for Rio+20 highlighting that green economy and sustainable production also include the appropriate management of legacies of historic production of an industrial sector (here the organochlorine industry).

Epidemiology of childhood heart failure in Port Harcourt, Nigeria ...

African Journals Online (AJOL)

Background: Heart failure (HF) is a clinical syndrome that complicates a variety of childhood illnesses. Recent studies in various parts of Nigeria show a prevalence rate of 5.8-15.5%. There is relatively scant data on heart failure in children in the south-south geo-political region of the country, necessitating this study. Aim: To ...

Can dispersion modeling of air pollution be improved by land-use regression? An example from Stockholm, Sweden.

Science.gov (United States)

Korek, Michal; Johansson, Christer; Svensson, Nina; Lind, Tomas; Beelen, Rob; Hoek, Gerard; Pershagen, Göran; Bellander, Tom

2017-11-01

Both dispersion modeling (DM) and land-use regression modeling (LUR) are often used for assessment of long-term air pollution exposure in epidemiological studies, but seldom in combination. We developed a hybrid DM-LUR model using 93 biweekly observations of NO x at 31 sites in greater Stockholm (Sweden). The DM was based on spatially resolved topographic, physiographic and emission data, and hourly meteorological data from a diagnostic wind model. Other data were from land use, meteorology and routine monitoring of NO x . We built a linear regression model for NO x , using a stepwise forward selection of covariates. The resulting model predicted observed NO x (R 2 =0.89) better than the DM without covariates (R 2 =0.68, P-interaction <0.001) and with minimal apparent bias. The model included (in descending order of importance) DM, traffic intensity on the nearest street, population (number of inhabitants) within 100 m radius, global radiation (direct sunlight plus diffuse or scattered light) and urban contribution to NO x levels (routine urban NO x , less routine rural NO x ). Our results indicate that there is a potential for improving estimates of air pollutant concentrations based on DM, by incorporating further spatial characteristics of the immediate surroundings, possibly accounting for imperfections in the emission data.

Stockholm Safety Conference. Analysis of the sessions on radiological protection, licensing and risk assessment

International Nuclear Information System (INIS)

Gea, A.

1981-01-01

A summary of the sessions on radiological protection, licensing and risk assessment in the safety conference of Stockholm is presented. It is considered the new point of view of the nuclear safety, probabilistic analysis, components failures probability and accident analysis. They are included conclusions applicable in many cases to development countries. (author)

Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department

Energy Technology Data Exchange (ETDEWEB)

Moraes, Ricardo Casalino Sanches de [Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Katz, Marcelo [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Tarasoutchi, Flávio [Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

2014-07-01

To evaluate the clinical and epidemiological profile of patients with valvular heart disease who arrived decompensated at the emergency department of a university hospital in Brazil. A descriptive analysis of clinical and echocardiographic data of 174 patients with severe valvular disease, who were clinically decompensated and went to the emergency department of a tertiary cardiology hospital, in the State of São Paulo, in 2009. The mean age of participants was 56±17 years and 54% were female. The main cause of valve disease was rheumatic in 60%, followed by 15% of degenerative aortic disease and mitral valve prolapse in 13%. Mitral regurgitation (27.5%) was the most common isolated valve disease, followed by aortic stenosis (23%), aortic regurgitation (13%) and mitral stenosis (11%). In echocardiographic data, the mean left atrial diameter was 48±12mm, 38±12mm for the left ventricular systolic diameter, and 54±12mm for the diastolic diameter; the mean ejection fraction was 56±13%, and the mean pulmonary artery pressure was 53±16mmHg. Approximately half of patients (44%) presented atrial fibrillation, and over one third of them (37%) had already undergone another cardiac surgery. Despite increased comorbidities and age-dependent risk factors commonly described in patients with valvular heart disease, the clinical profile of patients arriving at the emergency department represented a cohort of rheumatic patients in more advanced stages of disease. These patients require priority care in high complexity specialized hospitals.

Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department

International Nuclear Information System (INIS)

Moraes, Ricardo Casalino Sanches de; Katz, Marcelo; Tarasoutchi, Flávio

2014-01-01

To evaluate the clinical and epidemiological profile of patients with valvular heart disease who arrived decompensated at the emergency department of a university hospital in Brazil. A descriptive analysis of clinical and echocardiographic data of 174 patients with severe valvular disease, who were clinically decompensated and went to the emergency department of a tertiary cardiology hospital, in the State of São Paulo, in 2009. The mean age of participants was 56±17 years and 54% were female. The main cause of valve disease was rheumatic in 60%, followed by 15% of degenerative aortic disease and mitral valve prolapse in 13%. Mitral regurgitation (27.5%) was the most common isolated valve disease, followed by aortic stenosis (23%), aortic regurgitation (13%) and mitral stenosis (11%). In echocardiographic data, the mean left atrial diameter was 48±12mm, 38±12mm for the left ventricular systolic diameter, and 54±12mm for the diastolic diameter; the mean ejection fraction was 56±13%, and the mean pulmonary artery pressure was 53±16mmHg. Approximately half of patients (44%) presented atrial fibrillation, and over one third of them (37%) had already undergone another cardiac surgery. Despite increased comorbidities and age-dependent risk factors commonly described in patients with valvular heart disease, the clinical profile of patients arriving at the emergency department represented a cohort of rheumatic patients in more advanced stages of disease. These patients require priority care in high complexity specialized hospitals

The Stockholm-3 (STHLM3) Model can Improve Prostate Cancer Diagnostics in Men Aged 50-69 yr Compared with Current Prostate Cancer Testing.

Science.gov (United States)

Eklund, Martin; Nordström, Tobias; Aly, Markus; Adolfsson, Jan; Wiklund, Peter; Brandberg, Yvonne; Thompson, James; Wiklund, Fredrik; Lindberg, Johan; Presti, Joseph C; StLezin, Mark; Clements, Mark; Egevad, Lars; Grönberg, Henrik

2016-11-23

Prostate cancer screening is associated with low specificity, unnecessary biopsies, and overdiagnosis. We have previously shown that the Stockholm-3 model (S3M) can reduce biopsies compared with using prostate-specific antigen (PSA) ≥3ng/ml as an indication for biopsy. Urologists in today's current prostate cancer testing (CPT) have access to numerous variables in addition to PSA (eg, age, ethnicity, family history, free PSA, PSA velocity, digital rectal examination, and prostate volume) to support biopsy decisions. We estimated the number of prostate cancers diagnosed and prostate biopsies performed if S3M replaced CPT in Stockholm, Sweden, by comparing biopsy results in 56 282 men who underwent PSA testing according to CPT in Stockholm in 2011 with the 47 688 men enrolled in the STHLM3 validation cohort 2012-2015. With the same sensitivity as CPT to diagnose Gleason score ≥7 prostate cancer, S3M was estimated to reduce the number of men biopsied by 53% (95% confidence interval [CI]: 41-65%), avoid 76% (95% CI: 67-81%) of negative biopsies, and reduce Gleason score 6 cancers by 23% (95% CI: 6-40%). S3M has the potential to improve prostate cancer diagnostics by better selecting men with high risk of GS ≥7 prostate cancer. We modeled the effect the Stockholm-3 model would have on prostate cancer diagnostics if it replaced current clinical practice. We found that Stockholm-3 model may substantially reduce the number of biopsies, while maintaining the same sensitivity to diagnose clinically significant prostate cancer. Copyright © 2016. Published by Elsevier B.V.

Modern treatment methods for heart failure

Directory of Open Access Journals (Sweden)

Bojan Vrtovec

2011-04-01

Full Text Available Abstract: Chronic heart failure is a clinical syndrome that can result from many cardiac diseases, the most common being cardiomyopathies and coronary artery disease. According to recent epidemiological data, heart failure is the only cardiologic entity whose prevalence is actually increasing and is present in 2–5 % of general population and in 10 % of people older than 65 years. The scope of this paper includes algorithms of initial heart failure diagnostic work-up , medical management and contemporary non-medical treatment options.

Foreign Reports about Stepan Razin’s Execution. New Documents from the Stockholm Archive

Directory of Open Access Journals (Sweden)

Gleb M. Kazakov

2017-12-01

Full Text Available This paper analyzes reports written by foreign authors about the execution of Stepan Razin. The main focus is on two dispatches written by the Swedish citizen and merchant in Moscow, Christoff Koch, in May–June 1671 and sent to Narva, and from there, they were forwarded to the Swedish capital, among other places. They are now kept at the State Archives in Stockholm, and they have not been discussed previously in the scholarly literature. The paper contains the full translation into Russian of two long reports written by Koch about Razin’s capture, delivery to Moscow, interrogation, and execution, with our comments. Special attention is given to a unique colored drawing, showing the brothers, Stepan and Frol Razin, as well as the body parts of the executed Stepan. From the written documents it becomes clear that the drawing was sent from Moscow to the governor of Swedish Ingria in Narva, and then forwarded to Stockholm, together with the two Koch dispatches. The authors come to the conclusion that several copies must have been made and that they were intentionally distributed among foreigners in Moscow. Most probably only one copy has survived to our days, the one in Stockholm. Arguments are given for the hypothesis that one copy of the drawing ended up in England and served as the prototype for the well-known imprint of 1672, which shows the Razin brothers when they were being delivered to Moscow. In our study we also compare the information given by Koch with descriptions of Razin’s death that were published in West-European newspapers, pamphlets, and books during the 1670s. This comparison brings us to the conclusion that the information about the execution of the leader of the rebellion reached the European press from several witnesses to the events, and that, over time, the original information was filled out with invented details.

Pulmonary hypertension due to left heart disease.

Science.gov (United States)

Berthelot, Emmanuelle; Bailly, Minh Tam; Hatimi, Safwane El; Robard, Ingrid; Rezgui, Hatem; Bouchachi, Amir; Montani, David; Sitbon, Olivier; Chemla, Denis; Assayag, Patrick

Pulmonary hypertension due to left heart disease, also known as group 2 pulmonary hypertension according to the European Society of Cardiology/European Respiratory Society classification, is the most common cause of pulmonary hypertension. In patients with left heart disease, the development of pulmonary hypertension favours right heart dysfunction, which has a major impact on disease severity and outcome. Over the past few years, this condition has been considered more frequently. However, epidemiological studies of group 2 pulmonary hypertension are less exhaustive than studies of other causes of pulmonary hypertension. In group 2 patients, pulmonary hypertension may be caused by an isolated increase in left-sided filling pressures or by a combination of this condition with increased pulmonary vascular resistance, with an abnormally high pressure gradient between arteries and pulmonary veins. A better understanding of the conditions underlying pulmonary hypertension is of key importance to establish a comprehensive diagnosis, leading to an adapted treatment to reduce heart failure morbidity and mortality. In this review, epidemiology, mechanisms and diagnostic approaches are reviewed; then, treatment options and future approaches are considered. Copyright © 2017. Published by Elsevier Masson SAS.

Genetically elevated apolipoprotein A-I, high-density lipoprotein cholesterol levels, and risk of ischemic heart disease

DEFF Research Database (Denmark)

Lundegaard, Christiane; Tybjærg-Hansen, Anne; Grande, Peer

2010-01-01

Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD).......Epidemiologically, levels of high-density lipoprotein (HDL) cholesterol and its major protein constituent, apolipoprotein A-I (apoA-I), are inversely related to risk of ischemic heart disease (IHD)....

Heart failure as a general pandemic in Asia.

Science.gov (United States)

Shimokawa, Hiroaki; Miura, Masanobu; Nochioka, Kotaro; Sakata, Yasuhiko

2015-09-01

Heart failure (HF) is an epidemic in healthcare worldwide, including Asia. It appears that HF will become more serious in the near future, with the epidemiological transition and ageing of the population. However, in contrast to Western countries, information on HF epidemiology is still limited in Asia, particularly in South Asia. In this review, we will briefly summarize available information regarding the current and future burden of HF in Asia, which indicates the importance of both primary prevention of underlying diseases of HF and secondary prevention, including management of ischaemic HF, HF with preserved EF, and HF in the elderly. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

Diabetes Mellitus and Heart Failure.

Science.gov (United States)

Lehrke, Michael; Marx, Nikolaus

2017-06-01

Epidemiologic and clinical data from the last 2 decades have shown that the prevalence of heart failure in diabetes is very high, and the prognosis for patients with heart failure is worse in those with diabetes than in those without diabetes. Experimental data suggest that various mechanisms contribute to the impairment in systolic and diastolic function in patients with diabetes, and there is an increased recognition that these patients develop heart failure independent of the presence of coronary artery disease or its associated risk factors. In addition, current clinical data demonstrated that treatment with the sodium glucose cotransporter 2 inhibitor empagliflozin reduced hospitalization for heart failure in patients with type 2 diabetes mellitus and high cardiovascular risk. This review article summarizes recent data on the prevalence, prognosis, pathophysiology, and therapeutic strategies to treat patients with diabetes and heart failure. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Caracterización clínica y epidemiológica de las cardiopatías congénitas Clinical and epidemiological characterization of congenital heart diseases

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Yanett Sarmiento Portal

2013-04-01

Full Text Available Introducción: las cardiopatías congénitas constituyen un grupo heterogéneo de defectos morfofuncionales del corazón y los vasos sanguíneos. Objetivo: caracterizar los factores clínicos y epidemiológicos asociados a las cardiopatías congénitas. Material y Método: se realizó un estudio observacional, analítico, tipo caso-control en el servicio de Neonatología del Hospital "Abel Santamaría", años 2010-11. El universo lo constituyeron los 11 138 nacidos vivos en dicho período. La muestra se dividió en Grupo Estudio: 70 niños con diagnóstico de CC en el período neonatal y Grupo Control: 140 recién nacidos a término, nacidos consecutivos a los del estudio, tomando dos controles por cada caso. Se utilizó el test de Ji Cuadrado con nivel de significación pIntroduction: congenital heart diseases constitute a heterogeneous group of heart morpho-functional and blood vessels defects. Objective: to characterize clinical and epidemiological factors associated with congenital heart diseases. Material and method: an observational, analytical, case-control type study was carried out in neonatology service at "Abel Santamaria Cuadrado" University Hospital during 2010-2011. The target group was comprised of 11 138 newborn infants in such period. The sample was divided into: Study Group (70 newborn infants having the diagnosis of congenital heart disease in the neonatal period and a Control Group: 140 at term newborn infants, born consecutively of those included into the Study Group, taking two controls per each case. Chi-square test with a level of significance p<0.05 and the odd ratio were used to determine the strength of association among the variables. Results: the incidence of heart diseases during the period was 6,3 per 1000 alive newborn infants. Maternal ages between 20 and 34 years old prevailed, where anaemia was the most prevailing disease found in the study group (17,1%, which was a risk factor. Toxic habits were present in 58

Dietary fiber and risk of coronary heart disease

DEFF Research Database (Denmark)

Pereira, Mark A; O'Reilly, Eilis; Augustsson, Katarina

2004-01-01

BACKGROUND: Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk...... of coronary heart disease. METHODS: We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease. RESULTS: Over 6 to 10 years of follow-up, 5249 incident total coronary cases...... associated with risk of coronary heart disease....

Application of Haddon’s matrix in qualitative research methodology: an experience in burns epidemiology

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Deljavan R

2012-07-01

Full Text Available Reza Deljavan,1 Homayoun Sadeghi-Bazarganim,2,3 Nasrin Fouladim,4 Shahnam Arshi,5 Reza Mohammadi61Injury Epidemiology and Prevention Research Center, 2Neuroscience Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran; 3Public Health Department, Karolinska Institute, Stockholm, Sweden; 4Ardabil University of Medical Sciences, Ardabil, Iran; 5Shahid Beheshti University of Medical Sciences, Tehran, Iran; 6Public Health Department, Karolinska Institute, Stockholm, SwedenBackground: Little has been done to investigate the application of injury specific qualitative research methods in the field of burn injuries. The aim of this study was to use an analytical tool (Haddon’s matrix through qualitative research methods to better understand people’s perceptions about burn injuries.Methods: This study applied Haddon’s matrix as a framework and an analytical tool for a qualitative research methodology in burn research. Both child and adult burn injury victims were enrolled into a qualitative study conducted using focus group discussion. Haddon’s matrix was used to develop an interview guide and also through the analysis phase.Results: The main analysis clusters were pre-event level/human (including risky behaviors, belief and cultural factors, and knowledge and education, pre-event level/object, pre-event phase/environment and event and post-event phase (including fire control, emergency scald and burn wound management, traditional remedies, medical consultation, and severity indicators. This research gave rise to results that are possibly useful both for future injury research and for designing burn injury prevention plans.Conclusion: Haddon’s matrix is applicable in a qualitative research methodology both at data collection and data analysis phases. The study using Haddon’s matrix through a qualitative research methodology yielded substantially rich information regarding burn injuries

The potential role of honey and its polyphenols in preventing heart ...

African Journals Online (AJOL)

Many epidemiological studies have shown that regular intake of phenolic compounds is associated with reduced risk of heart diseases. In coronary heart disease, the protective effects of phenolic compounds include mainly antithrombotic, anti-ischemic, anti-oxidant, and vasorelaxant. It is suggested that flavonoids decrease ...

Komentovaný překlad: Love and Stockholm Syndrome: The Mystery of Loving an Abuser. Joe Carver, PhD. http: drjoecarver.makeswebsites.com/clients/49355/File/love_and_stockholm_syndrome.html

OpenAIRE

Vašková, Adéla

2013-01-01

This bachelor's thesis consists of a Czech translation of an article Love and Stockholm Syndrome: The Mystery of Loving an Abuser written by an american author Joseph Carver, Ph.D., and a commentary on the translation. The commentary is divided into four parts: an analysis of the source text based on the model of Christiane Nord, the translation problems and their solutions, typology of the translation shifts based on the theory of Anton Popovič and the chosen translation method.

Improved survival after an educational project on colon cancer management in the county of Stockholm--a population based cohort study.

Science.gov (United States)

Bernhoff, R; Martling, A; Sjövall, A; Granath, F; Hohenberger, W; Holm, T

2015-11-01

Outcomes in rectal cancer have improved dramatically after the introduction of total mesorectal excision (TME). Recently, the TME concept has been transformed into that of complete mesocolic excision (CME) in an attempt to improve prognosis for patients with colon cancer. Multidisciplinary team (MDT) workshops including the CME concept were held annually between 2004 and 2008 at the Karolinska University Hospital. The workshops focused on preoperative staging, surgery and histopathology and included lectures and live surgery sessions. To compare survival before and after the "Stockholm Colon Cancer Project" all patients diagnosed with a right sided colon cancer between January 1, 2001 and December 31, 2003 (Group 1) and from January 1, 2006 until December 31, 2008 (Group 2) in Stockholm were identified from the Swedish ColoRectal Cancer Registry (SCRCR). The proportion of patients having a tumour resection and the proportion having emergency surgery was higher in Group 1. There were more early tumours and more R0 resections in Group 2. Overall survival in all diagnosed patients and disease free survival after tumour resection was improved in the second time period. Surgical teaching programmes may have an impact on the management and outcome in colon cancer. The exact impact from the "Stockholm Colon Cancer Project" cannot be established, however it is likely that it contributed to the improved survival. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Changing Epidemiology of Pediatric Endocarditis.

Science.gov (United States)

Elder, Robert W; Baltimore, Robert S

2015-09-01

The epidemiology of infective endocarditis (IE) appears to be related to changes in the management of children with congenital heart disease (CHD) and the virtual disappearance of rheumatic heart disease. To better understand these changes, we divide the history into: I. The pre-surgical era, II. The early years of CHD surgical intervention, correlated with introduction of antibiotics, III. The modern era of cardiac interventions. Microbiologic changes include an early predominance of viridans streptococci and an overtaking by staphylococci. Additionally, there have been advances in imaging that allow earlier detection of IE and a reduction in IE-related mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

Heart Transplant in Patients with Predominantly Rheumatic Valvular Heart Disease.

Science.gov (United States)

Rosa, Vitor E E; Lopes, Antonio S S A; Accorsi, Tarso A D; Fernandes, Joao Ricardo C; Spina, Guilherme S; Sampaio, Roney O; Bacal, Fernando; Tarasoutchi, Flavio

2015-09-01

International records indicate that only 2.6% of patients with heart transplants have valvular heart disease. The study aim was to evaluate the epidemiological and clinical profile of patients with valvular heart disease undergoing heart transplantation. Between 1985 and 2013, a total of 569 heart transplants was performed at the authors' institution. Twenty patients (13 men, seven women; mean age 39.5 +/- 15.2 years) underwent heart transplant due to structural (primary) valvular disease. Analyses were made of the patients' clinical profile, laboratory data, echocardiographic and histopathological data, and mortality and rejection. Of the patients, 18 (90%) had a rheumatic etiology, with 85% having undergone previous valve surgery (45% had one or more operations), and 95% with a normal functioning valve prosthesis at the time of transplantation. Atrial fibrillation was present in seven patients (35%), while nine (45%) were in NYHA functional class IV and eight (40%) in class III. The indication for cardiac transplantation was refractory heart failure in seven patients (35%) and persistent NYHA class III/IV in ten (50%). The mean left ventricular ejection fraction (LVEF) was 26.6 +/- 7.9%. The one-year mortality was 20%. Histological examination of the recipients' hearts showed five (27.7%) to have reactivated rheumatic myocarditis without prior diagnosis at the time of transplantation. Univariate analysis showed that age, gender, LVEF, rheumatic activity and rejection were not associated with mortality at one year. Among the present patient cohort, rheumatic heart disease was the leading cause of heart transplantation, and a significant proportion of these patients had reactivated myocarditis diagnosed in the histological analyses. Thus, it appears valid to investigate the existence of rheumatic activity, especially in valvular cardiomyopathy with severe systolic dysfunction before transplantation.

From research institution to astronomical museum: a history of the Stockholm Observatory

Science.gov (United States)

Yaskell, Steven Haywood

2008-07-01

The Royal Swedish Academy of Sciences (RSAS) (or Kungliga Vetenskapsakademien [KvA] in Swedish) founded 1739, opened its first permanent building, an astronomical and meteorological observatory, on 20 September 1753. This was situated at Brunkebergsåsen (formerly Observatorie Lunden, or Observatory Hill), on a high terrace in a northern quarter of Stockholm. This historic building is still sometimes called Gamla Observatoriet (the Old Observatory) and now is formally the Observatory Museum. This paper reviews the history of the Observatory from its function as a scientific astronomical institution to its relatively-recent relegation to museum status.

Epidemiology and pathogesis of human immunodifiency virus(HIV ...

African Journals Online (AJOL)

Epidemiology and pathogesis of human immunodifiency virus(HIV) related heart disease: A review. MU Sani, BN Okeahialam. Abstract. No Abstract. Nigerian Journal of Medicine Vol. 14(3) 2005: 255-260. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African ...

The effect of leisure-time physical activity on the risk of acute myocardial infarction depending on Body Mass Index: a population-based case-control study

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Reuterwall Christina

2006-12-01

Full Text Available Abstract Background High body mass index (BMI and lack of physical activity have been recognized as important risk factors for coronary heart disease. The aim of the present study was to evaluate whether leisure-time physical activity compensates for the increased risk of acute myocardial infarction associated with overweight and obesity. Methods Data from the SHEEP (Stockholm Heart Epidemiology Program study were used. The SHEEP study is a large Swedish population-based case-control study, comprising 1204 male and 550 female cases, and 1538 male and 777 female controls, conducted in Stockholm County, Sweden, during the period 1992–1994. Odds ratios (OR, together with 95 % confidence intervals (95% CI, were calculated using unconditional logistic regression, as estimates of the relative risks. Results Regular leisure-time physical activity was associated with a decreased risk of myocardial infarction among lean, normal-weight and overweight subjects, but not among obese subjects. Obese (BMI ≥ 30 and physically active persons had an almost twofold risk of myocardial infarction, compared with normal-weight and sedentary persons (OR 1.85, 95% CI 1.07–3.18. The results were similar for men and women. Conclusion While regular leisure-time physical activity seems to provide protection against myocardial infarction among lean, normal-weight and overweight subjects, this does not appear to be the case in obese subjects.

Mid-21st century air quality at the urban scale under the influence of changed climate and emissions: case studies for Paris and Stockholm

Science.gov (United States)

Markakis, K.; Valari, M.; Engardt, M.; Lacressonnière, G.; Vautard, R.; Andersson, C.

2015-10-01

Ozone, PM10 and PM2.5 concentrations over Paris, France and Stockholm, Sweden were modeled at 4 and 1 \\unit{km} horizontal resolutions respectively for the present and 2050 periods employing decade-long simulations. We account for large-scale global climate change (RCP-4.5) and fine resolution bottom-up emission projections developed by local experts and quantify their impact on future pollutant concentrations. Moreover, we identify biases related to the implementation of regional scale emission projections over the study areas by comparing modeled pollutant concentrations between the fine and coarse scale simulations. We show that over urban areas with major regional contribution (e.g., the city of Stockholm) the bias due to coarse emission inventory may be significant and lead to policy misclassification. Our results stress the need to better understand the mechanism of bias propagation across the modeling scales in order to design more successful local-scale strategies. We find that the impact of climate change is spatially homogeneous in both regions, implying strong regional influence. The climate benefit for ozone (daily average and maximum) is up to -5 % for Paris and -2 % for Stockholm city. The joined climate benefit on PM2.5 and PM10 in Paris is between -10 and -5 % while for Stockholm we observe mixed trends up to 3 % depending on season and size class. In Stockholm, emission mitigation leads to concentration reductions up to 15 % for daily average and maximum ozone and 20 % for PM and through a sensitivity analysis we show that this response is entirely due to changes in emissions at the regional scale. On the contrary, over the city of Paris (VOC-limited photochemical regime), local mitigation of NOx emissions increases future ozone concentrations due to ozone titration inhibition. This competing trend between the respective roles of emission and climate change, results in an increase in 2050 daily average ozone by 2.5 % in Paris. Climate and not

Mid-21st century air quality at the urban scale under the influence of changed climate and emissions - case studies for Paris and Stockholm

Science.gov (United States)

Markakis, Konstantinos; Valari, Myrto; Engardt, Magnuz; Lacressonniere, Gwendoline; Vautard, Robert; Andersson, Camilla

2016-02-01

Ozone, PM10 and PM2.5 concentrations over Paris, France and Stockholm, Sweden were modelled at 4 and 1 km horizontal resolutions respectively for the present and 2050 periods employing decade-long simulations. We account for large-scale global climate change (RCP-4.5) and fine-resolution bottom-up emission projections developed by local experts and quantify their impact on future pollutant concentrations. Moreover, we identify biases related to the implementation of regional-scale emission projections by comparing modelled pollutant concentrations between the fine- and coarse-scale simulations over the study areas. We show that over urban areas with major regional contribution (e.g. the city of Stockholm) the bias related to coarse-scale projections may be significant and lead to policy misclassification. Our results stress the need to better understand the mechanism of bias propagation across the modelling scales in order to design more successful local-scale strategies. We find that the impact of climate change is spatially homogeneous in both regions, implying strong regional influence. The climate benefit for ozone (daily mean and maximum) is up to -5 % for Paris and -2 % for Stockholm city. The climate benefit on PM2.5 and PM10 in Paris is between -5 and -10 %, while for Stockholm we estimate mixed trends of up to 3 % depending on season and size class. In Stockholm, emission mitigation leads to concentration reductions up to 15 % for daily mean and maximum ozone and 20 % for PM. Through a sensitivity analysis we show that this response is entirely due to changes in emissions at the regional scale. On the contrary, over the city of Paris (VOC-limited photochemical regime), local mitigation of NOx emissions increases future ozone concentrations due to ozone titration inhibition. This competing trend between the respective roles of emission and climate change, results in an increase in 2050 daily mean ozone by 2.5 % in Paris. Climate and not emission change

'Hearts and minds': association, causation and implication of cognitive impairment in heart failure.

Science.gov (United States)

Cannon, Jane A; McMurray, John Jv; Quinn, Terry J

2015-01-01

The clinical syndrome of heart failure is one of the leading causes of hospitalisation and mortality in older adults. An association between cognitive impairment and heart failure is well described but our understanding of the relationship between the two conditions remains limited. In this review we provide a synthesis of available evidence, focussing on epidemiology, the potential pathogenesis, and treatment implications of cognitive decline in heart failure. Most evidence available relates to heart failure with reduced ejection fraction and the syndromes of chronic cognitive decline or dementia. These conditions are only part of a complex heart failure-cognition paradigm. Associations between cognition and heart failure with preserved ejection fraction and between acute delirium and heart failure also seem evident and where data are available we will discuss these syndromes. Many questions remain unanswered regarding heart failure and cognition. Much of the observational evidence on the association is confounded by study design, comorbidity and insensitive cognitive assessment tools. If a causal link exists, there are several potential pathophysiological explanations. Plausible underlying mechanisms relating to cerebral hypoperfusion or occult cerebrovascular disease have been described and it seems likely that these may coexist and exert synergistic effects. Despite the prevalence of the two conditions, when cognitive impairment coexists with heart failure there is no specific guidance on treatment. Institution of evidence-based heart failure therapies that reduce mortality and hospitalisations seems intuitive and there is no signal that these interventions have an adverse effect on cognition. However, cognitive impairment will present a further barrier to the often complex medication self-management that is required in contemporary heart failure treatment.

Antioxidant vitamins and coronary heart disease risk

DEFF Research Database (Denmark)

Knekt, Paul; Ritz, John; Pereira, Mark A

2004-01-01

BACKGROUND: Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear. OBJECTIVE: We studied the relation between the intake...

The independent relationship between triglycerides and coronary heart disease

OpenAIRE

Alan Morrison, John E Hokanson

2008-01-01

Alan Morrison1, John E Hokanson21SCRIBCO, Blue Bell, PA, USA; 2Department of Epidemiology, Colorado School of Public Health, University of Colorado at Denver Denver, CO, USAAims: The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD).Methods and results: We systematically reviewed population-based cohort studies in which basel...

Adult Congenital Heart Disease: Scope of the Problem.

Science.gov (United States)

Mazor Dray, Efrat; Marelli, Ariane J

2015-11-01

This article reviews the changing epidemiology of congenital heart disease summarizing its impact on the demographics of the congenital heart disease population and the progress made in order to improve outcomes in this patient population. Birth prevalence of congenital heart disease can be modified by many factors. As a result of decreasing mortality and increasing survival in all forms of congenital heart disease, the median age of patients has increased and adults now compose two-thirds of patients with congenital heart disease. Disease burden and resulting health services utilization increase significantly across the lifespan. Bridging the gap between policy and quality of care can be improved by referral to specialized adult congenital heart disease centers and planning delivery of specialized services that are commensurate with population needs, program accreditation criteria and certified training of designated workforce. Copyright © 2015 Elsevier Inc. All rights reserved.

Life and Death in the City: Demography and Living Standards during Stockholm's Industrialization

DEFF Research Database (Denmark)

Molitoris, Joseph John

2015-01-01

’s intergenerational social mobility, and infant and child mortality during Stockholm’s industrialization and fertility transition. The results of this work challenge many existing explanations of the fertility decline and reveal how, despite overall improvements in living standards, elite socioeconomic groups were......This dissertation uses longitudinal micro-data from Stockholm between 1878 and 1926 to study the causes and consequences of the fertility transition and to examine the development of living standards inequality during industrialization. Although both processes have received much interest from...... able to continually leverage their superior resources to maintain significantly lower levels of infant and child mortality....

Heart failure among Indigenous Australians: a systematic review

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Woods John A

2012-11-01

Full Text Available Abstract Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports. Results There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2. Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%, noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure. Conclusions Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data

Solubility and Potential Mobility of Heavy Metals in Two Contaminated Urban Soils from Stockholm, Sweden

International Nuclear Information System (INIS)

Oborn, Ingrid; Linde, Mats

2001-01-01

The solubility and potential mobility of heavy metals (Cd, Cu,Hg, Pb and Zn) in two urban soils were studied by sequential and leaching extractions (rainwater). Compared to rural (arable) soils on similar parent material, the urban soils were highly contaminated with Hg and Pb and to a lesser extent also with Cd,Cu and Zn. Metal concentrations in rainwater leachates were related to sequential extractions and metal levels reported from Stockholm groundwater. Cadmium and Zn in the soils were mainly recovered in easily extractable fractions, whereas Cu and Pb were complex bound. Concentrations of Pb in the residual fraction were between two- and eightfold those in arable soils, indicating that the sequential extraction scheme did not reflect the solid phases affected by anthropogenic inputs. Cadmium and Zn conc. in the rainwater leachates were within the range detected in Stockholm groundwater, while Cu and Pb conc. were higher, which suggests that Cu and Pb released from the surface soil were immobilised in deeper soil layers. In a soil highly contaminated with Hg, the Hg conc. in the leachate was above the median concentration, but still 50 times lower than the max concentration found in groundwater, indicating the possibility of other sources. In conclusion, it proved difficult to quantitatively predict the mobility of metals in soils by sequential extractions

Epidemiology, health systems and stakeholders in rheumatic heart disease in Africa: a systematic review protocol.

Science.gov (United States)

Moloi, Annesinah Hlengiwe; Watkins, David; Engel, Mark E; Mall, Sumaya; Zühlke, Liesl

2016-05-20

Rheumatic heart disease (RHD) is a chronic disease affecting the heart valves, secondary to group A streptococcal infection (GAS) and subsequent acute rheumatic fever (ARF). However, RHD cure and preventative measures are inextricably linked with socioeconomic development, as the disease mainly affects children and young adults living in poverty. In order to address RHD, public health officials and health policymakers require up-to-date knowledge on the epidemiology of GAS, ARF and RHD, as well as the existing enablers and gaps in delivery of evidence-based care for these conditions. We propose to conduct a systematic review to assess the literature comprehensively, synthesising all existing quantitative and qualitative data relating to RHD in Africa. We plan to conduct a comprehensive literature search using a number of databases and reference lists of relevant articles published from January 1995 to December 2015. Two evaluators will independently review and extract data from each article. Additionally, we will assess overall study quality and risk of bias, using the Newcastle-Ottawa Scale and the Critical Appraisal Skills Programme criteria for quantitative and qualitative studies, respectively. We will meta-analyse estimates of prevalence, incidence, case fatality and mortality for each of the conditions separately for each country. Qualitative meta-analysis will be conducted for facilitators and barriers in RHD health access. Lastly, we will create a list of key stakeholders. This protocol is registered in the PROSPERO International Prospective Register of systematic reviews, registration number CRD42016032852. The information provided by this review will inform and assist relevant stakeholders in identifying key areas of intervention, and designing and implementing evidence-based programmes and policies at the local and regional level. With slight modifications (ie, to the country terms in the search strategy), this protocol can be used as part of a needs

Prevalence of Autism in Children of Somali Origin Living in Stockholm: Brief Report of an At-Risk Population

Science.gov (United States)

Barnevik-Olsson, Martina; Gillberg, Christopher; Fernell, Elisabeth

2010-01-01

This work was a follow-up study (birth years 1999-2003) of the prevalence of autism in children of Somali background living in the county of Stockholm, Sweden. In a previous study (birth years 1988-98), the prevalence of autism associated with learning disability was found to be three to four times higher among Somali children compared with other…

Recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 13–15 November 2016

DEFF Research Database (Denmark)

2017-01-01

-Karolinska Stroke Update Meeting was held in Stockholm on 13–15 November 2016. There were 10 scientific sessions discussed in the meeting and each session produced a consensus statement (Full version with background, issues, conclusions and references are published as web-material and at http...... and statistical reviews (at least one randomised controlled trial plus one statistical review). Grade B Evidence: Support from randomised controlled trials and statistical reviews (one randomised controlled trial or one statistical review). Grade C Evidence: No reasonable support from randomised controlled trials...

Planning the Green Walkable City: Conceptualizing Values and Conflicts for Urban Green Space Strategies in Stockholm

Directory of Open Access Journals (Sweden)

Hélène Littke

2015-08-01

Full Text Available Urban green spaces are essential elements of cities, contributing to the quality of life in numerous ways. However, densification strategies create a complex relationship between urban development and the quality, as well as the quantity, of urban green space. This paper examines the Green Walkable City Programme in Stockholm, a document developed to supplement the comprehensive plan as a strategic backbone for green urban planning. Based on interviews and content analysis, this paper identifies and discusses concerns raised in the development of the planning programme, and addresses the importance of urban green space for citizens’ well-being. The new comprehensive plan has introduced a shift in the attitude towards the urban green space in Stockholm. The need for urban growth is used to justify development of green fields, and a focus on the quality, rather than the quantity, of urban green space is promoted. Despite this progress, the public requests definitions for this quality approach and fears that nature within the city will be “parkified”. Therefore, this paper offers a critical reflection on the role of the Green Walkable City Programme, its situation within the context of Swedish green urban planning, and various areas of concern that have been highlighted.

The emergence of a post-industrial music economy? : Music and ICT synergies in Stockholm, Sweden.

OpenAIRE

Power, Dominic; Jansson, Johan

2004-01-01

Research into the music industry has for a long time been almost exclusively dominated by a focus on the production of albums and songs. In recent years, however, cities such as Stockholm have seen the growth of a profitable and varied music services industry producing everything from remixes to music marketing strategies. Standing at the forefront of this growth industry are a large number of firms attempting to combine in innovative ways music and ICT. This can take a variety of forms, for ...

[Gender issues in the epidemiology of cardiovascular diseases].

Science.gov (United States)

Härtel, Ursula

2007-06-01

In the last decade our knowledge about sex differences in the epidemiology of cardiovascular diseases has substantially increased. However; most information relates to coronary heart disease, and relatively little information is available on other forms of heart disease or cerebrovascular diseases. In the present paper, first, the age-adjusted mortality and morbidity rates of men and women across different European countries will be described as well as differences in case-fatality after myocardial infarction. Second, gender differences regarding the impact of traditional and novel risk factors on the development of coronary heart disease will be addressed, together with recent evidence from cardiac rehabilitation research. In general, we can say that significant sex differences exist at each stage of coronary heart disease, which need to be taken into account in primary prevention, acute therapy, and long-term rehabilitation. Further research is required on other forms of cardiovascular diseases, which are more prevalent among women than among men, especially in higher age groups.

[Jan Kusberg, Kleine Geschichte St. Petersburgs. (Regensburg, 2009) ; Ingrid Bohn. Kleine Geschichte Stockholms. (Regensburg, 2008) ; Konrad Dittrich. Kleine Lübecker Stadtgeschichte. (Regensburg, 2007)] / Dennis Hortmuth

Index Scriptorium Estoniae

Hormuth, Dennis

2011-01-01

Arvustus: Jan Kusberg, Kleine Geschichte St. Petersburgs. (Regensburg, 2009) ; Ingrid Bohn. Kleine Geschichte Stockholms. (Regensburg, 2008) ; Konrad Dittrich. Kleine Lübecker Stadtgeschichte. (Regensburg, 2007)

The Humanistic Medicine program at the Karolinska Institute, Stockholm, Sweden.

Science.gov (United States)

Ahlzén, Rolf; Stolt, Carl-Magnus

2003-10-01

In 1998, the Humanistic Medicine program was established at the Karolinska Institute, Stockholm, Sweden. A fundamental element of the program is to promote medical humanities within clinical practice. The program's design focuses on three interconnected areas of study, the history of medicine, philosophy of medical science and practice, and aspects of the clinical encounter. The program offers undergraduate and postgraduate studies. The program's humanities content is bolstered in the medical curriculum by The Doctor School, a line of teaching medical students follow through their first four semesters. From this parallel series of lectures and seminars, students are exposed to further humanities and medical training. Students also have the option to select from humanities courses for their 17 eligible weeks of electives. It is hoped that the Karolinska Institute will continue to develop the humanities content of its curriculum, intertwining scientific exploration and humanistic understanding.

Biological and chemical characterization of harbour sediments from the Stockholm area

Energy Technology Data Exchange (ETDEWEB)

Eklund, Britta; Elfstroem, Maria; Bengtsson, Bengt-Erik; Breitholtz, Magnus [Dept. of Applied Environmental Science (ITM), Stockholm Univ. (Sweden); Gallego, Irene [Granada Univ. (Spain)

2010-01-15

Purpose: The main objective of the current study was to assess the impact of pleasure boat activities on harbour sediment quality in the Stockholm area. Sediment contamination is a growing ecological issue, and there is consequently a need to use sediment bioassays in combination with chemical analysis to determine the impact on the ecosystem. To generate sediment toxicity data relevant for the Baltic Sea, a secondary objective was to further develop and evaluate two well-established bioassays for saltwater, with the macroalga Ceramium tenuicorne and the crustacean Nitocra spinipes, to be useful also for toxicity testing of whole sediment. A major concern has been to minimize any manipulation of the sediments. A third objective was to assess whether a simple leaching procedure could be used to simulate sediment toxicity by comparing results from whole sediment and leachate tests. Materials and methods: Surface sediments (0-2 cm) from five different types of pleasure boat harbours were collected. Chemical measurements of boat related compounds, i.e. tin organic substances (tributyltin (TBT), dibutyl tin, and monobutyl tin), polyaromatic hydrocarbons (PAHs), copper, zinc, lead, tin and irgarol were conducted. The sediments were tested for toxic effects using the established Microtox {sup registered} test as well as the developed sediment tests with C. tenuicorne and N. spinipes. The endpoints are growth inhibition for the algal test and for the crustacean test mortality of larvae and rate of development expressed as the ratio between nauplia and copepodites. Two different procedures have been compared with both organisms, i.e. exposure to whole sediment and to leachate. The duration of both tests is around 1 week. Results and discussion: All harbour locations were more or less heavily contaminated with remnants from use of antifouling paints. The sediment in a smaller marina (ca. 250 boats) contained the highest levels of TBT (max 1,400 {mu}g/kg dry weight (dw

The High-Density Lipoprotein Puzzle: Why Classic Epidemiology, Genetic Epidemiology, and Clinical Trials Conflict?

Science.gov (United States)

Rosenson, Robert S

2016-05-01

Classical epidemiology has established the incremental contribution of the high-density lipoprotein (HDL) cholesterol measure in the assessment of atherosclerotic cardiovascular disease risk; yet, genetic epidemiology does not support a causal relationship between HDL cholesterol and the future risk of myocardial infarction. Therapeutic interventions directed toward cholesterol loading of the HDL particle have been based on epidemiological studies that have established HDL cholesterol as a biomarker of atherosclerotic cardiovascular risk. However, therapeutic interventions such as niacin, cholesteryl ester transfer protein inhibitors increase HDL cholesterol in patients treated with statins, but have repeatedly failed to reduce cardiovascular events. Statin therapy interferes with ATP-binding cassette transporter-mediated macrophage cholesterol efflux via miR33 and thus may diminish certain HDL functional properties. Unraveling the HDL puzzle will require continued technical advances in the characterization and quantification of multiple HDL subclasses and their functional properties. Key mechanistic criteria for clinical outcomes trials with HDL-based therapies include formation of HDL subclasses that improve the efficiency of macrophage cholesterol efflux and compositional changes in the proteome and lipidome of the HDL particle that are associated with improved antioxidant and anti-inflammatory properties. These measures require validation in genetic studies and clinical trials of HDL-based therapies on the background of statins. © 2016 American Heart Association, Inc.

Tea and coronary heart disease : protection through estrogenlike activity?

NARCIS (Netherlands)

Geleijnse, J.M.; Witteman, J.C.; Launer, L.J.; Lamberts, S.J.; Pols, H.A.

2000-01-01

Tea drinking appears to be protective against coronary heart disease in a number of epidemiologic studies. It has been suggested that tea flavonols with antioxidative activity, including quercetin, kaempferol, and myricetin,1 could account for the favorable effect on cardiovascular health. In the

Effort-Reward Imbalance at Work and Incident Coronary Heart Disease

DEFF Research Database (Denmark)

Dragano, Nico; Siegrist, Johannes; Nyberg, Solja T.

2017-01-01

Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance...... between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease...... have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress....

Socioeconomic context in area of living and risk of myocardial infarction: results from Stockholm Heart Epidemiology Program (SHEEP)

DEFF Research Database (Denmark)

Kölegård Stjärne, M; Diderichsen, F; Reuterwall, C

2002-01-01

STUDY OBJECTIVE: To analyse if socioeconomic characteristics in area of living affect the risk of myocardial infarction in a Swedish urban population, and to evaluate to what extent the contextual effect is confounded by the individual exposures. DESIGN: A population based case-referent study......; class structure, social exclusion and poverty. Among men, there were increased relative risks of similar magnitudes (1.28 to 1.33) in the more deprived areas according to all three dimensions of the socioeconomic context. However, when adjusting for individual exposures, the poverty factor had...

Patients' experience of care and treatment outcome at the Department of Clinical Oral Physiology, Dental Public Service in Stockholm.

Science.gov (United States)

Christidis, Nikolaos; Smedberg, Erica; Hägglund, Helene; Hedenberg-Magnusson, Britt

2010-01-01

Chronic pain conditions in the craniofacial region are common in the adult population with a prevalence of approximately 10%. They are included in the generic term temporomandibular disorders (TMD) and accompanied by restricted mouth opening capacity, chewing difficulties, headache and neck pain. These pain conditions cause psychological suffering, impaired social relations, and recurrent sick leave, subsequently leading to frequent use of health care, medication and consequently to a decreased quality of life. Approximately 25% of children have signs of TMD and girls are shown to be more affected than boys. These signs increase with age and in the adult population the prevalence is approximately 38-40%, also here with a higher frequency in women than in men. This study comprised 198 patients who answered an anonymous questionnaire after termination of their treatment. The study aimed to investigate the activity at the department of clinical oral physiology at the Folktandvården Eastman Institute in Stockholm, Sweden, regarding the patients and their cause of care-seeking, as well as the patients' subjective experiences of the specialist care and the treatment outcome. As a secondary aim the purpose was to investigate how/if the clinicians at the department of clinical oral physiology reached their intention of being "curious", "considerate" and "accessible". The results from this study show that the majority of the patients (57.1%) were referred from the dental public service in Stockholm. 71.7% of the patients were young women between the ages of 11 and 20. The main causes of care-seeking were temporomandibular joint clickings, followed by limited jaw movement, headache and orofacial pain. Further, an immense majority of the patients (89.9%) were very satisfied with their treatment as well as the treatment outcome. These results indicate that the clinicians at the department reached their intention of being "curious", "considerate"and "accessible", which also

77 FR 2072 - Proposed Collection; Comment Request; Prevalence, Incidence, Epidemiology and Molecular Variants...

Science.gov (United States)

2012-01-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; Comment Request; Prevalence, Incidence, Epidemiology and Molecular Variants of HIV in Blood Donors in Brazil... 1995, for opportunity for public comment on proposed data collection projects, the National Heart, Lung...

The control of nuclear proliferation: future challenges. Swedish Institute of International Affairs, Stockholm, 23 April 1998

International Nuclear Information System (INIS)

ElBaradei, M.

1998-01-01

The document reproduces the text of the conference given by the Director General of the IAEA at the Swedish Institute of International Affairs in Stockholm on 23 April 1998. After a short presentation of the Agency's current verification activities, particularly in Iraq and Democratic People's Republic of Korea, the Director General focuses on the present and future role of the IAEA in the control of nuclear proliferation through its strengthened safeguards system, in the prevention of nuclear terrorism, and future challenges of controlling nuclear proliferation from both political and technical point of view

Dietary cholesterol, heart disease risk and cognitive dissonance.

Science.gov (United States)

McNamara, Donald J

2014-05-01

In the 1960s, the thesis that dietary cholesterol contributes to blood cholesterol and heart disease risk was a rational conclusion based on the available science at that time. Fifty years later the research evidence no longer supports this hypothesis yet changing the dietary recommendation to limit dietary cholesterol has been a slow and at times contentious process. The preponderance of the clinical and epidemiological data accumulated since the original dietary cholesterol restrictions were formulated indicate that: (1) dietary cholesterol has a small effect on the plasma cholesterol levels with an increase in the cholesterol content of the LDL particle and an increase in HDL cholesterol, with little effect on the LDL:HDL ratio, a significant indicator of heart disease risk, and (2) the lack of a significant relationship between cholesterol intake and heart disease incidence reported from numerous epidemiological surveys. Over the last decade, many countries and health promotion groups have modified their dietary recommendations to reflect the current evidence and to address a now recognised negative consequence of ineffective dietary cholesterol restrictions (such as inadequate choline intake). In contrast, health promotion groups in some countries appear to suffer from cognitive dissonance and continue to promote an outdated and potentially hazardous dietary recommendation based on an invalidated hypothesis. This review evaluates the evidence for and against dietary cholesterol restrictions and the potential consequences of such restrictions.

Rheumatic heart disease and the asap programme: fresh insights ...

African Journals Online (AJOL)

rheumatic heart disease (RHD), which could potentially result in 1.4 million deaths per year from the disease and its complications.2 These individuals are predominantly children, adolescents and young adults who live in poor and under-resourced areas of the world. Current epidemiology. The prevalence of RHD has ...

Age at immigration and crime in Stockholm using sibling comparisons.

Science.gov (United States)

Beckley, Amber L

2015-09-01

Past Swedish research has shown that immigrants arriving in the receiving country at an older age are less likely to commit crime than immigrants arriving at a younger age. Segmented assimilation theory argues that the family and neighborhood may be important factors affecting how age at immigration and crime are related to one another. This study used population-based register data on foreign-background males from Stockholm to test the effect of age at immigration on crime. Potential confounding from the family and neighborhood was addressed using variables and modeling strategies. Initial results, using variables to control for confounding, showed that people who immigrated around age 4 were the most likely to be suspected of a crime. When controlling for unmeasured family characteristics, it seemed that a later age at immigration was tied to a lower likelihood of crime, which does not corroborate past research findings. The effect of age at immigration, however, was not statistically significant. The results imply that future research on entire families may be a worthwhile endeavor. Copyright © 2015 Elsevier Inc. All rights reserved.

Proceedings from the Fissile Material Cut-off seminar in Stockholm

International Nuclear Information System (INIS)

Arbman, G.

1998-01-01

The Swedish Defence Research Establishment hosted an international expert seminar on the subject of verifying a prohibition of the production of fissile material for nuclear weapons purpose (cut-off) in Stockholm, June 3-5 1998. The objective of the seminar was to provide an opportunity for informal discussions among scientific and technical experts on various technical matters relating to the verification of a future Fissile Material Cut-off Treaty (FMCT). A stated aim of the seminar was to keep issues of scope to a minimum. Invited speakers and commentators were given an opportunity to present their views as written contributions. The present seminar proceedings are essentially the result of these views. In addition, short summaries of the discussions following each session are included. Although an attempt was made to be as complete and accurate as possible in reproducing these discussions, the editors apologise if some important points or statements have been omitted. If so, the main reason is that the documentation of the discussions were based on written notes, not taped recordings. Eight longer contributions have been separately indexed

Proceedings from the Fissile Material Cut-off seminar in Stockholm

Energy Technology Data Exchange (ETDEWEB)

Arbman, G. [ed.

1998-07-01

The Swedish Defence Research Establishment hosted an international expert seminar on the subject of verifying a prohibition of the production of fissile material for nuclear weapons purpose (cut-off) in Stockholm, June 3-5 1998. The objective of the seminar was to provide an opportunity for informal discussions among scientific and technical experts on various technical matters relating to the verification of a future Fissile Material Cut-off Treaty (FMCT). A stated aim of the seminar was to keep issues of scope to a minimum. Invited speakers and commentators were given an opportunity to present their views as written contributions. The present seminar proceedings are essentially the result of these views. In addition, short summaries of the discussions following each session are included. Although an attempt was made to be as complete and accurate as possible in reproducing these discussions, the editors apologise if some important points or statements have been omitted. If so, the main reason is that the documentation of the discussions were based on written notes, not taped recordings. Eight longer contributions have been separately indexed.

Epidemiologic studies of fatal and nonfatal cardiovascular disease and ETS exposure from spousal smoking.

OpenAIRE

Thun, M; Henley, J; Apicella, L

1999-01-01

This article reviews the epidemiologic studies of the association of ischemic heart disease risk and environmental tobacco smoke (ETS) exposure from a spouse who smokes. Seventeen studies (nine cohort, eight case-control) comprising more than 485,000 lifelong nonsmokers and 7,345 coronary heart disease (CHD) events were included in a meta-analysis. Together, these studies include 36% more CHD events and 58% more study subjects than were available for review by the U. S. Occupational Safety an...

EURObservational Research Programme: the Heart Failure Pilot Survey (ESC-HF Pilot)

DEFF Research Database (Denmark)

Maggioni, Aldo P; Dahlström, Ulf; Filippatos, Gerasimos

2010-01-01

The primary objective of the new ESC-HF Pilot Survey was to describe the clinical epidemiology of outpatients and inpatients with heart failure (HF) and the diagnostic/therapeutic processes applied across 12 participating European countries. This pilot study was specifically aimed at validating...

The dynamics of social-ecological systems in urban landscapes: Stockholm and the National Urban Park, Sweden.

Science.gov (United States)

Elmqvist, T; Colding, J; Barthel, S; Borgstrom, S; Duit, A; Lundberg, J; Andersson, E; Ahrné, K; Ernstson, H; Folke, C; Bengtsson, J

2004-06-01

This study addresses social-ecological dynamics in the greater metropolitan area of Stockholm County, Sweden, with special focus on the National Urban Park (NUP). It is part of the Millennium Ecosystem Assessment (MA) and has the following specific objectives: (1) to provide scientific information on biodiversity patterns, ecosystem dynamics, and ecosystem services generated; (2) to map interplay between actors and institutions involved in management of ecosystem services; and (3) to identify strategies for strengthening social-ecological resilience. The green areas in Stockholm County deliver numerous ecosystem services, for example, air filtration, regulation of microclimate, noise reduction, surface water drainage, recreational and cultural values, nutrient retention, and pollination and seed dispersal. Recreation is among the most important services and NUP, for example, has more than 15 million visitors per year. More than 65 organizations representing 175,000 members are involved in management of ecosystem services. However, because of population increase and urban growth during the last three decades, the region displays a quite dramatic loss of green areas and biodiversity. An important future focus is how management may reduce increasing isolation of urban green areas and enhance connectivity. Comanagement should be considered where locally managed green space may function as buffer zones and for management of weak links that connect larger green areas; for example, there are three such areas around NUP identified. Preliminary results indicate that areas of informal management represent centers on which to base adaptive comanagement, with the potential to strengthen biodiversity management and resilience in the landscape.

EURObservational Research Programme : The Heart Failure Pilot Survey (ESC-HF Pilot)

NARCIS (Netherlands)

Maggioni, Aldo P.; Dahlstrom, Ulf; Filippatos, Gerasimos; Chioncel, Ovidiu; Crespo Leiro, Marisa; Drozdz, Jaroslaw; Fruhwald, Friedrich; Gullestad, Lars; Logeart, Damien; Metra, Marco; Parissis, John; Persson, Hans; Ponikowski, Piotr; Rauchhaus, Mathias; Voors, Adriaan A.; Nielsen, Olav Wendelboe; Zannad, Faiez; Tavazzi, Luigi

2010-01-01

The primary objective of the new ESC-HF Pilot Survey was to describe the clinical epidemiology of outpatients and inpatients with heart failure (HF) and the diagnostic/therapeutic processes applied across 12 participating European countries. This pilot study was specifically aimed at validating the

EU Water Framework Directive and Stockholm Convention: can we reach the targets for priority substances and persistent organic pollutants?

Science.gov (United States)

Fuerhacker, Maria

2009-08-01

Water is a renewable resource and acceptable quality is important for human health, ecological and economic reasons, but human activity can cause great damage to the natural aquatic environment. Managing the water cycle in a sustainable way is the key to protect natural resources and human health. On a global level, the microbiological contamination of water sources is a major problem in connection with poverty and the United Nations Millennium Development Declaration is an important initiative to handle this problem. In terms of environmental health, persistent organic pollutants (POPs) circulate globally; as they travel long distances, they are found in remote areas far from their original source of application and can cause damage wherever they move to. On a global scale, United Nations Environmental Programme (UNEP) issued the Stockholm Convention to reduce POPs; in the European Union (EU), one intention of the Water Framework Directive (WFD) is to reach the good chemical status of waters; beside these regulations, there are other directives in support of these goals. The aim of this paper is to discuss whether the Stockholm Convention and the WFD allows meeting the targets of protection of human and environmental health, which are established in the different directives and how could we approach the targets. The aims and scopes of different directives are compiled and compared with the actual quality of water, different approaches of standard settings are compared and potential treatment options are discussed. Under the Stockholm Convention on POPs, which came into force in May 2004, governments are required to develop a National Implementation Plan (NIP) setting out how they will address their obligations under the convention and how they will take measures to eliminate or reduce the release of POPs into the environment by the use of best available techniques (BAT) and application of best environmental practices (BEP). On a European level, the WFD has been in

The PATT 26 conference Stockholm, Sweden 26–30 June 2012 : Technology Education in the 21st Century

OpenAIRE

2012-01-01

PATT 26 will be held at the Royal Institute of Technology (KTH) in Stockholm, the beautiful capital of Sweden. The PATT 26 conference is part of a two-conference arrangement organized by the Royal Institute of Technology and the Centre for School Technology Education, CETIS, Linköping University, under the common heading Technology Education in the 21st Century. We hereby welcome international colleagues to this golden opportunity to share and learn more about the latest on-going and complete...

Early life environment and social determinants of cardiac health in children with congenital heart disease.

Science.gov (United States)

Wong, Peter; Denburg, Avram; Dave, Malini; Levin, Leo; Morinis, Julia Orkin; Suleman, Shazeen; Wong, Jonathan; Ford-Jones, Elizabeth; Moore, Aideen M

2018-04-01

Congenital heart disease is a significant cause of infant mortality. Epidemiology and social context play a crucial role in conditioning disease burden and modulating outcomes, while diagnosis and treatment remain resource intensive. This review will address the role of social demographics, environmental exposure, epigenetics and nutrition in the aetiology of congenital heart disease. We then discuss the determinant effect of social factors on the provision and outcomes of care for congenital heart disease and implications for practice. It is our hope that enhanced knowledge of the intersection of social determinants of health and congenital heart disease will facilitate effective preventative strategies at the individual and population levels to optimize heart health outcomes across the life course.

β-adrenergic receptor responsiveness in aging heart and clinical implications

Science.gov (United States)

Ferrara, Nicola; Komici, Klara; Corbi, Graziamaria; Pagano, Gennaro; Furgi, Giuseppe; Rengo, Carlo; Femminella, Grazia D.; Leosco, Dario; Bonaduce, Domenico

2014-01-01

Elderly healthy individuals have a reduced exercise tolerance and a decreased left ventricle inotropic reserve related to increased vascular afterload, arterial-ventricular load mismatching, physical deconditioning and impaired autonomic regulation (the so called “β-adrenergic desensitization”). Adrenergic responsiveness is altered with aging and the age-related changes are limited to the β-adrenergic receptor density reduction and to the β-adrenoceptor-G-protein(s)-adenylyl cyclase system abnormalities, while the type and level of abnormalities change with species and tissues. Epidemiological studies have shown an high incidence and prevalence of heart failure in the elderly and a great body of evidence correlate the changes of β-adrenergic system with heart failure pathogenesis. In particular it is well known that: (a) levels of cathecolamines are directly correlated with mortality and functional status in heart failure, (b) β1-adrenergic receptor subtype is down-regulated in heart failure, (c) heart failure-dependent cardiac adrenergic responsiveness reduction is related to changes in G proteins activity. In this review we focus on the cardiovascular β-adrenergic changes involvement in the aging process and on similarities and differences between aging heart and heart failure. PMID:24409150

Risk of ischemic heart disease following occupational exposure to welding fumes

DEFF Research Database (Denmark)

Mocevic, Emina; Kristiansen, Pernille; Bonde, Jens Peter

2015-01-01

PURPOSE: Air pollution has been linked to an increased risk of ischemic heart disease (IHD), but less is known about occupational exposure to welding fumes and the risk of IHD. The objective of this paper was to review the epidemiological evidence on causal links between welding fume exposure...

Cheyne-stokes respiration in patients with heart failure.

Science.gov (United States)

AlDabal, Laila; BaHammam, Ahmed S

2010-01-01

Cheyne-Stokes respiration (CSR) is a form of central sleep-disordered breathing (SDB) in which there are cyclical fluctuations in breathing that lead to periods of central apneas/hypopnea, which alternate with periods of hyperpnea. The crescendo-decrescendo pattern of respiration in CSR is a compensation for the changing levels of blood oxygen and carbon dioxide. Severe congestive heart failure seems to be the most important risk factor for the development of CSR. A number of pathophysiologic changes, such as sleep disruption, arousals, hypoxemia-reoxygenation, hypercapnia/hypocapnia, and changes in intrathoracic pressure have harmful effects on the cardiovascular system, and the presence of CSR is associated with increased mortality and morbidity in subjects with variable degrees of heart failure. The management of CSR involves optimal control of underlying heart failure, oxygen therapy, and positive airway pressure support. In this review, we initially define and describe the epidemiology of central sleep apnea (CSA) and CSR, its pathogenesis, clinical presentation, diagnostic methods, and then discuss the recent developments in the management in patients with heart failure.

[Eco-epidemiology: towards epidemiology of complexity].

Science.gov (United States)

Bizouarn, Philippe

2016-05-01

In order to solve public health problems posed by the epidemiology of risk factors centered on the individual and neglecting the causal processes linking the risk factors with the health outcomes, Mervyn Susser proposed a multilevel epidemiology called eco-epidemiology, addressing the interdependence of individuals and their connection with molecular, individual, societal, environmental levels of organization participating in the causal disease processes. The aim of this epidemiology is to integrate more than a level of organization in design, analysis and interpretation of health problems. After presenting the main criticisms of risk-factor epidemiology focused on the individual, we will try to show how eco-epidemiology and its development could help to understand the need for a broader and integrative epidemiology, in which studies designed to identify risk factors would be balanced by studies designed to answer other questions equally vital to public health. © 2016 médecine/sciences – Inserm.

[Cross-sectional analysis of heart failure among patients in the Internal Medicine Service at a third-level hospital. Part I: epidemiologic analysis].

Science.gov (United States)

Cinza Sanjurjo, S; Cabarcos Ortiz de Barrón, A; Enrique Nieto Pol, E; Torre Carballada, J A

2007-06-01

To observe the epidemiologic characteristics of the patients intake during five years in a internal medicine department, with heart failure. A cross-sectional study of the intake patients in the Internal Medicine Service in the Hospital Clínico Universitario de Santiago de Compostela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intake by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with qualitative and quantitative measures, chi-cuadrado and t-student, and multivariant analyses. 248 patients were accepted for the study. We observed more women than men (55.2%) and bigger median age (79 years old vs. 73 years old in men, p < 0.001). The mean income was 13.61 days and a median of 11 days. The 41,8% of the patients had hypertension, 30.9% diabetes mellitus and 81,9% had someone heart disease. The aetiologies of heart failure most frequent were ischemic cardiopathy (27.2%) and hypertension (24.2%). The most frequent symptom was the dyspnea (68.9%). It made echocardiography in 20.9% of patients and 45.1% showed systolic disfunction. The only factor related with this small percentage of echocardiographies was the incoming time. The most frequent etiology was respiratory infections (39.5%). The 8.6% of patients was deceased. The pharmacologic treatment more prescribed were the diuretics (86.9%) and transcutaneous nitrates (49.5%). It was indicated ECAI or AAR-II in the 86.9% of patients and beta-blockers in 0.9%. The number of echocardiograms practiced to the patients is smaller that the number advised by international associations and smaller to the cardiologist registers. The beta-blockers and ECAI use is smaller too.

Death by streaming or vinyl revival? Exploring the spatial dynamics and value-creating strategies of independent record shops in Stockholm

OpenAIRE

Hracs, Brian; Jansson, Johan

2017-01-01

The contemporary retail landscape is in flux and there is a growing perception that shopping at bricks and mortar stores is more expensive and time-consuming than shopping online. For music, illegal downloading and streaming have restructured the retail landscape and put thousands of record shops out of business. Yet, some retailers remain attractive consumption spaces. Drawing on a qualitative case study of independent record shops in Stockholm, this paper considers three value-creating stra...

The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease

Science.gov (United States)

Seckeler, Michael D; Hoke, Tracey R

2011-01-01

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are significant public health concerns around the world. Despite decreasing incidence, there is still a significant disease burden, especially in developing nations. This review provides background on the history of ARF, its pathology and treatment, and the current reported worldwide incidence of ARF and prevalence of RHD. PMID:21386976

Spirituality and well being among elders: differences between elders with heart failure and those without heart failure

Directory of Open Access Journals (Sweden)

Mary T Quinn Griffin

2008-01-01

Full Text Available Mary T Quinn Griffin1, Yi-Hui Lee2, Ali Salman1, Yaewon Seo1, Patricia A Marin3, Randall C Starling3, Joyce J Fitzpatrick11Frances Payne Bolton School of Nursing Case Western Reserve University Cleveland, OH; 2College of Nursing and Health Wright State University Dayton, OH; 3Cleveland Clinic, Cleveland, OhioAbstract: Heart failure is a chronic debilitating disease that affects all aspects of a person’s life, including physical, mental and spiritual dimensions. The associations among these dimensions, and the relationship to overall health status, have not been clearly identified. The purpose of this quantitative, descriptive study was to explore differences between spirituality, depressive symptoms, and quality of life among elders with and without heart failure. A total of 44 elders with heart failure and 40 non-heart failure elders completed several questionnaires including: The Daily Spiritual Experiences Scale (DSES, Spirituality Index of Well-Being (SIWB, Center for Epidemiologic Studies Depression Scale (CES-D, and SF-12™ Health Survey. There were significant differences in the groups on gender and ethnicity; thus these variables were controlled in the analyses related to the dependent variables. After controlling for gender and ethnicity, there were significant differences in the physical component of quality of life and spiritual well-being. The heart failure patients had significantly lower physical quality of life but more spiritual well-being than the non-heart failure patients. There were no significant differences in daily spiritual experiences, mental component of quality of life, and depressive symptoms between the two groups.Keywords: spiritual experience, spiritual well-being, heart failure, depressive symptoms, quality of life, elders

Chocolate consumption is inversely associated with prevalent coronary heart disease: the National Heart, Lung, and Blood Institute Family Heart Study.

Science.gov (United States)

Djoussé, Luc; Hopkins, Paul N; North, Kari E; Pankow, James S; Arnett, Donna K; Ellison, R Curtis

2011-04-01

Epidemiologic studies have suggested beneficial effects of flavonoids on cardiovascular disease. Cocoa and particularly dark chocolate are rich in flavonoids and recent studies have demonstrated blood pressure lowering effects of dark chocolate. However, limited data are available on the association of chocolate consumption and the risk of coronary heart disease (CHD). We sought to examine the association between chocolate consumption and prevalent CHD. We studied in a cross-sectional design 4970 participants aged 25-93 years who participated in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Chocolate intake was assessed through a semi-quantitative food frequency questionnaire. We used generalized estimating equations to estimate adjusted odds ratios. Compared to subjects who did not report any chocolate intake, odds ratios (95% CI) for CHD were 1.01 (0.76-1.37), 0.74 (0.56-0.98), and 0.43 (0.28-0.67) for subjects consuming 1-3 times/month, 1-4 times/week, and 5+ times/week, respectively (p for trend Consumption of non-chocolate candy was associated with a 49% higher prevalence of CHD comparing 5+/week vs. 0/week [OR = 1.49 (0.96-2.32)]. These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general United States population. Published by Elsevier Ltd.

The Atlantic divide in coronary heart disease: Epidemiology and patient care in the US and Portugal.

Science.gov (United States)

Lobo, Mariana F; Azzone, Vanessa; Resnic, Frederic S; Melica, Bruno; Teixeira-Pinto, Armando; Azevedo, Luís Filipe; Freitas, Alberto; Nisa, Cláudia; Bacelar-Nicolau, Leonor; Rocha-Gonçalves, Francisco Nuno; Pereira-Miguel, José; Costa-Pereira, Altamiro; Normand, Sharon-Lise

2017-09-01

We aimed to compare access to new health technologies to treat coronary heart disease (CHD) in the health systems of Portugal and the US, characterizing the needs of the populations and the resources available. We reviewed data for 2000 and 2010 on epidemiologic profiles of CHD and on health care available to patients. Thirty health technologies (16 medical devices and 14 drugs) introduced during the period 1980-2015 were identified by interventional cardiologists. Approval and marketing dates were compared between countries. Relative to the US, Portugal has lower risk profiles and less than half the hospitalizations per capita, but fewer centers per capita provide catheterization and cardiothoracic surgery services. More than 70% of drugs were available sooner in the US, whereas 12 out of 16 medical devices were approved earlier in Portugal. Nevertheless, at least five of these devices were adopted first or diffused faster in the US. Mortality due to CHD and myocardial infarction (MI) was lower in Portugal (CHD: 72.8 vs. 168 and MI: 48.7 vs. 54.1 in Portugal and the US, respectively; age- and gender-adjusted deaths per 100000 population, 2010); but only CHD deaths exhibited a statistically significant difference between the countries. Differences in regulatory mechanisms and price regulations have a significant impact on the types of health technologies available in the two countries. However, other factors may influence their adoption and diffusion, and this appears to have a greater impact on mortality, due to acute conditions. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Aligning the systems of environmental accounting: From EU to Stockholm and vice versa

Energy Technology Data Exchange (ETDEWEB)

Burstroem, F.; Frostell, B. [Royal Inst. of Technology, Stockholm (Sweden). Dept. of Environmental Technology and Work Science

2001-07-01

During the last decade, authorities in local and regional communities, nations and international governance organisations, like the European Union (EU), have developed several systems for environmental accounting. An important issue in this development is the collection and collation of data. Except for the question of what data to collect, there is also a question of how to collect data. Focusing in particular on developments of physical environmental accounting systems in Sweden, a member nation of the EU, and drawing from experiences from work with materials accounting in the City of Stockholm, this paper discusses the need to align environmental accounting systems of different societal levels. It is argued that the systems of collecting 'environmental' data have to be better aligned with the objectives and strategies of environmental management and policy making, taking into account all aspects of utilisation of the basic data to be collected. If not, the result will be a conservation of the fragmented point solutions of environmental accounting systems we face today, resulting in inconsistency of data, duplication of data collection and processing efforts, and inflexibility to deal with changes. From this, it is also argued that the collection of data for physical environmental accounting (i.e. data on flows and stocks of materials and substances in society and the environment), would preferably be performed by a local/regional authority, but co-ordinated by national authorities and a national statistical office, under supervision of international authorities and statistical offices. Finally, the paper presents a structural framework for regional materials accounting, which combines a product-oriented strand with a substance-oriented strand of materials accounting, and allows for accounting and analysis on different levels of aggregation. This framework, which has been developed in co-operation with the City of Stockholm, should mainly be considered

Statins attenuate but do not eliminate the reverse epidemiology of total serum cholesterol in patients with non-ischemic chronic heart failure.

Science.gov (United States)

Fröhlich, Hanna; Raman, Nandita; Täger, Tobias; Schellberg, Dieter; Goode, Kevin M; Kazmi, Syed; Grundtvig, Morten; Hole, Torstein; Cleland, John G F; Katus, Hugo A; Agewall, Stefan; Clark, Andrew L; Atar, Dan; Frankenstein, Lutz

2017-07-01

In patients with chronic heart failure (CHF) increasing levels of total serum cholesterol are associated with improved survival - while statin usage is not. The impact of statin treatment on the "reverse epidemiology" of cholesterol is unclear. 2992 consecutive patients with non-ischemic CHF due to left ventricular systolic dysfunction from the Norwegian CHF Registry and the CHF Registries of the Universities of Hull, UK, and Heidelberg, Germany, were studied. 1736 patients were individually double-matched on both cholesterol levels and the individual propensity scores for statin treatment. All-cause mortality was analyzed as a function of baseline cholesterol and statin use in both the general and the matched sample. 1209 patients (40.4%) received a statin. During a follow-up of 13,740 patient-years, 360 statin users (29.8%) and 573 (32.1%) statin non-users died. When grouped according to total cholesterol levels as low (≤3.6mmol/L), moderate (3.7-4.9mmol/L), high (4.8-6.2mmol/L), and very high (>6.2mmol/L), we found improved survival with very high as compared with low cholesterol levels. This association was present in statin users and non-users in both the general and matched sample (p<0.05 for each group comparison). The negative association of total cholesterol and mortality persisted when cholesterol was treated as a continuous variable (HR 0.83, 95%CI 0.77-0.90, p<0.001 for matched patients), but it was less pronounced in statin users than in non-users (F-test p<0.001). Statins attenuate but do not eliminate the reverse epidemiological association between increasing total serum cholesterol and improved survival in patients with non-ischemic CHF. Copyright © 2017 Elsevier B.V. All rights reserved.

Regional development via high-speed rail : A study of the Stockholm-Mälaren region and possibilities for Melbourne-regional Victoria

OpenAIRE

Bayley, Michael

2012-01-01

The purpose of this thesis is to examine, based on a study of the regional high-speed corridors in the Stockholm-Mälaren Region, the possibilities for regional high-speed rail in Melbourne-regional Victoria (Australia) to improve accessibility, and achieve regional development and balanced growth between the capital and its surrounding regions. It deals with the concept of 'regional' high-speed rail, a variant of classic high-speed rail that serves centres along regional corridors stemming fr...

Discussing compliance. Summary report from discussions with Robert Bernero and Chris Whipple regarding compliance with the Swedish HLW Regulations from meetings in Stockholm May 3 and 4, 1999

Energy Technology Data Exchange (ETDEWEB)

Jensen, Mikael

1999-06-01

Summary report from discussions with Robert Bernero and Chris Whipple regarding compliance with the Swedish HLW Regulations from meetings in Stockholm. The report also contains bibliographical information and preliminary observations made by Robert Bernero and Chris Whipple.

Discussing compliance. Summary report from discussions with Robert Bernero and Chris Whipple regarding compliance with the Swedish HLW Regulations from meetings in Stockholm May 3 and 4, 1999

International Nuclear Information System (INIS)

Jensen, Mikael

1999-06-01

Summary report from discussions with Robert Bernero and Chris Whipple regarding compliance with the Swedish HLW Regulations from meetings in Stockholm. The report also contains bibliographical information and preliminary observations made by Robert Bernero and Chris Whipple

Children with hemodynamically significant congenital heart disease can be identified through population-based registers

DEFF Research Database (Denmark)

Bergman, Gunnar; Hærskjold, Ann; Stensballe, Lone Graff

2015-01-01

BACKGROUND: Epidemiological research is facilitated in Sweden by a history of national health care registers, making large unselected national cohort studies possible. However, for complex clinical populations, such as children with congenital heart disease (CHD), register-based studies...... are challenged by registration limitations. For example, the diagnostic code system International Classification of Diseases, 10th version (ICD-10) does not indicate the clinical significance of abnormalities, therefore may be of limited use if used as the sole parameter in epidemiological research. Palivizumab...

Profesi Epidemiologi

Directory of Open Access Journals (Sweden)

Buchari Lapau

2011-01-01

Full Text Available Makalah ini pertama kali menjelaskan perlu adanya profesi kesehatan masyarakat dalam rangka pembangunan kesehatan. Lalu dijelaskan apa profesi itu dan standar keberadaan profesi, atas dasar mana dapat ditetapkan bahwa pelayanan epidemiologi merupakan salah satu profesi. Dalam rangka pembinaan profesi kesehatan masyarakat, IAKMI dan APTKMI telah membentuk Majelis Kolegium Kesehatan Masyarakat Indonesia (MKKMI yang terdiri atas 8 kolegium antara lain Kolegium Epidemiologi, yang telah menyusun Standar Profesi Epidemiologi yang terdiri atas beberapa standar. Masing-masing standar dijelaskan mulai dari kurikulum, standar pelayanan epidmiologi, profil epidemiolog kesehatan, peran epidemiolog kesehatan, fungsi epidemiolog kesehatan, standar kompetensi epidemiologi, dan standar pendidikan profesi epidemiologi.

Changing Landscape of Congenital Heart Disease.

Science.gov (United States)

Bouma, Berto J; Mulder, Barbara J M

2017-03-17

Congenital heart disease is the most frequently occurring congenital disorder affecting ≈0.8% of live births. Thanks to great efforts and technical improvements, including the development of cardiopulmonary bypass in the 1950s, large-scale repair in these patients became possible, with subsequent dramatic reduction in morbidity and mortality. The ongoing search for progress and the growing understanding of the cardiovascular system and its pathophysiology refined all aspects of care for these patients. As a consequence, survival further increased over the past decades, and a new group of patients, those who survived congenital heart disease into adulthood, emerged. However, a large range of complications raised at the horizon as arrhythmias, endocarditis, pulmonary hypertension, and heart failure, and the need for additional treatment became clear. Technical solutions were sought in perfection and creation of new surgical techniques by developing catheter-based interventions, with elimination of open heart surgery and new electronic devices enabling, for example, multisite pacing and implantation of internal cardiac defibrillators to prevent sudden death. Over time, many pharmaceutical studies were conducted, changing clinical treatment slowly toward evidence-based care, although results were often limited by low numbers and clinical heterogeneity. More attention has been given to secondary issues like sports participation, pregnancy, work, and social-related difficulties. The relevance of these issues was already recognized in the 1970s when the need for specialized centers with multidisciplinary teams was proclaimed. Finally, research has become incorporated in care. Results of intervention studies and registries increased the knowledge on epidemiology of adults with congenital heart disease and their complications during life, and at the end, several guidelines became easily accessible, guiding physicians to deliver care appropriately. Over the past decades

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…

Influence of diabetes mellitus on heart failure risk and outcome

Directory of Open Access Journals (Sweden)

Van Belle Eric

2003-01-01

Full Text Available Abstract Our aim is to summarize and discuss the recent literature linking diabetes mellitus with heart failure, and to address the issue of the optimal treatment for diabetic patients with heart failure. The studies linking diabetes mellitus (DM with heart failure (HF The prevalence of diabetes mellitus in heart failure populations is close to 20% compared with 4 to 6% in control populations. Epidemiological studies have demonstrated an increased risk of heart failure in diabetics; moreover, in diabetic populations, poor glycemic control has been associated with an increased risk of heart failure. Various mechanisms may link diabetes mellitus to heart failure: firstly, associated comorbidities such as hypertension may play a role; secondly, diabetes accelerates the development of coronary atherosclerosis; thirdly, experimental and clinical studies support the existence of a specific diabetic cardiomyopathy related to microangiopathy, metabolic factors or myocardial fibrosis. Subgroup analyses of randomized trials demonstrate that diabetes is also an important prognostic factor in heart failure. In addition, it has been suggested that the deleterious impact of diabetes may be especially marked in patients with ischemic cardiomyopathy. Treatment of heart failure in diabetic patients The knowledge of the diabetic status may help to define the optimal therapeutic strategy for heart failure patients. Cornerstone treatments such as ACE inhibitors or beta-blockers appear to be uniformly beneficial in diabetic and non diabetic populations. However, in ischemic cardiomyopathy, the choice of the revascularization technique may differ according to diabetic status. Finally, clinical studies are needed to determine whether improved metabolic control might favorably influence the outcome of diabetic heart failure patients.

Incidence, aetiology and injury characteristics of traumatic spinal cord injury in Stockholm, Sweden: A prospective, population-based update.

Science.gov (United States)

Joseph, Conran; Andersson, Nina; Bjelak, Sapko; Giesecke, Kajsa; Hultling, Claes; Nilsson Wikmar, Lena; Phillips, Julie; Seiger, Åke; Stenimahitis, Vasilios; Trok, Katarzyna; Åkesson, Elisabet; Wahman, Kerstin

2017-05-16

To update the incidence rate, aetiology and injury characteristics of acutely-injured adults with traumatic spinal cord injury in Stockholm, Sweden, using international standards of reporting. Prospective, (regional) population-based observation. Forty-nine consecutively enrolled individuals. A surveillance system of newly-injured adults with traumatic spinal cord injury was implemented for an 18-month period. The International Spinal Cord Injury Core Data Set was used to collect data on those who survived the first 7 days post-injury. After an 18-month period, 49 incident cases were registered, of whom 45 were included in this study. The crude incidence rate was 19.0 per million, consisting mainly of men (60%), and the mean age of the cohort was 55 years (median 58). Causes of injury were almost exclusively limited to falls and transport-related events, accounting for 58% and 40% of cases, respectively. The incidence has remained stable when compared with the previous study; however, significant differences exist for injury aetiology (p = 0.004) and impairment level (p = 0.01) in that more fall- and transport-related spinal cord injury occurred, and a larger proportion of persons was left with resultant tetraplegia, in the current study, compared with more sport-related injuries and those left with paraplegia in the previous study. The incidence rate appeared to remain stable in Stockholm, Sweden. However, significant changes in injury aetiology and impairment-level post injury were found, compared with the previous study. There remains a need for developing fall-related prevention strategies in rehabilitation settings as well as in population-based programmes.

The Development of Marine Accidents Human Reliability Assessment Approach: HEART Methodology and MOP Model

Directory of Open Access Journals (Sweden)

Ludfi Pratiwi Bowo

2017-06-01

Full Text Available Humans are one of the important factors in the assessment of accidents, particularly marine accidents. Hence, studies are conducted to assess the contribution of human factors in accidents. There are two generations of Human Reliability Assessment (HRA that have been developed. Those methodologies are classified by the differences of viewpoints of problem-solving, as the first generation and second generation. The accident analysis can be determined using three techniques of analysis; sequential techniques, epidemiological techniques and systemic techniques, where the marine accidents are included in the epidemiological technique. This study compares the Human Error Assessment and Reduction Technique (HEART methodology and the 4M Overturned Pyramid (MOP model, which are applied to assess marine accidents. Furthermore, the MOP model can effectively describe the relationships of other factors which affect the accidents; whereas, the HEART methodology is only focused on human factors.

C-Reactive Protein and Coronary Heart Disease: All Said—Is Not It?

Directory of Open Access Journals (Sweden)

Frederik Strang

2014-01-01

Full Text Available C-reactive protein (CRP and coronary heart disease (CHD have been the subject of intensive investigations over the last decades. Epidemiological studies have shown an association between moderately elevated CRP levels and incident CHD whereas genetic studies have shown that polymorphisms associated with elevated CRP levels do not increase the risk of ischemic vascular disease, suggesting that CRP might be a bystander rather than a causal factor in the progress of atherosclerosis. Beside all those epidemiological and genetic studies, the experimental investigations also try to reveal the role of CRP in the progress of atherosclerosis. This review will highlight the complex results of genomic, epidemiological, and experimental studies on CRP and will show why further studies investigating the relationship between CRP and atherosclerosis might be needed.

Radiofrequency radiation at Stockholm Central Railway Station in Sweden and some medical aspects on public exposure to RF fields

OpenAIRE

Hardell, Lennart; Koppel, Tarmo; Carlberg, Michael; Ahonen, Mikko; Hedendahl, Lena

2016-01-01

The Stockholm Central Railway Station in Sweden was investigated for public radiofrequency (RF) radiation exposure. The exposimeter EME Spy 200 was used to collect the RF exposure data across the railway station. The exposimeter covers 20 different radiofrequency bands from 88 to 5,850 MHz. In total 1,669 data points were recorded. The median value for total exposure was 921 ?W/m2 (or 0.092 ?W/cm2; 1 ?W/m2=0.0001 ?W/cm2) with some outliers over 95,544 ?W/m2 (6 V/m, upper detection limit). The...

Multi-organ expression profiling uncovers a gene module in coronary artery disease involving transendothelial migration of leukocytes and LIM domain binding 2: The Stockholm Atherosclerosis Gene Expression (STAGE) study

KAUST Repository

Hä gg, Sara; Skogsberg, Josefin; Lundströ m, Jesper; Noori, Peri; Nilsson, Roland; Zhong, Hua; Maleki, Shohreh; Shang, Ming-Mei; Brinne, Bjö rn; Bradshaw, Maria; Bajic, Vladimir B.; Samnegå rd, Ann; Silveira, Angela; Kaplan, Lee M.; Gigante, Bruna; Leander, Karin; de Faire, Ulf; Rosfors, Stefan; Lockowandt, Ulf; Liska, Jan; Konrad, Peter; Takolander, Rabbe; Franco-Cereceda, Anders; Schadt, Eric E.; Ivert, Torbjö rn; Hamsten, Anders; Tegné r, Jesper; Bjö rkegren, Johan

2009-01-01

of coronary artery disease (CAD). The primary aim of the Stockholm Atherosclerosis Gene Expression (STAGE) study was to determine whether there are functionally associated genes (rather than individual genes) important for CAD development. To this end, two

Outbreak of enterovirus D68 of the new B3 lineage in Stockholm, Sweden, August to September 2016.

Science.gov (United States)

Dyrdak, Robert; Grabbe, Malin; Hammas, Berit; Ekwall, Jonas; Hansson, Karin E; Luthander, Joachim; Naucler, Pontus; Reinius, Henrik; Rotzén-Östlund, Maria; Albert, Jan

2016-11-17

We report an enterovirus D68 (EV-D68) outbreak in Stockholm Sweden in 2016. Between 22 August and 25 September EV-D68 was detected in 74/495 respiratory samples analysed at the Karolinska University Hospital. During the peak week, 30/91 (33%) samples were EV-D68 positive. Viral protein (VP)P4/VP2 sequencing revealed that cases were caused by B3 lineage strains. Forty-four (59%) EV-D68-positive patients were children aged ≤ 5 years. Ten patients had severe respiratory or neurological symptoms and one died. This article is copyright of The Authors, 2016.

Involvement of interleukin-1 genotypes in the association of coronary heart disease with periodontitis

DEFF Research Database (Denmark)

Geismar, Karen; Enevold, Christian; Sørensen, Lars Korsbæk

2008-01-01

Epidemiologic studies demonstrated an association between periodontitis (PE) and coronary heart disease (CHD). The coexistence of the two disease entities could be dependent on mutual risk factors, and polymorphism of the interleukin (IL)-1 gene cluster associated with the severity of PE might also...

Space Radiation Heart Disease Risk Estimates for Lunar and Mars Missions

Science.gov (United States)

Cucinotta, Francis A.; Chappell, Lori; Kim, Myung-Hee

2010-01-01

The NASA Space Radiation Program performs research on the risks of late effects from space radiation for cancer, neurological disorders, cataracts, and heart disease. For mortality risks, an aggregate over all risks should be considered as well as projection of the life loss per radiation induced death. We report on a triple detriment life-table approach to combine cancer and heart disease risks. Epidemiology results show extensive heterogeneity between populations for distinct components of the overall heart disease risks including hypertension, ischaemic heart disease, stroke, and cerebrovascular diseases. We report on an update to our previous heart disease estimates for Heart disease (ICD9 390-429) and Stroke (ICD9 430-438), and other sub-groups using recent meta-analysis results for various exposed radiation cohorts to low LET radiation. Results for multiplicative and additive risk transfer models are considered using baseline rates for US males and female. Uncertainty analysis indicated heart mortality risks as low as zero, assuming a threshold dose for deterministic effects, and projections approaching one-third of the overall cancer risk. Medan life-loss per death estimates were significantly less than that of solid cancer and leukemias. Critical research questions to improve risks estimates for heart disease are distinctions in mechanisms at high doses (>2 Gy) and low to moderate doses (<2 Gy), and data and basic understanding of radiation doserate and quality effects, and individual sensitivity.

Intake of ruminant trans fatty acids and risk of coronary heart disease - An overview

DEFF Research Database (Denmark)

Jakobsen, Marianne Uhre; Bysted, Anette; Andersen, Niels Lyhne

2006-01-01

Epidemiological studies have shown a strong direct (positive) association between the intake of trans fatty acids (TRA) and the risk of coronary heart disease (CHD), primarily accounted for by industrially produced TFA (IP-TFA). However, comparisons, between ruminant TEA (R-TFA) and IP-TFA and risk...

Chronobiological considerations for exercise and heart disease.

Science.gov (United States)

Atkinson, Greg; Drust, Barry; George, Keith; Reilly, Thomas; Waterhouse, Jim

2006-01-01

Although regular physical activity is beneficial for many clinical conditions, an acute bout of exercise might increase the risk of an adverse clinical event, such as sudden cardiac death or myocardial infarction, particularly in vulnerable individuals. Since it is also known that the incidence of these events peaks in the morning and that some cardiac patients prefer to schedule leisure-time physical activity before lunch, the question arises as to whether morning exercise is 'inherently' more risky than physical activity performed at other times of day. We attempt to answer this question by reviewing the relevant epidemiological data as well as the results of chronobiological and exercise-related studies that have concentrated on the pathophysiological mechanisms for sudden cardiac events. We also consider generally how chronobiology might impact on exercise prescription in heart disease. We performed a structured literature search in the PubMed and WEBofSCIENCE databases for relevant studies published between 1981 and 2004. The limited amount of published epidemiological data did not allow us to conclude that a bout of vigorous exercise in the morning increases the relative risk of either primary cardiac events in apparently healthy individuals, or secondary events in cardiac patients enrolled in supervised exercise programmes. Nevertheless, these data are not directly relevant to individuals who have a history of heart disease and perform uncontrolled habitual activities. It appears as though the influence of time of day on the cardiovascular safety of this type of exercise has not been examined in this population. There is evidence that several pathophysiological variables (e.g. blood pressure, endothelial function, fibrinolysis) vary in parallel with typical diurnal changes in freely chosen activity. Nevertheless, few studies have been designed to examine specifically whether such variables respond differently to a 'set' level of exercise in the morning

Thermoregulation: Research and Clinical Applications

Science.gov (United States)

1989-08-01

NEDERGAARD The Wenner-Gren Institute, Biologihus F3, University of Stockholm, S-106 91 Stockholm (Sweden) and *Cdtedra de Bioquimica , Facultad de Quimica...heart rate and a lack of arrhythmias. This was true as the temperature dropped and reached a low of 30-32°C, as well as in the actual recovery peri...like this to establish whether the response is linear with added amount, and the actual absorbance observed on each plate is not only a function of

Do tax incentives affect households' adoption of ‘green’ cars? A panel study of the Stockholm congestion tax

International Nuclear Information System (INIS)

Mannberg, Andrea; Jansson, Johan; Pettersson, Thomas; Brännlund, Runar; Lindgren, Urban

2014-01-01

Policymakers have made several attempts to introduce local and national policies to reduce CO 2 emissions and stimulate the consumer adoption of alternative fuel vehicles (ethanol/E85 cars). The purpose of this paper is to analyze how a local policy measure impacts the composition of the car fleet over time. More specifically, we take advantage of the natural experiment setting caused by the introduction of the Stockholm congestion tax (2006) to analyze how the tax affected purchases of ethanol cars that were exempted from the tax. To estimate effects, we employ a Difference-in-differences methodology. By using a comprehensive database of the car fleet and car owners, sociodemographic and geographic factors are analyzed, which is unique in the existing literature. Our results suggest that the congestion tax had a significant impact on ethanol car purchases although the effect fades away over time. Furthermore, there is a positive relationship between the level of education and ethanol car purchases. Previous adoption of an ethanol car is found to be the strongest predictor of ethanol car purchases. Finally, data indicate that Stockholmers substantially increased purchases of ethanol cars half a year before the introduction of the congestion tax, which we refer to as an anticipation effect. - Highlights: • Uses a database of car owners to analyze impacts of a congestion tax on car fleet. • Results show that the tax had a significant effect on ethanol car purchases. • Prior ownership of ethanol car and education correlates with ethanol car purchases

Joint physical custody, turning to parents for emotional support, and subjective health: A study of adolescents in Stockholm, Sweden.

Science.gov (United States)

Låftman, Sara Brolin; Bergström, Malin; Modin, Bitte; Östberg, Viveca

2014-07-01

Among children with separated parents, the arrangement of joint physical custody, i.e. children living equally much in both parents' homes, has increased substantially during the last decades in Sweden. To date, empirical research on the living conditions of this group is limited. This study analyses family type differences in turning to parents for emotional support and in subjective health among adolescents. The focus of the study is adolescents in joint physical custody, who are compared with those living with two original parents in the same household; those living (only) in a single-parent household; and those living (only) in a reconstituted family. The data come from the Stockholm School Survey of 2004, a total population survey of students in grade 9 (15-16 years) in Stockholm (n=8,840). Ordinary least squares (OLS) regressions were conducted. Turning to both parents about problems is most commonly reported by adolescents in intact families, followed by those in joint physical custody. Adolescents in non-traditional family types report worse subjective health than adolescents in intact families, but the difference is smaller for those in joint physical custody than for those living with a single parent. The slightly poorer health of adolescents in joint physical custody than those in intact families is not explained by their lower use of parents as a source of emotional support. The study suggests that joint physical custody is associated with a higher inclination to use parents as a source of emotional support and better subjective health than other post-divorce family types. © 2014 the Nordic Societies of Public Health.

Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden.

Science.gov (United States)

Craftman, Åsa Gransjön; Johnell, Kristina; Fastbom, Johan; Westerbotn, Margareta; von Strauss, Eva

2016-01-01

New drugs and expanded drug indications are constantly being introduced. Welfare states strive to provide equity in drug treatment for all of its citizens and todaýs healthcare systems spend financial resources on drugs for the elderly in a higher rate than for any other age group. Drug utilization in elderly persons has an impact in health and wellbeing in older people. It was to describe the changes in medication use including people aged 78 years and over regardless of residence and other characteristics over 20 years. The study population consisted of 4304 participants in three population-based cross-sectional surveys conducted in the Kungsholmen area of central Stockholm, Sweden. The participant's current drug utilization was reviewed by physicians following standardized protocols. Data were statistical analyzed. Logistic regression models was used to estimate odds ratios and 95% confidence intervals for use of analgesics and psychotropic drugs in the cohorts of 2001 and 2007, controlling for age, gender, education and cognition. Results shows that the prevalence of medication use and polypharmacy in older adults has increased dramatically the late 1980s to the 2000s in central Stockholm, Sweden. In particular, the use of analgesics increased significantly, while some drug groups decreased, i.e., antipsychotics. Women used more medication than men in all three cohorts. Older adults living in service buildings used the largest amount of drugs in 1987, whereas those living in institutions were the most frequent users in 2001 and 2007. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Who takes paternity leave? A cohort study on prior social and health characteristics among fathers in Stockholm.

Science.gov (United States)

Månsdotter, Anna; Fredlund, Peeter; Hallqvist, Johan; Magnusson, Cecilia

2010-09-01

Progress towards gender equality involves changes in the traditional parental division - female caring and male breadwinning. One aspect is increased parental leave for fathers, which may benefit the health of mothers, children, and fathers themselves. We examined how social and health characteristics (2002) were associated with paternity leave in excess of the 'father quota' of 60 days (2003-2006) in the Stockholm Public Health Cohort. Generally, fathers with stable social position, fit lifestyles, and good health had increased chances of paternity leave uptake. Our findings may contribute to identifying target groups for parental leave strategies among fathers; they indicate also that research on gender equality and public health must carefully address the problems of confounding and health-related selection.

A new multiple regression model to identify multi-family houses with a high prevalence of sick building symptoms "SBS", within the healthy sustainable house study in Stockholm (3H).

Science.gov (United States)

Engvall, Karin; Hult, M; Corner, R; Lampa, E; Norbäck, D; Emenius, G

2010-01-01

The aim was to develop a new model to identify residential buildings with higher frequencies of "SBS" than expected, "risk buildings". In 2005, 481 multi-family buildings with 10,506 dwellings in Stockholm were studied by a new stratified random sampling. A standardised self-administered questionnaire was used to assess "SBS", atopy and personal factors. The response rate was 73%. Statistical analysis was performed by multiple logistic regressions. Dwellers owning their building reported less "SBS" than those renting. There was a strong relationship between socio-economic factors and ownership. The regression model, ended up with high explanatory values for age, gender, atopy and ownership. Applying our model, 9% of all residential buildings in Stockholm were classified as "risk buildings" with the highest proportion in houses built 1961-1975 (26%) and lowest in houses built 1985-1990 (4%). To identify "risk buildings", it is necessary to adjust for ownership and population characteristics.

Epidemiología de campo y epidemiología social Field epidemiology and social epidemiology

Directory of Open Access Journals (Sweden)

Javier Segura del Pozo

2006-03-01

Full Text Available Mediante la comparación de la epidemiología de campo y la epidemiología social, se pretende reflexionar sobre los imaginarios no explícitos que operan en ambos ámbitos, necesariamente convergentes, sobre los obstáculos de la práctica epidemiológica actual para alcanzar su función social y sobre la necesidad de cambiar las bases epistemológicas, metodológicas y prácticas que operan en la epidemiología, empezando por la formación del epidemiólogo de campo. La epidemiología de campo tiende a la acción sin marco teórico. La epidemiología social, por el contrario, tiende a los desarrollos teóricos (reflexión e investigación sobre los determinantes sociales alejados de la acción, debido a los limitantes para cambiar las políticas públicas. Otras diferencias se sitúan en el nivel de intervención (micro/macroespacios, el objeto de intervención (control del brote frente a control de las desigualdades y en la forma de articular la comunicación con la sociedad. Se asemejan en la preocupación por el método, la predominancia de una orientación positivista y condicionada por la estadística, aunque en proceso de cierta apertura epistemológica, la tensión experimentada entre relacionarse con un mundo virtual de bases de datos o con la sociedad real, su situación en la periferia del sistema político-social-institucional-profesional y por estar abocadas a la frustración profesional. Finalmente, se formulan 10 interrogantes a los epidemiólogos de campo sobre su práctica actual, a través de los cuales se podría evaluar si están realizando una epidemiología social, y se sugieren cambios para introducir en la formación y práctica del epidemiólogo.Comparing field epidemiology and social epidemiology, we pretend to think about the no explicit images and meanings operating in both necessary convergent fields, about the obstacles present in epidemiological practice to fulfil its social function and about the necessity of

Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study

DEFF Research Database (Denmark)

Andell, Pontus; Li, Xinjun; Martinsson, Andreas

2017-01-01

OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients...

Understanding healthcare innovation systems: the Stockholm region case.

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Larisch, Lisa-Marie; Amer-Wåhlin, Isis; Hidefjäll, Patrik

2016-11-21

Purpose There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs). Design/methodology/approach The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed. Findings The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations. Research limitations/implications In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities. Social implications Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring. Originality/value This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public

Sensitization of children in the Stockholm area to house dust mites.

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Nordvall, S L; Eriksson, M; Rylander, E; Schwartz, B

1988-09-01

Atopic sensitization of children in the Stockholm area to house dust mites (HDM) was investigated in a case-control study. Sixty children with and 60 without positive skin prick tests for HDM were matched for age and sex. HDM-sensitized children had previously more often lived in other areas known to be mite infested than the control children. Sensitization to mites was related to dampness in the homes, but no significant relationship was found to the type of residence, frequent visits to a summer house in the archipelago or parental smoking. Dust samples from mattresses of the children with the strongest positive reactions to mites in skin prick tests and the respective controls were subjected to an enzyme immunoassay, to measure the content of the major allergens of the Dermatophagoides (D.) species D. pterinyssinus, D. farinae and D. microceras. Mattress dust samples from the beds of HDM-sensitized children contained significantly higher HDM antigen concentrations than those from the beds of controls. Private houses contained significantly more HDM antigens than flats and 10 of 11 homes in which a dampness problem was recognized contained mite antigens. It is postulated that mite infestation is increasing in the area, energy-saving measures creating improved conditions for HDM survival.

The heart of Africa: succeeding against the odds.

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Sliwa, Karen

2016-12-17

South Africa and other areas of sub-Saharan Africa have in the past 20 years undergone rapid demographical changes, largely due to urbanisation and changes in lifestyle. This rapid change has led to a marked increase in specific cardiac conditions, such as hypertensive heart disease and coronary artery disease (with the highest prevalence in the middle-aged population), in conjunction with a range of other heart diseases, which are historically common in Africa-eg, rheumatic heart disease, cardiomyopathies, and unoperated congenital heart disease. The short supply of well-equipped screening facilities, late diagnosis, and inadequate care at primary, secondary, and tertiary levels have led to a large burden of patients with poorly treated heart failure. Excellent progress has been made in the understanding of the epidemiology, sociodemographical factors, effect of urbanisation, and pathophysiology of cardiac conditions, such as peripartum cardiomyopathy, rheumatic heart disease, and tuberculous pericarditis, which are common in sub-Saharan Africa. This progress has been achieved largely through several studies, such as the Heart of Soweto, THESUS, REMEDY, BA-HEF, Abeokuta-HF, and the PAPUCO studies. Studies on the suitable therapeutic management of several heart conditions have also been done or are underway. In this Lecture, I provide a personal perspective on the evolving burden of cardiac disease, as witnessed since my appointment at Chris Hani Baragwanath Hospital, in Soweto, South Africa, in 1992, which was also the year that the referendum to end apartheid in South Africa was held. Subsequently, a network of cardiologists was formed under the umbrella of the Heart of Africa Studies and the Pan African Cardiac Society. Furthermore, I summarise the major gaps in the health-care system dealing with the colliding epidemic of communicable and non-communicable heart diseases, including cardiac diseases common in peripartum women. I also touch on the fantastic

Prevalence and correlates of heart disease among adults in Singapore.

Science.gov (United States)

Picco, Louisa; Subramaniam, Mythily; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann

2016-02-01

Heart disease is one of the leading causes of morbidity and mortality worldwide and it has been well established that it is associated with both mental and physical conditions. This paper describes the prevalence of heart disease with mental disorders and other chronic physical conditions among the Singapore resident population. Data were from the Singapore Mental Health Study which was a representative, cross-sectional epidemiological survey undertaken with 6616 Singapore residents, between December 2009 and December 2010. The Composite International Diagnostic Interview Version 3.0 was used to establish the diagnosis of mental disorders, while a chronic medical conditions checklist was used to gather information on 15 physical conditions, including various forms of heart disease. Health-related quality of life was measured using the Euro-Quality of Life Scale (EQ-5D). The lifetime prevalence of heart disease was 2.8%. Socio-demographic correlates of heart disease included older age, Indian ethnicity, secondary education (vs. tertiary) and being economically inactive. After adjusting for socio-demographic variables and other comorbid physical and mental disorders, the prevalence of major depressive disorder and bipolar disorder were significantly higher among those with heart disease, as were diabetes, arthritis, kidney failure and lung disease. These findings highlight important associations between heart disease and various socio-demographic correlates, mental disorders and physical conditions. Given the high prevalence of mood disorders among heart disease patients, timely and appropriate screening and treatment of mental disorders among this group is essential. Copyright © 2015 Elsevier B.V. All rights reserved.

Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC Heart Failure Long-Term Registry.

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Chioncel, Ovidiu; Mebazaa, Alexandre; Harjola, Veli-Pekka; Coats, Andrew J; Piepoli, Massimo Francesco; Crespo-Leiro, Maria G; Laroche, Cecile; Seferovic, Petar M; Anker, Stefan D; Ferrari, Roberto; Ruschitzka, Frank; Lopez-Fernandez, Silvia; Miani, Daniela; Filippatos, Gerasimos; Maggioni, Aldo P

2017-10-01

To identify differences in clinical epidemiology, in-hospital management and 1-year outcomes among patients hospitalized for acute heart failure (AHF) and enrolled in the European Society of Cardiology Heart Failure Long-Term (ESC-HF-LT) Registry, stratified by clinical profile at admission. The ESC-HF-LT Registry is a prospective, observational study collecting hospitalization and 1-year follow-up data from 6629 AHF patients. Among AHF patients enrolled in the registry, 13.2% presented with pulmonary oedema (PO), 2.9% with cardiogenic shock (CS), 61.1% with decompensated heart failure (DHF), 4.8% with hypertensive heart failure (HT-HF), 3.5% with right heart failure (RHF) and 14.4% with AHF and associated acute coronary syndromes (ACS-HF). The 1-year mortality rate was 28.1% in PO, 54.0% in CS, 27.2% in DHF, 12.8% in HT-HF, 34.0% in RHF and 20.6% in ACS-HF patients. When patients were classified by systolic blood pressure (SBP) at initial presentation, 1-year mortality was 34.8% in patients with SBP 140 mmHg. These differences tended to diminish in the months post-discharge, and 1-year mortality for the patients who survived at least 6 months post-discharge did not vary significantly by either clinical profile or SBP classification. Rates of adverse outcomes in AHF remain high, and substantial differences have been found when patients were stratified by clinical profile or SBP. However, patients who survived at least 6 months post-discharge represent a more homogeneous group and their 1-year outcome is less influenced by clinical profile or SBP at admission. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

BMI change during puberty and the risk of heart failure.

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Kindblom, J M; Bygdell, M; Sondén, A; Célind, J; Rosengren, A; Ohlsson, C

2018-03-12

Hospitalization for heart failure amongst younger men has increased. The reason for this is unknown but it coincides with the obesity epidemic. The aim of this study was to evaluate the association between childhood BMI (Body Mass Index) and BMI change during puberty for risk of adult heart failure in men. Using the BMI Epidemiology Study (BEST), a population-based study in Gothenburg, Sweden, we collected information on childhood BMI at age 8 years and BMI change during puberty (BMI at age 20 - BMI at 8) for men born 1945-1961, followed until December 2013 (n = 37 670). BMI was collected from paediatric growth charts and mandatory military conscription tests. Information on heart failure was retrieved from high-quality national registers (342 first hospitalizations for heart failure). BMI change during puberty was independently of childhood BMI associated with risk of heart failure in a nonlinear J-shaped manner. Subjects in the upper quartile of BMI change during puberty (Q4) had more than twofold increased risk of heart failure compared with subjects in Q1 [HR (Hazard Ratio) = 2.29, 95% CI (Confidence Interval) 1.68-3.12]. Childhood BMI was not independently associated with risk of heart failure. Boys developing overweight during puberty (HR 3.14; 95% CI 2.25-4.38) but not boys with childhood overweight that normalized during puberty (HR 1.12, 95% CI 0.63-2.00) had increased risk of heart failure compared with boys without childhood or young adult overweight. BMI change during puberty is a novel risk factor for adult heart failure in men. © 2018 The Association for the Publication of the Journal of Internal Medicine.

Risk of self-reported Chlamydia trachomatis infection by social and lifestyle factors: a study based on survey data from young adults in Stockholm, Sweden.

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Deogan, Charlotte; Cnattingius, Sven; Månsdotter, Anna

2012-12-01

To analyse the associations between demographic, socio-economic and lifestyle factors, and the risk of self-reported chlamydial infection among young adults (20-29 years old) in Stockholm, Sweden. This study was based on the Stockholm Public Health Survey of 2006 (N = 4278). Demographic factors (gender, age, and country of birth), socio-economic factors (individual and parental educational levels, individual income level, and employment status), and lifestyle factors (body mass index, mental health, alcohol consumption, and partnership status) were taken into account. Possible associations were analysed by logistic regression. The risk of self-reported chlamydial infection decreases with age, is higher among individuals both who personally, and whose parents, were educated to high school level compared to university level education, and is higher among those employed, unemployed or on sick-leave/pre-retired compared to students. The risk of chlamydial infection is also higher among subjects who report greater alcohol consumption, and those who live without a partner. After considering demographic, socio-economic and lifestyle factors, the associations with age, educational level, employment status and alcohol consumption are strong and statistically significant. Indicators of risk-taking behaviours, especially in settings with generally little educational ambition or options, should be incorporated in the design of STI prevention strategies.

Big heart data: advancing health informatics through data sharing in cardiovascular imaging.

Science.gov (United States)

Suinesiaputra, Avan; Medrano-Gracia, Pau; Cowan, Brett R; Young, Alistair A

2015-07-01

The burden of heart disease is rapidly worsening due to the increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be reused beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data reuse, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases.

Epidemiology: past, present and future.

Science.gov (United States)

Kesteloot, H

2004-01-01

Epidemiology in the past was concerned essentially by the study of infectious diseases which were the cause of huge mortalities especially since urbanisation was initiated. Epidemics of pest, typhus, cholera, influenza a.o. were common. The epidemics were halted by better hygiene, vaccination and antibiotics. Since the second world war epidemiology was dominated by an "epidemic" of new chronic diseases, especially heart disease and cancer. This was due to an increase in life span and to an increase in smoking habits and in the intake of saturated fat and a too small intake of fruit and vegetables combined with a too high intake of salt (NaCl). Gradually epidemiology evolved as the study of the causes, the distribution, the risk factors and the prevention of chronic diseases, but also including accidents, suicide, depression a.o., diseases with a mass occurrence at the population level. The importance of nutrition as a determinant of health gradually became recognized, but remains undervalued by the medical profession. Mortality at the population level follows some simple mathematical laws and can be represented accurately (r2>0.99) between the ages of 35 and 84 year by either Gompertz equations (ln mortality versus age) or by a polynomial equation (ln mortality versus age, age2). This is valid for all populations and both sexes and remains valid at times of great and rapid changes in mortality. This shows that measures for prevention should be directed towards the total population. The future of epidemiology should be directed towards the slowing of the ageing process at the population level by a healthy life style consisting of: not smoking, avoiding obesity, a fair amount of physical activity and a healthy nutrition i.e little salt, little saturated fat, an adequate amount of omega-3 fatty acids and a large amount of fruit and vegetables, with an occasional glass of red wine. This contains the secret of a long and healthy life. Conceptually it will be important

Heart and coronary artery damage related to Kawasaki syndrome

Directory of Open Access Journals (Sweden)

A. A. Leontyeva

2014-01-01

Full Text Available Kawasaki syndrome is an acute systemic vasculitis of unknown etiology, which mainly affects children within the first 5 years of fife. At the present time, Kawasaki syndrome is recognized to be a leading cause of acquired organic heart diseases in children, which may result in coronary heart disease, myocardial infarction, and sudden death in children and young people. Most complications are associated with the cardiovascular system, with coronary artery changes in particular. Transthoracic echocardiography, which, besides coronary artery assessment, makes it possible to evaluate right and left ventricular systolic and diastolic functions and to study the cardiac valves and changes in pericardial effusion, is a major technique in Kawasaki syndrome. The paper outlines an update on the epidemiology, etiology, pathogenetic mechanisms, and pathomorphology of Kawasaki syndrome and considers possible coronary and noncoronary changes, outcomes, and clinical manifestations.

Evidence of the Role of Physical Activity and Cardiorespiratory Fitness in the Prevention of Coronary Heart Disease.

Science.gov (United States)

Leon, Arthur S.; Norstrom, Jane

1995-01-01

This paper presents epidemiologic evidence on the contributions of physical inactivity and reduced cardiorespiratory fitness to risk of coronary heart disease (CHD). The types and dose of physical activity to reduce risk of CHD and plausible biologic mechanisms for the partial protective effect are reviewed. (Author/SM)

Municipal policies and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm, Sweden: a cross-sectional study.

Science.gov (United States)

Guldbrandsson, Karin; Wennerstad, Karin Modig; Rasmussen, Finn

2009-08-03

Promoting physical activity and healthy eating habits by structural measures that reach most children in a society is presumably the most sustainable way of preventing development of overweight and obesity in childhood. The main purpose of the present study was to analyse whether policies and plans of action at the central level in municipalities increased the number of measures that aim to promote physical activity and healthy eating habits among schoolchildren aged six to 16. Another purpose was to analyse whether demographic and socio-economic characteristics were associated with the level of such measures. Questionnaires were used to collect data from 25 municipalities and 18 town districts in Stockholm County, Sweden. The questions were developed to capture municipal structural work and factors facilitating physical activity and the development of healthy eating habits for children. Local policy documents and plans of action were gathered. Information regarding municipal demographic and socio-economic characteristics was collected from public statistics. Policy documents and plans of action in municipalities and town districts did not seem to influence the number of measures aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm County. Municipal demographic and socio-economic characteristics were, however, shown to influence the number of measures. In town districts with a high total population size, and in municipalities and town districts with a high proportion of adults with more than 12 years of education, a higher level of health-promoting measures was found. In municipalities with a high annual population growth, the number of measures was lower than in municipalities with a lower annual population growth. Another key finding was the lack of agreement between what was reported in the questionnaires regarding existence and contents of local policies and plans of action and what was actually found when these

Prevalence of Heart Disease Demonstrated in 60 Years of the Arquivos Brasileiros de Cardiologia

Energy Technology Data Exchange (ETDEWEB)

Evora, Paulo Roberto Barbosa, E-mail: prbevora@cardiol.br; Nather, Julio Cesar; Rodrigues, Alfredo José [Departamento de Cirurgia e Anatomia da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP (Brazil)

2014-01-15

Considering the historical and academic relevance of the Brazilian Archives of Cardiology (ABC), as its MEDLINE indexing began in 1950, it was assumed as a hypothesis that the analysis of the publications over the last 60 years could reflect the changing trends of heart disease in Brazil. The study data were collected using a program developed for this purpose, allowing the automatic extraction of information from the MEDLINE database. The study information were collected by searching 'Brazilian Archives of Cardiology AND selected parameter in English'. Four observational groups were determined: (1) major groups of heart diseases (coronary artery disease, valvular heart disease, congenital heart disease and cardiomyopathies); (2) relevant diseases in clinical practice (cardiac arrhythmias, cor pulmonale, myocardial infarction and congestive heart failure); (3) cardiovascular risk factors (hypertension, diabetes, dyslipidemia and atherosclerosis); and (4) group determined due to the growing trend of publications on congestive heart failure seen in previous groups (congestive heart failure, myocardial infarction, rheumatic heart disease and Chagasic heart disease) All publications within the established groups were described, highlighting the increasing importance of heart failure and diabetes as risk factors. A relatively easy search was carried out, using the computer program developed for literature search covering six decades. Emphasizing the limitations of the study, we suggest the existence of an epidemiological link between cardiac diseases that are prevalent in Brazil and the publications of the Brazilian Archives of Cardiology.

Prevalence of Heart Disease Demonstrated in 60 Years of the Arquivos Brasileiros de Cardiologia

International Nuclear Information System (INIS)

Evora, Paulo Roberto Barbosa; Nather, Julio Cesar; Rodrigues, Alfredo José

2014-01-01

Considering the historical and academic relevance of the Brazilian Archives of Cardiology (ABC), as its MEDLINE indexing began in 1950, it was assumed as a hypothesis that the analysis of the publications over the last 60 years could reflect the changing trends of heart disease in Brazil. The study data were collected using a program developed for this purpose, allowing the automatic extraction of information from the MEDLINE database. The study information were collected by searching 'Brazilian Archives of Cardiology AND selected parameter in English'. Four observational groups were determined: (1) major groups of heart diseases (coronary artery disease, valvular heart disease, congenital heart disease and cardiomyopathies); (2) relevant diseases in clinical practice (cardiac arrhythmias, cor pulmonale, myocardial infarction and congestive heart failure); (3) cardiovascular risk factors (hypertension, diabetes, dyslipidemia and atherosclerosis); and (4) group determined due to the growing trend of publications on congestive heart failure seen in previous groups (congestive heart failure, myocardial infarction, rheumatic heart disease and Chagasic heart disease) All publications within the established groups were described, highlighting the increasing importance of heart failure and diabetes as risk factors. A relatively easy search was carried out, using the computer program developed for literature search covering six decades. Emphasizing the limitations of the study, we suggest the existence of an epidemiological link between cardiac diseases that are prevalent in Brazil and the publications of the Brazilian Archives of Cardiology

Prevalence of Heart Disease Demonstrated in 60 Years of the Arquivos Brasileiros de Cardiologia

Energy Technology Data Exchange (ETDEWEB)

Evora, Paulo Roberto Barbosa, E-mail: prbevora@cardiol.br; Nather, Julio Cesar; Rodrigues, Alfredo José [Departamento de Cirurgia e Anatomia da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP (Brazil)

2014-01-15

Considering the historical and academic relevance of the Brazilian Archives of Cardiology (ABC), as its MEDLINE indexing began in 1950, it was assumed as a hypothesis that the analysis of the publications over the last 60 years could reflect the changing trends of heart disease in Brazil. The study data were collected using a program developed for this purpose, allowing the automatic extraction of information from the MEDLINE database. The study information were collected by searching 'Brazilian Archives of Cardiology AND selected parameter in English'. Four observational groups were determined: (1) major groups of heart diseases (coronary artery disease, valvular heart disease, congenital heart disease and cardiomyopathies); (2) relevant diseases in clinical practice (cardiac arrhythmias, cor pulmonale, myocardial infarction and congestive heart failure); (3) cardiovascular risk factors (hypertension, diabetes, dyslipidemia and atherosclerosis); and (4) group determined due to the growing trend of publications on congestive heart failure seen in previous groups (congestive heart failure, myocardial infarction, rheumatic heart disease and Chagasic heart disease) All publications within the established groups were described, highlighting the increasing importance of heart failure and diabetes as risk factors. A relatively easy search was carried out, using the computer program developed for literature search covering six decades. Emphasizing the limitations of the study, we suggest the existence of an epidemiological link between cardiac diseases that are prevalent in Brazil and the publications of the Brazilian Archives of Cardiology.

The National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study (REDS-III): A research program striving to improve blood donor and transfusion recipient outcomes

Science.gov (United States)

Kleinman, Steven; Busch, Michael P; Murphy, Edward L; Shan, Hua; Ness, Paul; Glynn, Simone A.

2014-01-01

Background The Recipient Epidemiology and Donor Evaluation Study -III (REDS-III) is a 7-year multicenter transfusion safety research initiative launched in 2011 by the National Heart, Lung, and Blood Institute. Study design The domestic component involves 4 blood centers, 12 hospitals, a data coordinating center, and a central laboratory. The international component consists of distinct programs in Brazil, China, and South Africa which involve US and in-country investigators. Results REDS-III is using two major methods to address key research priorities in blood banking/transfusion medicine. First, there will be numerous analyses of large “core” databases; the international programs have each constructed a donor/donation database while the domestic program has established a detailed research database that links data from blood donors and their donations, the components made from these donations, and data extracts from the electronic medical records of the recipients of these components. Secondly, there are more than 25 focused research protocols involving transfusion recipients, blood donors, or both that are either in progress or scheduled to begin within the next 3 years. Areas of study include transfusion epidemiology and blood utilization; transfusion outcomes; non-infectious transfusion risks; HIV-related safety issues (particularly in the international programs); emerging infectious agents; blood component quality; donor health and safety; and other donor issues. Conclusions It is intended that REDS-III serve as an impetus for more widespread recipient and linked donor-recipient research in the US as well as to help assure a safe and available blood supply in the US and in international locations. PMID:24188564

Participatory epidemiology: the contribution of participatory research to epidemiology

Directory of Open Access Journals (Sweden)

Mario Bach

2017-02-01

Full Text Available Abstract Background Epidemiology has contributed in many ways to identifying various risk factors for disease and to promoting population health. However, there is a continuing debate about the ability of epidemiology not only to describe, but also to provide results which can be better translated into public health practice. It has been proposed that participatory research approaches be applied to epidemiology as a way to bridge this gap between description and action. A systematic account of what constitutes participatory epidemiology practice has, however, been lacking. Methods A scoping review was carried out focused on the question of what constitutes participatory approaches to epidemiology for the purpose of demonstrating their potential for advancing epidemiologic research. Relevant databases were searched, including both the published and non-published (grey literature. The 102 identified sources were analyzed in terms of comparing common epidemiologic approaches to participatory counterparts regarding central aspects of the research process. Exemplary studies applying participatory approaches were examined more closely. Results A highly diverse, interdisciplinary body of literature was synthesized, resulting in a framework comprised of seven aspects of the research process: research goal, research question, population, context, data synthesis, research management, and dissemination of findings. The framework specifies how participatory approaches not only differ from, but also how they can enhance common approaches in epidemiology. Finally, recommendations for the further development of participatory approaches are given. These include: enhancing data collection, data analysis, and data validation; advancing capacity building for research at the local level; and developing data synthesis. Conclusion The proposed framework provides a basis for systematically developing the emergent science of participatory epidemiology.

High radiofrequency radiation at Stockholm Old Town: An exposimeter study including the Royal Castle, Supreme Court, three major squares and the Swedish Parliament

OpenAIRE

Hardell, Lennart; Carlberg, Michael; Koppel, Tarmo; Hedendahl, Lena

2017-01-01

Exposure to radiofrequency (RF) radiation was classified as a possible human carcinogen, Group 2B, by the International Agency for Research on Cancer at WHO in 2011. The exposure pattern is changing due to the rapid development of technology. Outdoor RF radiation level was measured during five tours in Stockholm Old Town in April, 2016 using the EME Spy 200 exposimeter with 20 predefined frequencies. The results were based on 10,437 samples in total. The mean level of the total RF radiation w...

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association.

Science.gov (United States)

Lui, George K; Saidi, Arwa; Bhatt, Ami B; Burchill, Luke J; Deen, Jason F; Earing, Michael G; Gewitz, Michael; Ginns, Jonathan; Kay, Joseph D; Kim, Yuli Y; Kovacs, Adrienne H; Krieger, Eric V; Wu, Fred M; Yoo, Shi-Joon

2017-11-14

Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention. © 2017 American Heart Association, Inc.

The Spectrum of Epidemiology Underlying Sudden Cardiac Death

Science.gov (United States)

Hayashi, Meiso; Shimizu, Wataru; Albert, Christine M.

2015-01-01

Sudden cardiac death (SCD) from cardiac arrest is a major international public health problem accounting for an estimated 15–20% of all deaths. Although resuscitation rates are generally improving throughout the world, the majority of individuals who suffer a sudden cardiac arrest will not survive. SCD most often develops in older adults with acquired structural heart disease, but it also rarely occurs in the young, where it is more commonly due to inherited disorders. Coronary heart disease (CHD) is known to be the most common pathology underlying SCD, followed by cardiomyopathies, inherited arrhythmia syndromes, and valvular heart disease. Over the past three decades, declines in SCD rates have not been as steep as for other causes of CHD deaths, and there is a growing fraction of SCDs not due to CHD and/or ventricular arrhythmias, particularly among certain subsets of the population. The growing heterogeneity of the pathologies and mechanisms underlying SCD present major challenges for SCD prevention, which are magnified further by a frequent lack of recognition of the underlying cardiac condition prior to death. Multifaceted preventative approaches, which address risk factors in seemingly low risk and known high-risk populations will be required to decrease the burden of SCD. In this Compendium, we review the wide-ranging spectrum of epidemiology underlying SCD within both the general population and in high-risk subsets with established cardiac disease placing an emphasis on recent global trends, remaining uncertainties, and potential targeted preventive strategies. PMID:26044246

Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association.

Science.gov (United States)

Konstam, Marvin A; Kiernan, Michael S; Bernstein, Daniel; Bozkurt, Biykem; Jacob, Miriam; Kapur, Navin K; Kociol, Robb D; Lewis, Eldrin F; Mehra, Mandeep R; Pagani, Francis D; Raval, Amish N; Ward, Carey

2018-05-15

hemodynamic and biochemical markers are associated with worsening RHF and can serve to guide clinical assessment and therapeutic decision making. Pharmacological and mechanical interventions targeting isolated acute and chronic RHF have not been well investigated. Specific therapies promoting stabilization and recovery of RV function are lacking. RHF is a complex syndrome including diverse causes, pathways, and pathological processes. In this scientific statement, we review the causes and epidemiology of RV dysfunction and the pathophysiology of acute and chronic RHF and provide guidance for the management of the associated conditions leading to and caused by RHF. © 2018 American Heart Association, Inc.

Association between glycated haemoglobin and the risk of congestive heart failure in diabetes mellitus : systematic review and meta-analysis

NARCIS (Netherlands)

Erqou, Sebhat; Lee, Chee-Tin Christine; Suffoletto, Matthew; Echouffo-Tcheugui, Justin B.; de Boer, Rudolf A.; van Melle, Joost P.; Adler, Amanda I.

Clinical trials to date have not provided definitive evidence regarding the effects of glucose lowering on the incidence of congestive heart failure (CHF). We synthesized available prospective epidemiological data on the association between glycaemia measured by haemoglobin A(1c) (HbA(1c)) and

Diagnosis and management of acute heart failure

Science.gov (United States)

Ural, Dilek; Çavuşoğlu, Yüksel; Eren, Mehmet; Karaüzüm, Kurtuluş; Temizhan, Ahmet; Yılmaz, Mehmet Birhan; Zoghi, Mehdi; Ramassubu, Kumudha; Bozkurt, Biykem

2016-01-01

Acute heart failure (AHF) is a life threatening clinical syndrome with a progressively increasing incidence in general population. Turkey is a country with a high cardiovascular mortality and recent national statistics show that the population structure has turned to an ‘aged’ population. As a consequence, AHF has become one of the main reasons of admission to cardiology clinics. This consensus report summarizes clinical and prognostic classification of AHF, its worldwide and national epidemiology, diagnostic work-up, principles of approach in emergency department, intensive care unit and ward, treatment in different clinical scenarios and approach in special conditions and how to plan hospital discharge. PMID:26574757

[Lessons from a heart valve prosthesis controversy].

Science.gov (United States)

Vandenbroucke, J P; Grobbee, D E

1998-07-18

Two lessons are to be learnt from the Björk-Shiley heart valve prosthesis tragedy. In the first place pharmacoepidemiologic studies are seriously hampered by recent privacy legislation. Individual patients carrying such a prosthesis cannot be traced and advised as to their health risks any more, because their legal autonomy has to be respected. This is clearly not to their advantage. In the second place the atmosphere of marketing and litigation and the increasing dependency of researchers on money from sources with conflicting interests is not conducive to a well-informed and balanced judgement of the epidemiological evidence of safety and efficacy of medical treatments.

Valvular Heart Disease in Heart Failure

Directory of Open Access Journals (Sweden)

Giuseppe MC Rosano

2017-01-01

Full Text Available Structural valvular heart disease may be the cause of heart failure or may worsen the clinical status of patients with heart failure. Heart failure may also develop in patients treated with valve surgery. Patients with heart failure with valvular heart disease are at increased risk of events including sudden cardiac death. Before considering intervention (surgical or percutaneous all patients should receive appropriate medical and device therapy taking into account that vasodilators must be used with caution in patients with severe aortic stenosis. Numerous percutaneous and/or hybrid procedures have been introduced in the past few years and they are changing the management of valvular heart disease. In patients with heart failure and valvular heart disease, either primary or functional, the whole process of decision-making should be staged through a comprehensive evaluation of the risk– benefit ratio of different treatment strategies and should be made by a multidisciplinary ‘heart team’ with a particular expertise in valvular heart disease. The heart team should include heart failure cardiologists, cardiac surgeons/structural valve interventionists, imaging specialists, anaesthetists, geriatricians and intensive care specialists. This article will review recent developments and distill practical guidance in the management of this important heart failure co-morbidity.

Epidemiology and prevention of coronary heart disease in families.

Science.gov (United States)

Higgins, M

2000-04-01

Although family histories are used primarily to aid in diagnosis and risk assessment, their value is enhanced when the family is considered as a unit for research and disease prevention. The value of a family history of coronary heart disease (CHD) is increased when the age, sex, number of relatives, and age at onset of disease are incorporated in a quantitative family risk score. Medical and lifestyle risk factors that aggregate in families include dyslipidemia, hypertension, obesity, hyperfibrinogenemia, diabetes mellitus, smoking habits, eating patterns, alcohol consumption, physical activity, and socioeconomic status. Advances in detecting and understanding interactions between genetic susceptibility and modifiable risk factors should lead to improvements in prevention and treatment. However, working with families can be difficult. In the United States, families are usually small, are often widely dispersed, and may not be intact. Family histories may be unknown, affected relatives may be dead, and secular trends mask similarities among generations. Many exposures occur outside the home, and families change over time. Ethical, legal, and social issues arise when dealing with families. Nevertheless, opportunities are missed when research, clinical practice, and prevention focus on individual patients. Greater emphasis on families is needed to reduce the burden of CHD.

Heart failure with preserved ejection fraction: mechanisms, clinical features, and therapies.

Science.gov (United States)

Sharma, Kavita; Kass, David A

2014-06-20

The clinical syndrome comprising heart failure (HF) symptoms but with a left ventricular ejection fraction (EF) that is not diminished, eg, HF with preserved EF, is increasingly the predominant form of HF in the developed world, and soon to reach epidemic proportions. It remains among the most challenging of clinical syndromes for the practicing clinician and scientist alike, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common comorbidities. Importantly, its morbidity and mortality are on par with HF with reduced EF, and as the list of failed treatments continues to grow, HF with preserved EF clearly represents a major unmet medical need. The field is greatly in need of a more unified approach to its definition and view of the syndrome that engages integrative and reserve pathophysiology beyond that related to the heart alone. We need to reflect on prior treatment failures and the message this is providing, and redirect our approaches likely with a paradigm shift in how the disease is viewed. Success will require interactions between clinicians, translational researchers, and basic physiologists. Here, we review recent translational and clinical research into HF with preserved EF and give perspectives on its evolving demographics and epidemiology, the role of multiorgan deficiencies, potential mechanisms that involve the heart and other organs, clinical trials, and future directions. © 2014 American Heart Association, Inc.

HIV and pregnancy

OpenAIRE

Lindgren, Susanne

1996-01-01

From the Department of Clinical Science, Divisions of Obstetrics and Gynaecology and Paediatrics and the Department of Immumology, Microbiology, Pathology and Infectious Diseases, Division of Clinical Virology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden HIV and Pregnancy An Epidemiological, Clinical and Virological Study of HIV-infected Pregnant Women amd T...

In search of the cancer candidate: can lay epidemiology help?

Science.gov (United States)

Macdonald, Sara; Watt, Graham; Macleod, Una

2013-05-01

First published in 1991, the ideas embedded in 'Lay epidemiology and the prevention paradox' offered a novel and rational explanation for the lay public's failure to fully engage with the lifestyle messages offered by health educators. During the course of a large ethnographic study in South Wales, Davison and colleagues described the emergence of what they termed the coronary candidate. Candidacy provides a 'cultural mechanism' that facilitates the estimation of risk for coronary heart disease. The model has rarely been applied to other major illnesses. This article presents findings from a study that sought to explore the lay epidemiology model, candidacy and cancer. In a series of in-depth individual interviews, members of the lay public discussed their ideas about cancer, and what emerged was an explanatory hierarchy to account for cancer events. Yet the random and unpredictable nature of cancer was emphasised as well as a general reluctance to accept the idea of cancer candidacy. © 2012 The Authors. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

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 ...

Annual report 1978. From the Research Institute of Physics, Stockholm

International Nuclear Information System (INIS)

Nilsson, A.

1978-01-01

This report covers the activities in 1978 at the Research Institute of Physics, Stockholm, Sweden. During this year the construction work on the caves for nuclear physics research in the new experimental hall has been completed. The cyclotron has been started up again after a shut-down of about 15 months. A new mini-computer system has been bought and installed at the institute which will be used for on-line data aquisition as well as for off-line computations and analysis. The experimental nuclear physics program has naturally been hampered by the shut-down of the cyclotron. During the main part of the year, experiments with participation of nuclear physicists from the institute have been carried out at laboratories in Uppsala, Aabo, Risoe, Darmstadt and Orsay. The collaboration with the CERN group studying exotic atoms has continued. The activities of the group working in the field of atomic physics at the 400kV accelerator show a clear trend towards the studies of reaction phenomena occuring in collisions of ions with solids and gases. The construction of the new high-power electron accelerator for research in time-resolved precision spectroscopy of atoms and molecules has been completed. The fusion-related experimental program of the surface physics group has continued with an emphasis on the work done in collaboration with the Institut fur Plasmaphysik, KFA, Julich. In order to be able to perform in situ sputtering and thin film migration studies, a new ultra-high-vacuum chamber is being connected simultaneously to the new 100V-10kV low-energy accelerator and the 2MV Van de Graaff accelerator. (E.R.)

US State-level income inequality and risks of heart attack and coronary risk behaviors: longitudinal findings.

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Pabayo, Roman; Kawachi, Ichiro; Gilman, Stephen E

2015-07-01

To examine prospectively the association between US state income inequality and incidence of heart attack. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,445). Respondents completed interviews at baseline (2001-2002) and follow-up (2004-2005). Weighted multilevel modeling was used to determine if US state-level income inequality (measured by the Gini coefficient) at baseline was a predictor of heart attack during follow-up, controlling for individual-level and state-level covariates. In comparison to residents of US states in the lowest quartile of income inequality, those living in the second [Adjusted Odds Ratio (AOR) = 1.71, 95 % CI 1.16-2.53)], third (AOR = 1.81, 95 % CI 1.28-2.57), and fourth (AOR = 2.04, 95 % CI 1.26-3.29) quartiles were more likely to have a heart attack. Similar findings were obtained when we excluded those who had a heart attack prior to baseline. This study is one of the first to empirically show the longitudinal relationship between income inequality and coronary heart disease. Living in a state with higher income inequality increases the risk for heart attack among US adults.

Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations?

DEFF Research Database (Denmark)

Bauman, Adrian E.; Grunseit, Anne C.; Rangul, Vegar

2017-01-01

Background: Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether 'PA patterns' (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality...... and time 3, and sport and active travel at times 1 and 2 with BMI, waist, hip circumference and mortality (death from coronary heart disease (CHD) and cardiovascular disease (CVD)) were compared to 'PA patterns' spanning multiple time points. PA pattern classified participants' PA as either 1) inactive......: The moderately and highly active groups for PA at times 1 and 3 had up to 1.7 cm lower increase in waist circumference compared with the inactive/low active group. Across 'PA patterns', 'active maintainers' had a 2.0 cm lower waist circumference than 'inactive/low maintainers'. Waist circumference was inversely...

Heart failure in numbers: Estimates for the 21st century in Portugal.

Science.gov (United States)

Fonseca, Cândida; Brás, Daniel; Araújo, Inês; Ceia, Fátima

2018-02-01

Heart failure is a major public health problem that affects a large number of individuals and is associated with high mortality and morbidity. This study aims to estimate the probable scenario for HF prevalence and its consequences in the short-, medium- and long-term in Portugal. This assessment is based on the EPICA (Epidemiology of Heart Failure and Learning) project, which was designed to estimate the prevalence of chronic heart failure in mainland Portugal in 1998. Estimates of heart failure prevalence were performed for individuals aged over 25 years, distributed by age group and gender, based on data from the 2011 Census by Statistics Portugal. The expected demographic changes, particularly the marked aging of the population, mean that a large number of Portuguese will likely be affected by this syndrome. Assuming that current clinical practices are maintained, the prevalence of heart failure in mainland Portugal will increase by 30% by 2035 and by 33% by 2060, compared to 2011, resulting in 479 921 and 494 191 affected individuals, respectively. In addition to the large number of heart failure patients expected, it is estimated that the hospitalizations and mortality associated with this syndrome will significantly increase its economic impact. Therefore, it is extremely important to raise awareness of this syndrome, as this will favor diagnosis and early referral of patients, facilitating better management of heart failure and helping to decrease the burden it imposes on Portugal. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Heart rate control with adrenergic blockade: Clinical outcomes in cardiovascular medicine

Directory of Open Access Journals (Sweden)

David Feldman

2010-05-01

Full Text Available David Feldman1, Terry S Elton2, Doron M Menachemi3, Randy K Wexler41Heart Failure/Transplant and VAD Programs, Minneapolis Heart Institute, Minneapolis, Minnesota, USA; 2Division of Pharmacology, College of Pharmacology, The Ohio State University, Columbus, Ohio, USA; 3Heart Failure Services, Edith Wolfson Medical Center, The Heart Institute, Sakler School of Medicine, Tel-Aviv University, Holon, Israel; 4Department of Clinical Family Medicine, The Ohio State University, Columbus, Ohio, USAAbstract: The sympathetic nervous system is involved in regulating various cardiovascular parameters including heart rate (HR and HR variability. Aberrant sympathetic nervous system expression may result in elevated HR or decreased HR variability, and both are independent risk factors for development of cardiovascular disease, including heart failure, myocardial infarction, and hypertension. Epidemiologic studies have established that impaired HR control is linked to increased cardiovascular morbidity and mortality. One successful way of decreasing HR and cardiovascular mortality has been by utilizing β-blockers, because their ability to alter cell signaling at the receptor level has been shown to mitigate the pathogenic effects of sympathetic nervous system hyperactivation. Numerous clinical studies have demonstrated that β-blocker-mediated HR control improvements are associated with decreased mortality in postinfarct and heart failure patients. Although improved HR control benefits have yet to be established in hypertension, both traditional and vasodilating β-blockers exert positive HR control effects in this patient population. However, differences exist between traditional and vasodilating β-blockers; the latter reduce peripheral vascular resistance and exert neutral or positive effects on important metabolic parameters. Clinical evidence suggests that attainment of HR control is an important treatment objective for patients with cardiovascular

Telehealth solutions to enable global collaboration in rheumatic heart disease screening.

Science.gov (United States)

Lopes, Eduardo Lv; Beaton, Andrea Z; Nascimento, Bruno R; Tompsett, Alison; Dos Santos, Julia Pa; Perlman, Lindsay; Diamantino, Adriana C; Oliveira, Kaciane Kb; Oliveira, Cassio M; Nunes, Maria do Carmo P; Bonisson, Leonardo; Ribeiro, Antônio Lp; Sable, Craig

2018-02-01

Background The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease. Objective We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais. Methods The Programa de Rastreamento da Valvopatia Reumática (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data. Results PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted. Discussion A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle

Myostatin signaling is up-regulated in female patients with advanced heart failure.

Science.gov (United States)

Ishida, Junichi; Konishi, Masaaki; Saitoh, Masakazu; Anker, Markus; Anker, Stefan D; Springer, Jochen

2017-07-01

Myostatin, a negative regulator of skeletal muscle mass, is up-regulated in the myocardium of heart failure (HF) and increased myostatin is associated with weight loss in animal models with HF. Although there are disparities in pathophysiology and epidemiology between male and female patients with HF, it remains unclear whether there is gender difference in myostatin expression and whether it is associated with weight loss in HF patients. Heart tissue samples were collected from patients with advanced heart failure (n=31, female n=5) as well as healthy control donors (n=14, female n=6). Expression levels of myostatin and its related proteins in the heart were evaluated by western blotting analysis. Body mass index was significantly lower in female HF patients than in male counterparts (20.0±4.2 in female vs 25.2±3.8 in male, p=0.04). In female HF patients, both mature myostatin and pSmad2 were significantly up-regulated by 1.9 fold (p=0.05) and 2.5 fold (pmyostatin was not. There was no significant difference in protein expression related to myostatin signaling between male and female patients. In this study, myostatin and pSmad2 were significantly up-regulated in the failing heart of female patients, but not male patients, and female patients displayed lower body mass index. Enhanced myostatin signaling in female failing heart may causally contribute to pathogenesis of HF and cardiac cachexia. Copyright © 2017 Elsevier B.V. All rights reserved.

Heart failure in sub-Saharan Africa: A clinical approach.

Science.gov (United States)

Kraus, S; Ogunbanjo, G; Sliwa, K; Ntusi, N A B

2016-01-01

Despite medical advances, heart failure (HF) remains a global health problem and sub-Saharan Africa (SSA) is no exception, with decompensated HF being the most common primary diagnosis for patients admitted to hospital with heart disease. In SSA the in-hospital mortality rate of decompensated HF is up to 8.3%. HF is a clinical syndrome that is caused by a diverse group of aetiologies, each requiring unique management strategies, highlighting the need for diagnostic certainty and a broad understanding of the complex pathophysiology of this condition. While there are a number of advanced medical, device and surgical interventions being tailored for HF internationally, the fundamental basic principles of HF management, such as patient education, effective management of congestion and initiation of disease-modifying medical therapies, remain a challenge on our continent. This review addresses both the epidemiology of HF in SSA and principles of management that focus specifically on symptom relief, prevention of hospitalisation and improving survival in this population.

A meta-analysis of four genome-wide association studies of survival to age 90 years or older: the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium.

Science.gov (United States)

Newman, Anne B; Walter, Stefan; Lunetta, Kathryn L; Garcia, Melissa E; Slagboom, P Eline; Christensen, Kaare; Arnold, Alice M; Aspelund, Thor; Aulchenko, Yurii S; Benjamin, Emelia J; Christiansen, Lene; D'Agostino, Ralph B; Fitzpatrick, Annette L; Franceschini, Nora; Glazer, Nicole L; Gudnason, Vilmundur; Hofman, Albert; Kaplan, Robert; Karasik, David; Kelly-Hayes, Margaret; Kiel, Douglas P; Launer, Lenore J; Marciante, Kristin D; Massaro, Joseph M; Miljkovic, Iva; Nalls, Michael A; Hernandez, Dena; Psaty, Bruce M; Rivadeneira, Fernando; Rotter, Jerome; Seshadri, Sudha; Smith, Albert V; Taylor, Kent D; Tiemeier, Henning; Uh, Hae-Won; Uitterlinden, André G; Vaupel, James W; Walston, Jeremy; Westendorp, Rudi G J; Harris, Tamara B; Lumley, Thomas; van Duijn, Cornelia M; Murabito, Joanne M

2010-05-01

Genome-wide association studies (GWAS) may yield insights into longevity. We performed a meta-analysis of GWAS in Caucasians from four prospective cohort studies: the Age, Gene/Environment Susceptibility-Reykjavik Study, the Cardiovascular Health Study, the Framingham Heart Study, and the Rotterdam Study participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Longevity was defined as survival to age 90 years or older (n = 1,836); the comparison group comprised cohort members who died between the ages of 55 and 80 years (n = 1,955). In a second discovery stage, additional genotyping was conducted in the Leiden Longevity Study cohort and the Danish 1905 cohort. There were 273 single-nucleotide polymorphism (SNP) associations with p < .0001, but none reached the prespecified significance level of 5 x 10(-8). Of the most significant SNPs, 24 were independent signals, and 16 of these SNPs were successfully genotyped in the second discovery stage, with one association for rs9664222, reaching 6.77 x 10(-7) for the combined meta-analysis of CHARGE and the stage 2 cohorts. The SNP lies in a region near MINPP1 (chromosome 10), a well-conserved gene involved in regulation of cellular proliferation. The minor allele was associated with lower odds of survival past age 90 (odds ratio = 0.82). Associations of interest in a homologue of the longevity assurance gene (LASS3) and PAPPA2 were not strengthened in the second stage. Survival studies of larger size or more extreme or specific phenotypes may support or refine these initial findings.

Century Perspective of Heavy Metal Use in Urban Areas. A Case Study in Stockholm

International Nuclear Information System (INIS)

Soerme, L.; Bergbaeck, B.; Lohm, U.

2001-01-01

The inflow and stock (amount in use) of heavy metals (cadmium(Cd), chromium (Cr), copper (Cu), lead (Pb), mercury (Hg), nickel (Ni) and zinc (Zn)) in goods in 1995 have been quantified in the anthroposphere of Stockholm, Sweden. Statistics on national, regional and local level were used. Contacts were established with representatives from production and construction in the industrial sector and with authorities. The results show that the stock of Cd is 0,2 kg per capita. For the other heavy metals the corresponding result per capita is: Cr 8, Cu 170, Hg 0,01, Ni 4, Pb 73 and Zn 40 kg. The inflow varies between2-8%of the stock indicating the importance of the stock. The lowest levels are for Cu and Pb. Heavy metal levels in solid waste are high, between 15-45% of the amount in the inflow (Hg excluded), the lowest values were for Cu and Pb. Thus, recycling is incomplete. Long life expectancy goods form the majority of the stock but there is a tendency that short life expectancy goods increase their importance in the inflow. Concealed goods are also more frequent in inflow than in the stock

Renal dysfunction in patients with heart failure with preserved versus reduced ejection fraction

DEFF Research Database (Denmark)

McAlister, Finlay A; Ezekowitz, Justin; Tarantini, Luigi

2012-01-01

Prior studies in heart failure (HF) have used the Modification of Diet in Renal Disease (MDRD) equation to calculate estimated glomerular filtration rate (eGFR). The Chronic Kidney Disease-Epidemiology Collaboration Group (CKD-EPI) equation provides a more-accurate eGFR than the MDRD when compared...... against the radionuclide gold standard. The prevalence and prognostic import of renal dysfunction in HF if the CKD-EPI equation is used rather than the MDRD is uncertain....

Prehospital management and fluid resuscitation in hypotensive trauma patients admitted to Karolinska University Hospital in Stockholm.

Science.gov (United States)

Talving, Peep; Pålstedt, Joakim; Riddez, Louis

2005-01-01

Few previous studies have been conducted on the prehospital management of hypotensive trauma patients in Stockholm County. The aim of this study was to describe the prehospital management of hypotensive trauma patients admitted to the largest trauma center in Sweden, and to assess whether prehospital trauma life support (PHTLS) guidelines have been implemented regarding prehospital time intervals and fluid therapy. In addition, the effects of the age, type of injury, injury severity, prehospital time interval, blood pressure, and fluid therapy on outcome were investigated. This is a retrospective, descriptive study on consecutive, hypotensive trauma patients (systolic blood pressure Karolinska University Hospital in Stockholm, Sweden, during 2001-2003. The reported values are medians with interquartile ranges. Basic demographics, prehospital time intervals and interventions, injury severity scores (ISS), type and volumes of prehospital fluid resuscitation, and 30-day mortality were abstracted. The effects of the patient's age, gender, prehospital time interval, type of injury, injury severity, on-scene and emergency department blood pressure, and resuscitation fluid volumes on mortality were analyzed using the exact logistic regression model. In 102 (71 male) adult patients (age > or = 15 years) recruited, the median age was 35.5 years (range: 27-55 years) and 77 patients (75%) had suffered blunt injury. The predominant trauma mechanisms were falls between levels (24%) and motor vehicle crashes (22%) with an ISS of 28.5 (range: 16-50). The on-scene time interval was 19 minutes (range: 12-24 minutes). Fluid therapy was initiated at the scene of injury in the majority of patients (73%) regardless of the type of injury (77 blunt [75%] / 25 penetrating [25%]) or injury severity (ISS: 0-20; 21-40; 41-75). Age (odds ratio (OR) = 1.04), male gender (OR = 3.2), ISS 21-40 (OR = 13.6), and ISS >40 (OR = 43.6) were the significant factors affecting outcome in the exact

Radiofrequency radiation at Stockholm Central Railway Station in Sweden and some medical aspects on public exposure to RF fields.

Science.gov (United States)

Hardell, Lennart; Koppel, Tarmo; Carlberg, Michael; Ahonen, Mikko; Hedendahl, Lena

2016-10-01

The Stockholm Central Railway Station in Sweden was investigated for public radiofrequency (RF) radiation exposure. The exposimeter EME Spy 200 was used to collect the RF exposure data across the railway station. The exposimeter covers 20 different radiofrequency bands from 88 to 5,850 MHz. In total 1,669 data points were recorded. The median value for total exposure was 921 µW/m2 (or 0.092 µW/cm2; 1 µW/m2=0.0001 µW/cm2) with some outliers over 95,544 µW/m2 (6 V/m, upper detection limit). The mean total RF radiation level varied between 2,817 to 4,891 µW/m2 for each walking round. High mean measurements were obtained for GSM + UMTS 900 downlink varying between 1,165 and 2,075 µW/m2. High levels were also obtained for UMTS 2100 downlink; 442 to 1,632 µW/m2. Also LTE 800 downlink, GSM 1800 downlink, and LTE 2600 downlink were in the higher range of measurements. Hot spots were identified, for example close to a wall mounted base station yielding over 95,544 µW/m2 and thus exceeding the exposimeter's detection limit. Almost all of the total measured levels were above the precautionary target level of 3-6 µW/m2 as proposed by the BioInitiative Working Group in 2012. That target level was one-tenth of the scientific benchmark providing a safety margin either for children, or chronic exposure conditions. We compare the levels of RF radiation exposures identified in the present study to published scientific results reporting adverse biological effects and health harm at levels equivalent to, or below those measured in this Stockholm Central Railway Station project. It should be noted that these RF radiation levels give transient exposure, since people are generally passing through the areas tested, except for subsets of people who are there for hours each day of work.

An epidemiological analysis of the burden of chronic thromboembolic pulmonary hypertension in the USA, Europe and Japan

Directory of Open Access Journals (Sweden)

Henning Gall

2017-03-01

Full Text Available Epidemiological data for chronic thromboembolic pulmonary hypertension (CTEPH are limited and there are conflicting reports regarding its pathogenesis. A literature review was conducted to identify CTEPH epidemiological data up to June 2014. Data were analysed to provide estimates of the incidence of CTEPH in the USA, Europe and Japan. An epidemiological projection model derived country-specific estimates of future incidence and diagnosis rates of CTEPH. Overall, 25 publications and 14 databases provided quantitative epidemiological data. In the USA and Europe, the crude annual incidence of diagnosed pulmonary embolism and crude annual full (i.e. diagnosed and undiagnosed incidence of CTEPH were 66–104 and 3–5 cases per 100 000 population, respectively, while in Japan these rates were lower at 6.7 and 1.9 per 100 000 population, respectively. In 2013, 7–29% of CTEPH cases in Europe and the USA were diagnosed, and the majority of patients were in New York Heart Association functional class III/IV at diagnosis. The projection model indicated that incidence of CTEPH will continue to increase over the next decade. These data suggest that CTEPH is underdiagnosed and undertreated, and there is an urgent need to increase awareness of CTEPH. High-quality epidemiological studies are required to increase understanding of CTEPH.

Acute Heart Failure in the Emergency Department: the SAFE-SIMEU Epidemiological Study.

Science.gov (United States)

Fabbri, Andrea; Marchesini, Giulio; Carbone, Giorgio; Cosentini, Roberto; Ferrari, Annamaria; Chiesa, Mauro; Bertini, Alessio; Rea, Federico

2017-08-01

Patients with acute heart failure (AHF) have high rates of attendance to emergency departments (EDs), with significant health care costs. We aimed to describe the clinical characteristics of patients attending Italian EDs for AHF and their diagnostic and therapeutic work-up. We carried out a retrospective analysis on 2683 cases observed in six Italian EDs for AHF (January 2011 to June 2012). The median age of patients was 84 years (interquartile range 12), with females accounting for 55.8% of cases (95% confidence interval [CI] 53.5-57.6%). A first episode of AHF was recorded in 55.3% (95% CI 55.4-57.2%). Respiratory disease was the main precipitating factor (approximately 30% of cases), and multiple comorbidities were recorded in > 50% of cases (history of acute coronary syndrome, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, valvular heart disease). The treatment was based on oxygen (69.7%; 67.9-71.5%), diuretics (69.2%; 67.9-71.5%), nitroglycerin (19.7%; 18.3-21.4%), and noninvasive ventilation (15.2%; 13.8-16.6%). Death occurred within 6 h in 2.5% of cases (2.0-3.1%), 6.4% (5.5-7.3%) were referred to the care of their general practitioners within a few hours from ED attendance or after short-term (< 24 h) observation 13.9% (12.6-15.2%); 60.4% (58.5-62.2%) were admitted to the hospital, and 16.8% (15.4-18.3%) were cared for in intensive care units according to disease severity. Our study reporting the "real-world" clinical activity indicates that subjects attending the Italian EDs for AHF are rather different from those reported in international registries. Subjects are older, with a higher proportion of females, and high prevalence of cardiac and noncardiac comorbidities. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of the Chronic Kidney Disease Epidemiology Collaboration, the Modification of Diet in Renal Disease study and the Cockcroft-Gault equation in patients with heart failure.

Science.gov (United States)

Szummer, Karolina; Evans, Marie; Carrero, Juan Jesus; Alehagen, Urban; Dahlström, Ulf; Benson, Lina; Lund, Lars H

2017-01-01

It is unknown how the creatinine-based renal function estimations differ for dose adjustment cut-offs and risk prediction in patients with heart failure. The renal function was similar with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (median 59 mL/min/1.73 m 2 , IQR 42 to 77) and Modification of Diet in Renal Disease Study (MDRD) (59 mL/min/1.73 m 2 , IQR 43 to 75) and slightly lower with the Cockcroft-Gault (CG) equation (57 mL/min, IQR 39 to 82). Across the commonly used renal function stages, the CKD-EPI and the MDRD classified patients into the same stage in 87.2% (kappa coefficient 0.83, pFailure Registry (n= 40 736) with standardised creatinine values between 2000 and 2012 had their renal function estimated with the CKD-EPI, the MDRD and the CG. Agreement between the formulas was compared for categories. Prediction of death was assessed with c-statistics and with NRI. The choice of renal function estimation formula has clinical implications and differing results at various cut-off levels. For prognosis, the CG predicts mortality better than the CKD-EPI and MDRD.

The web cast of the Nobel Prize of Physics of 2008, transmitted direct from Stockholm to the Globe of Science at CERN. Followed by a discussion among CERN theorists, with the participation of Jack Steinberger and John Ellis.

CERN Multimedia

Claudia Marcelloni

2008-01-01

The web cast of the Nobel Prize of Physics of 2008, transmitted direct from Stockholm to the Globe of Science at CERN. Followed by a discussion among CERN theorists, with the participation of Jack Steinberger and John Ellis.

Development of a Coronary Heart Disease Risk Prediction Model for Type 1 Diabetes: The Pittsburgh CHD in Type 1 Diabetes Risk Mode

NARCIS (Netherlands)

Zgibor, J.C.; Ruppert, K.; Orchard, T.J.; Soedamah-Muthu, S.S.; Fuller, J.H.; Chaturvedi, N.; Roberts, M.S.

2010-01-01

Aim - To create a coronary heart disease (CHD) risk prediction model specific to type 1 diabetes. Methods - Development of the model used data from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC). EDC subjects had type 1 diabetes diagnosed between 1950 and 1980, received their

Evaluation of epidemiological studies

International Nuclear Information System (INIS)

Breckow, J.

1995-01-01

The publication is intended for readers with a professional background in radiation protection who are not experts in the field of epidemiology. The potentials and the limits of epidemiology are shown and concepts and terminology of radioepidemilogic studies as well as epidemiology in general are explained, in order to provide the necessary basis for understanding or performing evaluations of epidemiologic studies. (orig./VHE) [de

Remnant cholesterol and ischemic heart disease

DEFF Research Database (Denmark)

Varbo, Anette; Nordestgaard, Børge G

2014-01-01

PURPOSE OF REVIEW: To review recent advances in the field of remnant cholesterol as a contributor to the development of ischemic heart disease (IHD). RECENT FINDINGS: Epidemiologic, mechanistic, and genetic studies all support a role for elevated remnant cholesterol (=cholesterol in triglyceride......-rich lipoproteins) as a contributor to the development of atherosclerosis and IHD. Observational studies show association between elevated remnant cholesterol and IHD, and mechanistic studies show remnant cholesterol accumulation in the arterial wall like LDL-cholesterol (LDL-C) accumulation. Furthermore, large...... genetic studies show evidence of remnant cholesterol as a causal risk factor for IHD independent of HDL-cholesterol levels. Genetic studies also show that elevated remnant cholesterol is associated with low-grade inflammation, whereas elevated LDL-C is not. There are several pharmacologic ways of lowering...

Case-control study of factors associated with chronic Chagas heart disease in patients over 50 years of age

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Silvana de Araújo Silva

2007-11-01

Full Text Available A case-control study on chronic Chagas heart disease (CCHD was carried out between 1997 and 2005. Ninety patients over 50 years of age were examined for factors related to (CCHD. Fourty-six patients (51.1% with Chagas heart disease (anomalous ECG were assigned to the case group and 44 (48.9% were included in the control group as carriers of undetermined forms of chronic disease. Social, demographic (age, gender, skin color, area of origin, epidemiological (permanence within an endemic zone, family history of Chagas heart disease or sudden death, physical strain, alcoholism, and smoking, and clinical (systemic hypertension variables were analyzed. The data set was assessed through single-variable and multivariate analysis. The two factors independently associated with heart disease were age - presence of heart disease being three times higher in patients over 60 years of age (odds ratio, OR: 2.89; confidence interval of 95%: 1.09-7.61 - and family history of Chagas heart disease (OR: 2.833, CI 95%: 1.11-7.23. Systemic hypertension and gender did not prove to hold any association with heart disease, as neither did skin color, but this variable showed low statistical power due to reduced sample size.

A systematic review of trends and patterns of congenital heart disease in children in Nigeria from 1964-2015.

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Abdulkadir, Mohammed; Abdulkadir, Zainab

2016-06-01

Congenital heart diseases cause significant childhood morbidity and mortality. Several restricted studies have been conducted on the epidemiology in Nigeria. No truly nationwide data on patterns of congenital heart disease exists. To determine the patterns of congenital heart disease in children in Nigeria and examine trends in the occurrence of individual defects across 5 decades. We searched PubMed database, Google scholar, TRIP database, World Health Organisation libraries and reference lists of selected articles for studies on patterns of congenital heart disease among children in Nigeria between 1964 and 2015. Two researchers reviewed the papers independently and extracted the data. Seventeen studies were selected that included 2,953 children with congenital heart disease. The commonest congenital heart diseases in Nigeria are ventricular septal defect (40.6%), patent ductus arteriosus (18.4%), atrial septal defect (11.3%) and tetralogy of Fallot (11.8%). There has been a 6% increase in the burden of VSD in every decade for the 5 decades studied and a decline in the occurrence of pulmonary stenosis. Studies conducted in Northern Nigeria demonstrated higher proportions of atrial septal defects than patent ductus arteriosus. Ventricular septal defects are the commonest congenital heart diseases in Nigeria with a rising burden.

Preattentive processing of heart cues and the perception of heart symptoms in congenital heart disease.

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Karsdorp, Petra A; Kindt, Merel; Everaerd, Walter; Mulder, Barbara J M

2007-08-01

The present study was aimed at clarifying whether preattentive processing of heart cues results in biased perception of heart sensations in patients with congenital heart disease (ConHD) who are also highly trait anxious. Twenty-six patients with ConHD and 22 healthy participants categorized heart-related (heart rate) or neutral sensations (constant vibration) as either heart or neutral. Both sensations were evoked using a bass speaker that was attached on the chest of the participant. Before each physical sensation, a subliminal heart-related or neutral prime was presented. Biased perception of heart-sensations would become evident by a delayed categorization of the heart-related sensations. In line with the prediction, a combination of high trait anxiety and ConHD resulted in slower responses after a heart-related sensation that was preceded by a subliminal heart cue. Preattentive processing of harmless heart cues may easily elicit overperception of heart symptoms in highly trait anxious patients with ConHD.

Genetic factors may play a prominent role in the development of coronary heart disease dependent on important environmental factors

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Song, C; Chang, Z; Magnusson, P K E; Ingelsson, E; Pedersen, N L

2014-01-01

Astract Song C, Chang Z, Magnusson PKE, Ingelsson E, Pedersen NL (Karolinska Institutet, Stockholm; Uppsala University, Uppsala; Sweden). Genetic factors may play a prominent role in the developmentofcoronary heart diseasedependenton important environmental factors. J InternMed2014; 275: 631–639. Objective The aim of the study was to examine whether various lifestyle factors modify genetic influences on coronary heart disease (CHD). Design The effect of lifestyle factors [including smoking, sedentary lifestyle, alcohol intake and body mass index (BMI)] on risk of CHD was evaluated via Cox regression models in a twin study of gene–environment interaction. Using structure equation modelling, we estimated genetic variance of CHD dependent on lifestyle factors. Subjects In total, 51 065 same-sex twins from 25 715 twin pairs born before 1958 and registered in the Swedish Twin Registry were eligible for this study. During the 40-year follow-up, 7264 incident CHD events were recorded. Results Smoking, sedentary lifestyle and above average BMI were significantly associated with increased CHD incidence. The heritability of CHD decreased with increasing age, as well as with increasing levels of BMI, in both men and women. Conclusions The difference in the genetic component of CHD as a function of BMI suggests that genetic factors may play a more prominent role for disease development in the absence of important environmental factors. Increased knowledge of gene–environment interactions will be important for a full understanding of the aetiology of CHD. PMID:24330166

Tracheostomy After Operations for Congenital Heart Disease: An Analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

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Mastropietro, Christopher W; Benneyworth, Brian D; Turrentine, Mark; Wallace, Amelia S; Hornik, Christoph P; Jacobs, Jeffrey P; Jacobs, Marshall L

2016-06-01

Information concerning tracheostomy after operations for congenital heart disease has come primarily from single-center reports. We aimed to describe the epidemiology and outcomes associated with postoperative tracheostomy in a multi-institutional registry. The Society of Thoracic Surgeons Congenital Heart Database (2000 to 2014) was queried for all index operations with the adverse event "postoperative tracheostomy" or "respiratory failure, requiring tracheostomy." Patients with preoperative tracheostomy or weighing less than 2.5 kg undergoing isolated closure of patent ductus arteriosus were excluded. Trends in tracheostomy incidence over time from January 2000 to June 2014 were analyzed with a Cochran-Armitage test. The patient characteristics associated with operative mortality were analyzed for January 2010 to June 2014, including deaths occurring up to 6 months after transfer of patients to long-term care facilities. From 2000 to 2014, the incidence of tracheostomy after operations for congenital heart disease increased from 0.11% in 2000 to a high of 0.76% in 2012 (p tracheostomy. The median age at operation was 2.5 months (25th, 75th percentile: 0.4, 7). Prematurity (n = 165, 26%), genetic abnormalities (n = 298, 46%), and preoperative mechanical ventilation (n = 275, 43%) were common. Postoperative adverse events were also common, including cardiac arrest (n = 131, 20%), extracorporeal support (n = 87, 13%), phrenic or laryngeal nerve injury (n = 114, 18%), and neurologic deficit (n = 51, 8%). The operative mortality was 25% (n = 153). Tracheostomy as an adverse event of operations for congenital heart disease remains rare but has been increasingly used over the past 15 years. This trend and the considerable mortality risk among patients requiring postoperative tracheostomy support the need for further research in this complex population. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Low dose epidemiology

International Nuclear Information System (INIS)

Tirmarche, M.; Hubert, P.

1992-01-01

Actually, epidemiological studies have to establish if the assessment of cancer risk can be verified at low chronic radiation doses. The population surveillance must be very long, the side effects and cancers of such radiation appearing much later. In France, this epidemiological study on nuclear workers have been decided recently. Before describing the experiment and french projects in epidemiology of nuclear workers, the authors present the main english and american studies

Sensitivity of a Remote Alpine System to the Stockholm and LRTAP Regulations in POP Emissions

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Barend L. van Drooge

2014-04-01

Full Text Available Persistent Organic Pollutants (POPs have been restricted and prohibited at national level for several decades now and since the 21st century at international level under the Stockholm Convention and the Convention of Long-Range Transboundary Air Pollution (LRTAP. A high mountain lake sediment core was sampled in the Alps (Gossenköllesee in summer 2010 and analyzed on POPs to examine whether the expected decreasing trends due to the implementation of the international Conventions could be observed. Higher POPs concentrations were observed in the sections corresponding to the period of large scale production and usage. p,p’-DDE and p,p’-DDD showed maximum concentrations in the core sections corresponding to the 1970s. These concentrations decreased to more or less constant levels in the top sediments, which is in agreement with the timing of past usage and banning of this pesticide. On the other hand, PCBs and HCB peaked in 1980s and the concentrations fluctuated afterwards. These observed profiles suggest that the studied site is still under influence of primary or secondary emissions and that the regulations of the international Conventions have still not been noticed in this site.

Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension : Insights from the Global TOPP Registry (tracking outcomes and practice in paediatric pulmonary hypertension)

NARCIS (Netherlands)

Beghetti, M.; Schulze-Neick, I.; Berger, R. M. F.; Ivy, D. D.; Bonnet, D.; Weintraub, R. G.; Saji, T.; Yung, D.; Mallory, G. B.; Geiger, R.; Berger, J. T.; Barst, R. J.; Humpl, T.; Mattos, S.; Jing, Z. C.; Han, Z. Y.; Sondergaard, L.; Jensen, T.; Levy, M.; Mebus, S.; Apitz, Ch.; Szatmari, A.; Ablonczy, L.; Milanesi, O.; Favero, V.; Pulido, T.; De La Garza, P.; Douwes, J. M.; Brun, H.; Moll, L.; Michalak, K.; Kawalec, W.; Zuk, M.; Boillat, M. Fasnacht; Olgunturk, R.; Kula, S. Serdar; Alehan, D.; Day, R. W.; Austin, E.; Moore, D. J.; Atz, A. M.; Feinstein, J. A.

2016-01-01

Background: The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC

Heart transplantation in adults with congenital heart disease.

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Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien

2017-05-01

With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes. Copyright © 2017. Published by Elsevier Masson SAS.

Should the history of epidemiology be taught in epidemiology training programs?

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Laskaris, Zoey; Morabia, Alfredo

2015-01-01

Currently, there is no evidence concerning the presence of historical content in the epidemiology curricula of the United States and abroad. Similarly, it is not known how epidemiologists view this topic in the context of master's or doctoral level course work. We attempted to fill these knowledge gaps with data from 2 online surveys-Survey I administered to persons in charge of all epidemiology training programs in North America and Survey II to epidemiologists practicing around the world. A substantial minority (39%) of graduate programs in epidemiology in the United States teach a course on the history of the field. In both surveys, the most common reasons selected for teaching such a course were "To build a sense of identity as an epidemiologist" and "As a tool for achieving a deeper understanding into specific methods and concepts." The majority of respondents, from 63 countries, agreed that the history of epidemiology should be included in curricula for graduate students in epidemiology.

Management of the Preterm Infant with Congenital Heart Disease.

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Axelrod, David M; Chock, Valerie Y; Reddy, V Mohan

2016-03-01

The premature neonate with congenital heart disease (CHD) represents a challenging population for clinicians and researchers. The interaction between prematurity and CHD is poorly understood; epidemiologic study suggests that premature newborns are more likely to have CHD and that fetuses with CHD are more likely to be born premature. Understanding the key physiologic features of this special patient population is paramount. Clinicians have debated optimal timing for referral for cardiac surgery, and management in the postoperative period has rapidly advanced. This article summarizes the key concepts and literature in the care of the premature neonate with CHD. Copyright © 2016 Elsevier Inc. All rights reserved.

Women's Heart Disease: Heart Attack Symptoms

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... of this page please turn JavaScript on. Feature: Women's Heart Disease Heart Attack Symptoms Past Issues / Winter ... most common heart attack symptom in men and women is chest pain or discomfort. However, women also ...

Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients.

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Inglis, Sally C; Conway, Aaron; Cleland, John Gf; Clark, Robyn A

2015-06-01

There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. The mean or median age of participants was 70 or more years in eight of the 16 (n=2659/5613; 47%) structured telephone support studies and four of the 11 (n=894/2710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure. © The European Society of Cardiology 2014.

Disability-adjusted Life Years Lost to Ischemic Heart Disease in Spain.

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Fernández de Larrea-Baz, Nerea; Morant-Ginestar, Consuelo; Catalá-López, Ferrán; Gènova-Maleras, Ricard; Álvarez-Martín, Elena

2015-11-01

The health indicator disability-adjusted life years combines the fatal and nonfatal consequences of a disease in a single measure. The aim of this study was to evaluate the burden of ischemic heart disease in 2008 in Spain by calculating disability-adjusted life years. The years of life lost due to premature death were calculated using the ischemic heart disease deaths by age and sex recorded in the Spanish National Institute of Statistics and the life-table in the 2010 Global Burden of Disease study. The years lived with disability, calculated for acute coronary syndrome, stable angina, and ischemic heart failure, used hospital discharge data and information from population studies. Disability weights were taken from the 2010 Global Burden of Disease study. We calculated crude and age standardized rates (European Standard Population). Univariate sensitivity analyses were performed. In 2008, 539 570 disability-adjusted life years were lost due to ischemic heart disease in Spain (crude rate, 11.8/1000 population; standardized, 8.6/1000). Of the total years lost, 96% were due to premature death and 4% due to disability. Among the years lost due to disability, heart failure accounted for 83%, stable angina 15%, and acute coronary syndrome 2%. In the sensitivity analysis, weighting by age was the factor that changed the results to the greatest degree. Ischemic heart disease continues to have a huge impact on the health of our population, mainly because of premature death. The results of this study provide an overall vision of the epidemiologic situation in Spain and could serve as the basis for evaluating interventions targeting the acute and chronic manifestations of cardiac ischemia. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

[The relationship between depression, anxiety and heart disease - a psychosomatic challenge].

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Kapfhammer, Hans-Peter

2011-12-01

Depressive and cardiological disorders present a major comorbidity. Their manifold interrelations may be best analysed within a biopsychosocial model of disease. A systematic research was done on empirical studies published during the last 15 years and dealing with epidemiological, etiopathogenetic and therapeutic dimensions of the comorbidity of depression, anxiety and heart disease. From an epidemiological perspective recurrent depressions are associated with a significantly increased risk of coronary heart disease. Depressive disorders play a major role in triggering critical cardiac events, e.g. myocardial infarction. The prevalence rates of depressive disorders in various cardiological conditions are significantly higher than the frequencies that can be expected in healthy general population. Depression shows a negative impact on the somatic morbidity and mortality during the further course of illness. Anxiety and posttraumatic stress disorders seem to be interrelated with cardiological conditions in quite a similar way, probably contributing even more negatively to critical and lethal cardiological events than depression. From an etiopathogenetic perspective some clusters of depressive symptoms seem to be linked to cardiotoxicity more closely than other, vital exhaustion, anhedonia, and hopelessness probably mediating a special risk. In any case, postmyocardial infarct depression that proves treatment-resistent indicates a negative prognosis of the prevailing cardiological condition. On a level of psychological and psychosocial constructs type-A personality, anger/hostility, type-D personality, and alexithymia have been explored regarding its proper pathogenetic role. Psychological and psychopathological variables have to be set into a context of psychosocial stressors on the one hand, and have to be simultaneously analysed with various underlying psycho- and neurobiological variables on the other. Above all, HPA- and sympathicomedullary dysfunctions, reduced

Heart murmurs

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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 ...

Epidemiology of IBD

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... IBD? Projects and Partners Data and Statistics Resources Epidemiology of the IBD Recommend on Facebook Tweet Share ... 5:1424-9. 2 Loftus EV, Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental ...

The New Epidemiology--A Challenge to Health Administration. Issues in Epidemiology for Administration.

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Crichton, Anne, Ed.; Neuhauser, Duncan, Ed.

The role of epidemiology in health administration is considered in 11 articles, and three course descriptions and a bibliography are provided. Titles and authors include the following: "The Need for Creative Managerial Epidemiology" (Gary L. Filerman); "The Growing Role of Epidemiology in Health Administration" (Maureen M.…

Prospective Heart Tracking for Whole-heart Magnetic Resonance Angiography

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Moghari, Mehdi H.; Geva, Tal; Powell, Andrew J.

2015-01-01

Purpose To develop a prospective respiratory-gating technique (Heart-NAV) for use with contrast-enhanced 3D inversion recovery (IR) whole-heart magnetic resonance angiography (MRA) acquisitions that directly tracks heart motion without creating image inflow artifact. Methods With Heart-NAV, 1 of the startup pulses for the whole-heart steady-state free precession MRA sequence is used to collect the centerline of k-space, and its 1-dimensional reconstruction is fed into the standard diaphragm-navigator (NAV) signal analysis process to prospectively gate and track respiratory-induced heart displacement. Ten healthy volunteers underwent non-contrast whole-heart MRA acquisitions using the conventional diaphragm-NAV and Heart-NAV with 5 and 10 mm acceptance windows in a 1.5T scanner. Five patients underwent contrast-enhanced IR whole-heart MRA using a diaphragm-NAV and Heart-NAV with a 5 mm acceptance window. Results For non-contrast whole-heart MRA with both the 5 and 10 mm acceptance windows, Heart-NAV yielded coronary artery vessel sharpness and subjective visual scores that were not significantly different than those using a conventional diaphragm-NAV. Scan time for Heart-NAV was 10% shorter (p<0.05). In patients undergoing contrast-enhanced IR whole-heart MRA, inflow artifact was seen with the diaphragm-NAV but not with Heart-NAV. Conclusion Compared to a conventional diaphragm-NAV, Heart-NAV achieves similar image quality in a slightly shorter scan time and eliminates inflow artifact. PMID:26843458

Comparison of the Chronic Kidney Disease Epidemiology Collaboration, the Modification of Diet in Renal Disease study and the Cockcroft-Gault equation in patients with heart failure

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Szummer, Karolina; Evans, Marie; Carrero, Juan Jesus; Alehagen, Urban; Dahlström, Ulf; Benson, Lina; Lund, Lars H

2017-01-01

Background It is unknown how the creatinine-based renal function estimations differ for dose adjustment cut-offs and risk prediction in patients with heart failure. Method and results The renal function was similar with the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (median 59 mL/min/1.73 m2, IQR 42 to 77) and Modification of Diet in Renal Disease Study (MDRD) (59 mL/min/1.73 m2, IQR 43 to 75) and slightly lower with the Cockcroft-Gault (CG) equation (57 mL/min, IQR 39 to 82). Across the commonly used renal function stages, the CKD-EPI and the MDRD classified patients into the same stage in 87.2% (kappa coefficient 0.83, pFailure Registry (n= 40 736) with standardised creatinine values between 2000 and 2012 had their renal function estimated with the CKD-EPI, the MDRD and the CG. Agreement between the formulas was compared for categories. Prediction of death was assessed with c-statistics and with NRI. Conclusion The choice of renal function estimation formula has clinical implications and differing results at various cut-off levels. For prognosis, the CG predicts mortality better than the CKD-EPI and MDRD. PMID:28761677

The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

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Bordoni B

2015-10-01

Full Text Available Bruno Bordoni,1–3 F Marelli2,3 1Don Carlo Gnocchi Foundation, Department of Cardiology, IRCCS Santa Maria Nascente, Milan, Italy; 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, AN, Italy; 3School CRESO, Osteopathic Centre for Research and Studies, Castellanza, VA, Italy Abstract: Chronic heart failure is a progressive, debilitating disease, resulting in a decline in the quality of life of the patient and incurring very high social economic costs. Chronic heart failure is defined as the inability of the heart to meet the demands of oxygen from the peripheral area. It is a multi-aspect complex disease which impacts negatively on all of the body systems. Presently, there are no texts in the modern literature that associate the symptoms of exercise intolerance of the patient with a dysfunction of the fascial system. In the first part of this article, we will discuss the significance of the disease, its causes, and epidemiology. The second part will explain the pathological adaptations of the myofascial system. The last section will outline a possible osteopathic treatment for patients with heart failure in order to encourage research and improve the general curative approach for the patient. Keywords: manual therapy, fatigue, chronic heart failure, osteopathic

The application of epidemiology in national veterinary services: Challenges and threats in Brazil.

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Gonçalves, Vitor Salvador Picão; de Moraes, Geraldo Marcos

2017-02-01

The application of epidemiology in national veterinary services must take place at the interface between science and politics. Animal health policy development and implementation require attention to macro-epidemiology, the study of economic, social and policy inputs that affect the distribution and impact of animal or human disease at the national level. The world has changed fast over the last three decades including the delivery of veterinary services, their remit and the challenges addressed by public and animal health policies. Rethinking the role of public services and how to make public programs more efficient has been at the heart of the political discussion. The WTO through its SPS Agreement has changed the way in which national veterinary services operate and how trade decisions are made. Most low and middle income countries are still struggling to keep up with the new international scene. Some of these countries, such as Brazil, have very important livestock industries and are key to the global food systems. Over the last two decades, Brazil became a leading player in exports of livestock products, including poultry, and this created a strong pressure on the national veterinary services to respond to trade demands, leading to focus animal health policies on the export-driven sector. During the same period, Brazil has gone a long way in the direction of integrating epidemiology with veterinary services. Epidemiology groups grew at main universities and have been working with government to provide support to animal health policy. The scope and quality of the applied epidemiological work improved and focused on complex data analysis and development of technologies and tools to solve specific disease problems. Many public veterinary officers were trained in modern epidemiological methods. However, there are important institutional bottlenecks that limit the impact of epidemiology in evidence-based decision making. More complex challenges require high levels

Air freight in the Stockholm region with focus on Eskilstuna Airport

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Kjell-Åke Allan Brorsson

2016-02-01

Full Text Available Purpose: The purpose of this article is to analyse the conditions for commencing air freight operations at the regional Eskilstuna Airport in Sweden, which require investments in airport infrastructure of at least SEK 140 –180 million. Design/ methodology: The qualitative data collection for the study was carried out through open-ended interviews with representatives of airport management, staff, representatives of residents, and actors and stakeholders in the field. In addition, much written material was collected from different authorities. Document analysis was used to systematically evaluate and review the collected documents. Content analysis was applied to organize collected data into categories. Based on the reports, decisions, environmental scanning and interviews, the data have been coded and categorized in tables via thematic analysis. Findings: The major findings of the study are that Eskilstuna Airport lacks cargo facilities and has limited apron space, and that there is strong competition from four other airports in the Stockholm region. The prospects for permanent air freight operations at Eskilstuna Airport are therefore not favourable in the current situation. However, if the development of Eskilstuna Logistics Park and the concept of inter modal highway-rail transportation are successful, they could serve as a major driving force for the development of air cargo. Furthermore, with sustainable development as a guiding principle, there is great potential to develop an airport with a high standard of environmental profile. Originality/ value: My findings are of great value to managers of airports and cargo airlines, as they highlight some of the competition aspects associated with engaging in air cargo at regional airports. The study fills a gap in existing research whose main focus is environmental issues concerning airports in general.

Epidemiology of valvular heart disease in a Swedish nationwide hospital-based register study.

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Andell, Pontus; Li, Xinjun; Martinsson, Andreas; Andersson, Charlotte; Stagmo, Martin; Zöller, Bengt; Sundquist, Kristina; Smith, J Gustav

2017-11-01

Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed. In the Swedish population (n=10 164 211), the incidence of VHD was 63.9 per 100 000 person-years, with aortic stenosis (AS; 47.2%), mitral regurgitation (MR; 24.2%) and aortic regurgitation (AR; 18.0%) contributing most of the VHD diagnoses. The majority of VHDs were diagnosed in the elderly (68.9% in subjects aged ≥65 years), but pulmonary valve disease incidence peaked in newborns. Incidences of AR, AS and MR were higher in men who were also more frequently diagnosed at an earlier age. Mitral stenosis (MS) incidence was higher in women. Rheumatic fever was rare. Half of AS cases had concomitant atherosclerotic vascular disease (48.4%), whereas concomitant heart failure and atrial fibrillation were common in mitral valve disease and tricuspid regurgitation. Other common comorbidities were thoracic aortic aneurysms in AR (10.3%), autoimmune disorders in MS (24.5%) and abdominal hernias or prolapse in MR (10.7%) and TR (10.3%). Clinically diagnosed VHD was primarily a disease of the elderly. Rheumatic fever was rare in Sweden, but specific VHDs showed a range of different comorbidity profiles . Pronounced sex-specific patterns were observed for AR and MS, for which the mechanisms remain incompletely understood. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mortality from heart attack in Belgrade population during the period 1990-2004

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Ratkov Isidora

2008-01-01

Full Text Available INTRODUCTION In most countries, cardiovascular diseases are the leading disorders, with ischemic heart diseases being the leading cause of death. According to WHO data, every year about 17 million people die of cardiovascular diseases, which is 30% of all deaths. Ischemic heart diseases contribute from one-third to one-half of all deaths due to cardiovascular diseases. Three point eight million men and 3.4 million women in the world die every year from ischemic heart diseases, and in Europe about 2 million. The highest mortality rate from ischemic heart diseases occurs in India, China and Russia. OBJECTIVE The aim of this descriptive epidemiological study was to determine heart attack mortality in Belgrade population during the period 1990-2004. METHOD In the study, we conducted investigation of Belgrade population during the period 1990-2004. Mortality data were obtained from the city institution for statistics. The mortality rates were calculated based on the total Belgrade population obtained from the mean values for the last two register years (1991 and 2002. The mortality rates were standardized using the direct method of standardization according to the world (Segi standard population. RESULTS In the Belgrade population during the period 1990-2004, the participation of mortality rate due to heart attack among deaths from cardiovascular diseases was 17% in males and 10% in females. In Belgrade male population, mean standardized mortality rates (per 100,000 habitants were 50.5 for heart attack, 8.3 for chronic ischemic heart diseases and 4.6 for angina pectoris, while in females the rates were 30.8, 6.7 and 4.2, respectively. Mortality from ischemic heart diseases and from heart attack was higher in males than in females. During the studied 15-year period, on average 755 males and 483 females died due to heart attack every year. Mean standardized mortality rates per 100,000 habitants were 50.0 in male and 31.1 in female population. Males

Heart Failure

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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 ...

Telemedical Support in Patients with Chronic Heart Failure: Experience from Different Projects in Germany

Directory of Open Access Journals (Sweden)

Axel Müller

2010-01-01

Full Text Available The great epidemiological significance and costs associated with chronic heart failure pose a challenge to health systems in Western industrial countries. In the past few years, controlled randomised studies have shown that patients with chronic heart failure benefit from telemedical monitoring; specifically, telemonitoring of various vital parameters combined with a review of the symptoms, drug compliance and patient education. In Germany, various telemedical monitoring projects for patients with chronic heart failure have been initiated in the past few years; seven of them are presented here. Currently 7220 patients are being monitored in the seven selected projects. Most patients (51.1% are in NYHA stage II, 26.3% in NYHA stage III, 14.5% in NYHA stage I and only 6.6% in NYHA stage IV respectively. Most projects are primarily regional. Their structure of telemedical monitoring tends to be modular and uses stratification according to the NYHA stages. All projects include medical or health economics assessments. The future of telemedical monitoring projects for patients with chronic heart failure will depend on the outcome of these assessments. Only of there is statistical evidence for medical benefit to the individual patient as well as cost savings will these projects continue.

Effort–Reward Imbalance at Work and Incident Coronary Heart Disease

Science.gov (United States)

Siegrist, Johannes; Nyberg, Solja T.; Lunau, Thorsten; Fransson, Eleonor I.; Alfredsson, Lars; Bjorner, Jakob B.; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Fahlén, Göran; Goldberg, Marcel; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Knutsson, Anders; Madsen, Ida E. H.; Nielsen, Martin L.; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H.; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Singh-Manoux, Archana; Steptoe, Andrew; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J. M.; Westerlund, Hugo; Virtanen, Marianna; Zins, Marie; Batty, G. David; Kivimäki, Mika

2017-01-01

Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. Results: At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain. Conclusions: Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress. PMID:28570388

Influence of renal impairment on aldosterone status, calcium metabolism, and vasopressin activity in outpatients with systolic heart failure

DEFF Research Database (Denmark)

Bosselmann, Helle; Tonder, Niels; Sölétormos, György

2017-01-01

AIMS: Renal dysfunction (RD) is associated with increased morbidity and mortality in heart failure (HF). At present, no specific treatment for patients with RD, to prevent progression of HF, has been developed. How different hormone axes-and thereby potential treatment options-are affected by RD...... in HF warrants further investigations. METHODS AND RESULTS: Patients with left ventricular ejection fraction (LVEF) Chronic Kidney Disease Epidemiology Collaboration equation (e...

SU-F-T-119: Development of Heart Prediction Model to Increase Accuracy of Dose Reconstruction for Radiotherapy Patients

International Nuclear Information System (INIS)

Mosher, E; Choi, M; Lee, C; Jones, E

2016-01-01

Purpose: To assess individual variation in heart volume and location in order to develop a prediction model of the heart. This heart prediction model will be used to calculate individualized heart doses for radiotherapy patients in epidemiological studies. Methods: Chest CT images for 30 adult male and 30 adult female patients were obtained from NIH Clinical Center. Image-analysis computer programs were used to segment the whole heart and 8 sub-regions and to measure the volume of each sub- region and the dimension of the whole heart. An analytical dosimetry method was used for the 30 adult female patients to estimate mean heart dose during conventional left breast radiotherapy. Results: The average volumes of the whole heart were 803.37 cm"3 (COV 18.8%) and 570.19 cm"3 (COV 18.8%) for adult male and female patients, respectively, which are comparable with the international reference volumes of 807.69 cm"3 for males and 596.15 cm"3 for females. Some patient characteristics were strongly correlated (R"2>0.5) with heart volume and heart dimensions (e.g., Body Mass Index vs. heart depth in males: R"2=0.54; weight vs. heart width in the adult females: R"2=0.63). We found that the mean heart dose 3.805 Gy (assuming prescribed dose of 50 Gy) in the breast radiotherapy simulations of the 30 adult females could be an underestimate (up to 1.6-fold) or overestimate (up to 1.8-fold) of the patient-specific heart dose. Conclusion: The study showed the significant variation in patient heart volumes and dimensions, resulting in substantial dose errors when a single average heart model is used for retrospective dose reconstruction. We are completing a multivariate analysis to develop a prediction model of the heart. This model will increase accuracy in dose reconstruction for radiotherapy patients and allow us to individualize heart dose calculations for patients whose CT images are not available.

SU-F-T-119: Development of Heart Prediction Model to Increase Accuracy of Dose Reconstruction for Radiotherapy Patients

Energy Technology Data Exchange (ETDEWEB)

Mosher, E; Choi, M; Lee, C [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD (United States); Jones, E [Radiology and Imaging Sciences Clinical Center, National Institutes of Health, Bethesda, MD (United States)

2016-06-15

Purpose: To assess individual variation in heart volume and location in order to develop a prediction model of the heart. This heart prediction model will be used to calculate individualized heart doses for radiotherapy patients in epidemiological studies. Methods: Chest CT images for 30 adult male and 30 adult female patients were obtained from NIH Clinical Center. Image-analysis computer programs were used to segment the whole heart and 8 sub-regions and to measure the volume of each sub- region and the dimension of the whole heart. An analytical dosimetry method was used for the 30 adult female patients to estimate mean heart dose during conventional left breast radiotherapy. Results: The average volumes of the whole heart were 803.37 cm{sup 3} (COV 18.8%) and 570.19 cm{sup 3} (COV 18.8%) for adult male and female patients, respectively, which are comparable with the international reference volumes of 807.69 cm{sup 3} for males and 596.15 cm{sup 3} for females. Some patient characteristics were strongly correlated (R{sup 2}>0.5) with heart volume and heart dimensions (e.g., Body Mass Index vs. heart depth in males: R{sup 2}=0.54; weight vs. heart width in the adult females: R{sup 2}=0.63). We found that the mean heart dose 3.805 Gy (assuming prescribed dose of 50 Gy) in the breast radiotherapy simulations of the 30 adult females could be an underestimate (up to 1.6-fold) or overestimate (up to 1.8-fold) of the patient-specific heart dose. Conclusion: The study showed the significant variation in patient heart volumes and dimensions, resulting in substantial dose errors when a single average heart model is used for retrospective dose reconstruction. We are completing a multivariate analysis to develop a prediction model of the heart. This model will increase accuracy in dose reconstruction for radiotherapy patients and allow us to individualize heart dose calculations for patients whose CT images are not available.

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

The independent relationship between triglycerides and coronary heart disease.

Science.gov (United States)

Morrison, Alan; Hokanson, John E

2009-01-01

The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD). We systematically reviewed population-based cohort studies in which baseline serum levels of triglycerides and HDL-C were included as explanatory variables in multivariate analyses with the development of CHD (coronary events or coronary death) as dependent variable. A total of 32 unique reports describing 38 cohorts were included. The independent association between elevated triglycerides and risk of CHD was statistically significant in 16 of 30 populations without pre-existing CHD. Among populations with diabetes mellitus or pre-existing CHD, or the elderly, triglycerides were not significantly independently associated with CHD in any of 8 cohorts. Triglycerides and HDL-C were mutually exclusive predictors of coronary events in 12 of 20 analyses of patients without pre-existing CHD. Epidemiologic studies provide evidence of an association between triglycerides and the development of primary CHD independently of HDL-C. Evidence of an inverse relationship between triglycerides and HDL-C suggests that both should be considered in CHD risk estimation and as targets for intervention.

The Good- & Socially Sustainable Street, from a Human Perspective : Focusing on the Relationship between Physical Environments and Social Life, with Hornsgatan in Stockholm as a Case Study

OpenAIRE

Thurell, Erik

2012-01-01

With over 300 years serving as a traffic route it is no wonder that Hornsgatan has the role of a major ‘artery’ in today’s Stockholm. This thesis will analyze and investigate how the street environment on Hornsgatan is affecting the people spending time on the street, and how a better street life and street quality can be brought out when it comes to enhance the social aspects for the street and its people. Through methods such as observations of the street and interviews with business owners...

Basic concepts of epidemiology

International Nuclear Information System (INIS)

Savitz, D.A.

1984-01-01

Epidemiology can be defined simply as the science of the distribution and determinants of disease in human populations. As a descriptive tool, epidemiology can aid health care service providers, for example, in allocation of resources. In its analytic capacity, the epidemiologic approach can help identify determinants of disease through the study of human populations. Epidemiology is primarily an observational rather than experimental methodology, with corresponding strengths and limitations. Relative to other approaches for assessing disease etiology and impacts of potential health hazards, epidemiology has a rather unique role that is complementary to, but independent of, both basic biologic sciences and clinical medicine. Experimental biologic sciences such as toxicology and physiology provide critical information on biologic mechanisms of disease required for causal inference. Clinical medicine often serves as the warning system that provides etiologic clues to be pursued through systematic investigation. The advantage of the epidemiologic approach is its reliance on human field experience, that is, the real world. While laboratory experimentation is uniquely well suited to defining potential hazards, it can neither determine whether human populations have actually been affected nor quantify that effect. Building all the complexities of human behavior and external factors into a laboratory study or mathematical model is impossible. By studying the world as it exists, epidemiology examines the integrated, summarized product of the myriad factors influencing health

WHO - IPHECA: Epidemiological aspects

International Nuclear Information System (INIS)

Souchkevitch, G.

1996-01-01

In May 1991 the World Health Assembly endorsed the establishment of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA) under the auspices of WHO. Five pilot projects have been carried out within IPHECA in the study territories of Belarus, Russian Federation and Ukraine in a period from 1991 to 1994. This pilot projects dealt with the detection and treatment of leukaemia and related diseases (Haematology Project), thyroid disorders (Thyroid project), brain damage during exposure 'in-utero' (Brain Damage 'in-Utero' project) and with the development of the Chernobyl registries (Epidemiological Registry Project). A fifth pilot project on oral health was performed only in Belarus. Epidemiological investigations have been an important component of all IPHECA pilot projects. Within 'Epidemiological Registry' Project such investigations have been the principal activity. But with respect to other IPHECA projects it was carried out in addition to main objectives relating to medical monitoring, early diagnosis and treatment of specific diseases included in project protocols. To support the epidemiological investigations within IPHECA, WHO supplied 41 computers in Belarus, Russian Federation and Ukraine and provided training for specialists from these countries in internationally recognized centres. The training programmes and host countries were as follows: standardization of epidemiological investigations (United Kingdom), radiation epidemiology (Russia), development of software (United Kingdom), principles of epidemiological investigations (The Czech Republic), cohort investigations (Japan)

WHO - IPHECA: Epidemiological aspects

Energy Technology Data Exchange (ETDEWEB)

Souchkevitch, G [World Health Organization, Geneva (Swaziland)

1996-07-01

In May 1991 the World Health Assembly endorsed the establishment of the International Programme on the Health Effects of the Chernobyl Accident (IPHECA) under the auspices of WHO. Five pilot projects have been carried out within IPHECA in the study territories of Belarus, Russian Federation and Ukraine in a period from 1991 to 1994. This pilot projects dealt with the detection and treatment of leukaemia and related diseases (Haematology Project), thyroid disorders (Thyroid project), brain damage during exposure 'in-utero' (Brain Damage 'in-Utero' project) and with the development of the Chernobyl registries (Epidemiological Registry Project). A fifth pilot project on oral health was performed only in Belarus. Epidemiological investigations have been an important component of all IPHECA pilot projects. Within 'Epidemiological Registry' Project such investigations have been the principal activity. But with respect to other IPHECA projects it was carried out in addition to main objectives relating to medical monitoring, early diagnosis and treatment of specific diseases included in project protocols. To support the epidemiological investigations within IPHECA, WHO supplied 41 computers in Belarus, Russian Federation and Ukraine and provided training for specialists from these countries in internationally recognized centres. The training programmes and host countries were as follows: standardization of epidemiological investigations (United Kingdom), radiation epidemiology (Russia), development of software (United Kingdom), principles of epidemiological investigations (The Czech Republic), cohort investigations (Japan)

Traffic-related air pollution exposure and incidence of stroke in four cohorts from Stockholm.

Science.gov (United States)

Korek, Michal J; Bellander, Tom D; Lind, Tomas; Bottai, Matteo; Eneroth, Kristina M; Caracciolo, Barbara; de Faire, Ulf H; Fratiglioni, Laura; Hilding, Agneta; Leander, Karin; Magnusson, Patrik K E; Pedersen, Nancy L; Östenson, Claes-Göran; Pershagen, Göran; Penell, Johanna C

2015-01-01

We investigated the risk of stroke related to long-term ambient air pollution exposure, in particular the role of various exposure time windows, using four cohorts from Stockholm County, Sweden. In total, 22,587 individuals were recruited from 1992 to 2004 and followed until 2011. Yearly air pollution levels resulting from local road traffic emissions were assessed at participant residences using dispersion models for particulate matter (PM10) and nitrogen oxides (NOX). Cohort-specific hazard ratios were estimated for time-weighted air pollution exposure during different time windows and the incidence of stroke, adjusted for common risk factors, and then meta-analysed. Overall, 868 subjects suffered a non-fatal or fatal stroke during 238,731 person-years of follow-up. An increment of 20 μg/m(3) in estimated annual mean of road-traffic related NOX exposure at recruitment was associated with a hazard ratio of 1.16 (95% CI 0.83-1.61), with evidence of heterogeneity between the cohorts. For PM10, an increment of 10 μg/m(3) corresponded to a hazard ratio of 1.14 (95% CI 0.68-1.90). Time-window analyses did not reveal any clear induction-latency pattern. In conclusion, we found suggestive evidence of an association between long-term exposure to NOX and PM10 from local traffic and stroke at comparatively low levels of air pollution.

Chronic kidney disease in congenital heart disease patients: a narrative review of evidence.

Science.gov (United States)

Morgan, Catherine; Al-Aklabi, Mohammed; Garcia Guerra, Gonzalo

2015-01-01

Patients with congenital heart disease have a number of risk factors for the development of chronic kidney disease (CKD). It is well known that CKD has a large negative impact on health outcomes. It is important therefore to consider that patients with congenital heart disease represent a population in whom long-term primary and secondary prevention strategies to reduce CKD occurrence and progression could be instituted and significantly change outcomes. There are currently no clear guidelines for clinicians in terms of renal assessment in the long-term follow up of patients with congenital heart disease. Consolidation of knowledge is critical for generating such guidelines, and hence is the purpose of this view. This review will summarize current knowledge related to CKD in patients with congenital heart disease, to highlight important work that has been done to date and set the stage for further investigation, development of prevention strategies, and re-evaluation of appropriate renal follow-up in patients with congenital heart disease. The literature search was conducted using PubMed and Google Scholar. Current epidemiological evidence suggests that CKD occurs in patients with congenital heart disease at a higher frequency than the general population and is detectable early in follow-up (i.e. during childhood). Best evidence suggests that approximately 30 to 50 % of adult patients with congenital heart disease have significantly impaired renal function. The risk of CKD is higher with cyanotic congenital heart disease but it is also present with non-cyanotic congenital heart disease. Although significant knowledge gaps exist, the sum of the data suggests that patients with congenital heart disease should be followed from an early age for the development of CKD. There is an opportunity to mitigate CKD progression and negative renal outcomes by instituting interventions such as stringent blood pressure control and reduction of proteinuria. There is a need to

Factors related to outcome in heart failure with a preserved (or normal) left ventricular ejection fraction.

Science.gov (United States)

Sanderson, John E

2016-07-01

Heart failure with a preserved ejection faction (HFpEF) is a growing and expensive cause of heart failure (HF) affecting particularly the elderly. It differs in substantial ways in addition to the normal left ventricular ejection fraction, from the more easily recognized form of heart failure with a reduced ejection fraction (HFrEF or 'systolic heart failure') and unlike HFrEF there have been little advances in treatment. In part, this relates to the complexity of the pathophysiology and identifying the correct targets. In HFpEF, there appears to be widespread stiffening of the vasculature and the myocardium affecting ventricular function (both systolic and diastolic), impeding ventricular suction, and thus early diastolic filling leading to breathlessness on exertion and later atrial failure and fibrillation. Left ventricular ejection fraction tends to gradually decline and some evolve into HFrEF. Most patients also have a mixture of several co-morbidities including hypertension, diabetes, obesity, poor renal function, lack of fitness, and often poor social conditions. Therefore, many factors may influence outcome in an individual patient. In this review, the epidemiology, possible causation, pathophysiology, the influence of co-morbidities and some of the many potential predictors of outcome will be considered.

Methodologic frontiers in environmental epidemiology.

OpenAIRE

Rothman, K J

1993-01-01

Environmental epidemiology comprises the epidemiologic study of those environmental factors that are outside the immediate control of the individual. Exposures of interest to environmental epidemiologists include air pollution, water pollution, occupational exposure to physical and chemical agents, as well as psychosocial elements of environmental concern. The main methodologic problem in environmental epidemiology is exposure assessment, a problem that extends through all of epidemiologic re...

Substance flow analysis of polybrominated diphenyl ethers in plastic from EEE/WEEE in Nigeria in the frame of Stockholm Convention as a basis for policy advice.

Science.gov (United States)

Babayemi, Joshua; Sindiku, Omotayo; Osibanjo, Oladele; Weber, Roland

2015-10-01

This study investigated the material/substance flow of polybrominated diphenyl ethers listed in the Stockholm Convention (SC) as persistent organic pollutant (POP-PBDEs) in the most relevant plastic fractions in Nigeria. Considering the prohibition of production and the use of POP-PBDEs and knowing that these pollutants are still contained in electrical and electronic equipment (EEE) and associated wastes (WEEE), it is necessary to determine their flows, especially in developing countries with limited end-of-life management. Following the inventory approach of the SC Guidance and utilizing the existing national e-waste inventory together with monitoring data, a material/substance flow analysis was conducted using the STAN tool. Within the period of 2000 to 2010, the total import for EEE/WEEE in Category 3 and 4 was approximately 8 million tonnes (Mt) containing approximately 2.4 Mt of polymers. For the inventory year 2010, it was estimated that from these polymers, about 0.8 Mt was still in stock and 1.6 Mt has reached the end-of-life. It was also estimated that approximately 1.1 Mt has ended in dumpsites, 0.3 Mt was burned in the open, and 0.2 Mt was recycled. In the plastic fractions, 1,270 t of POP-PBDEs was contained with about 370 t still in use/stock and approximately 900 t has entered the end-of-life phase. All three major end-of-life treatments result in environmental pollution with associated exposure risk. The implementation of the Stockholm Convention represents an important opportunity to improve this management situation in Nigeria and other developing countries.

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 ...

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) ...

Women's Heart Disease: Heart Disease Risk Factors

Science.gov (United States)

... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease Risk Factors Past Issues / Winter 2014 Table ... or habits may raise your risk for coronary heart disease (CHD). These conditions are known as risk ...

Epidemiology, morbidity, and treatment of overweight and obesity.

Science.gov (United States)

Aronne, L J

2001-01-01

Although still considered more of a cosmetic problem by both the general public and some areas of the medical community, overweight and obesity have reached epidemic proportions worldwide. Overweight and obesity have not only a significant psychological impact but also result in an increased risk for development of numerous chronic and sometimes fatal diseases. The morbidity from obesity-associated disorders increases with higher body mass index and begins within the normal weight range. The costs (direct and indirect) associated with treating obesity and its comorbid conditions are notable and increasing. Obesity rates in patients with schizophrenia are at least as high, if not higher, than in the general population. This article reviews the epidemiology and burden of obesity and its associated comorbid disorders. The guidelines from the National Heart, Lung, and Blood Institute of the National Institutes of Health for diagnosing and treating obesity are also discussed.

Epidemiological causality.

Science.gov (United States)

Morabia, Alfredo

2005-01-01

Epidemiological methods, which combine population thinking and group comparisons, can primarily identify causes of disease in populations. There is therefore a tension between our intuitive notion of a cause, which we want to be deterministic and invariant at the individual level, and the epidemiological notion of causes, which are invariant only at the population level. Epidemiologists have given heretofore a pragmatic solution to this tension. Causal inference in epidemiology consists in checking the logical coherence of a causality statement and determining whether what has been found grossly contradicts what we think we already know: how strong is the association? Is there a dose-response relationship? Does the cause precede the effect? Is the effect biologically plausible? Etc. This approach to causal inference can be traced back to the English philosophers David Hume and John Stuart Mill. On the other hand, the mode of establishing causality, devised by Jakob Henle and Robert Koch, which has been fruitful in bacteriology, requires that in every instance the effect invariably follows the cause (e.g., inoculation of Koch bacillus and tuberculosis). This is incompatible with epidemiological causality which has to deal with probabilistic effects (e.g., smoking and lung cancer), and is therefore invariant only for the population.

Asthma, allergy and eczema among adults in multifamily houses in Stockholm (3-HE study)--associations with building characteristics, home environment and energy use for heating.

Science.gov (United States)

Norbäck, Dan; Lampa, Erik; Engvall, Karin

2014-01-01

Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings) were invited (one subject/dwelling) and 7,554 participated (73%). Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR = 1.74) and mould odour (OR = 1.79). Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR = 1.45) and was associated with redecoration (OR = 1.48) and mould odour (OR = 2.35). Pollen allergy was less common in buildings using more energy for heating (OR = 0.75) and was associated with humid air (OR = 1.76) and mould odour (OR = 2.36). Eczema was more common in larger buildings (OR 1.07) and less common in buildings using more energy for heating (OR = 0.85) and was associated with water damage (OR = 1.47), humid air (OR = 1.73) and mould odour (OR = 2.01). Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR = 0.49; 95% CI 0.29-0.82). Pollen allergy was less common if the building maintenance was outsourced (OR = 0.67; 95% CI 0.51-0.88). Eczema was more common when management accessibility was only at the division level (OR = 1.49; 95% CI 1.06-2.11). In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness. Energy saving may have consequences for allergy and eczema. More

Epidemiology: Then and Now.

Science.gov (United States)

Kuller, Lewis H

2016-03-01

Twenty-five years ago, on the 75th anniversary of the Johns Hopkins Bloomberg School of Public Health, I noted that epidemiologic research was moving away from the traditional approaches used to investigate "epidemics" and their close relationship with preventive medicine. Twenty-five years later, the role of epidemiology as an important contribution to human population research, preventive medicine, and public health is under substantial pressure because of the emphasis on "big data," phenomenology, and personalized medical therapies. Epidemiology is the study of epidemics. The primary role of epidemiology is to identify the epidemics and parameters of interest of host, agent, and environment and to generate and test hypotheses in search of causal pathways. Almost all diseases have a specific distribution in relation to time, place, and person and specific "causes" with high effect sizes. Epidemiology then uses such information to develop interventions and test (through clinical trials and natural experiments) their efficacy and effectiveness. Epidemiology is dependent on new technologies to evaluate improved measurements of host (genomics), epigenetics, identification of agents (metabolomics, proteomics), new technology to evaluate both physical and social environment, and modern methods of data collection. Epidemiology does poorly in studying anything other than epidemics and collections of numerators and denominators without specific hypotheses even with improved statistical methodologies. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Epidemiologic Study of Opium Use in Pars Cohort Study: A Study of 9000 Adults in a Rural Southern Area of Iran.

Science.gov (United States)

Fallahzadeh, Mohammad Amin; Salehi, Alireza; Naghshvarian, Mojtaba; Fallahzadeh, Mohammad Hossein; Poustchi, Hossein; Sepanlou, Sadaf G; Gandomkar, Abdullah; Malekzadeh, Reza

2017-04-01

Opium is one of the most common substances used worldwide with variable epidemiologic features in different regions. This study was performed in southern Iran, to find the epidemiology of opium use and its association with different factors and diseases. This cross-sectional study was performed on baseline data extracted from Pars Cohort Study performed in Valashahr, a rural area in southern Iran. For any subject, information was collected about demographic factors, some common diseases including heart disease, stroke and hypertension and the state of using opium, other substances and cigarettes. There were 4276 males and 4988 females, with a mean age of 52.6 ± 9.7 years of whom 8.4% reported opium use (17.3% of males and 0.7% of females). In men, the history of stroke and heart disease were significantly more common in opium users (12.6% vs. 8.8%, P = 0.001 and 2.8% vs. 1.5%, P = 0.01, respectively) while the history of hypertension was significantly more common in non-opium users (7.8% vs. 10.3%, P = 0.04). Younger age, male gender, being non-married and positive history of joint pain, cigarette smoking and alcohol consumption were the factors associated with opium use. Opium use is common in non-married men who have a positive history of cigarette smoking and alcohol consumption in the rural population of southern Iran. It is associated with increased risk of heart disease and stroke and decreased risk of hypertension in males. Global interventional and preventive measures are required to control this complicated social problem.

Epidemiology and the Tobacco Epidemic: How Research on Tobacco and Health Shaped Epidemiology.

Science.gov (United States)

Samet, Jonathan M

2016-03-01

In this article, I provide a perspective on the tobacco epidemic and epidemiology, describing the impact of the tobacco-caused disease epidemic on the field of epidemiology. Although there is an enormous body of epidemiologic evidence on the associations of smoking with health, little systematic attention has been given to how decades of research have affected epidemiology and its practice. I address the many advances that resulted from epidemiologic research on smoking and health, such as demonstration of the utility of observational designs and important parameters (the odds ratio and the population attributable risk), guidelines for causal inference, and systematic review approaches. I also cover unintended and adverse consequences for the field, including the strategy of doubt creation and the recruitment of epidemiologists by the tobacco industry to serve its mission. The paradigm of evidence-based action for addressing noncommunicable diseases began with the need to address the epidemic of tobacco-caused disease, an imperative for action documented by epidemiologic research. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Epidemiology applied to health physics

International Nuclear Information System (INIS)

1983-01-01

The technical program of the mid-year meeting of the Health Physics Society, entitled Epidemiology Applied to Health physics, was developed to meet three objectives: (1) give health physicists a deeper understanding of the basics of epidemiological methods and their use in developing standards, regulations, and criteria and in risk assessment; (2) present current reports on recently completed or on-going epidemiology studies; and (3) encourage greater interaction between the health physics and epidemiology disciplines. Included are studies relating methods in epidemiology to radiation protection standards, risk assessment from exposure to bone-seekers, from occupational exposures in mines, mills and nuclear facilities, and from radioactivity in building materials

Overview of Coronary Heart Disease Risk Initiatives in South Asia.

Science.gov (United States)

Kalra, Ankur; Bhatt, Deepak L; Rajagopalan, Sanjay; Suri, Kunal; Mishra, Sundeep; Iqbal, Romaina; Virani, Salim S

2017-06-01

Cardiovascular disease (CVD) is now the leading cause of morbidity and mortality worldwide. Industrialization and economic growth have led to an unprecedented increment in the burden of CVD and their risk factors in less industrialized regions of the world. While there are abundant data on CVD and their risk factors from longitudinal cohort studies done in the West, good-quality data from South Asia are lacking. Several multi-institutional, observational, prospective registries, and epidemiologic cohorts in South Asia have been established to systematically evaluate the burden of CVD and their risk factors. The PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP), the Kerala Acute Coronary Syndrome (ACS), and Trivandrum Heart Failure registries have focused on secondary prevention of CVD and performance measurement in both outpatient and inpatient settings, respectively. The Prospective Urban and Rural Epidemiology (PURE), Centre for Cardiometabolic Risk Reduction in South Asia (CARRS), and other epidemiologic and genetic studies have focused on primary prevention of CVD and evaluated variables such as environment, smoking, physical activity, health systems, food and nutrition policy, dietary consumption patterns, socioeconomic factors, and healthy neighborhoods. The international cardiovascular community has been responsive to a burgeoning cardiovascular disease burden in South Asia. Several collaborations have formed between the West (North America in particular) and South Asia to catalyze evidence-based and data-driven changes in the federal health policy in this part of the world to promote cardiovascular health and mitigate cardiovascular risk.

Relations between nature-based solutions of green-blue area accessibility and socio-economic-ethnic patterns in the urban Stockholm region

Science.gov (United States)

Goldenberg, Romain; Kalantari, Zahra; Destouni, Georgia

2017-04-01

More than half of the world's population lives in cities, a proportion expected to increase to two thirds by 2050 (United Nations (UN), 2015). In this study, we investigate the spatial relationships that may exist between income and/or nationality homogeneity/heterogeneity levels of urban populations and their accessibility to local green-blue areas as possible nature-based solutions for sustainable urban design. For this investigation, we consider as a concrete case study the urban region of Stockholm, Sweden, for which we compile and use available land-cover and vegetation density data (the latter in terms of Normalised Difference Vegetation Index, NDVI) in order to identify and assess the spatial distributions of various green-blue area types and aspects. We further combine this data with spatial distribution data for population density, income and nationality, as well as with road-network data for assessing population travel times to nearby green-blue areas within the region. The present study results converge with those of other recent studies in showing large socio-economic-ethnic segregation in the Stockholm region. Moreover, the present data combination and analysis also show large spatial differences in and important socio-economic-ethnic correlations with accessibility to local green areas and nearby water bodies. Specifically, population income and share of Swedish nationals are well correlated in this region, with increases in both of these variables implying greater possibility to choose where to live within the region. The living choices of richer and more homogeneous (primarily Swedish) population parts are then found to be areas with greater local vegetation density (local green areas as identified by high-resolution NDVI data) and greater area extent of nearby water bodies (blue areas). For comparison, no such correlation is found between increased income or Swedish nationality homogeneity and accessibility to nearby forest areas (overall green

Characterizing potential heart agents with an isolated perfused heart system

International Nuclear Information System (INIS)

Pendleton, D.B.; Sands, H.; Gallagher, B.M.; Camin, L.L.

1984-01-01

The authors have used an isolated perfused heart system for characterizing potential myocardial perfusion radiopharamaceuticals. Rabbit or guinea pig (GP) hearts are removed and perfused through the aorta with a blood-free buffer. Heart rate and ventricular pressure are monitored as indices of viability. Tc-99m-MAA is 96-100% retained in these hearts, and Tc-99m human serum albumin shows less than 5% extraction. Tl-201 is 30-40% extracted. It is known that in-vivo, Tc-99m(dmpe)/sub 2/Cl/sub 2//sup +/ is taken up by rabbit heart but not by GP or human heart. Analogous results are obtained with the isolated perfused heart model, where the complex is extracted well by the isolated rabbit heart (24%) but not by the GP heart (<5%). Values are unchanged if human, rabbit or GP blood is mixed and co-injected with the complex. Tc-99m)dmpe)/sub 3//sup +/ is also taken up by rabbit but not by GP hearts in-vivo. However, isolated perfused hearts of both species extract this complex well (45-52%). Heart uptake is diminished to <7% if the complex is pre-equilibrated with human blood. GP blood produces a moderate inhibition (in GP hearts only) and rabbit blood has no effect. This suggests that a human or GP blood factor may have a significant effect on heart uptake of this complex. Tc-99m(CN-t-butyl)/sub 6//sup +/ is taken up well by both rabbit and GP hearts in-vivo, and is extracted 100% by both isolated perfused hearts. Heart retention remains high (73-75%) in the presence of human blood

Heart Diseases

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... 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 ...

Heart Transplantation

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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 ...

2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

Science.gov (United States)

Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

2014-03-01

This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

CEDR: Comprehensive Epidemiologic Data Resource

Energy Technology Data Exchange (ETDEWEB)

1993-08-01

The Department of Energy (DOE) and its predecessor agencies have a long history of epidemiologic research programs. The main focus of these programs has been the Health and Mortality Study of the DOE work force. This epidemiologic study began in 1964 with a feasibility study of workers at the Hanford facility. Studies of other populations exposed to radiation have also been supported, including the classic epidemiologic study of radium dial painters and studies of atomic bomb survivors. From a scientific perspective, these epidemiologic research program have been productive, highly credible, and formed the bases for many radiological protection standards. Recently, there has been concern that, although research results were available, the data on which these results were based were not easily obtained by interested investigators outside DOE. Therefore, as part of an effort to integrate and broaden access to its epidemiologic information, the DOE has developed the Comprehensive Epidemiologic Data Resource (CEDR) Program. Included in this effort is the development of a computer information system for accessing the collection of CEDR data and its related descriptive information. The epidemiologic data currently available through the CEDAR Program consist of analytic data sets, working data sets, and their associated documentation files. In general, data sets are the result of epidemiologic studies that have been conducted on various groups of workers at different DOE facilities during the past 30 years.

Pediatric heart surgery

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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 ...

Mapping epidemiology's past to inform its future: metaknowledge analysis of epidemiologic topics in leading journals, 1974-2013.

Science.gov (United States)

Trinquart, Ludovic; Galea, Sandro

2015-07-15

An empiric perspective on what epidemiology has studied over time might inform discussions about future directions for the discipline. We aimed to identify the main areas of epidemiologic inquiry and determine how they evolved over time in 5 high-impact epidemiologic journals. We analyzed the titles and abstracts of 20,895 articles that were published between 1974 and 2013. In 5 time periods that reflected approximately equal numbers of articles, we identified the main topics by clustering terms based on co-occurrence. Infectious disease and cardiovascular disease epidemiology were the prevailing topics over the 5 periods. Cancer epidemiology was a major topic from 1974 to 2001 but disappeared thereafter. Nutritional epidemiology gained relative importance from 1974 to 2013. Environmental epidemiology appeared during 1996-2001 and continued to be important, whereas 2 clusters related to methodology and meta-analysis in genetics appeared during 2008-2013. Several areas of epidemiology, including injury or psychiatric epidemiology, did not make an appearance as major topics at any time. In an ancillary analysis of 6 high-impact general medicine journals, we found patterns of epidemiologic articles that were overall consistent with the findings in epidemiologic journals. This metaknowledge investigation allowed identification of the dominant topics in and conversely those that were absent from 5 major epidemiologic journals. We discuss implications for the field. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

International Lymphoma Epidemiology Consortium

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The InterLymph Consortium, or formally the International Consortium of Investigators Working on Non-Hodgkin's Lymphoma Epidemiologic Studies, is an open scientific forum for epidemiologic research in non-Hodgkin's lymphoma.

Combined heart-kidney transplantation after total artificial heart insertion.

Science.gov (United States)

Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F

2015-01-01

We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

Professor André Jouve (1909-2001): A French cardiologist who was a pioneer of clinical vector-electrocardiography and cardiovascular epidemiology.

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Puddu, Paolo Emilio

2016-01-01

André, Julien, Auguste Jouve was born in Marseilles on June 10, 1909 son of Xavier Marie Francois Louis Jouve MD and Marie Louise Charlotte Vigliengo his wife. He had a brilliant medical career in Marseilles: Resident at Marseilles Hospitals in 1931, major of his promotion, then an Assistant in 1943 and a Chief in 1951, to become Associate Professor of Medicine in 1946 and finally Full Professor of Clinical and Experimental Cardiology in 1954. Fellow of several Cardiological Societies, he became President of the French Society of Cardiology in 1968, Vice-President of the European Society of Cardiology in 1972 and finally President of the French College of Vascular Pathology in 1973. He had been a WHO Expert for degenerative and cardiovascular diseases from 1958 to 1981 and a National correspondent of the Academy of Medicine in 1977. He was decorated by the Légion d'Honneur (Officer in 1975). He retired in 1981 and died in 2001. Clinical vector-electrocardiology and cardiovascular epidemiology were the main areas of his interest where he made essential contributions such as the famous treatise on ECG. The Heart Cantini Center was considered his leading creation and action, where the first French heart transplantation was performed in 1968, the first French epidemiological investigation on coronary risk factors took place, the idea of starting prevention at pediatric age was clearly outlined and the need of concentrating on psychological and dysmetabolic factors was precisely advocated for indexing later development of ischemic heart diseases. These achievements are reviewed and put into perspective. Copyright © 2016 Elsevier Inc. All rights reserved.

Transient Receptor Potential channels: What's happening? Reflections in the wake of the 2009 TRP Meeting, Karolinska Institutet, Stockholm.

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Goswami, Chandan; Islam, Md Shahidul

2010-01-01

More than 150 participants from 25 countries gathered in Stockholm during 25(th) to 27(th) Sept 2009 to attend the meeting "TRP channels: from sensory signaling to human disease" and enjoyed an international, intensive and vibrant meeting. This meeting shed lights on the recent advances made in this field of research in different sectors of biology, and identified directions for future research and the areas where TRP channels could be used as potential targets for prevention and treatment of human diseases. The participants of this meeting shared their recent largely unpublished data, state-of-the-art techniques and their critical views which would push research in this field forward in the new decade. Another major outcome of this meeting was the realization that extensive work remains to be done to develop the necessary tools and enhance the quality of research in this area so that the prevailing controversies can be resolved. In this report we summarize the latest scientific excitements, some critical issues, as well as some future directions for research that were addressed and discussed in this meeting.

Epidemiology of prostatitis

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Krieger, John N.; Lee, Shaun Wen Huey; Jeon, Jeonseong; Cheah, Phaik Yeong; Liong, Men Long; Riley, Donald E.

2008-01-01

Background Prostatitis describes a combination of infectious diseases (acute and chronic bacterial prostatitis), chronic pelvic pain syndrome, and asymptomatic inflammation. Materials and methods We employed evidence-based methods to review the epidemiology of prostatitis syndromes. Results The prevalence of prostatitis symptoms could be compared in five studies surveying 10 617 men. Overall, 873 participants met various criteria for prostatitis, representing an overall rate of 8.2%, with prevalence ranging from 2.2 to 9.7%. A history of sexually transmitted diseases was associated with an increased risk for prostatitis symptoms. Men reporting a history of prostatitis symptoms had a substantially increased rate of benign prostatic hyperplasia, lower urinary tract symptoms and prostate cancer. In one study, the incidence of physician-diagnosed prostatitis was 4.9 cases per 1000 person-years. Two studies suggest that about one-third of men reporting prostatitis symptoms had resolution after 1 year. Patients with previous episodes and more severe symptoms are at higher risk for chronic pelvic pain. Discussion The prevalence of prostatitis symptoms is high, comparable to rates of ischamic heart disease and diabetes. Clinical evaluation appears necessary to verify that prostatitis is responsible for patients’ symptoms. Prostatitis symptoms may increase a man’s risk for benign prostate hypertrophy, lower urinary tract symptoms and prostate cancer. We need to define natural history and consequences of prostatitis, develop better algorithms for diagnosis and treatment, and develop strategies for prevention. PMID:18164907

Healthy Body, Happy Heart: Improve Your Heart Health

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... November 2017 Print this issue Healthy Body, Happy Heart Improve Your Heart Health En español Send us your comments Every moment of the day, your heart is pumping blood throughout your body. In silent ...

Against Popperized epidemiology.

Science.gov (United States)

Jacobsen, M

1976-03-01

The recommendation of Popper's philosophy of science should be adopted by epidemiologists is disputed. Reference is made to other authors who have shown that the most constructive elements in Popper's ideas have been advocated by earlier philosophers and have been used in epidemiology without abandoning inductive reasoning. It is argued that Popper's denigration of inductive methods is particularly harmful to epidemiology. Inductive reasoning and statistical inference play a key role in the science; it is suggested that unfamiliarity with these ideas contributes to widespread misunderstanding of the function of epidemiology. Attention is drawn to a common fallacy involving correlations between three random variables. The prevalence of the fallacy may be related to confusion between deductive and inductive logic.

Rheumatic fever and rheumatic heart disease in Bangladesh: A review

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Islam, A.K.M. Monwarul; Majumder, A.A.S.

2016-01-01

Rheumatic fever (RF) and rheumatic heart disease (RHD) are the most-common cardiovascular disease in young people aged diseases over the last century. In concert with the progresses in socioeconomic indicators, advances in health sectors, improved public awareness, and antibiotic prophylaxis, acute RF came into control. However, chronic RHD continues to be prevalent, and the actual disease burden may be much higher. RHD predominantly affects the young adults, seriously incapacitates them, follows a protracted course, gets complicated because of delayed diagnosis and is sometimes maltreated. The treatment is often palliative and expensive. Large-scale epidemiological and clinical researches are needed to formulate evidence-based national policy to tackle this important public health issue in future. PMID:26896274

Development and application of Human Genome Epidemiology

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Xu, Jingwen

2017-12-01

Epidemiology is a science that studies distribution of diseases and health in population and its influencing factors, it also studies how to prevent and cure disease and promote health strategies and measures. Epidemiology has developed rapidly in recent years and it is an intercross subject with various other disciplines to form a series of branch disciplines such as Genetic epidemiology, molecular epidemiology, drug epidemiology and tumor epidemiology. With the implementation and completion of Human Genome Project (HGP), Human Genome Epidemiology (HuGE) has emerged at this historic moment. In this review, the development of Human Genome Epidemiology, research content, the construction and structure of relevant network, research standards, as well as the existing results and problems are briefly outlined.

Participation in Heart-Healthy Behaviors: A Secondary Analysis of the American Heart Association Go Red Heart Match Data.

Science.gov (United States)

Arslanian-Engoren, Cynthia; Eastwood, Jo-Ann; De Jong, Marla J; Berra, Kathy

2015-01-01

The American Heart Association created Go Red Heart Match, a free and secure online program that enables women to connect with each other to fight heart disease either personally or as a caregiver for someone with heart disease. Through these connections, participants have an opportunity to develop a personal, private, and supportive relationship with other women; share common experiences; and motivate and encourage each other to follow a heart-healthy lifestyle. The aims of this study were to describe the demographic characteristics of the Go Red Heart Match responders and to determine whether participation in the program prompted participants to engage in heart-healthy behaviors. A secondary analysis of data collected as part of a needs assessment survey from the American Heart Association Go Red Heart Match was conducted. A total of 117 (35%) of the 334 invited women completed the survey. Most responders were female, married, and college educated. A total of 105 (90%) responders were diagnosed with a type of heart disease or stroke and 77 (73%) responders had undergone treatment. As a result of participating in the program, 75% of the responders reported the following improvements in heart-healthy behaviors: eating a more heart-healthy diet (54%), exercising more frequently (53%), losing weight (47%), and quitting smoking (10%). Responders who had a diagnosis of heart attack (n = 48) were more likely (P = .003) to quit smoking than were those with other diagnoses (n = 69). Notably, 48% of responders reported encouraging someone else in their life to speak to their doctor about their risk for heart disease. Most women who participated in Heart Match reported engaging in new heart-healthy behaviors. The findings support expanding the existing program in a more diverse population as a potentially important way to reach women and encourage cardiovascular disease risk reduction for those with heart disease and stroke.

Enlarged Heart

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... rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge. Disease of the heart ...

Women's Heart Disease: Join the Heart Truth Community

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... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter 2014 Table of Contents National Symbol The centerpiece of The Heart Truth ® is The Red Dress ® which was introduced ...

Contribution of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic to de novo presentations of heart disease in the Heart of Soweto Study cohort.

Science.gov (United States)

Sliwa, Karen; Carrington, Melinda J; Becker, Anthony; Thienemann, Friedrich; Ntsekhe, Mpiko; Stewart, Simon

2012-04-01

The contemporary impact of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic on heart disease in South Africa (>5 million people affected) is unknown. The Heart of Soweto Study provides a unique opportunity to identify the contribution of cardiac manifestations of this epidemic to de novo presentations of heart disease in an urban African community in epidemiological transition. Chris Hani Baragwanath Hospital services the >1 million people living in Soweto, South Africa. A prospective, clinical registry captured data from all de novo cases of heart disease presenting to the Cardiology Unit during 2006-08. We describe all cases where HIV/AIDS was concurrently diagnosed. Overall, 518 of 5328 de novo cases of heart disease were identified as HIV-positive (9.7%) with 54% of these prescribed highly active anti-retroviral therapies on presentation. Women (62%) and Africans (97%) predominated with women being significantly younger than men 38 ± 13 vs. 42 ± 13 years (P = 0.002). The most common primary diagnosis attributable to HIV/AIDS was HIV-related cardiomyopathy (196 cases, 38%); being prescribed more anti-retroviral therapy (127/196 vs. 147/322; odds ratio 2.85, 95% confidence interval 1.81-3.88) with higher viral loads [median 110 000 (inter-quartile range 26 000-510 000) vs. 19 000 (3200-87 000); P = 0.018] and a lower CD4 count [median 180 (71-315) vs. 211 (96-391); P = 0.019] than the rest. An additional 128 cases (25%) were diagnosed with pericarditis/pericardial effusion with a range of other concurrent diagnoses evident, including 42 cases (8.1%) of HIV-related pulmonary arterial hypertension. Only 14 of all 581 cases of coronary artery disease (CAD) (2.4%, mean age 41 ± 13 years) were confirmed HIV-positive. Cardiac manifestations of HIV/AIDS identified within this cohort were relatively infrequent. While HIV-related cardiomyopathy and pericardial disease remain important targets for early detection and treatment in

The independent relationship between triglycerides and coronary heart disease

Science.gov (United States)

Morrison, Alan; Hokanson, John E

2009-01-01

Aims: The aim was to review epidemiologic studies to reassess whether serum levels of triglycerides should be considered independently of high-density lipoprotein-cholesterol (HDL-C) as a predictor of coronary heart disease (CHD). Methods and results: We systematically reviewed population-based cohort studies in which baseline serum levels of triglycerides and HDL-C were included as explanatory variables in multivariate analyses with the development of CHD (coronary events or coronary death) as dependent variable. A total of 32 unique reports describing 38 cohorts were included. The independent association between elevated triglycerides and risk of CHD was statistically significant in 16 of 30 populations without pre-existing CHD. Among populations with diabetes mellitus or pre-existing CHD, or the elderly, triglycerides were not significantly independently associated with CHD in any of 8 cohorts. Triglycerides and HDL-C were mutually exclusive predictors of coronary events in 12 of 20 analyses of patients without pre-existing CHD. Conclusions: Epidemiologic studies provide evidence of an association between triglycerides and the development of primary CHD independently of HDL-C. Evidence of an inverse relationship between triglycerides and HDL-C suggests that both should be considered in CHD risk estimation and as targets for intervention. PMID:19436658

Heart Health: Learn the Truth About Your Heart

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... Bar Home Current Issue Past Issues Cover Story Heart Health Learn the Truth About Your Heart Past Issues / Winter 2009 Table of Contents For ... turn Javascript on. Photo: iStock February is American Heart Month. Now is the time to make sure ...

Alcohol in moderation, cardioprotection, and neuroprotection: epidemiological considerations and mechanistic studies.

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Collins, Michael A; Neafsey, Edward J; Mukamal, Kenneth J; Gray, Mary O; Parks, Dale A; Das, Dipak K; Korthuis, Ronald J

2009-02-01

In contrast to many years of important research and clinical attention to the pathological effects of alcohol (ethanol) abuse, the past several decades have seen the publication of a number of peer-reviewed studies indicating the beneficial effects of light-moderate, nonbinge consumption of varied alcoholic beverages, as well as experimental demonstrations that moderate alcohol exposure can initiate typically cytoprotective mechanisms. A considerable body of epidemiology associates moderate alcohol consumption with significantly reduced risks of coronary heart disease and, albeit currently a less robust relationship, cerebrovascular (ischemic) stroke. Experimental studies with experimental rodent models and cultures (cardiac myocytes, endothelial cells) indicate that moderate alcohol exposure can promote anti-inflammatory processes involving adenosine receptors, protein kinase C (PKC), nitric oxide synthase, heat shock proteins, and others which could underlie cardioprotection. Also, brain functional comparisons between older moderate alcohol consumers and nondrinkers have received more recent epidemiological study. In over half of nearly 45 reports since the early 1990s, significantly reduced risks of cognitive loss or dementia in moderate, nonbinge consumers of alcohol (wine, beer, liquor) have been observed, whereas increased risk has been seen only in a few studies. Physiological explanations for the apparent CNS benefits of moderate consumption have invoked alcohol's cardiovascular and/or hematological effects, but there is also experimental evidence that moderate alcohol levels can exert direct "neuroprotective" actions-pertinent are several studies in vivo and rat brain organotypic cultures, in which antecedent or preconditioning exposure to moderate alcohol neuroprotects against ischemia, endotoxin, beta-amyloid, a toxic protein intimately associated with Alzheimer's, or gp120, the neuroinflammatory HIV-1 envelope protein. The alcohol

Low doses of ionizing radiation and risk of cardiovascular disease: A review of epidemiological studies

International Nuclear Information System (INIS)

Metz-Flamant, C.; Bonaventure, A.; Tirmarche, M.; Laurier, D.; Bernier, M.O.; Milliat, F.

2009-01-01

Background While cardiovascular risks associated with high level of ionizing radiation are well-established, long-term effects of low and medium levels of exposure, between 0 and 5 gray (Gy), on the cardiovascular system are debated. Methods Available literature was reviewed considering various populations, such as survivors of atomic bombs, nuclear workers, Chernobyl liquidators, radiologists and radiological technologists and patients exposed for medical reasons. Results A significant increased risk of cardiovascular diseases associated with low doses of ionizing radiation was observed in 13 studies among the 27 analyzed. The ischemic heart diseases risk was detailed in 16 studies and seven of them showed a significant increase. The cerebrovascular risk was significantly increased in five studies among the 12 considered. Conclusion Some epidemiological and experimental data are clearly in favour of an increased cardiovascular risk associated with exposure to low doses. However, given the multi-factorial origin of cardiovascular diseases and the lack of a clear pathophysiologic mechanism, epidemiological results have to be carefully interpreted. Further research should be conducted in this area. (authors)

Association between resting heart rate and N-terminal pro-brain natriuretic peptide in a community-based population study in Beijing

Directory of Open Access Journals (Sweden)

Cao R

2014-12-01

Full Text Available Ruihua Cao, Yongyi Bai, Ruyi Xu, Ping Ye Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People’s Republic of China Background: N-terminal pro-brain natriuretic peptide (NT-proBNP is associated with an increased risk of cardiac insufficiency, which possibly leads to heart failure. However, the relationship between resting heart rate and NT-proBNP is unclear.Objective: This study focuses on this relativity between resting heart rate and plasma NT-proBNP levels in a surveyed community-based population.Methods: We evaluated the relativity between resting heart rate and plasma levels of NT-proBNP in 1,567 participants (mean age 61.0 years, range 21–96 years from a community-based population in Beijing, People’s Republic of China.Results: In patients with high resting heart rate (≥75 beats/min, NT-proBNP was higher than in those having low resting heart rate (<75 beats/min. In multiple linear stepwise regression analysis, plasma NT-proBNP was associated with resting heart rate (partial correlation coefficient, 0.82; 95% confidence interval, 0.18–1.51; P=0.011. A subsequent subgroup analysis revealed that the association between resting heart rate and plasma NT-proBNP was strengthened in subjects over 60 years old (partial correlation coefficient 1.28; 95% confidence interval, 0.49–2.36; P=0.031; while the relativity between resting heart rate and plasma NT-proBNP was not emerged in the younger subgroup (<60 years old.Conclusions: Resting heart rate was associated with plasma NT-proBNP in the elderly, which indicated a relationship between resting heart rate and cardiac function damage. Keywords: resting heart rate, N-terminal pro-brain natriuretic peptide, epidemiology, cardiac function, relationship

Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association.

Science.gov (United States)

van Diepen, Sean; Katz, Jason N; Albert, Nancy M; Henry, Timothy D; Jacobs, Alice K; Kapur, Navin K; Kilic, Ahmet; Menon, Venu; Ohman, E Magnus; Sweitzer, Nancy K; Thiele, Holger; Washam, Jeffrey B; Cohen, Mauricio G

2017-10-17

Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities. © 2017 American Heart Association, Inc.

Retrospective review of congenital heart disease in 976 dogs.

Science.gov (United States)

Oliveira, P; Domenech, O; Silva, J; Vannini, S; Bussadori, R; Bussadori, C

2011-01-01

Knowledge of epidemiology is important for recognition of cardiovascular malformations. Review the incidence of congenital heart defects in dogs in Italy and assess breed and sex predispositions. Nine hundred and seventy-six dogs diagnosed with congenital heart disease (CHD) of 4,480 dogs presented to Clinica Veterinaria Gran Sasso for cardiovascular examination from 1997 to 2010. A retrospective analysis of medical records regarding signalment, history, clinical examination, radiography, electrocardiography, echocardiography, angiography, and postmortem examination was performed. Breed and sex predisposition were assessed with the odds ratio test. CHD was observed in 21.7% of cases. A total of 1,132 defects were observed with single defects in 832 cases (85%), 2 concurrent defects in 132 cases (14%), and 3 concurrent defects in 12 cases (1%). The most common defects were pulmonic stenosis (PS; 32.1%), subaortic stenosis (SAS; 21.3%), and patent ductus arteriosus (20.9%), followed by ventricular septal defect (VSD; 7.5%), valvular aortic stenosis (AS; 5.7%), and tricuspid dysplasia (3.1%). SAS, PS, and VSD frequently were associated with other defects. Several breed and sex predispositions were identified. The results of this study are in accordance with previous studies, with slight differences. The breed and sex predilections identified may be of value for the diagnosis and screening of CHD in dogs. Additionally, the relatively high percentage of concurrent heart defects emphasizes the importance of accurate and complete examinations for identification. Because these data are from a cardiology referral center, a bias may exist. Copyright © 2011 by the American College of Veterinary Internal Medicine.

Heart health risk factors in Punjabi early teens

Directory of Open Access Journals (Sweden)

Elizabeth Mary John

2014-01-01

Full Text Available Context: India is experiencing an epidemiological health transition characterized by rapid decline in nutritional and parasitic diseases (pre-transitional diseases with an alarming rise in cardiovascular diseases, mainly coronary heart disease and stroke (post-transitional diseases. Many of these risk factors manifesting themselves as diseases in adults can be found during adolescence. Aims: To determine the prevalence of risk factors of heart disease among urban high-school students aged 13-15 yrs in Ludhiana city. Materials and Methods: This cross-sectional study included 330 high school-going early teens aged 13-15 years using a pretested questionnaire. Details regarding food habits, physical activity, and family history were collected along with anthropometric measures and blood pressure recordings. Statistical Analysis Used: Data was analysed using frequencies and proportion. Chi-square was the test of significance. Results: The prevalence of at least one risk factor in the population was 48.5%. Family history with prevalence of at least one coronary artery disease risk factor was of 27.4%, diabetic parents 12.2%, hypertension 17.6%, and heart disease was 1.8%. Physical inactivity as a risk factor showed an overall prevalence of 73%. Nearly 50% of the students consumed some junk food every day. Only 18.2% consume 3-5 servings of fruits per day, 11.2% do not take any fruits at all. Prevalence of overweight was 11.2% and 4.6% of them were obese. Hypertension was seen in 20.1% of subjects. Conclusions: The present generation of early teens are at high risk of future cardiovascular disease and schools and society need to address these issues urgently.

Simple, heart-smart substitutions

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

The contribution of epidemiology

NARCIS (Netherlands)

Brandt, P. van den; Voorrips, L.; Hertz-Picciotto, I.; Shuker, D.; Boeing, H.; Speijers, G.; Guittard, C.; Kleiner, J.; Knowles, M.; Wolk, A.; Goldbohm, A.

2002-01-01

Epidemiologic studies directly contribute data on risk (or benefit) in humans as the investigated species, and in the full food intake range normally encountered by humans. This paper starts with introducing the epidemiologic approach, followed by a discussion of perceived differences between

Coronary heart disease

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Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... buildup of plaque in the arteries to your heart. This may also be called hardening of the ...

Syndromic Hirschsprung's disease and associated congenital heart disease: a systematic review.

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Duess, Johannes W; Puri, Prem

2015-08-01

Hirschsprung's disease (HD) occurs as an isolated phenotype in 70% of infants and is associated with additional congenital anomalies or syndromes in approximately 30% of patients. The cardiac development depends on neural crest cell proliferation and is closely related to the formation of the enteric nervous system. HD associated with congenital heart disease (CHD) has been reported in 5-8% of cases, with septation defects being the most frequently recorded abnormalities. However, the prevalence of HD associated with CHD in infants with syndromic disorders is not well documented. This systematic review was designed to determine the prevalence of CHD in syndromic HD. A systematic review of the literature using the keywords "Hirschsprung's disease", "aganglionosis", "congenital megacolon", "congenital heart disease" and "congenital heart defect" was performed. Resulting publications were reviewed for epidemiology and morbidity. Reference lists were screened for additional relevant studies. A total of fifty-two publications from 1963 to 2014 reported data on infants with HD associated with CHD. The overall reported prevalence of HD associated with CHD in infants without chromosomal disorders was 3%. In infants with syndromic disorders, the overall prevalence of HD associated with CHD ranged from 20 to 80 % (overall prevalence 51%). Septation defects were recorded in 57% (atrial septal defects in 29%, ventricular septal defects in 32%), a patent ductus arteriosus in 39%, vascular abnormalities in 16%, valvular heart defects in 4% and Tetralogy of Fallot in 7%. The prevalence of HD associated with CHD is much higher in infants with chromosomal disorders compared to infants without associated syndromes. A routine echocardiogram should be performed in all infants with syndromic HD to exclude cardiac abnormalities.

Preattentive processing of heart cues and the perception of heart symptoms in congenital heart disease

NARCIS (Netherlands)

Karsdorp, Petra A.; Kindt, Merel; Everaerd, Walter; Mulder, Barbara J. M.

2007-01-01

The present study was aimed at clarifying whether preattentive processing of heart cues results in biased perception of heart sensations in patients with congenital heart disease (ConHD) who are also highly trait anxious. Twenty-six patients with ConHD and 22 healthy participants categorized

Genetic and other factors determining mannose-binding lectin levels in American Indians: the Strong Heart Study

DEFF Research Database (Denmark)

Best, Lyle G; Ferrell, Robert E; Decroo, Susan

2009-01-01

control of MBL2 expression is complex and genetic background effects in specific populations are largely unknown. METHODS: The Strong Heart Study is a longitudinal, cohort study of cardiovascular disease among American Indians. A subset of individuals genotyped for the above mentioned case-control study...... in Caucasian and other populations, result in markedly reduced expression of functional protein. Prospective epidemiologic studies, including a nested, case-control study from the present population, have demonstrated the ability of MBL2 genotypes to predict complications of atherosclerosis,. The genetic...

Spectrum of heart diseases in children: an echocardiographic study of 1,666 subjects in a pediatric hospital, Yaounde, Cameroon.

Science.gov (United States)

Chelo, David; Nguefack, Félicitée; Menanga, Alain P; Ngo Um, Suzanne; Gody, Jean C; Tatah, Sandra A; Koki Ndombo, Paul O

2016-02-01

Children's health programs in Sub-Saharan Africa have always been oriented primarily to infectious diseases and malnutrition. We are witnessing in the early 21(st) century an epidemiological transition marked by the decline of old diseases and the identification of new diseases including heart disease. Therefore, it is necessary to describe the spectrum of these diseases in order to better prepare health workers to these new challenges. We conducted a cross-sectional study focused on heart disease diagnosed by echocardiography in children seen from January 2006 to December 2014 in a pediatric hospital of Yaounde. We collected socio-demographic data and the types of heart disease from registers, patients files as well as the electronic database of echocardiographic records. A total of 2,235 patients underwent echocardiographic examination during the study period including 1,666 subjects with heart disease. Congenital cardiopathies were found in 1,230 (73.8%) patients and acquired abnormalities in 429 (25.8%). Seven children (0.4%) had a combination of both types. Congenital heart defects (CHD) were dominated by ventricular septal defect (VSD). Acquired heart disease was mostly rheumatic valvulopathies. Dyspnea on exertion was the most frequent presenting complaint (87.6%). Discovery of a heart murmur was the principal clinical finding on physical examination (81.4%). The median age was 9 months for congenital heart disease and 132 months for acquired heart disease. As infectious diseases recede and the diagnostic facilities are improving, pediatric heart diseases occupy a more important position in the spectrum of pediatric diseases in our context. However, the ability to evoke the diagnosis remains unsatisfactory by the majority of health personnel and therefore needs to be improved. Apart from congenital heart diseases, the impact of acquired heart diseases, rheumatic valvulopathy being the highest ranking, is remarkable in pediatrics. Awareness of health

Epidemiology and Radiation Protection

International Nuclear Information System (INIS)

1987-01-01

Epidemiology aims at providing direct evidence of the long term health effects in humans due to potentially dangerous exposures to various nuisance agents, including ionising radiation. Inappropriate interpretation and use of the results of epidemiological studies may result in inaccurate assessments of the risks associated with radiation exposure. This report presents the proceedings of a Workshop organised by the NEA to create an opportunity for epidemiologists and radiation protection specialists to exchange their experiences and views on the problems of methodology in epidemiological research and on the application of its results to the assessment of radiation risks

Mitochondrial damage: An important mechanism of ambient PM2.5 exposure-induced acute heart injury in rats

International Nuclear Information System (INIS)

Li, Ruijin; Kou, Xiaojing; Geng, Hong; Xie, Jingfang; Tian, Jingjing; Cai, Zongwei; Dong, Chuan

2015-01-01

Highlights: • PM 2.5 induces heart mitochondrial morphological damage of rats. • Mitochondrial fission/fusion gene expression is important regulation mechanism. • Proinflammatoy cytokine level changes are accompanied with mitochondrial damage. • Alterations in oxidative stress and calcium homeostasis are focused on. - Abstract: Epidemiological studies suggested that ambient fine particulate matter (PM 2.5 ) exposure was associated with cardiovascular disease. However, the underlying mechanism, especially the mitochondrial damage mechanism, of PM 2.5 -induced heart acute injury is still unclear. In this study, the alterations of mitochondrial morphology and mitochondrial fission/fusion gene expression, oxidative stress, calcium homeostasis and inflammation in hearts of rats exposed to PM 2.5 with different dosages (0.375, 1.5, 6.0 and 24.0 mg/kg body weight) were investigated. The results indicated that the PM 2.5 exposure induced pathological changes and ultra-structural damage in hearts such as mitochondrial swell and cristae disorder. Furthermore, PM 2.5 exposure significantly increased specific mitochondrial fission/fusion gene (Fis1, Mfn1, Mfn2, Drp1 and OPA1) expression in rat hearts. These changes were accompanied by decreases of activities of superoxide dismutase (SOD), Na + K + -ATPase and Ca 2+ -ATPase and increases of levels of malondialdehyde (MDA), inducible nitric oxide synthase (iNOS) and nitric oxide (NO) as well as levels of pro-inflammatory mediators including TNF-α, IL-6 and IL-1β in rat hearts. The results implicate that mitochondrial damage, oxidative stress, cellular homeostasis imbalance and inflammation are potentially important mechanisms for the PM 2.5 -induced heart injury, and may have relations with cardiovascular disease

16 CFR 1000.26 - Directorate for Epidemiology.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Directorate for Epidemiology. 1000.26... AND FUNCTIONS § 1000.26 Directorate for Epidemiology. The Directorate for Epidemiology, managed by the Associate Executive Director for Epidemiology, is responsible for the collection and analysis of data on...

[Scientific, practical and educational aspects of clinical epidemiology].

Science.gov (United States)

Briko, N I

2012-01-01

This article defines clinical epidemiology and describes its goal and objectives. The author claims that clinical epidemiology is a section of epidemiology which underlies the development of evidence-based standards for diagnostics, treatment and prevention and helps to select the appropriate algorithm for each clinical case. The study provides a comprehensive overview of the relationship between clinical epidemiology and evidence-based medicine. Epidemiological research is shown to be methodological basis of clinical epidemiology and evidence-based medicine with randomized controlled trials being the "gold standard" for obtaining reliable data. The key stages in the history of clinical epidemiology are discussed and further development of clinical epidemiology and the integration of courses on clinical epidemiology in education is outlined for progress in medical research and health care practice.

Heart regeneration.

Science.gov (United States)

Breckwoldt, Kaja; Weinberger, Florian; Eschenhagen, Thomas

2016-07-01

Regenerating an injured heart holds great promise for millions of patients suffering from heart diseases. Since the human heart has very limited regenerative capacity, this is a challenging task. Numerous strategies aiming to improve heart function have been developed. In this review we focus on approaches intending to replace damaged heart muscle by new cardiomyocytes. Different strategies for the production of cardiomyocytes from human embryonic stem cells or human induced pluripotent stem cells, by direct reprogramming and induction of cardiomyocyte proliferation are discussed regarding their therapeutic potential and respective advantages and disadvantages. Furthermore, different methods for the transplantation of pluripotent stem cell-derived cardiomyocytes are described and their clinical perspectives are discussed. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. Copyright © 2015 Elsevier B.V. All rights reserved.

Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.

Science.gov (United States)

Alberti, K G M M; Eckel, Robert H; Grundy, Scott M; Zimmet, Paul Z; Cleeman, James I; Donato, Karen A; Fruchart, Jean-Charles; James, W Philip T; Loria, Catherine M; Smith, Sidney C

2009-10-20

A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.

HEART OF MYTH – HEART OF SCIENCE Part I

Science.gov (United States)

Bound Alberti, Fay

2015-01-01

This article explores the history and meanings of the heart and its diseases as aspects of the histories of science and emotion. Analyzing the twofold meanings of the heart as both bodily object and cultural symbol, it explores the reasons for the apparent conflict in meanings of the heart of science and the heart of emotion in Western medical culture since the 19th century. In Part I, a case study of the writer, economist, and philosopher Harriet Martineau is used to demonstrate and trace that conflict, while Part II highlights the manifold meanings of the heart both in the past and in the present. PMID:26167117

History and philosophy of modern epidemiology

DEFF Research Database (Denmark)

Andersen, Hanne

2012-01-01

Epidemiological studies of chronic diseases began around the mid-20th century. Contrary to the infectious disease epidemiology which had prevailed at the beginning of the 20th century and which had focused on single agents causing individual diseases, the chronic disease epidemiology which emerge...

Women and Heart Disease: Sharing Advice from the Heart

Science.gov (United States)

... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring 2016 Table of Contents This ... inspired you to get involved in the American Heart Association's Go Red For Women movement and Red ...

The potential of the infrastructural system of Hammarby Sjöstad in Stockholm, Sweden

International Nuclear Information System (INIS)

Iveroth, Sofie Pandis; Johansson, Stefan; Brandt, Nils

2013-01-01

The purpose of this paper is to explore to what extent the integrated infrastructural system in Hammarby Sjöstad, Stockholm, also named the Hammarby Model, reduces the metabolic flows of the district, and to what extent the district is self-sufficient, in terms of generated energy. Furthermore, the paper aspires to help create a deeper understanding of the system in order to guide the implementation of similar models in other districts, creating more sustainable cities. The method has been to quantify the local mass and energy flows of the model, using the secondary energy generated within Hammarby Sjöstad as basis when creating the system boundaries of the calculations. The findings demonstrate that the Hammarby Model reduces the metabolic flows of Hammarby Sjöstad but that the district is far from self-sufficient in terms of secondary energy. The conclusions of the paper are that the development of integrated infrastructural systems is one way to help create more sustainable cities. However, in order to reduce metabolic flows even further, the efficiency of the system must be improved by integrating more renewable energy sources. At the same time less energy has to be used in the households. - Highlights: • The integrated infrastructural system reduces the metabolic flows of the district. • Integrated infrastructural systems helps creating sustainable cities. • However, Hammarby Sjöstad is far from self-sufficient. • To reduce metabolic flows further, integrate more renewables. • At the same time less energy has to be used in the households

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 ...

Types of Heart Failure

Science.gov (United States)

... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and procedures related to heart disease and stroke. Heart Failure Questions to Ask Your Doctor Use these questions ...

Employment after heart transplantation among adults with congenital heart disease.

Science.gov (United States)

Tumin, Dmitry; Chou, Helen; Hayes, Don; Tobias, Joseph D; Galantowicz, Mark; McConnell, Patrick I

2017-12-01

Adults with congenital heart disease may require heart transplantation for end-stage heart failure. Whereas heart transplantation potentially allows adults with congenital heart disease to resume their usual activities, employment outcomes in this population are unknown. Therefore, we investigated the prevalence and predictors of work participation after heart transplantation for congenital heart disease. Retrospective review of a prospective registry. United Network for Organ Sharing registry of transplant recipients in the United States. Adult recipients of first-time heart transplantation with a primary diagnosis of congenital heart disease, performed between 2004 and 2015. None. Employment status reported by transplant centers at required follow-up intervals up to 5 y posttransplant. Among 470 patients included in the analysis (mean follow-up: 5 ± 3 y), 127 (27%) worked after transplant, 69 (15%) died before beginning or returning to work, and 274 (58%) survived until censoring, but did not participate in paid work. Multivariable competing-risks regression analysis examined characteristics associated with posttransplant employment, accounting for mortality as a competing outcome. In descriptive and multivariable analysis, pretransplant work participation was associated with a greater likelihood of posttransplant employment, while the use of Medicaid insurance at the time of transplant was associated with a significantly lower likelihood of working after transplant (subhazard ratio compared to private insurance: 0.55; 95% confidence interval: 0.32, 0.95; P = .032). Employment was rare after heart transplantation for congenital heart disease, and was significantly less common than in the broader population of adults with congenital heart disease. Differences in return to work were primarily related to pretransplant employment and the use of public insurance, rather than clinical characteristics. © 2017 Wiley Periodicals, Inc.

Histone methylations in heart development, congenital and adult heart diseases.

Science.gov (United States)

Zhang, Qing-Jun; Liu, Zhi-Ping

2015-01-01

Heart development comprises myocyte specification, differentiation and cardiac morphogenesis. These processes are regulated by a group of core cardiac transcription factors in a coordinated temporal and spatial manner. Histone methylation is an emerging epigenetic mechanism for regulating gene transcription. Interplay among cardiac transcription factors and histone lysine modifiers plays important role in heart development. Aberrant expression and mutation of the histone lysine modifiers during development and in adult life can cause either embryonic lethality or congenital heart diseases, and influences the response of adult hearts to pathological stresses. In this review, we describe current body of literature on the role of several common histone methylations and their modifying enzymes in heart development, congenital and adult heart diseases.

Methodological and conceptual issues regarding occupational psychosocial coronary heart disease epidemiology.

Science.gov (United States)

Burr, Hermann; Formazin, Maren; Pohrt, Anne

2016-05-01

Overview Psychosocial occupational epidemiology has mainly focused on the demand-control and, to a much lesser extent, the effort-reward-imbalance (ERI) models. These models and the strong focus on them raise some conceptual and methodological issues we will address in the following letter. The conceptual issues include the empirical confirmation of the assumptions of these models, the extent to which the focus on the demand-control and ERI models is warranted, and whether the sub-dimensions of the scales in these models have common health effects. We argue that there is a lack of empirical approval of (i) the assumptions behind both models and (ii) the focus on these models. The methodological issues include how exposure to job strain is categorized, how ERI previously has been measured, and the validity of self-reports of job strain. We argue that (i) a population independent definition of job strain is lacking, (ii) the older measurements of ERI mix exposure and effect, and (iii) we know little regarding the validity of the measurement of the psychosocial working environment. Finally, we suggest that analyses of monitoring data with a broader focus on the psychosocial working environment can be used to shed light to some of the issues raised above. Introduction In the last three decades (1, 2), psychosocial occupational epidemiology related to coronary heart disease (CHD) has mainly focused on the job-strain model, also referred to as the demand-control model (3, 4). In this model, two aspects of work are deemed relevant: demands and control. Negative consequences to health are to be expected when high demands are simultaneously present with low control. This combination has been termed job strain (3, 4). Recently, there has also been increased interest in the ERI model (5, 6) which considers the level of effort relative to rewards at work: an imbalance is present when the efforts outweigh the rewards (5, 6). In longitudinal studies of CHD, there has been only a

Residential surface soil guidance values applied worldwide to the original 2001 Stockholm Convention POP pesticides.

Science.gov (United States)

Jennings, Aaron A; Li, Zijian

2015-09-01

Surface soil contamination is a worldwide problem. Many regulatory jurisdictions attempt to control human exposures with regulatory guidance values (RGVs) that specify a soil's maximum allowable concentration. Pesticides are important soil contaminants because of their intentional toxicity and widespread surface soil application. Worldwide, at least 174 regulatory jurisdictions from 54 United Nations member states have published more than 19,400 pesticide RGVs for at least 739 chemically unique pesticides. This manuscript examines the variability of the guidance values that are applied worldwide to the original 2001 Stockholm Convention persistent organic pollutants (POP) pesticides (Aldrin, Chlordane, DDT, Dieldrin, Endrin, Heptachlor, Mirex, and Toxaphene) for which at least 1667 RGVs have been promulgated. Results indicate that the spans of the RGVs applied to each of these pesticides vary from 6.1 orders of magnitude for Toxaphene to 10.0 orders of magnitude for Mirex. The distribution of values across these value spans resembles the distribution of lognormal random variables, but also contain non-random value clusters. Approximately 40% of all the POP RGVs fall within uncertainty bounds computed from the U.S. Environmental Protection Agency (USEPA) RGV cancer risk model. Another 22% of the values fall within uncertainty bounds computed from the USEPA's non-cancer risk model, but the cancer risk calculations yield the binding (lowest) value for all POP pesticides except Endrin. The results presented emphasize the continued need to rationalize the RGVs applied worldwide to important soil contaminants. Copyright © 2015 Elsevier Ltd. All rights reserved.

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...

Patterns of Suicide and Other Trespassing Fatalities on State-Owned Railways in Greater Stockholm; Implications for Prevention

Directory of Open Access Journals (Sweden)

Helena Rådbo

2012-03-01

Full Text Available Each year, approximately 80–100 people are killed on state-owned railways due to train-person collisions in Sweden. Underlying causes are suicide and accidents; suicide constituting a vast majority. Earlier Swedish studies at a national level revealed a relation between population density and incident frequency, however, with places of occurrence often located to the outskirts of cities some distance away from station areas where victims can await approaching trains in seclusion. The aim of this study was to investigate whether this national pattern also applies to larger urban areas such as greater Stockholm, and to discuss preventative implications based on these observations. All registered incidents (N = 41 where people were hit or run-over by trains with a fatal outcome over the four-year period 2005–2008 were investigated. Results deviating from the national pattern include that most incidents occur at station areas, and that most victims enter the tracks from platforms. Passing express trains appear to be overrepresented, compared to commuter trains. Due to a low number of cases, our observations must be interpreted with caution. However, they imply that preventative measures in this type of area should focus on platform safety foremost, especially protection against rapid trains passing by station areas.

Dimensional analysis of heart rate variability in heart transplant recipients

Energy Technology Data Exchange (ETDEWEB)

Zbilut, J.P.; Mayer-Kress, G.; Geist, K.

1987-01-01

We discuss periodicities in the heart rate in normal and transplanted hearts. We then consider the possibility of dimensional analysis of these periodicities in transplanted hearts and problems associated with the record.

Potential implications of the helical heart in congenital heart defects.

Science.gov (United States)

Corno, Antonio F; Kocica, Mladen J

2007-01-01

The anatomic and functional observations made by Francisco Torrent-Guasp, in particular his discovery of the helical ventricular myocardial band (HVMB), have challenged what has been taught to cardiologists and cardiac surgeons over centuries. A literature debate is ongoing, with interdependent articles and comments from supporters and critics. Adequate understanding of heart structure and function is obviously indispensable for the decision-making process in congenital heart defects. The HVMB described by Torrent-Guasp and the potential impact on the understanding and treatment of congenital heart defects has been analyzed in the following settings: embryology, ventriculo-arterial discordance (transposition of great arteries), Ebstein's anomaly, pulmonary valve regurgitation after repair of tetralogy of Fallot, Ross operation, and other congenital heart defects. The common structural spiral feature is only one of the elements responsible for the functional interaction of right and left ventricles, and understanding the form/function relationship in congenital heart defects is more difficult than for acquired heart disease because of the variety and complexity of congenital heart defects. Individuals involved in the care of patients with congenital heart defects have to be stimulated to consider further investigations and alternative surgical strategies.

Million Hearts: Key to Collaboration to Reduce Heart Disease

Science.gov (United States)

Brinkman, Patricia

2016-01-01

Extension has taught successful classes to address heart disease, yet heart disease remains the number one killer in the United States. The U.S. government's Million Hearts initiative seeks collaboration among colleges, local and state health departments, Extension and other organizations, and medical providers in imparting a consistent message…

Mitochondrial damage: An important mechanism of ambient PM{sub 2.5} exposure-induced acute heart injury in rats

Energy Technology Data Exchange (ETDEWEB)

Li, Ruijin; Kou, Xiaojing; Geng, Hong; Xie, Jingfang; Tian, Jingjing [Institute of Environmental Science, College of Environmental & Resource Sciences, Shanxi University, Taiyuan (China); Cai, Zongwei, E-mail: zwcai@hkbu.edu.hk [State Key Laboratory of Environmental and Biological Analysis, Department of Chemistry, Hong Kong Baptist University, Hong Kong SAR (China); Dong, Chuan, E-mail: dc@sxu.edu.cn [Institute of Environmental Science, College of Environmental & Resource Sciences, Shanxi University, Taiyuan (China)

2015-04-28

Highlights: • PM{sub 2.5} induces heart mitochondrial morphological damage of rats. • Mitochondrial fission/fusion gene expression is important regulation mechanism. • Proinflammatoy cytokine level changes are accompanied with mitochondrial damage. • Alterations in oxidative stress and calcium homeostasis are focused on. - Abstract: Epidemiological studies suggested that ambient fine particulate matter (PM{sub 2.5}) exposure was associated with cardiovascular disease. However, the underlying mechanism, especially the mitochondrial damage mechanism, of PM{sub 2.5}-induced heart acute injury is still unclear. In this study, the alterations of mitochondrial morphology and mitochondrial fission/fusion gene expression, oxidative stress, calcium homeostasis and inflammation in hearts of rats exposed to PM{sub 2.5} with different dosages (0.375, 1.5, 6.0 and 24.0 mg/kg body weight) were investigated. The results indicated that the PM{sub 2.5} exposure induced pathological changes and ultra-structural damage in hearts such as mitochondrial swell and cristae disorder. Furthermore, PM{sub 2.5} exposure significantly increased specific mitochondrial fission/fusion gene (Fis1, Mfn1, Mfn2, Drp1 and OPA1) expression in rat hearts. These changes were accompanied by decreases of activities of superoxide dismutase (SOD), Na{sup +}K{sup +}-ATPase and Ca{sup 2+}-ATPase and increases of levels of malondialdehyde (MDA), inducible nitric oxide synthase (iNOS) and nitric oxide (NO) as well as levels of pro-inflammatory mediators including TNF-α, IL-6 and IL-1β in rat hearts. The results implicate that mitochondrial damage, oxidative stress, cellular homeostasis imbalance and inflammation are potentially important mechanisms for the PM{sub 2.5}-induced heart injury, and may have relations with cardiovascular disease.

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 ...

Asthma, Allergy and Eczema among Adults in Multifamily Houses in Stockholm (3-HE Study) - Associations with Building Characteristics, Home Environment and Energy Use for Heating

Science.gov (United States)

Norbäck, Dan; Lampa, Erik; Engvall, Karin

2014-01-01

Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings) were invited (one subject/dwelling) and 7,554 participated (73%). Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR = 1.74) and mould odour (OR = 1.79). Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR = 1.45) and was associated with redecoration (OR = 1.48) and mould odour (OR = 2.35). Pollen allergy was less common in buildings using more energy for heating (OR = 0.75) and was associated with humid air (OR = 1.76) and mould odour (OR = 2.36). Eczema was more common in larger buildings (OR 1.07) and less common in buildings using more energy for heating (OR = 0.85) and was associated with water damage (OR = 1.47), humid air (OR = 1.73) and mould odour (OR = 2.01). Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR = 0.49; 95% CI 0.29–0.82). Pollen allergy was less common if the building maintenance was outsourced (OR = 0.67; 95% CI 0.51–0.88). Eczema was more common when management accessibility was only at the division level (OR = 1.49; 95% CI 1.06–2.11). In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness

Asthma, allergy and eczema among adults in multifamily houses in Stockholm (3-HE study--associations with building characteristics, home environment and energy use for heating.

Directory of Open Access Journals (Sweden)

Dan Norbäck

Full Text Available Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings were invited (one subject/dwelling and 7,554 participated (73%. Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR = 1.74 and mould odour (OR = 1.79. Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR = 1.45 and was associated with redecoration (OR = 1.48 and mould odour (OR = 2.35. Pollen allergy was less common in buildings using more energy for heating (OR = 0.75 and was associated with humid air (OR = 1.76 and mould odour (OR = 2.36. Eczema was more common in larger buildings (OR 1.07 and less common in buildings using more energy for heating (OR = 0.85 and was associated with water damage (OR = 1.47, humid air (OR = 1.73 and mould odour (OR = 2.01. Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR = 0.49; 95% CI 0.29-0.82. Pollen allergy was less common if the building maintenance was outsourced (OR = 0.67; 95% CI 0.51-0.88. Eczema was more common when management accessibility was only at the division level (OR = 1.49; 95% CI 1.06-2.11. In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness. Energy saving may have consequences for allergy and eczema. More

Electromagnetic fields and health effects-epidemiologic studies of cancer, diseases of the central nervous system and arrhythmia-related heart disease

Energy Technology Data Exchange (ETDEWEB)

Johansen, C.

2004-07-01

This epidemiologic investigation comprised separate studies of the risk of cancer, cause-specific mortality rates, risks for neurodegenerative diseases, and the risk of arrhythmia-related heart disease among employees exposed to extremely low- frequency (50-Hz) electromagnetic fields (EMF) in the Danish utility industry. All the employees in this industry were followed-up in several registers. The risk of disease was analyzed in relation to occupational exposure to EMF, latency, and duration of employment. A specific job-exposure matrix was developed and validated by comparison with direct measurements of EMF during a workday. Linkage with the Danish Cancer Register did not identify increased risks for the cancers suggested a priori to be associated with exposure to EMF, including leukemia, brain tumors, and breast cancer. Significantly increased risks for lung cancer and mesothelioma were identified for workers highly exposed to asbestos. Linkage with the National Mortality Register revealed a significantly increased overall mortality rate from amyotrophic lateral sclerosis (ALS), with an increasing trend with duration of employment and EMF exposure. In addition, a significantly increased mortality rate from electric accidents was observed. It was hypothesized that the observation of increased mortality from ALS was associated with exposure to EMF or electric shocks. No increased mortality rate from cardiovascular or cerebrovascular disease was observed. Linkage with the National Hospital Register also revealed an increased risk of ALS and, thereby confirmed the finding of an increased mortality rate for this disease in the previous study. Linkage of the cohort with the Multiple Sclerosis Register revealed an increased risk of multiple sclerosis, which was not, however, significant Linkage with the Pacemaker Register showed no increased risk of severe arrhythmia-related heart disease. The second part of the study included the establishment of a large, nationwide

Desafíos a la epidemiología (pasos para una epidemiología "Miltoniana" Challenges to epidemiology (steps to a "Miltonian" epidemiology

Directory of Open Access Journals (Sweden)

Juan Samaja

2003-06-01

Full Text Available Se sostiene que uno de los grandes desafíos que enfrenta la Epidemiología contemporánea está situado en el campo teórico, y consiste esencialmente en la exigencia de revisar la conceptualización del objeto de la epidemiología dominante que reduce la salud de las poblaciones al comportamiento de los riesgos concebidos con abstracción de los vínculos particulares que los sujetos guardan con sus corporeidades geográficas y medioambientales. El artículo pretende reintroducir la perspectiva dialéctica que deja de lado la visión sustancialista de la realidad de las poblaciones de un lado y del medio ambiente, del otro lado, para proponer una visión estructural, funcional e histórica de ambos conceptos, desarrollando, en este sentido el espíritu de la obra del Gran Geógrafo Brasileiro.This paper argues that one of the major challenges that contemporary Epidemiology has to face is at the level of theory. In essence, it is necessary to revise the abstract conceptualization of the dominant Epidemiology object, which has reduced the health of the population to behavioral risks, without taking into account the link that people have to their geographical and environmental corporities. This article then seeks to reinsert the dialectical perspective that leaves aside the substantialist view of population reality, on one side, and that of the environment, on the other, in order to propose a structural, functional and historical perspective of both concepts, developing, in this way, the spirit of the Great Brazilian Geographer's work.

Epidemiology of Heart Failure

NARCIS (Netherlands)

A. Mosterd (Arend)

1997-01-01

textabstractCardiovascular mortality rates have decline'd significantly in most industrialized countries over the past three decades.2 Nevertheless, cardiovascular disease remains one of the most important causes of morbidity and mortality in Western society, especially as the average age of the

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 ...

FISH CONSUMPTION, METHYLMERCURY, AND HUMAN HEART DISEASE.

Energy Technology Data Exchange (ETDEWEB)

LIPFERT, F.W.; SULLIVAN, T.M.

2005-09-21

Environmental mercury continues to be of concern to public health advocates, both in the U.S. and abroad, and new research continues to be published. A recent analysis of potential health benefits of reduced mercury emissions has opened a new area of public health concern: adverse effects on the cardiovascular system, which could account for the bulk of the potential economic benefits. The authors were careful to include caveats about the uncertainties of such impacts, but they cited only a fraction of the applicable health effects literature. That literature includes studies of the potentially harmful ingredient (methylmercury, MeHg) in fish, as well as of a beneficial ingredient, omega-3 fatty acids or ''fish oils''. The U.S. Food and Drug Administration (FDA) recently certified that some of these fat compounds that are primarily found in fish ''may be beneficial in reducing coronary heart disease''. This paper briefly summarizes and categorizes the extensive literature on both adverse and beneficial links between fish consumption and cardiovascular health, which are typically based on studies of selected groups of individuals (cohorts). Such studies tend to comprise the ''gold standard'' of epidemiology, but cohorts tend to exhibit a great deal of variability, in part because of the limited numbers of individuals involved and in part because of interactions with other dietary and lifestyle considerations. Note that eating fish will involve exposure to both the beneficial effects of fatty acids and the potentially harmful effects of contaminants like Hg or PCBs, all of which depend on the type of fish but tend to be correlated within a population. As a group, the cohort studies show that eating fish tends to reduce mortality, especially due to heart disease, for consumption rates up to about twice weekly, above which the benefits tend to level off. A Finnish cohort study showed increased mortality risks

The Effect of Methanolic Soy Extract on Heart Tissue Changes in Ovariectomized Rats

Directory of Open Access Journals (Sweden)

Mohammad Reza Nasirzadeh

2012-04-01

Full Text Available Background & Objectives: Following to estrogen depletion in postmenopausal womens, its cardioprotective effect decreases. Stroke usually occurs in women during the menopause years. Estrogen hormone therapy is still controversial. Epidemiological data suggest that phytoestrogens have a preventive effect on various estrogen-related diseases/symptoms such as menopausal symptoms, cardiovascular diseases. Some studies suggest that genistein as an important component of soy have cardioprotection effects but its role on inflammation and cardiomyocte injury remained to be elucidated. So, this study was goaled to investigate the cardioprotective effect of methanolic soy extract on heart tissue injures.   Method: In this study 40 female rats were randomly allocated into 4 groups: 1 Control (intact animals, 2 sham surgery (without ovarictomy, 3 ovariectomized (ovx, and 4 treatment (ovx and soy gavage group that received 60mg/kg per day soy extract in drinking water for 28days (4 weeks. At the end of experiments, the rat heart tissue was processed histologically and the sections were stained with hematoxylin and eosin to examine under light microscope. Statistical analysis was performed using the wilcoxon test.   Results: The results showed that ovariectomy significantly increased inflammation and cardiomyocte injury and soy extract significantly promoted heart tissue recovery (p<0.05.   Conclosions: This study indicated that oral administration of soy extract has a positive effect on attenuation of inflammation and myocyte injury in ovariectomized rat.

Classes of Heart Failure

Science.gov (United States)

... Introduction Types of Heart Failure Classes of Heart Failure Heart Failure in Children Advanced Heart Failure • Causes and ... and Advanced HF • Tools and Resources • Personal Stories Heart Failure Questions to Ask Your Doctor Use these questions ...

Heart valve surgery

Science.gov (United States)

... replacement; Valve repair; Heart valve prosthesis; Mechanical valves; Prosthetic valves ... surgery. Your heart valve has been damaged by infection ( endocarditis ). You have received a new heart valve ...

Effects of omega-3 fatty acids on resting heart rate, heart rate recovery after exercise, and heart rate variability in men with healed myocardial infarctions and depressed ejection fractions.

Science.gov (United States)

O'Keefe, James H; Abuissa, Hussam; Sastre, Antonio; Steinhaus, David M; Harris, William S

2006-04-15

We explored possible mechanisms by which recommended intakes of omega-3 fatty acids may decrease the risk for sudden cardiac death in patients with documented coronary heart disease. The cardioprotective effects of omega-3 fatty acids have been documented in epidemiologic and randomized controlled trials. These fatty acids are presumed to decrease susceptibility to fatal arrhythmias, but whether this is mediated by classic risk factors or direct cardiac mechanisms is not known. Eighteen white men with a history of myocardial infarction and ejection fractions <40% were randomized to placebo or omega-3 fatty acids (585 mg of docosahexaenoic acid and 225 mg of eicosapentaenoic acid) for two 4-month periods in a crossover design. At the end of each period, heart rate (HR), HR variability, and rate of HR recovery after exercise were determined, as were effects on arterial compliance, blood pressure, cardiac function, and fasting serum levels of lipids and inflammatory markers. Omega-3 fatty acids decreased HR at rest from 73 +/- 13 to 68 +/- 13 beats/min (p <0.0001) and improved 1-minute HR recovery after exercise (-27 +/- 10 to -32 +/- 12 beats/min, p <0.01). HR variability in the high-frequency band increased (p <0.02), but no change was noted in overall HR variability. There were no significant effects on blood pressure, arterial compliance, lipids, or inflammatory markers. These changes are consistent with an increase in vagal activity and may in part explain the observed decrease in risk for sudden cardiac death seen with omega-3 fatty acid supplementation.

Current practice of epidemiology in Africa: highlights of the 3rd conference of the African epidemiological association and 1st conference of the Cameroon society of epidemiology, Yaoundé, Cameroon, 2014.

Science.gov (United States)

Nkwescheu, Armand Seraphin; Fokam, Joseph; Tchendjou, Patrice; Nji, Akindeh; Ngouakam, Hermann; Andre, Bita Fouda; Joelle, Sobngwi; Uzochukwu, Benjamin; Akinroye, Kingsley; Mbacham, Wilfred; Colizzi, Vittorio; Leke, Rose; Victora, Cesar

2015-01-01

As the study of disease occurrence and health indicators in human populations, Epidemiology is a dynamic field that evolves with time and geographical context. In order to update African health workers on current epidemiological practices and to draw awareness of early career epidemiologists on concepts and opportunities in the field, the 3(rd) African Epidemiology Association and the 1st Cameroon Society of Epidemiology Conference was organized in June 2-6, 2014 at the Yaoundé Mont Febe Hotel, in Cameroon. Under the theme«Practice of Epidemiology in Africa: Stakes, Challenges and Perspectives», the conference attracted close to five hundred guest and participants from all continents. The two main programs were the pre-conference course for capacity building of African Early Career epidemiologists, and the conference itself, providing a forum for scientific exchanges on recent epidemiological concepts, encouraging the use of epidemiological methods in studying large disease burden and neglected tropical diseases; and highlighting existing opportunities.

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 ...

Engineered Heart Repair.

Science.gov (United States)

Fujita, B; Zimmermann, W-H

2017-08-01

There is a pressing need for the development of advanced heart failure therapeutics. Current state-of-the-art is protection from neurohumoral overstimulation, which fails to address the underlying cause of heart failure, namely loss of cardiomyocytes. Implantation of stem cell-derived cardiomyocytes via tissue-engineered myocardium is being advanced to realize the remuscularization of the failing heart. Here, we discuss pharmacological challenges pertaining to the clinical translation of tissue-engineered heart repair with a focus on engineered heart muscle (EHM). © 2017 American Society for Clinical Pharmacology and Therapeutics.

The influence of heart disease on characteristics, quality of life, use of health resources, and costs of COPD in primary care settings

Directory of Open Access Journals (Sweden)

Hernandez-Barrera Valentín

2010-02-01

Full Text Available Abstract Background To evaluate the influence of heart disease on clinical characteristics, quality of life, use of health resources, and costs of patients with COPD followed at primary care settings under common clinical practice conditions. Methods Epidemiologic, observational, and descriptive study (EPIDEPOC study. Patients ≥ 40 years of age with stable COPD attending primary care settings were included. Demographic, clinical characteristics, quality of life (SF-12, seriousness of the disease, and treatment data were collected. Results were compared between patients with or without associated heart disease. Results A total of 9,390 patients with COPD were examined of whom 1,770 (18.8% had heart disease and 78% were males. When comparing both patient groups, significant differences were found in the socio-demographic characteristics, health profile, comorbidities, and severity of the airway obstruction, which was greater in patients with heart disease. Differences were also found in both components of quality of life, physical and mental, with lower scores among those patients with heart disease. Higher frequency of primary care and pneumologist visits, emergency-room visits and number of hospital admissions were observed among patients with heart diseases. The annual total cost per patient was significantly higher in patients with heart disease; 2,937 ± 2,957 vs. 1,749 ± 2,120, p Conclusion Patients with COPD plus heart disease had greater disease severity and worse quality of life, used more healthcare resources and were associated with greater costs compared to COPD patients without known hearth disease.

Prevalence and correlates of coronary heart disease: first population-based study in Lebanon

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Zeidan RK

2016-03-01

Full Text Available Rouba Karen Zeidan,1 Rita Farah,2 Mirna N Chahine,3 Roland Asmar,3 Hassan Hosseini,4,5 Pascale Salameh,6,7 Atul Pathak8 1Doctoral School of Biology Health and Biotechnologies, Toulouse III University, Toulouse, 2Doctoral School of Life and Health Sciences, Paris-Est University, Creteil, France; 3Foundation-Medical Research Institutes, F-MRI®, Beirut, Lebanon; 4Department of Neurology, Henri Mondor Hospital AP-HP, 5EA 4391, Nerve Excitability and Therapeutics, Université Paris-Est, Creteil, France; 6School of Pharmacy, Lebanese American University, Byblos, 7Laboratory of Clinical and Epidemiology Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon; 8Department of Cardiovascular Medicine, Hypertension, Risk Factors and Heart Failure Unit, Clinique Pasteur, Toulouse, France Background: Lebanon is experiencing a growing epidemic of coronary heart diseases (CHDs, as most low- and middle-income countries currently are. However, this growth can be attenuated if effective preventive strategies are adopted. Purpose: To provide the first national population-based prevalence of CHD and to describe the profile of Lebanese adults with prevalent CHD. Methods: We carried out a cross-sectional study using a multistage cluster sample across Lebanon. We interviewed residents aged 40 years and older using a questionnaire that captured the presence of CHDs and their risk factors (RFs. Results: Our study showed that 13.4% of the Lebanese population aged ≥40 years suffer from a prevalent CHD. CHD seemed to appear more prematurely than in developed countries, and males seemed to be more subject to CHD than females until a certain age. CHD was associated with older age, male sex, a lower economic situation, hypercholesterolemia, hypertension, having a family history of premature cardiovascular diseases, and suffering from diabetes. However, smoking and waist circumference did not seem to have an independent effect on CHD, but rather an effect

Ethical aspects of registry-based research in the Nordic countries

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Ludvigsson JF

2015-11-01

Full Text Available Jonas F Ludvigsson,1,2 Siri E Håberg,3 Gun Peggy Knudsen,3 Pierre Lafolie,4,5 Helga Zoega,6 Catharina Sarkkola,7 Stephanie von Kraemer,7 Elisabete Weiderpass,1,7–10 Mette Nørgaard11 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 2Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; 3Norwegian Institute of Public Health, Oslo, Norway; 4Department of Medicine, Clinical Pharmacology Unit, 5The Stockholm Regional Ethical Review Board, Karolinska Institutet, Stockholm, Sweden; 6Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; 7Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland; 8Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, 9The Arctic University of Norway, Tromsø, 10Department of Research, Cancer Registry of Norway, Oslo, Norway; 11Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Abstract: National health care registries in the Nordic countries share many attributes, but different legal and ethical frameworks represent a challenge to promoting effective joint research. Internationally, there is a lack of knowledge about how ethical matters are considered in Nordic registry-based research, and a lack of knowledge about how Nordic ethics committees operate and what is needed to obtain an approval. In this paper, we review ethical aspects of registry-based research, the legal framework, the role of ethics review boards in the Nordic countries, and the structure of the ethics application. We discuss the role of informed consent in registry-based research and how to safeguard the integrity of study participants, including vulnerable subjects and children. Our review also provides information on the different government agencies that contribute registry-based data, and a list of the major health registries in Denmark, Finland, Iceland, Norway, and

An animated depiction of major depression epidemiology

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Patten Scott B

2007-06-01

Full Text Available Abstract Background Epidemiologic estimates are now available for a variety of parameters related to major depression epidemiology (incidence, prevalence, etc.. These estimates are potentially useful for policy and planning purposes, but it is first necessary that they be synthesized into a coherent picture of the epidemiology of the condition. Several attempts to do so have been made using mathematical modeling procedures. However, this information is not easy to communicate to users of epidemiological data (clinicians, administrators, policy makers. Methods In this study, up-to-date data on major depression epidemiology were integrated using a discrete event simulation model. The mathematical model was animated in Virtual Reality Modeling Language (VRML to create a visual, rather than mathematical, depiction of the epidemiology. Results Consistent with existing literature, the model highlights potential advantages of population health strategies that emphasize access to effective long-term treatment. The paper contains a web-link to the animation. Conclusion Visual animation of epidemiological results may be an effective knowledge translation tool. In clinical practice, such animations could potentially assist with patient education and enhanced long-term compliance.

An animated depiction of major depression epidemiology.

Science.gov (United States)

Patten, Scott B

2007-06-08

Epidemiologic estimates are now available for a variety of parameters related to major depression epidemiology (incidence, prevalence, etc.). These estimates are potentially useful for policy and planning purposes, but it is first necessary that they be synthesized into a coherent picture of the epidemiology of the condition. Several attempts to do so have been made using mathematical modeling procedures. However, this information is not easy to communicate to users of epidemiological data (clinicians, administrators, policy makers). In this study, up-to-date data on major depression epidemiology were integrated using a discrete event simulation model. The mathematical model was animated in Virtual Reality Modeling Language (VRML) to create a visual, rather than mathematical, depiction of the epidemiology. Consistent with existing literature, the model highlights potential advantages of population health strategies that emphasize access to effective long-term treatment. The paper contains a web-link to the animation. Visual animation of epidemiological results may be an effective knowledge translation tool. In clinical practice, such animations could potentially assist with patient education and enhanced long-term compliance.

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 ...

Multivariate Autoregressive Model Based Heart Motion Prediction Approach for Beating Heart Surgery

Directory of Open Access Journals (Sweden)

Fan Liang

2013-02-01

Full Text Available A robotic tool can enable a surgeon to conduct off-pump coronary artery graft bypass surgery on a beating heart. The robotic tool actively alleviates the relative motion between the point of interest (POI on the heart surface and the surgical tool and allows the surgeon to operate as if the heart were stationary. Since the beating heart's motion is relatively high-band, with nonlinear and nonstationary characteristics, it is difficult to follow. Thus, precise beating heart motion prediction is necessary for the tracking control procedure during the surgery. In the research presented here, we first observe that Electrocardiography (ECG signal contains the causal phase information on heart motion and non-stationary heart rate dynamic variations. Then, we investigate the relationship between ECG signal and beating heart motion using Granger Causality Analysis, which describes the feasibility of the improved prediction of heart motion. Next, we propose a nonlinear time-varying multivariate vector autoregressive (MVAR model based adaptive prediction method. In this model, the significant correlation between ECG and heart motion enables the improvement of the prediction of sharp changes in heart motion and the approximation of the motion with sufficient detail. Dual Kalman Filters (DKF estimate the states and parameters of the model, respectively. Last, we evaluate the proposed algorithm through comparative experiments using the two sets of collected vivo data.

Two New Meal- and Web-Based Interactive Food Frequency Questionnaires : Validation of Energy and Macronutrient Intake

OpenAIRE

Christensen, Sara; Möller, Elisabeth; Bonn, Stephanie; Ploner, Alexander; Wright, Antony; Sjölander, Arvid; Bälter, Olle; Lissner, Lauren; Bälter, Katarina

2013-01-01

Background: Meal-Q and its shorter version, MiniMeal-Q, are 2 new Web-based food frequency questionnaires. Their meal-based and interactive format was designed to promote ease of use and to minimize answering time, desirable improvements in large epidemiological studies. Objective: We evaluated the validity of energy and macronutrient intake assessed with Meal-Q and MiniMeal-Q as well as the reproducibility of Meal-Q. Methods: Healthy volunteers aged 20-63 years recruited from Stockholm Count...

Cancer Epidemiology Data Repository (CEDR)

Science.gov (United States)

In an effort to broaden access and facilitate efficient data sharing, the Epidemiology and Genomics Research Program (EGRP) has created the Cancer Epidemiology Data Repository (CEDR), a centralized, controlled-access database, where Investigators can deposit individual-level de-identified observational cancer datasets.

Heart disease and diet

Science.gov (United States)

Diet - heart disease; CAD - diet; Coronary artery disease - diet; Coronary heart disease - diet ... diet and lifestyle can reduce your risk of: Heart disease, heart attacks, and stroke Conditions that lead ...

Heart-Health Screenings

Science.gov (United States)

... Tools For Your Heart Health • Watch, Learn & Live Animations Library Subscribe to Heart Insight magazine and monthly ... in Spanish . Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

Simulation of Blood flow in Artificial Heart Valve Design through Left heart

Science.gov (United States)

Hafizah Mokhtar, N.; Abas, Aizat

2018-05-01

In this work, an artificial heart valve is designed for use in real heart with further consideration on the effect of thrombosis, vorticity, and stress. The design of artificial heart valve model is constructed by Computer-aided design (CAD) modelling and simulated using Computational fluid dynamic (CFD) software. The effect of blood flow pattern, velocity and vorticity of the artificial heart valve design has been analysed in this research work. Based on the results, the artificial heart valve design shows that it has a Doppler velocity index that is less than the allowable standards for the left heart with values of more than 0.30 and less than 2.2. These values are safe to be used as replacement of the human heart valve.

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 ...

Open heart surgery

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002950.htm Open heart surgery To use the sharing features on this ... large arteries connected to the heart. The term "open heart surgery" means that you are connected to a ...

Epidemiological and morphological studies of double-chambered right ventricle in dogs.

Science.gov (United States)

Fukushima, Ryuji; Tanaka, Ryou; Suzuki, Shuji; Hamabe, Rina; Machida, Noboru; Nakao, Shu; Saida, Yuto; Takashima, Kazuaki; Matsumoto, Hirotaka; Koyama, Hidekazu; Hirose, Hisashi; Yamane, Yoshihisa

2011-10-01

The double-chambered right ventricle (DCRV) is a rare congenital cardiac disease in dogs, and its detailed epidemiological and morphological features are not clearly understood. By investigating the profile, clinical signs, and characteristics of examination findings of eleven dogs with DCRV by means of a retrospective study, we attempted to clarify the epidemiology and morphology of the condition. The study group consisted of nine males and two females. Breeds included Pug (n=3), Miniature Dachshund (n=1), French Bull-dog (n=1), Shiba (n=1), and Retrievers (n=5). The attachment site of the anomalous muscular bundle was continuous with the cardiac apex in nine dogs, and it was attached to the right ventricle free wall in the other two dogs. In dogs with DCRV, at least one of the following conditions was present concurrently: congenital or acquired tricuspid valve regurgitation (TR), ventricular septal defect, and atrial septal defect. Also, the pressure difference between the two chambers increased over time, and progressive right-sided heart failure was observed. In summary, DCRV occurs in small breeds of dog as well as in large breeds of dog and it may be more prevalent in males. The existence of two types of DCRV in dogs was established. Dog with DCRVs will have a high incidence of concurrent cardiac abnormalities. Concurrent TR may be either congenital or acquired. DCRV is a congenital disorder, but the clinical condition progresses as the dog develops.

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 ...

Right heart ventriculography

Science.gov (United States)

Angiography - right heart ... moved forward into the right side of the heart. As the catheter is advanced, the doctor can ... is injected into the right side of the heart. It helps the cardiologist determine the size and ...

A Baltic Sea estuary as a phosphorus source and sink after drastic load reduction: seasonal and long-term mass balances for the Stockholm inner archipelago for 1968-2015

Science.gov (United States)

Walve, Jakob; Sandberg, Maria; Larsson, Ulf; Lännergren, Christer

2018-05-01

Internal phosphorus (P) loading from sediments, controlled by hypoxia, is often assumed to hamper the recovery of lakes and coastal areas from eutrophication. In the early 1970s, the external P load to the inner archipelago of Stockholm, Sweden (Baltic Sea), was drastically reduced by improved sewage treatment, but the internal P loading and its controlling factors have been poorly quantified. We use two slightly different four-layer box models to calculate the area's seasonal and annual P balance (input-export) and the internal P exchange with sediments in 1968-2015. For 10-20 years after the main P load reduction, there was a negative P balance, small in comparison to the external load, and probably due to release from legacy sediment P storage. Later, the stabilized, near-neutral P balance indicates no remaining internal loading from legacy P, but P retention is low, despite improved oxygen conditions. Seasonally, sediments are a P sink in spring and a P source in summer and autumn. Most of the deep-water P release from sediments in summer-autumn appears to be derived from the settled spring bloom and is exported to outer areas during winter. Oxygen consumption and P release in the deep water are generally tightly coupled, indicating limited iron control of P release. However, enhanced P release in years of deep-water hypoxia suggests some contribution from redox-sensitive P pools. Increasing deep-water temperatures that stimulate oxygen consumption rates in early summer have counteracted the effect of lowered organic matter sedimentation on oxygen concentrations. Since the P turnover time is short and legacy P small, measures to bind P in Stockholm inner archipelago sediments would primarily accumulate recent P inputs, imported from the Baltic Sea and from Lake Mälaren.

Ophthalmic epidemiology in Europe

DEFF Research Database (Denmark)

Delcourt, Cécile; Korobelnik, Jean-François; Buitendijk, Gabriëlle H S

2016-01-01

The European Eye Epidemiology (E3) consortium is a recently formed consortium of 29 groups from 12 European countries. It already comprises 21 population-based studies and 20 other studies (case-control, cases only, randomized trials), providing ophthalmological data on approximately 170,000 Euro......The European Eye Epidemiology (E3) consortium is a recently formed consortium of 29 groups from 12 European countries. It already comprises 21 population-based studies and 20 other studies (case-control, cases only, randomized trials), providing ophthalmological data on approximately 170......,000 European participants. The aim of the consortium is to promote and sustain collaboration and sharing of data and knowledge in the field of ophthalmic epidemiology in Europe, with particular focus on the harmonization of methods for future research, estimation and projection of frequency and impact...

How to make epidemiological training infectious.

Directory of Open Access Journals (Sweden)

Steve E Bellan

Full Text Available Modern infectious disease epidemiology builds on two independently developed fields: classical epidemiology and dynamical epidemiology. Over the past decade, integration of the two fields has increased in research practice, but training options within the fields remain distinct with few opportunities for integration in the classroom. The annual Clinic on the Meaningful Modeling of Epidemiological Data (MMED at the African Institute for Mathematical Sciences has begun to address this gap. MMED offers participants exposure to a broad range of concepts and techniques from both epidemiological traditions. During MMED 2010 we developed a pedagogical approach that bridges the traditional distinction between classical and dynamical epidemiology and can be used at multiple educational levels, from high school to graduate level courses. The approach is hands-on, consisting of a real-time simulation of a stochastic outbreak in course participants, including realistic data reporting, followed by a variety of mathematical and statistical analyses, stemming from both epidemiological traditions. During the exercise, dynamical epidemiologists developed empirical skills such as study design and learned concepts of bias while classical epidemiologists were trained in systems thinking and began to understand epidemics as dynamic nonlinear processes. We believe this type of integrated educational tool will prove extremely valuable in the training of future infectious disease epidemiologists. We also believe that such interdisciplinary training will be critical for local capacity building in analytical epidemiology as Africa continues to produce new cohorts of well-trained mathematicians, statisticians, and scientists. And because the lessons draw on skills and concepts from many fields in biology--from pathogen biology, evolutionary dynamics of host--pathogen interactions, and the ecology of infectious disease to bioinformatics, computational biology, and

Congenital heart disease

Science.gov (United States)

Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth. ... Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... Sabiston Textbook of Surgery: The Biological Basis of Modern ...

"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...

The evolving epidemiology of inflammatory bowel disease.

LENUS (Irish Health Repository)

Shanahan, Fergus

2009-07-01

Epidemiologic studies in inflammatory bowel disease (IBD) include assessments of disease burden and evolving patterns of disease presentation. Although it is hoped that sound epidemiologic studies provide aetiological clues, traditional risk factor-based epidemiology has provided limited insights into either Crohn\\'s disease or ulcerative colitis etiopathogenesis. In this update, we will summarize how the changing epidemiology of IBD associated with modernization can be reconciled with current concepts of disease mechanisms and will discuss studies of clinically significant comorbidity in IBD.

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 ...

Teacher Rated School Ethos and Student Reported Bullying—A Multilevel Study of Upper Secondary Schools in Stockholm, Sweden

Science.gov (United States)

Modin, Bitte; Låftman, Sara B.; Östberg, Viveca

2017-01-01

School ethos refers to the school leadership’s purposive efforts to shape and direct the attitudes, values and behaviors needed in order to promote an active learning environment and to prevent the emergence of undesirable behaviors by creating shared meaning and common goals for the school. The aim of this study was to examine how teacher rated aspects of school ethos are linked with manifestations of bullying among 11th grade students. Five teacher-rated sub-dimensions of school ethos (staff stability, teacher morale, structure-order, student focus, and academic atmosphere) were examined in relation to student-reported perpetration of and exposure to traditional school bullying and cyberbullying. The data material combines student and teacher information from two separate data collections performed in 2016, comprising teachers and students in 58 upper secondary schools in Stockholm. Analyses showed that bullying was associated with all but one of the five sub-dimensions of school ethos, namely structure and order for dealing with bullying behaviors at the school. Results are discussed in light of this counter-intuitive finding. Our findings nevertheless lend support to the idea that the social organization of schools, as reflected in their teacher-rated ethos, can affect individual students’ attitudes in a way that prevents the emergence of bullying behavior among students. PMID:29236039

Teacher Rated School Ethos and Student Reported Bullying-A Multilevel Study of Upper Secondary Schools in Stockholm, Sweden.

Science.gov (United States)

Modin, Bitte; Låftman, Sara B; Östberg, Viveca

2017-12-13

School ethos refers to the school leadership's purposive efforts to shape and direct the attitudes, values and behaviors needed in order to promote an active learning environment and to prevent the emergence of undesirable behaviors by creating shared meaning and common goals for the school. The aim of this study was to examine how teacher rated aspects of school ethos are linked with manifestations of bullying among 11th grade students. Five teacher-rated sub-dimensions of school ethos (staff stability, teacher morale, structure-order, student focus, and academic atmosphere) were examined in relation to student-reported perpetration of and exposure to traditional school bullying and cyberbullying. The data material combines student and teacher information from two separate data collections performed in 2016, comprising teachers and students in 58 upper secondary schools in Stockholm. Analyses showed that bullying was associated with all but one of the five sub-dimensions of school ethos, namely structure and order for dealing with bullying behaviors at the school. Results are discussed in light of this counter-intuitive finding. Our findings nevertheless lend support to the idea that the social organization of schools, as reflected in their teacher-rated ethos, can affect individual students' attitudes in a way that prevents the emergence of bullying behavior among students.

Chronic heart failure

OpenAIRE

Hopper, Ingrid; Easton, Kellie

2017-01-01

1. The common symptoms and signs of chronic heart failure are dyspnoea, ankle swelling, raised jugular venous pressure and basal crepitations. Other conditions may be confused with chronic heart failure, including dependent oedema or oedema due to renal or hepatic disease. Shortness of breath may be due to respiratory disease or severe anaemia. Heart failure secondary to lung disease (cor pulmonale) should be distinguished from congestive cardiac failure. Heart failure may also present with l...

Heart Failure

OpenAIRE

McMurray, John; Ponikowski, Piotr

2011-01-01

Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure.

Limited-Access Heart Surgery

Science.gov (United States)

... on the side of the chest. With traditional open heart surgery, the incision is usually 6 to 8 ... attached to a heart-lung machine. In traditional open heart surgery, patients would be connected to the heart- ...

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 ...

Comparative Study of Local and National Media Reporting: Conflict around the TV Oak in Stockholm, Sweden

Directory of Open Access Journals (Sweden)

Johan Östberg

2016-10-01

Full Text Available The TV oak (Television Oak conflict concerned felling an old tree in a wealthy area of Stockholm. The case received great public attention in different media formats with different scopes (e.g., newspapers, television, internet. The TV Oak issue involved actors with different, partly conflicting perceptions. Assuming that the relevance of urban tree management issues in particular leads to increased interest among the local audience, this paper compared differences in reporting on the TV Oak case in local and national newspapers. The comparison comprised the actors “speaking” in the newspapers, the interest roles attributed to different actors and the frames used. The empirical materials used were articles concerning the TV Oak published between October 2011 and June 2012 in one local and two national Swedish newspapers. Quantitative analysis of statements in these articles showed that the geographical scope of the newspaper was not the major driving force framing the TV Oak conflict and that variety of framings, ranging from a humanised perception of the oak to a more analytical hazard perception, were used. Differences between the interest roles allocated to different actors (e.g., in terms of victim, causer, and helper in the oak conflict showed that the framing of conflicts very much depended on single actors, in particular a high profile journalist in the national newspapers and private individuals writing letters to the editor in the local newspaper.

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 ...

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 ... your high blood pressure Fast food tips Heart failure - discharge Heart failure - fluids and diuretics Heart failure - what to ...

Epidemiological methods: a brief review

International Nuclear Information System (INIS)

Winkelstein, W. Jr.

1983-01-01

Epidemiology, the study of disease distributions in populations and the factors which influence these distributions, is an observational science, i.e., its data base consists of measurements made on free living individuals characterized by presence or absence of disease states and putative risk factors. Epidemiological studies are usually classified as descriptive or analytical. Descriptive studies are primarily used for planning and evaluating health programs or to generate etiological hypotheses. Analytical studies are primarily used for testing etiological hypotheses. Analytical studies are designed either as cohort investigations in which populations with and without a putative risk factor are followed through time to ascertain their differential incidence of disease, or case-control investigations in which the history of exposure to a putative risk factor is compared among persons with a disease and appropriate controls free of disease. Both descriptive and analytical epidemiological studies have been applied to health physics problems. Examples of such problems and the epidemiological methods used to explore them will be presented

False Heart Rate Feedback and the Perception of Heart Symptoms in Patients with Congenital Heart Disease and Anxiety

NARCIS (Netherlands)

Karsdorp, Petra A.; Kindt, Merel; Rietveld, Simon; Everaerd, Walter; Mulder, Barbara J. M.

2009-01-01

Background Little is known about the mechanisms explaining an increased perception of heart symptoms in congenital heart disease (ConHD). In the present study, it was suggested that a combination of high trait anxiety and disease history increases the perception of heart symptoms. Purpose It was

False heart rate feedback and the perception of heart symptoms in patients with congenital heart disease and anxiety

NARCIS (Netherlands)

Karsdorp, P.A.; Kindt, M.; Rietveld, S.; Everaerd, W.; Mulder, B.J.M.

2009-01-01

Background: Little is known about the mechanisms explaining an increased perception of heart symptoms in congenital heart disease (ConHD). In the present study, it was suggested that a combination of high trait anxiety and disease history increases the perception of heart symptoms. Purpose: It was

Protect Your Heart: Check Food Labels to Make Heart-Healthy Choices

Science.gov (United States)

... Protein 15g Total Amounts To make heart-healthy food choices, look at the totals and cut back on • ... Toolkit No. 8: Protect Your Heart: Make Smart Food Choices • Toolkit No. 9: Protect Your Heart: Choose Fats ...

Artificial heart

Energy Technology Data Exchange (ETDEWEB)

1984-10-18

Super-pure plutonium-238 could use heat produced during fission to power an implanted artificial heart. Three model hearts have worked for some time. Concern that excess heat would make the procedure unsafe for humans has broadened the search for another energy source, such as electrohydraulic drive or an external power battery. A back pack approach may provide an interim solution until materials are developed which can withstand heart activity and be small enough for implantation.

The epidemiology of adults with severe sepsis and septic shock in Scottish emergency departments.

Science.gov (United States)

Gray, Alasdair; Ward, Kirsty; Lees, Fiona; Dewar, Colin; Dickie, Sarah; McGuffie, Crawford

2013-05-01

The Surviving Sepsis Campaign (SSC) promotes a bundle approach to the care of septic patients to improve outcome. Some have questioned the capability of delivering the bundle in emergency departments (EDs). The authors report the epidemiology and 6 h bundle compliance of patients with severe sepsis/septic shock presenting to Scottish EDs. Analysis of the previously reported Scottish Trauma Audit Group sepsis database was performed including 20 mainland Scottish EDs. A total of 308,910 attendances were screened (between 2 March and 31 May 2009), and 5285 of 27,046 patients were identified after case note review and included on the database. This analysis includes patients who had severe sepsis/septic shock before leaving the ED. Epidemiological, severity of illness criteria, and ED management data were analysed. 626 patients (median age 73; M/F ratio 1:1; 637 presentations) met entrance criteria. The median number of cases per site was 16 (range 3-103). 561 (88.1%) patients arrived by ambulance. The most common source of infection was the respiratory tract (n=411, 64.5%) The most common physiological derangements were heart rate (n=523, 82.1%), respiratory rate (n=452, 71%) and white cell count (n=432, 67.8%). The median hospital stay was 9 days (IQR 4-17 days). 201 (31.6%) patients were admitted to critical care within 2 days, 130 (20.4%) directly from the ED. 180 patients (28.3%) died. There was poor compliance with all aspect of the SSC resuscitation bundle. Sepsis presentations are of variable frequency but have typical epidemiology and clinical outcomes. SSC bundle resuscitation uptake is poor in Scottish EDs.

Heart attack - discharge

Science.gov (United States)

... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Deep vein thrombosis - discharge Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass ... pacemaker - discharge High blood pressure - what to ask your doctor How to read ...

Heart Valve Diseases

Science.gov (United States)

Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

Acquired heart conditions in adults with congenital heart disease: a growing problem.

Science.gov (United States)

Tutarel, Oktay

2014-09-01

The number of adults with congenital heart disease is increasing due to the great achievements in the field of paediatric cardiology, congenital heart surgery and intensive care medicine over the last decades. Mortality has shifted away from the infant and childhood period towards adulthood. As congenital heart disease patients get older, a high prevalence of cardiovascular risk factors is encountered similar to the general population. Consequently, the contribution of acquired morbidities, especially acquired heart conditions to patient outcome, is becoming increasingly important. Therefore, to continue the success story of the last decades in the treatment of congenital heart disease and to further improve the outcome of these patients, more attention has to be given to the prevention, detection and adequate therapy of acquired heart conditions. The aim of this review is to give an overview about acquired heart conditions that may be encountered in adults with congenital 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.

Heart disease and the stress hypothesis in the mid-twentieth century: a historical review

Directory of Open Access Journals (Sweden)

Heather L. Rogers

2016-12-01

Full Text Available Abstract Background In the 1920s, heart disease (a noncommunicable disease, was the new leading cause of death in the USA. Simultaneously, experimental progress in the study of stress provided scientific justification for a new type of risk factor. The objective of the present work is to examine the history of heart disease as a public health problem and the contribution of advancements in scientific knowledge about stress in the 1930s–1960s supporting the hypothesis of stress as one cause of disease. Results In the process of studying heart disease risk factors in the 1950s, medical practitioners became responsible for the early detection of risk factors in order to “catch” chronic disease in its earliest stage. Coronary heart disease specifically was a disease of white, middle class, professional males, and “stress” was hypothesized as one reason why this population was particularly vulnerable. Walter Cannon and Hans Selye provided experimental evidence that stress might cause physical disease. In the 1930s, Cannon described how the body seeks to maintain homeostasis. When the body’s systemic equilibrium is challenged by something dangerous in the environment or an insult directly to the body, the sympathetic nervous system (SNS and adrenals are stimulated. In the 1940s and 1950s, Selye discovered that a universal triad of stress effects (hypertrophy of the adrenal glands, involution of the thymus and lymphoid tissue, and ulceration in the gastrointestinal tract was seen repeatedly after any noxious or aversive event (i.e., noise, shock, etc.. The stress responses occurred in a certain pattern, known as the general adaptation syndrome or GAS. Autopsy from Selye’s laboratory animals showed that, in addition to the general pathological effects of GAS, arteries were thickened and hardened, just as would be seen in human victims of heart and circulatory disorders. Conclusions Since then, large scale, prospective epidemiological

Air Quality and Heart Health: An Emerging Topic for Heart Month

Science.gov (United States)

Air Quality and Heart Health: An Emerging Topic for Heart Month: Ambient air particle pollution increases short- and long-term cardiovascular morbidity and mortality. Older-people, those with pre-existing heart disease and lung disease and diabetes are at higher risk. Mechanism...

Parental overprotection and heart-focused anxiety in adults with congenital heart disease.

Science.gov (United States)

Ong, Lephuong; Nolan, Robert P; Irvine, Jane; Kovacs, Adrienne H

2011-09-01

The care of adult patients with congenital heart disease (CHD) is challenging from a mental health perspective, as these patients continue to face a variety of biopsychosocial issues that may impact emotional functioning. Despite these issues, there are limited data on the psychosocial functioning of adults with CHD, and there are no data on the impact of parental overprotection on heart-focused anxiety in this patient population. The aim of this study was to examine the relationships between patient recollections of parental overprotection and current heart-focused anxiety in adults with CHD. A cross-sectional sample of 190 adult patients with CHD (51% male; mean age = 32.28, SD = 11.86 years) completed validated measures of perceived parental overprotection (Parental Bonding Instrument) and heart-focused anxiety (Cardiac Anxiety Questionnaire). The results indicated that perceived parental overprotection (β = 0.19, p = 0.02) and heart defect complexity (β = 0.17, p = 0.03) were significantly related to heart-focused anxiety. Contrary to hypotheses, perceived parental overprotection did not vary as a function of heart defect complexity (F (2, 169) = 0.02, p = 0.98). Perceived parental overprotection and heart defect complexity are associated with heart-focused anxiety in adults with congenital heart disease. These results can inform the development of clinical interventions aimed at improving the psychosocial adjustment of this patient population.

Radiation carcinogenesis: Epidemiology and biological significance

International Nuclear Information System (INIS)

Boice, J.D.; Fraumeni, J.F.

1984-01-01

Epidemiologic studies of populations exposed to radiation have led to the identification of a preventable cause of cancer, but in the long run perhaps the most important contribution of radiation studies will be to provide insights into the basic processes of human carcinogenesis. In this volume, key investigators of major epidemiologic projects summarize their observations to date, including information to help assess the effects of low-level exposures. Experimentalists and theorists emphasize the relevance of laboratory and epidemiologic data in elucidating carcinogenic risks and mechanisms in man. This volume was prepared with several objectives in mind: (a) organize and synthesize knowledge on radiation carcinogenesis through epidemiologic and experimental approaches; (b) illustrate and explore ways of utilizing this information to gain insights into the fundamental mechanisms of cancer development; (c) stimulate the formation of hypotheses suited to experimental or epidemiologic testing, theoretical modeling, and multidisciplinary approaches; and (d) identify recent advances that clarify dose-response relationships and the influence of low-dose exposures, provide leads to carcinogenic mechanisms and host-environmental interactions, and suggest strategies for future research and preventive action

Heart Age PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the September 2015 CDC Vital Signs report. Your heart age is the age of your heart and blood vessels as a result of your risk factors for heart attack and stroke. If you smoke or have high blood pressure, your heart age will be much higher than your actual age. Learn what you can do to lower your heart age and keep it low.

Mending Hearts and Building Bridges: The Save a Child's Heart Foundation

NARCIS (Netherlands)

Sasson, L.; Tamir, A.; Houri, S.; Betawe, A.; Darwazah, A.K.; Kapusta, L.; Pivnick, L.E.; Goldman, B.G.

2016-01-01

CONTEXT: Save a Child's Heart addresses the challenges of heart care for children in underdeveloped countries. OBJECTIVE: Save a Child's Heart has created a center of excellence for pediatric cardiac care at the Wolfson Medical Center in Israel, helped develop partner sites for evaluation and

Heart Attack

Science.gov (United States)

... family history of heart attack race – African Americans, Mexican Americans, Native Americans, and native Hawaiians are at ... Your doctor will prescribe the medicines that are right for you. If you have had a heart ...

Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation.

Science.gov (United States)

Lu, Chun-Wei; Wu, Mei-Hwan; Chen, Hui-Chi; Kao, Feng-Yu; Huang, San-Kuei

2014-07-01

The prevalence of Wolff-Parkinson-White (WPW) syndrome varies between 0.68 and 1.7/1000. The epidemiological profile may be modified after the introduction of transcatheter interventions. The aim of this study is to investigate the epidemiological trends of the WPW syndrome in a general population during a period with available and reimbursed transcatheter ablation. Data of WPW patients <50 years old were retrieved from our national database (2000-2010). We identified 6086 (61% male) patients, accounting for an overall prevalence of 0.36/1000 with a peak of 0.61/1000 in ages 20-24 years. The risk of death and sudden death was 0.071% and 0.02% per patient-year, respectively. The 42 deaths occurred at a median age of 29 years. Associated congenial heart disease was noted in 158 (2.6%) patients, including 42 with Ebstein's anomaly that increased the mortality risk (P=0.001, OR=8.5). In those without congenital heart disease, myocardial dysfunction occurred in 115 (1.9%) patients and increased the risk of death (P<0.001, OR=10.6) and sudden death. Radiofrequency catheter ablation was performed in 2527 patients at a median age of 25.7 years (4.54% per patient-year, discharge mortality 0.16%); 11 (0.4%) before the age of 5, and 2231 (88%) after the age of 15. Whereas repeated ablation procedures accounted for 6.0% of the procedures, those in Ebstein's patients were 25%. Radiofrequency catheter ablation is already a common treatment for WPW patients, particularly during young adulthood, which accounts for a lower prevalence. Myocardial dysfunction and associated congenital heart disease remain as risks of mortality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Heart Disease

Science.gov (United States)

... it may be caused by diseases, such as connective tissue disorders, excessive iron buildup in your body (hemochromatosis), the buildup of abnormal proteins (amyloidosis) or by some cancer treatments. Causes of heart infection A heart infection, ...

The science of epidemiology and the methods needed for public health assessments: a review of epidemiology textbooks.

Science.gov (United States)

Gouda, Hebe N; Powles, John W

2014-02-10

Epidemiology is often described as 'the science of public health'. Here we aim to assess the extent that epidemiological methods, as covered in contemporary standard textbooks, provide tools that can assess the relative magnitude of public health problems and can be used to help rank and assess public health priorities. Narrative literature review. Thirty textbooks were grouped into three categories; pure, extended or applied epidemiology, were reviewed with attention to the ways the discipline is characterised and the nature of the analytical methods described. Pure texts tend to present a strict hierarchy of methods with those metrics deemed to best serve aetiological inquiry at the top. Extended and applied texts employ broader definitions of epidemiology but in most cases, the metrics described are also those used in aetiological inquiry and may not be optimal for capturing the consequences and social importance of injuries and disease onsets. The primary scientific purpose of epidemiology, even amongst 'applied' textbooks, is aetiological inquiry. Authors do not readily extend to methods suitable for assessing public health problems and priorities.

Relative Validity of Micronutrient and Fiber Intake Assessed With Two New Interactive Meal- and Web-Based Food Frequency Questionnaires

OpenAIRE

Christensen, Sara E; Möller, Elisabeth; Bonn, Stephanie E; Ploner, Alexander; Bälter, Olle; Lissner, Lauren; Bälter, Katarina

2014-01-01

Background The meal- and Web-based food frequency questionnaires, Meal-Q and MiniMeal-Q, were developed for cost-efficient assessment of dietary intake in epidemiological studies. Objective The objective of this study was to evaluate the relative validity of micronutrient and fiber intake assessed with Meal-Q and MiniMeal-Q. The reproducibility of Meal-Q was also evaluated. Methods A total of 163 volunteer men and women aged between 20 and 63 years were recruited from Stockholm County, Sweden...

Mitochondrial DNA and Cancer Epidemiology Workshop

Science.gov (United States)

A workshop to review the state-of-the science in the mitochondrial DNA field and its use in cancer epidemiology, and to develop a concept for a research initiative on mitochondrial DNA and cancer epidemiology.

Radiation epidemiology: Past and present

International Nuclear Information System (INIS)

Boice, J.D. Jr.

1997-01-01

Major advancements in radiation epidemiology have occurred during the last several years in studies of atomic bomb survivors, patients given medical radiation, and radiation workers, including underground miners. Risks associated with the Chernobyl accident, indoor radon and childhood exposure to I-131 have yet to be elucidated. Situations in the former Soviet Union around Chelyabinsk, a nuclear installation in the southern Urals, and in the Altai, which received radioactive fallout from weapons testing at Semipalatinsk, Kazakhstan, have the potential to provide information on the effects of chronic radiation exposure. Since Roentgen's discovery of x-rays just 100 years ago, a tremendous amount of knowledge has been accumulated about human health effects following irradiation. The 1994 UNSCEAR report contains the latest compilation and synthesis of radiation epidemiology. This overview will cover epidemiology from a radiation perspective. The different types of study methodologies will be described, followed by a kaleidoscope coverage of past and present studies; ending with some remaining questions in radiation epidemiology. This should set the stage for future chapters, and stimulate thinking about implications of the new data on radiation cancer risks

Estimating Values of Carbon Sequestration and Nutrient Recycling in Forests: An Application to the Stockholm-Mälar Region in Sweden

Directory of Open Access Journals (Sweden)

Ing-Marie Gren

2015-10-01

Full Text Available We calculate values of forest carbon sequestration and nutrient recycling applying the replacement cost method. The value is then determined as the savings in costs by the replacement of more expensive abatement measures with these ecosystem services in cost-effective climate and nutrient programs. To this end, a dynamic optimization model is constructed, which accounts for uncertainty in sequestration. It is applied to the Stockholm-Mälar region in southeast Sweden where the EU 2050 climate policy for carbon emissions and the Baltic Sea action plan for nutrient discharges are applied. The results show that the value of carbon and nutrient sequestration can correspond to approximately 0.5% of the region’s gross domestic product, or 40% of the value of productive forest. The largest part of this value is attributed to carbon sequestration because of the relative stringency in targets and expensive alternative abatement measures. However, sequestration is uncertain because of stochastic weather conditions, and when society has a large risk aversion for not attaining climate and nutrient targets, the values of the forest carbon and nutrient sequestration can approach zero.

Research on persistent organic pollutants in China on a national scale: 10 years after the enforcement of the Stockholm Convention.

Science.gov (United States)

Liu, Li-Yan; Ma, Wan-Li; Jia, Hong-Liang; Zhang, Zi-Feng; Song, Wei-Wei; Li, Yi-Fan

2016-10-01

As a signatory of the Stockholm Convention and the largest developing country, China plays a very important role in implementation of the convention to reduce and finally eliminate persistent organic pollutants (POPs) in the world. In the past ten years after the enforcement in 2004, Chinese Government and scientists have made great progress on the study of POPs. The present work aims to provide an overview on recent studies on POPs in China, with particular focus on usage/emission inventory, residue inventory, and pollution status of POPs on national scale. Several legend (old) and new target POPs were comprehensively summarized with progress on inventory. Furthermore, several national scale monitoring programs have been selected for the occurrence, spatial and temporal trends of POPs in China, which are compared with Asian data and Global data. Based on the observed results, some important scientific issues, such as the primary and secondary distribution patterns, the primary and secondary fractionations, and air-soil exchange of POPs, are also discussed. It is proposed that more studies should be carried out for the new targeted POPs in future for both the national and global interests. Copyright © 2016 Elsevier Ltd. All rights reserved.

Translational Epidemiology in Psychiatry

Science.gov (United States)

Weissman, Myrna M.; Brown, Alan S.; Talati, Ardesheer

2012-01-01

Translational research generally refers to the application of knowledge generated by advances in basic sciences research translated into new approaches for diagnosis, prevention, and treatment of disease. This direction is called bench-to-bedside. Psychiatry has similarly emphasized the basic sciences as the starting point of translational research. This article introduces the term translational epidemiology for psychiatry research as a bidirectional concept in which the knowledge generated from the bedside or the population can also be translated to the benches of laboratory science. Epidemiologic studies are primarily observational but can generate representative samples, novel designs, and hypotheses that can be translated into more tractable experimental approaches in the clinical and basic sciences. This bedside-to-bench concept has not been explicated in psychiatry, although there are an increasing number of examples in the research literature. This article describes selected epidemiologic designs, providing examples and opportunities for translational research from community surveys and prospective, birth cohort, and family-based designs. Rapid developments in informatics, emphases on large sample collection for genetic and biomarker studies, and interest in personalized medicine—which requires information on relative and absolute risk factors—make this topic timely. The approach described has implications for providing fresh metaphors to communicate complex issues in interdisciplinary collaborations and for training in epidemiology and other sciences in psychiatry. PMID:21646577

Maritim epidemiologi på Supercourse

DEFF Research Database (Denmark)

Jensen, Olaf

2015-01-01

Maritim epidemiologi er nu kommet med i samlingen af undervisningsmidler på ”Supercourse”. Der er oprettet en særlig mappe med Maritime Epidemiology og alle der har gode bidrag inden for området opfordres hermed til at publicere her. Supercourse er en samling af foredrag beregnet til at være en r...

The Gazprom-Naftogaz Stockholm Arbitration Awards. Time for Settlements and Responsible Behaviour

International Nuclear Information System (INIS)

Eyl-Mazzega, Marc-Antoine

2018-01-01

The signing in January 2009 of the gas supply and transit contracts between Gazprom and Naftogaz marked a turning point in Russian-Ukrainian gas relations: yearly intergovernmental, last minute and non-transparent winter deals were replaced by a predictable, long term commercial relationship. Naftogaz quickly turned into Gazprom's most profitable customer, taking the largest gas volumes at the Russian border and paying a higher price than German customers for example,[1] while Naftogaz obtained a satisfying gas transit tariff. At least, the January 2009 gas crisis had resulted in this key improvement for the security of Ukrainian and European gas supplies. Yet almost ever since then, the contract terms had been disputed as the Ukrainian economy could no more afford the high gas prices, the high mandatory yearly purchase volumes and as transit volumes were below contract provisions especially when the Nord Stream pipeline was commissioned. Several temporary pricing or flexibility arrangements in the form of political or patronage-type concessions had been made under President Yanukovych. But following the 2014 regime change in Ukraine and payment arrears by Naftogaz, Gazprom sought to recover unpaid debts and the new reform and business-minded Naftogaz management filed a case at the Arbitration Institute of the Stockholm Chamber of Commerce (hereafter, the Institute) as the parties did not agree on a review of the contract terms. Claims and counter claims quickly reached sky high levels, leading to the most sensitive European gas arbitration involving Gazprom. Mutual claims amounted to about USD 125 billion and had the potential to bankrupt both Gazprom and Naftogaz. At the same time, Gazprom and Naftogaz proved responsible in agreeing to winter package agreements brokered by the European Commission that enabled continued temporary Russian gas exports to Ukraine and safe transit to Europe. Following four years of procedure, the Institute has finally made two

Human heart by art.

Science.gov (United States)

Tamir, Abraham

2012-11-01

Heart is of great importance in maintaining the life of the body. Enough to stop working for a few minutes to cause death, and hence the great importance in physiology, medicine, and research. This fact was already emphasized in the Bible in the Book of Proverbs, chapter 4 verse 23: "Keep your heart with all diligence, for out of it is the wellspring of life." Art was able to demonstrate the heart from various aspects; realistically, as done by Leonardo de Vinci who demonstrated the halves of the heart and its blood vessels. Symbolically, as a source of life, the heart was demonstrated by the artist Mrs. Erlondeiel, as a caricature by Salvador Dali, as an open heart by Sawaya, etc. Finally, it should be emphasized that different demonstrations of the human heart by many artworks make this most important organ of our body (that cannot be seen from outside) more familiar and clearer to us. And this is the purpose of this article-to demonstrate the heart through a large number of artworks of different kinds.

The total artificial heart.

Science.gov (United States)

Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

2015-12-01

The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

Goods in the Anthroposphere as a Metal Emission Source A Case Study of Stockholm, Sweden

International Nuclear Information System (INIS)

Soerme, L.; Bergbaeck, B.; Lohm, U.

2001-01-01

The aim of this study was to quantify the diffuse emissions during use of metal containing goods in the capital of Sweden,Stockholm. The following metals were studied: Cadmium (Cd), Chromium (Cr), Copper (Cu), Lead (Pb), Mercury (Hg), Nickel (Ni) and Zinc (Zn).A major part of the metals are found in a protected environment where degrading processes like corrosion are most limited. However, during the lifetime of some goods the metal release to the environment is significant. The quantitatively most dominant emissions were found for Cu and Zn. The tap water system and roofs/fronts (Cu) represent goods with large exposed areas but with relatively small release rates per unit. In contrast, brake linings, aerial lines and electrical grounding (Cu) and tyres, brake linings and chemicals (Zn) are all goods with high release rates but mostly limited exposed stocks.High yearly emissions are also found for Pb, ammunition and sinkers dominate the calculated emissions totally. For Cr and Ni, stainless steel represent the major part of the stocks, but corrosion was estimated to give only a minor contribution to the emissions. Potential emission sources, i.e. stabilisers,pigments and plated goods dominate the exposed Cd stock. These emissions were not quantified due to lack of data. Hg is currently phased out, but one major source of emission, i.e. the use of amalgam, will be continuously significant for several decades. The importance of the traffic sector is obvious. The emissions from brake linings (Cu, Zn and Pb), tyres (Zn, Pb, Cr and Ni)and asphalt wear (Cu, Zn, Cr, Ni and Pb) are all of large importance for the total emission from respectively metal

Snippets from the past: the evolution of Wade Hampton Frost's epidemiology as viewed from the American Journal of Hygiene/Epidemiology.

Science.gov (United States)

Morabia, Alfredo

2013-10-01

Wade Hampton Frost, who was a Professor of Epidemiology at Johns Hopkins University from 1919 to 1938, spurred the development of epidemiologic methods. His 6 publications in the American Journal of Hygiene, which later became the American Journal of Epidemiology, comprise a 1928 Cutter lecture on a theory of epidemics, a survey-based study of tonsillectomy and immunity to Corynebacterium diphtheriae (1931), 2 papers from a longitudinal study of the incidence of minor respiratory diseases (1933 and 1935), an attack rate ratio analysis of the decline of diphtheria in Baltimore (1936), and a 1936 lecture on the age, time, and cohort analysis of tuberculosis mortality. These 6 American Journal of Hygiene /American Journal of Epidemiology papers attest that Frost's personal evolution mirrored that of the emerging "early" epidemiology: The scope of epidemiology extended beyond the study of epidemics of acute infectious diseases, and rigorous comparative study designs and their associated quantitative methods came to light.

Metaiodobenzylguanidine and heart rate variability in heart failure

International Nuclear Information System (INIS)

Kurata, Chinori; Shouda, Sakae; Mikami, Tadashi; Uehara, Akihiko; Ishikawa, Keiko; Tawarahara, Kei; Nakano, Tomoyasu; Matoh, Fumitaka; Takeuchi, Kazuhiko

1998-01-01

It is assumed that the low-frequency power (LF) of heart rate variability (HRV) increases with progress of congestive heart failure (CHF), therefore positively correlating with cardiac 123 I-metaiodobenzylguanidine (MIBG) washout. It is demonstrated here that HRV, including normalized LF, correlated inversely with MIBG washout and positively with the ratio of heart-to-mediastinum MIBG activity in controls and CHF patients, whereas these correlations were not observed within CHF patients. Thus MIBG washout may increase and HRV including normalized LF may decrease with CHF, although the HRV and MIBG measures may not similarly change in proportion to the severity of the cardiac autonomic dysfunction in CHF. (author)

Metaiodobenzylguanidine and heart rate variability in heart failure

Energy Technology Data Exchange (ETDEWEB)

Kurata, Chinori; Shouda, Sakae; Mikami, Tadashi; Uehara, Akihiko; Ishikawa, Keiko [Hamamatsu Univ., Shizuoka (Japan). School of Medicine; Tawarahara, Kei; Nakano, Tomoyasu; Matoh, Fumitaka; Takeuchi, Kazuhiko

1998-10-01

It is assumed that the low-frequency power (LF) of heart rate variability (HRV) increases with progress of congestive heart failure (CHF), therefore positively correlating with cardiac {sup 123}I-metaiodobenzylguanidine (MIBG) washout. It is demonstrated here that HRV, including normalized LF, correlated inversely with MIBG washout and positively with the ratio of heart-to-mediastinum MIBG activity in controls and CHF patients, whereas these correlations were not observed within CHF patients. Thus MIBG washout may increase and HRV including normalized LF may decrease with CHF, although the HRV and MIBG measures may not similarly change in proportion to the severity of the cardiac autonomic dysfunction in CHF. (author)

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. ...

The Training of Epidemiologists and Diversity in Epidemiology: Findings from the 2006 Congress of Epidemiology Survey

Science.gov (United States)

Carter-Pokras, Olivia D.; Spirtas, Robert; Bethune, Lisa; Mays, Vickie; Freeman, Vincent L.; Cozier, Yvette C.

2013-01-01

Purpose In the past decade, we have witnessed increasing numbers of individuals entering the field of epidemiology. With the increase also has come a diversity of training and paths by which individuals entered the field. The purpose of this survey was characterization of the epidemiology workforce, its job diversity, and continuing education needs. Methods The Minority Affairs and Membership committees of the American College of Epidemiology (ACE) prepared and administered a workforce survey to identify racial/ethnic diversity, demographic background, workplace type, credentials, income, subspecialties, and continuing education needs of epidemiologists. The survey was self-administered to attendees of the Second North American Congress of Epidemiology in June 2006. Results A sample of 397 respondents of the 1348 registered for the Congress was captured (29.5% response). Epidemiologists who participated were from 36 states and 18 countries; 54.6% were trained at the doctoral level; 19.1% earned $120,001 or more a year. A wide range of epidemiology subspecialties and continuing education needs were identified. Conclusions This preliminary snapshot of epidemiologists indicates a wide range of training mechanisms, workplace sites, and subspecialties. Results indicate a need for examination of the core graduate training needs of epidemiologist as well as responding to desired professional development needs through the provision of continuing educations efforts. PMID:19344867

Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multicohort Study of 90,164 Individuals.

Science.gov (United States)

Dragano, Nico; Siegrist, Johannes; Nyberg, Solja T; Lunau, Thorsten; Fransson, Eleonor I; Alfredsson, Lars; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Fahlén, Göran; Goldberg, Marcel; Hamer, Mark; Heikkilä, Katriina; Jöckel, Karl-Heinz; Knutsson, Anders; Madsen, Ida E H; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Schupp, Jürgen; Singh-Manoux, Archana; Steptoe, Andrew; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; Virtanen, Marianna; Zins, Marie; Batty, G David; Kivimäki, Mika

2017-07-01

Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. This multicohort study (the "IPD-Work" consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00-1.35) was observed for effort-reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain. Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

HEART FAILURE AND DIABETES MELLITUS: SELECTED ISSUES OF ETIOLOGY AND PATHOGENESIS, PROGNOSIS AND TREATMENT

Directory of Open Access Journals (Sweden)

B. U. Mardanov

2016-01-01

Full Text Available This review is devoted to the study of issues relating to the features of associated course of chronic heart failure (CHF and diabetes mellitus (DM. The modern views on the epidemiology, pathogenesis of DM and CHF are systematized. The pathogenesis of diabetic cardiomyopathy is described in details. The results of the well-known studies that show the negative impact of DM on CHF prognosis are presented. The principles of CHF pathogenetic therapy in patients with DM including the role of neurohormonal modulators are analyzed. The results of multicenter studies in patients with CHF and concomitant DM type 2 show that almost all first-line drugs recommended for CHF treatment are effective in patients with DM.

A healthy heart is not a metronome: an integrative review of the heart's anatomy and heart rate variability.

Science.gov (United States)

Shaffer, Fred; McCraty, Rollin; Zerr, Christopher L

2014-01-01

Heart rate variability (HRV), the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operate on different time scales to adapt to challenges and achieve optimal performance. This article briefly reviews neural regulation of the heart, and its basic anatomy, the cardiac cycle, and the sinoatrial and atrioventricular pacemakers. The cardiovascular regulation center in the medulla integrates sensory information and input from higher brain centers, and afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. This article reviews sympathetic and parasympathetic influences on the heart, and examines the interpretation of HRV and the association between reduced HRV, risk of disease and mortality, and the loss of regulatory capacity. This article also discusses the intrinsic cardiac nervous system and the heart-brain connection, through which afferent information can influence activity in the subcortical and frontocortical areas, and motor cortex. It also considers new perspectives on the putative underlying physiological mechanisms and properties of the ultra-low-frequency (ULF), very-low-frequency (VLF), low-frequency (LF), and high-frequency (HF) bands. Additionally, it reviews the most common time and frequency domain measurements as well as standardized data collection protocols. In its final section, this article integrates Porges' polyvagal theory, Thayer and colleagues' neurovisceral integration model, Lehrer et al.'s resonance frequency model, and the Institute of HeartMath's coherence model. The authors conclude that a coherent heart is not a metronome because its rhythms are characterized by both complexity and stability over longer time scales. Future research should expand understanding of how the heart and its intrinsic nervous system influence the brain.

Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?

Science.gov (United States)

Attenhofer Jost, Christine H.; Schmidt, Dörthe; Huebler, Michael; Balmer, Christian; Noll, Georg; Caduff, Rosmarie; Greutmann, Matthias

2013-01-01

Due to impressive improvements in surgical repair options, even patients with complex congenital heart disease (CHD) may survive into adulthood and have a high risk of end-stage heart failure. Thus, the number of patients with CHD needing heart transplantation (HTx) has been increasing in the last decades. This paper summarizes the changing etiology of causes of death in heart failure in CHD. The main reasons, contraindications, and risks of heart transplantation in CHD are discussed and underlined with three case vignettes. Compared to HTx in acquired heart disease, HTx in CHD has an increased risk of perioperative death and rejection. However, outcome of HTx for complex CHD has improved over the past 20 years. Additionally, mechanical support options might decrease the waiting list mortality in the future. The number of patients needing heart-lung transplantation (especially for Eisenmenger's syndrome) has decreased in the last years. Lung transplantation with intracardiac repair of a cardiac defect is another possibility especially for patients with interatrial shunts. Overall, HTx will remain an important treatment option for CHD in the near future. PMID:23577237

The Danish Heart Registry

DEFF Research Database (Denmark)

Özcan, Cengiz; Juel, Knud; Lassen, Jens Flensted

2016-01-01

AIM: The Danish Heart Registry (DHR) seeks to monitor nationwide activity and quality of invasive diagnostic and treatment strategies in patients with ischemic heart disease as well as valvular heart disease and to provide data for research. STUDY POPULATION: All adult (≥15 years) patients...... undergoing coronary angiography (CAG), percutaneous coronary intervention (PCI), coronary artery bypass grafting, and heart valve surgery performed across all Danish hospitals were included. MAIN VARIABLES: The DHR contains a subset of the data stored in the Eastern and Western Denmark Heart Registries (EDHR...

GPCR-autoantibodies in chronic heart failure.

Science.gov (United States)

Boivin-Jahns, Valerie; Jahns, Roland

2018-06-01

Chronic heart failure (CHF) is a syndrome characterized by shortness of breath, fluid retention, and a progressive reduction in cardiac function. More than 60% of the cases are ischemic in origin (i.e., due to myo-cardial infarction) and about 30% are caused by non-ischemic myocardial damage (i.e., due to genetic or non-genetic causes like myocardial inflammation). Because of alterations in both cellular and humoral immunity patients with non-ischemic CHF often develop abnormal or misled immune responses, including cross-reacting antibodies and/or autoantibodies to various cardiac anti-gens. Non-ischemic myo-cardial damage was found to progress to CHF particularly, when associated (a) with the generation of autoantibodies directed against distinct myocyte membrane proteins critically involved in cardiac function - like G-protein coup-led membrane receptors (GPCRs), or (b) with virus persistence in the myocardium. This article will review current knowledge on the pathophysiological relevance of GPCR-autoreactivity in CHF by giving an overview on the so far available evidence from pre-clinical, clinical and epidemiological studies on the CHF-inducing potential of GPCR-autoantibodies and thereon based novel therapeutic approaches in GPCR autoantibody-associated CHF.

Construct validity of the Heart Failure Screening Tool (Heart-FaST) to identify heart failure patients at risk of poor self-care: Rasch analysis.

Science.gov (United States)

Reynolds, Nicholas A; Ski, Chantal F; McEvedy, Samantha M; Thompson, David R; Cameron, Jan

2018-02-14

The aim of this study was to psychometrically evaluate the Heart Failure Screening Tool (Heart-FaST) via: (1) examination of internal construct validity; (2) testing of scale function in accordance with design; and (3) recommendation for change/s, if items are not well adjusted, to improve psychometric credential. Self-care is vital to the management of heart failure. The Heart-FaST may provide a prospective assessment of risk, regarding the likelihood that patients with heart failure will engage in self-care. Psychometric validation of the Heart-FaST using Rasch analysis. The Heart-FaST was administered to 135 patients (median age = 68, IQR = 59-78 years; 105 males) enrolled in a multidisciplinary heart failure management program. The Heart-FaST is a nurse-administered tool for screening patients with HF at risk of poor self-care. A Rasch analysis of responses was conducted which tested data against Rasch model expectations, including whether items serve as unbiased, non-redundant indicators of risk and measure a single construct and that rating scales operate as intended. The results showed that data met Rasch model expectations after rescoring or deleting items due to poor discrimination, disordered thresholds, differential item functioning, or response dependence. There was no evidence of multidimensionality which supports the use of total scores from Heart-FaST as indicators of risk. Aggregate scores from this modified screening tool rank heart failure patients according to their "risk of poor self-care" demonstrating that the Heart-FaST items constitute a meaningful scale to identify heart failure patients at risk of poor engagement in heart failure self-care. © 2018 John Wiley & Sons Ltd.

Advances in radiation epidemiology

International Nuclear Information System (INIS)

Boice, J.

1997-01-01

The 1994 UNSCEAR report provides an informative review of radiation epidemiology. During the past 2 years there have been several major advances in our understanding of radiation effects based on new studies of atomic bomb survivors in Japan, of patients given diagnostic and therapeutic radiation (including iodine-131), of workers occupationally exposed, and of general populations exposed to residential radon. Laboratory approaches are also being incorporated into epidemiological investigations to learn more about the biological mechanism by which radiation causes cancer in man. (author)

Pediatric heart surgery - discharge

Science.gov (United States)

... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

Radiation-induced heart injury

International Nuclear Information System (INIS)

Suzuki, Yoshihiko; Niibe, Hideo

1975-01-01

In order to identify radiation-induced heart injury and to differentiate it from heart disease, an attempt was made to clarify post-irradiation heart injury by investigating the histological changes which occur during the internal between the irradiation and the time of demonstrable histological changes. A study was made of 83 autopsies in which most of the primary neoplasms were breast cancers, lung cancers and mediastinal tumors. In 43 of these autopsies the heart had been irradiated. Sixty eight dd-strain mice were also used for microautoradiographic study. Histological changes in the heart were observed in 27 of the 43 cases receiving irradiation. The limit of the tolerance dose to the heart for indicating histological changes was 1220 ret in humans. The latent period without histological changes was 2.7 months after initiation of radiation therapy. Greater heart injury was observed after re-irradiation or after the combined therapy of radiation and chemotherapy especially mitomycin (MMC). The histological findings after treatment with MMC were similar to those of radiation-induced heart injury. Results of the study indicate that the damage is secondary to radiation-induced changes of the vascula connective tissue. (Evans, G.)

Teacher Rated School Ethos and Student Reported Bullying—A Multilevel Study of Upper Secondary Schools in Stockholm, Sweden

Directory of Open Access Journals (Sweden)

Bitte Modin

2017-12-01

Full Text Available School ethos refers to the school leadership’s purposive efforts to shape and direct the attitudes, values and behaviors needed in order to promote an active learning environment and to prevent the emergence of undesirable behaviors by creating shared meaning and common goals for the school. The aim of this study was to examine how teacher rated aspects of school ethos are linked with manifestations of bullying among 11th grade students. Five teacher-rated sub-dimensions of school ethos (staff stability, teacher morale, structure-order, student focus, and academic atmosphere were examined in relation to student-reported perpetration of and exposure to traditional school bullying and cyberbullying. The data material combines student and teacher information from two separate data collections performed in 2016, comprising teachers and students in 58 upper secondary schools in Stockholm. Analyses showed that bullying was associated with all but one of the five sub-dimensions of school ethos, namely structure and order for dealing with bullying behaviors at the school. Results are discussed in light of this counter-intuitive finding. Our findings nevertheless lend support to the idea that the social organization of schools, as reflected in their teacher-rated ethos, can affect individual students’ attitudes in a way that prevents the emergence of bullying behavior among students.

High radiofrequency radiation at Stockholm Old Town: An exposimeter study including the Royal Castle, Supreme Court, three major squares and the Swedish Parliament

Science.gov (United States)

Hardell, Lennart; Carlberg, Michael; Koppel, Tarmo; Hedendahl, Lena

2017-01-01

Exposure to radiofrequency (RF) radiation was classified as a possible human carcinogen, Group 2B, by the International Agency for Research on Cancer at WHO in 2011. The exposure pattern is changing due to the rapid development of technology. Outdoor RF radiation level was measured during five tours in Stockholm Old Town in April, 2016 using the EME Spy 200 exposimeter with 20 predefined frequencies. The results were based on 10,437 samples in total. The mean level of the total RF radiation was 4,293 µW/m2 (0.4293 µW/cm2). The highest mean levels were obtained for global system for mobile communications (GSM) + universal mobile telecommunications system (UMTS) 900 downlink and long-term evolution (LTE) 2600 downlink (1,558 and 1,265 µW/m2, respectively). The town squares displayed highest total mean levels, with the example of Järntorget square with 24,277 µW/m2 (min 257, max 173,302 µW/m2). These results were in large contrast to areas with lowest total exposure, such as the Supreme Court, with a mean level of 404 µW/m2 (min 20.4, max 4,088 µW/m2). In addition, measurements in the streets surrounding the Royal Castle were lower than the total for the Old Town, with a mean of 756 µW/m2 (min 0.3, max 50,967 µW/m2). The BioInitiative 2012 Report defined the scientific benchmark for possible health risks as 30–60 µW/m2. Our results of outdoor RF radiation exposure at Stockholm Old Town are significantly above that level. The mean exposure level at Järntorget square was 405-fold higher than 60 µW/m2. Our results were below the reference level on 10,000,000 µW/m2 established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP), which, however, are less credible, as they do not take non-thermal effects into consideration and are not based on sound scientific evaluation. Our highest measured mean level at Järntorget was 0.24% of the ICNIRP level. A number of studies have found adverse, non-thermal (no measurable temperature

High radiofrequency radiation at Stockholm Old Town: An exposimeter study including the Royal Castle, Supreme Court, three major squares and the Swedish Parliament.

Science.gov (United States)

Hardell, Lennart; Carlberg, Michael; Koppel, Tarmo; Hedendahl, Lena

2017-04-01

Exposure to radiofrequency (RF) radiation was classified as a possible human carcinogen, Group 2B, by the International Agency for Research on Cancer at WHO in 2011. The exposure pattern is changing due to the rapid development of technology. Outdoor RF radiation level was measured during five tours in Stockholm Old Town in April, 2016 using the EME Spy 200 exposimeter with 20 predefined frequencies. The results were based on 10,437 samples in total. The mean level of the total RF radiation was 4,293 µW/m 2 (0.4293 µW/cm 2 ). The highest mean levels were obtained for global system for mobile communications (GSM) + universal mobile telecommunications system (UMTS) 900 downlink and long-term evolution (LTE) 2600 downlink (1,558 and 1,265 µW/m 2 , respectively). The town squares displayed highest total mean levels, with the example of Järntorget square with 24,277 µW/m 2 (min 257, max 173,302 µW/m 2 ). These results were in large contrast to areas with lowest total exposure, such as the Supreme Court, with a mean level of 404 µW/m 2 (min 20.4, max 4,088 µW/m 2 ). In addition, measurements in the streets surrounding the Royal Castle were lower than the total for the Old Town, with a mean of 756 µW/m 2 (min 0.3, max 50,967 µW/m 2 ). The BioInitiative 2012 Report defined the scientific benchmark for possible health risks as 30-60 µW/m 2 . Our results of outdoor RF radiation exposure at Stockholm Old Town are significantly above that level. The mean exposure level at Järntorget square was 405-fold higher than 60 µW/m 2 . Our results were below the reference level on 10,000,000 µW/m 2 established by the International Commission on Non-Ionizing Radiation Protection (ICNIRP), which, however, are less credible, as they do not take non-thermal effects into consideration and are not based on sound scientific evaluation. Our highest measured mean level at Järntorget was 0.24% of the ICNIRP level. A number of studies have found adverse, non-thermal (no measurable

Design and performance of heart assist or artificial heart control systems

Science.gov (United States)

Webb, J. A., Jr.; Gebben, V. D.

1978-01-01

The factors leading to the design of a controlled driving system for either a heart assist pump or artificial heart are discussed. The system provides square pressure waveform to drive a pneumatic-type blood pump. For assist usage the system uses an R-wave detector circuit that can detect the R-wave of the electrocardiogram in the presence of electrical disturbances. This circuit provides a signal useful for synchronizing an assist pump with the natural heart. It synchronizes a square wave circuit, the output of which is converted into square waveforms of pneumatic pressure suitable for driving both assist device and artificial heart. The pressure levels of the driving waveforms are controlled by means of feedback channels to maintain physiological regulation of the artificial heart's output flow. A more compact system that could achieve similar regulatory characteristics is also discussed.

Complex epidemiological approach to human mutagenesis

International Nuclear Information System (INIS)

Czeizel, A.

1980-01-01

The main characteristics of the epidemiological approach are summarised and the criteria discussed for the adoption of this approach for the detection of human mutagenesis. Mutation monitoring systems are described and results of epidemiological studies of higher risk populations are presented. (C.F.)

Retrospective study of epidemiological, clinicopathological and ...

African Journals Online (AJOL)

Retrospective study of epidemiological, clinicopathological and biological profils of 62 colorectal cancers cases in Jijel provence (Algeria) ... Our results were often compatible with the available literature and may provide reliable and relevant data on this disease. Key words: Colorectal cancer; Epidemiology; Therapy; ...

Carcinoid heart disease.

Science.gov (United States)

Hassan, Saamir A; Banchs, Jose; Iliescu, Cezar; Dasari, Arvind; Lopez-Mattei, Juan; Yusuf, Syed Wamique

2017-10-01

Rare neuroendocrine tumours (NETs) that most commonly arise in the gastrointestinal tract can lead to carcinoid syndrome and carcinoid heart disease. Patients with carcinoid syndrome present with vasomotor changes, hypermotility of the gastrointestinal system, hypotension and bronchospasm. Medical therapy for carcinoid syndrome, typically with somatostatin analogues, can help control symptoms, inhibit tumour progression and prolong survival. Carcinoid heart disease occurs in more than 50% of these patients and is the initial presentation of carcinoid syndrome in up to 20% of patients. Carcinoid heart disease has characteristic findings of plaque-like deposits composed of smooth muscle cells, myofibroblasts, extracellular matrix and an overlying endothelial layer which can lead to valve dysfunction. Valvular dysfunction can lead to oedema, ascites and right-sided heart failure. Medical therapy of carcinoid heart disease is limited to symptom control and palliation. Valve surgery for carcinoid heart disease should be considered for symptomatic patients with controlled metastatic carcinoid syndrome. A multidisciplinary approach is needed to guide optimal management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Salmonella epidemiology: A whirlwind of change.

Science.gov (United States)

Besser, John M

2018-05-01

The field of infectious disease epidemiology for Salmonella and other enteric pathogens is undergoing some of the most profound changes since the time of Kauffman and White. Rapid advances in "big data" technologies such as genomics and metagenomics are making it possible to monitor and control salmonellosis in new and exciting ways. Epidemiological methods are becoming increasingly robust through the routine use of standardized hypothesis-generating questionnaires, iterative open-ended interviewing, informational trace-backs and new modeling techniques for describing the attribution of disease to food sources. In addition, Salmonella epidemiology is facing important challenges and new opportunities due to the rapid adoption of culture independent diagnostic test panels by clinical laboratories. Where is this unprecedented wave of change taking us? This chapter will examine emerging trends in Salmonella epidemiology, and take a peek into the not-so-distant future. Published by Elsevier Ltd.

Epidemiology, epigenetics and the 'Gloomy Prospect': embracing randomness in population health research and practice.

Science.gov (United States)

Smith, George Davey

2011-06-01

Epidemiologists aim to identify modifiable causes of disease, this often being a prerequisite for the application of epidemiological findings in public health programmes, health service planning and clinical medicine. Despite successes in identifying causes, it is often claimed that there are missing additional causes for even reasonably well-understood conditions such as lung cancer and coronary heart disease. Several lines of evidence suggest that largely chance events, from the biographical down to the sub-cellular, contribute an important stochastic element to disease risk that is not epidemiologically tractable at the individual level. Epigenetic influences provide a fashionable contemporary explanation for such seemingly random processes. Chance events-such as a particular lifelong smoker living unharmed to 100 years-are averaged out at the group level. As a consequence population-level differences (for example, secular trends or differences between administrative areas) can be entirely explicable by causal factors that appear to account for only a small proportion of individual-level risk. In public health terms, a modifiable cause of the large majority of cases of a disease may have been identified, with a wild goose chase continuing in an attempt to discipline the random nature of the world with respect to which particular individuals will succumb. The quest for personalized medicine is a contemporary manifestation of this dream. An evolutionary explanation of why randomness exists in the development of organisms has long been articulated, in terms of offering a survival advantage in changing environments. Further, the basic notion that what is near-random at one level may be almost entirely predictable at a higher level is an emergent property of many systems, from particle physics to the social sciences. These considerations suggest that epidemiological approaches will remain fruitful as we enter the decade of the epigenome.

[Occupational epidemiology: some methodological considerations].

Science.gov (United States)

Alvear-Galindo, María Guadalupe; del Pilar Paz-Román, María

2006-01-01

During the last decade, occupational epidemiology has gained a great importance, not only because of the increase of pollutants and their noxiousness, but also because it has gone from the descriptive to the analytic level. The purpose of this work is to present what has been reported on epidemiological studies, different ways of characterizing and measuring occupational exposure, by emphasizing slants of exposure and selection measurement. In the reviewed studies, an interest in improving the exposure evaluation has been shown. The mainly reported measurement slants are the ways of measuring and classifying the exposure. The main designs were transversal with the use of matrixes to improve the evaluation of exposure. Conditions of hygiene and security were considered in order to control the quality of the information. This information was analyzed with different criteria. Some of the elements that hinder the research on occupational epidemiology are a mixed exposure, small populations, lack of exposure data, low levels of exposure and long periods of illness latency. Some breakthroughs in the strategies of epidemiological analysis and some other areas of knowledge have made possible a better understanding of work and health conditions of workers.

Assessment of potential heart donors: A statement from the French heart transplant community.

Science.gov (United States)

Dorent, Richard; Gandjbakhch, Estelle; Goéminne, Céline; Ivanes, Fabrice; Sebbag, Laurent; Bauer, Fabrice; Epailly, Eric; Boissonnat, Pascale; Nubret, Karine; Amour, Julien; Vermes, Emmanuelle; Ou, Phalla; Guendouz, Soulef; Chevalier, Philippe; Lebreton, Guillaume; Flecher, Erwan; Obadia, Jean-François; Logeart, Damien; de Groote, Pascal

2018-02-01

Assessment of potential donors is an essential part of heart transplantation. Despite the shortage of donor hearts, donor heart procurement from brain-dead organ donors remains low in France, which may be explained by the increasing proportion of high-risk donors, as well as the mismatch between donor assessment and the transplant team's expectations. Improving donor and donor heart assessment is essential to improve the low utilization rate of available donor hearts without increasing post-transplant recipient mortality. This document provides information to practitioners involved in brain-dead donor management, evaluation and selection, concerning the place of medical history, electrocardiography, cardiac imaging, biomarkers and haemodynamic and arrhythmia assessment in the characterization of potential heart donors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Heart Age PSA (:60)

Centers for Disease Control (CDC) Podcasts

2015-09-01

This 60 second public service announcement is based on the September 2015 CDC Vital Signs report. Your heart age is the age of your heart and blood vessels as a result of your risk factors for heart attack and stroke. If you smoke or have high blood pressure, your heart age will be much higher than your actual age. Learn what you can do to lower your heart age and keep it low.  Created: 9/1/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/1/2015.

Heart failure as an endpoint in heart failure and non-heart failure cardiovascular clinical trials: the need for a consensus definition

DEFF Research Database (Denmark)

Zannad, F.; Stough, W.G.; Pitt, B.

2008-01-01

Specific criteria have been established to define the occurrence of myocardial infarction (MI) and stroke in cardiovascular clinical trials, but there is not a consistent definition for heart failure. Heart failure events appear to occur at a rate that is similar to stroke and MI in trials...... of hypertension, hyperlipidaemia, diabetes, and coronary heart disease, yet a consistent approach to defining heart failure events has not yet been realized. The wide range of definitions used in clinical trials makes it difficult to interpret new data in the context of existing literature. This inconsistency has...... led to challenges in determining the incidence of heart failure in cardiovascular studies and the effects of interventions on these endpoints. This paper examines issues related to defining heart failure events in cardiovascular clinical trials and presents a definition to formally address this issue...

Heart Attack Recovery FAQs

Science.gov (United States)

... recommendations to make a full recovery. View an animation of a heart attack . Heart Attack Recovery Questions ... Support Network Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

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 ...

Heart Disease Risk Factors

Science.gov (United States)

... About CDC.gov . Home About Heart Disease Coronary Artery Disease Heart Attack Heart Attack Signs and Symptoms ... Privacy FOIA No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO ( ...

Descriptive and analytic epidemiology. Bridges to cancer control

International Nuclear Information System (INIS)

Mettlin, C.

1988-01-01

Epidemiology serves as a bridge between basic science and cancer control. The two major orientations of epidemiology are descriptive and analytic. The former is useful in assessing the scope and dimensions of the cancer problem and the latter is used to assess environmental and lifestyle sources of cancer risk. A recent development in descriptive epidemiology is the use of functional measures of disease such as lost life expectancy. In analytical epidemiology, there is new or renewed interest in several lifestyle factors including diet and exercise as well as environmental factors such as involuntary tobacco exposure and radon in dwellings. Review of the evidence should consider the strengths and weaknesses of different research procedures. Each method is inconclusive by itself but, the different research designs of epidemiology collectively may represent a hierarchy of proof. Although the roles of many factors remain to be defined, the aggregate epidemiologic data continue to demonstrate the special importance of personal behavior and lifestyle in affecting cancer risk

Epidemiology in Germany-general development and personal experience.

Science.gov (United States)

Wichmann, Heinz-Erich

2017-08-01

Did you ever hear about epidemiology in Germany? Starting from an epidemiological desert the discipline has grown remarkably, especially during the last 10-15 years: research institutes have been established, research funding has improved, multiple curriculae in Epidemiology and Public Health are offered. This increase has been quite steep, and now the epidemiological infrastructure is much better. Several medium-sized and even big population cohorts are ongoing, and the number and quality of publications from German epidemiologists has reached a respectable level. My own career in epidemiology started in the field of environmental health. After German reunification I concentrated for many years on environmental problems in East Germany and observed the health benefits after improvement of the situation. Later, I concentrated on population-based cohorts in newborns (GINI/LISA) and adults (KORA, German National Cohort), and on biobanking. This Essay describes the development in Germany after worldwar 2, illustrated by examples of research results and build-up of epidemiological infractructures worth mentioning.

Heart Failure in Women

Science.gov (United States)

Bozkurt, Biykem; Khalaf, Shaden

2017-01-01

Heart failure is an important cause of morbidity and mortality in women, and they tend to develop it at an older age compared to men. Heart failure with preserved ejection fraction is more common in women than in men and accounts for at least half the cases of heart failure in women. When comparing men and women who have heart failure and a low left ventricular ejection fraction, the women are more symptomatic and have a similarly poor outcome. Overall recommendations for guideline-directed medical therapies show no differences in treatment approaches between men and women. Overall, women are generally underrepresented in clinical trials for heart failure. Further studies are needed to shed light into different mechanisms, causes, and targeted therapies of heart failure in women. PMID:29744014

Reduced intrinsic heart rate is associated with reduced arrhythmic susceptibility in guinea-pig heart.

Science.gov (United States)

Osadchii, Oleg E

2014-12-01

In the clinical setting, patients with slower resting heart rate are less prone to cardiovascular death compared with those with elevated heart rate. However, electrophysiological adaptations associated with reduced cardiac rhythm have not been thoroughly explored. In this study, relationships between intrinsic heart rate and arrhythmic susceptibility were examined by assessments of action potential duration (APD) rate adaptation and inducibility of repolarization alternans in sinoatrial node (SAN)-driven and atrioventricular (AV)-blocked guinea-pig hearts perfused with Langendorff apparatus. Electrocardiograms, epicardial monophasic action potentials, and effective refractory periods (ERP) were assessed in normokalemic and hypokalemic conditions. Slower basal heart rate in AV-blocked hearts was associated with prolonged ventricular repolarization during spontaneous beating, and with attenuated APD shortening at increased cardiac activation rates during dynamic pacing, when compared with SAN-driven hearts. During hypokalemic perfusion, the inducibility of repolarization alternans and tachyarrhythmia by rapid pacing was found to be lower in AV-blocked hearts. This difference was ascribed to prolonged ERP in the setting of reduced basal heart rate, which prevented ventricular capture at critically short pacing intervals required to induce arrhythmia. Reduced basal heart rate is associated with electrophysiological changes that prevent electrical instability upon an abrupt cardiac acceleration.

La epidemiología ocupacional como herramienta básica para la salud de los trabajadores Occupational epidemiology as a basic tool for workers' health

Directory of Open Access Journals (Sweden)

Caristina Robaina Aguirre

2006-06-01

Full Text Available Se realizó un pequeño bosquejo del desarrollo de la Epidemiología como ciencia y su importancia en salud pública en general. Se transita por las definiciones de vieja y nueva epidemiología, de enfermedades crónicas, transmisibles y no transmisibles, del concepto de epidemiología social, etc. para posteriormente hablar de la importancia de la Epidemiología Ocupacional en la Salud PúblicaA review of the development of Epidemiology as a science, and its significance in public health in general, was made. The old and new definitions of epidemiology, of chronic, transmissible and non-transmissible diseases, of social epidemiology concept, etc., are analysed to further deal with the importance of Occupational Epidemiology in Public Health.

Getting a New Heart

Science.gov (United States)

... may be able to replace it with an artificial (man-made) valve. Cardiac size reduction . During this procedure, your doctor removes a piece of the heart muscle from an enlarged heart. This makes your heart ...

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 © ...

Do neonatal mouse hearts regenerate following heart apex resection?

DEFF Research Database (Denmark)

Andersen, Ditte Caroline; Ganesalingam, Suganya; Jensen, Charlotte Harken

2014-01-01

The mammalian heart has generally been considered nonregenerative, but recent progress suggests that neonatal mouse hearts have a genuine capacity to regenerate following apex resection (AR). However, in this study, we performed AR or sham surgery on 400 neonatal mice from inbred and outbred...

Epidemiological issues related to dose reconstruction

International Nuclear Information System (INIS)

Shore, R.E.

1996-01-01

When a dose reconstruction is performed around some nuclear site, a decision has to be made as to whether an epidemiologic study should be performed there and, if so, what form the study should take. The goal of this paper is to provide an overview of epidemiologic and biostatistical issues that help determine whether an epidemiologic study around a nuclear facility is worthwhile doing from a scientific standpoint. We are all aware that public health and sociopolitical concerns often assume considerable importance in these decisions, but they will not be considered here. 27 refs., 2 tabs

Heart Disease and Stroke Statistics

Science.gov (United States)

... Media for Heart.org Heart and Stroke Association Statistics Each year, the American Heart Association, in conjunction ... health and disease in the population. Heart & Stroke Statistics FAQs What is Prevalence? Prevalence is an estimate ...

Nuclear accidents and epidemiology

International Nuclear Information System (INIS)

1987-01-01

A consultation on epidemiology related to the Chernobyl accident was held in Copenhagen in May 1987 as a basis for concerted action. This was followed by a joint IAEA/WHO workshop in Vienna, which reviewed appropriate methodologies for possible long-term effects of radiation following nuclear accidents. The reports of these two meetings are included in this volume, and cover the subjects: 1) Epidemiology related to the Chernobyl nuclear accident. 2) Appropriate methodologies for studying possible long-term effects of radiation on individuals exposed in a nuclear accident. Figs and tabs

Cancer Epidemiology Cohorts

Science.gov (United States)

Cohort studies are fundamental for epidemiological research by helping researchers better understand the etiology of cancer and provide insights into the key determinants of this disease and its outcomes.

Illegal Drugs and Heart Disease

Science.gov (United States)

... Venous Thromboembolism Aortic Aneurysm More Illegal Drugs and Heart Disease Updated:May 3,2018 Most illegal drugs can ... www.dea.gov/druginfo/factsheets.shtml Alcohol and Heart Disease Caffeine and Heart Disease Tobacco and Heart Disease ...

Risks for Heart Disease & Stroke

Science.gov (United States)

... Prevent Risks for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and ... can’t change some of your risks for heart disease and stroke, but you can manage many of ...

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 ...

Heart rate monitoring mobile applications

OpenAIRE

Chaudhry, Beenish M.

2016-01-01

Total number of times a heart beats in a minute is known as the heart rate. Traditionally, heart rate was measured using clunky gadgets but these days it can be measured with a smartphone?s camera. This can help you measure your heart rate anywhere and at anytime, especially during workouts so you can adjust your workout intensity to achieve maximum health benefits. With simple and easy to use mobile app, ?Unique Heart Rate Monitor?, you can also maintain your heart rate history for personal ...

The heart and the liver

DEFF Research Database (Denmark)

Møller, Søren; Dümcke, Christine Winkler; Krag, Aleksander

2009-01-01

Cardiac failure affects the liver and liver dysfunction affects the heart. Chronic and acute heart failure can lead to cardiac cirrhosis and cardiogenic ischemic hepatitis. These conditions may impair liver function and treatment should be directed towards the primary heart disease and seek...... against the heart failure. Transjugular intrahepatic portosystemic shunt insertion and liver transplantation affect cardiac function in portal hypertensive patients and cause stress to the cirrhotic heart, with a risk of perioperative heart failure. The risk and prevalence of coronary artery disease...

Does menopausal hormone therapy reduce myocardial infarction risk if initiated early after menopause? A population-based case-control study.

Science.gov (United States)

Carrasquilla, Germán D; Berglund, Anita; Gigante, Bruna; Landgren, Britt-Marie; de Faire, Ulf; Hallqvist, Johan; Leander, Karin

2015-06-01

This study aims to assess whether the timing of menopausal hormone therapy initiation in relation to onset of menopause and hormone therapy duration is associated with myocardial infarction risk. This study was based on the Stockholm Heart Epidemiology Program, a population-based case-control study including 347 postmenopausal women who had experienced a nonfatal myocardial infarction and 499 female control individuals matched for age and residential area. Odds ratios (with 95% CIs) for myocardial infarction were calculated using logistic regression. Early initiation of hormone therapy (within 10 y of onset of menopause or before age 60 y), compared with never use, was associated with an odds ratio of 0.87 (95% CI, 0.58-1.30) after adjustments for lifestyle factors, body mass index, and socioeconomic status. For late initiation of hormone therapy, the corresponding odds ratio was 0.97 (95% CI, 0.53-1.76). For hormone therapy duration of 5 years or more, compared with never use, the adjusted odds ratio was 0.64 (95% CI, 0.35-1.18). For hormone therapy duration of less than 5 years, the odds ratio was 0.97 (95% CI, 0.63-1.48). Neither the timing of hormone therapy initiation nor the duration of therapy is significantly associated with myocardial infarction risk.

Heart Truth for Women: If You Have Heart Disease

Science.gov (United States)

... failure and a damaged heart muscle. My experience with heart disease started with typical symptoms. It took me some time to get my strength back, but now I exercise regularly and eat healthy foods. To ... counseling, and training. This part of rehab helps you understand your ...

Burden of heart failure on patients from China: results from a cross-sectional survey

Directory of Open Access Journals (Sweden)

Jackson JDS

2018-06-01

Full Text Available James DS Jackson,1 Sarah E Cotton,1 Sara Bruce Wirta,2 Catia C Proenca,3 Milun Zhang,4 Raquel Lahoz,5 Frederico J Calado5 1Real World Research, Adelphi Real World, Bollington, UK; 2Real World Evidence, Cardio-Metabolics Franchise, Novartis Sweden AB, Stockholm, Sweden; 3Wellmera AG, Basel, Switzerland; 4Health Economics and Outcomes Research and Access Strategy, Novartis Pharma China, Beijing, China; 5Real World Evidence, Cardio-Metabolics Franchise, Novartis Pharma AG, Basel, Switzerland Purpose: Little evidence exists on the burden that chronic heart failure (HF poses specifically to patients in China. The objective of this study, therefore, was to describe the burden of HF on patients in China.Materials and methods: A cross-sectional survey of cardiologists and their patients with HF was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Patients for whom a patient record form was completed were invited to complete a patient questionnaire.Results: Most of the 933 patients (mean [SD] age 65.8 [10.2] years; 55% male; 80% retired included in the study received care in tier 2 and 3 hospitals in large cities. Patients gave a median score of 4 on a scale from 1 (no disruption to 10 (severe disruption to describe how much HF disrupts their everyday life. Patients in paid employment (8% missed 10% of work time and experienced 29% impairment in their ability to work due to HF in the previous week. All aspects of patients’ health-related quality of life (QoL were negatively affected by their condition. Mean ± SD utility calculated by the 3-level 5-dimension EuroQol questionnaire was 0.8±0.2, and patients rated their health at 70.3 (11.5 on a 100 mm visual analog scale. Patients incurred costs associated with HF treatment, travel, and professional caregiving services.Conclusion: HF is associated with poor health-related QoL and considerable disruption in patients’ lives. Novel and improved therapies

Target Heart Rates

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... Check Recipe Certification Program Nutrition Requirements Heart-Check Professional Resources Contact the Heart-Check Certification Program Simple Cooking and Recipes Dining Out Choosing a Restaurant Deciphering ...

Heart valve surgery - discharge

Science.gov (United States)

... ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

Heart rate monitoring mobile applications.

Science.gov (United States)

Chaudhry, Beenish M

2016-01-01

Total number of times a heart beats in a minute is known as the heart rate. Traditionally, heart rate was measured using clunky gadgets but these days it can be measured with a smartphone's camera. This can help you measure your heart rate anywhere and at anytime, especially during workouts so you can adjust your workout intensity to achieve maximum health benefits. With simple and easy to use mobile app, 'Unique Heart Rate Monitor', you can also maintain your heart rate history for personal reflection and sharing with a provider.

Heart Disease in Women

Science.gov (United States)

... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing ... the blood vessels that supply blood to the heart itself. This is called coronary artery disease, and ...

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 ...

About the Epidemiology and Genomics Research Program

Science.gov (United States)

Epidemiology is the scientific study of the causes and distribution of disease in populations. NCI-funded epidemiology research is conducted through research at institutions in the United States and internationally.

[Obesity and heart].

Science.gov (United States)

Svačina, Štěpán

2014-12-01

Cardiovascular complications of obesity are traditionally considered an important complication of obesity. Obesity itself is probably not direct cause of atherosclerosis or coronary heart disease. This may occur indirectly in metabolic complications of obesity, especially diabetes and metabolic syndrome. However, thrombogenicity potential of obesity contributes to embolism and atherosclerosis development. In cardiology is well-known a phenomenon of obesity paradox when obese patients have better prognosis than thin. This is the case of heart failure and some other cardiovascular diseases. Recently, a new concept has emerged of myokines - hormones from muscle tissue that have extensive protective effects on organism and probably on heart. Whether heart is a source of myokines is uncertain. However, undoubted importance has epicardial and pericardial fatty tissue. The epicardial fatty tissue has mainly protective effects on myocardium. This fatty tissue may produce factors of inflammation affecting the myocardium. Relationship between amount of epicardial fatty tissue and coronary heart disease is rather pathogenic. Currently, it is certain that obesity brings more metabolic and cancer complications than cardiovascular and accurate contribution to pathogenic or protective character of fatty tissue in cardiology requires further research. Nevertheless, the conclusion is that adipose tissue of organism and around the heart may be in some circumstances beneficial.

[Cardiovascular disease prevention in adults with type 2 diabetes mellitus according to the recent statement from the American Heart Association/American Diabetes Association].

Science.gov (United States)

Avogaro, Angelo

2016-03-01

There is a clear epidemiologic association between glycemic control and cardiovascular disease. There is strong evidence of a microvascular benefit by lowering glycated hemoglobin diabetic patients, to control all major cardiovascular risk factors such as obesity, hypertension, and dyslipidemia. These risk factors, easily measurable, account for 90% of acute myocardial infarction. In this review, the update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus from the American Heart Association and the American Diabetes Association is discussed and commented.

Restoration of heart functions using human embryonic stem cells derived heart muscle cells.

Science.gov (United States)

Gepstein, Lior; Kehat, Izhak

2005-02-01

Extract: Recent advances in molecular and cellular biology and specifically in the areas of stem cell biology and tissue engineering have paved the way for the development of a new field in biomedicine, regenerative medicine. This exciting approach seeks to develop new biological solutions, using the mobilization of endogenous stem cells or delivery of exogenous cells to replace or modify the function of diseased, absent, or malfunctioning tissue. The adult heart represents an attractive candidate for these emerging technologies, since adult cardiomyocytes have limited regenerative capacity. Thus, any significant heart cell loss or dysfunction, such as occurs during heart attack, is mostly irreversible and may lead to the development of progressive heart failure, one of the leading causes of world-wide morbidity and mortality. Similarly, dysfunction of the specialized electrical conduction system within the heart may result in inefficient rhythm initiation or impulse conduction, leading to significant slowing of the heart rate, usually requiring the implantation of a permanent electronic pacemaker. Replacement of the dysfunctional myocardium (heart muscle) by implantation of external heart muscle cells is emerging as a novel paradigm for restoration of the myocardial electromechanical properties, but has been significantly hampered by the paucity of cell sources for human heart cells and by the relatively limited evidence for functional integration between grafted and host cells. The recently described human embryonic stem cell (hESC) lines may provide a possible solution for the aforementioned cell sourcing problem.

The globalization of epidemiology: introductory remarks.

Science.gov (United States)

Pearce, Neil

2004-10-01

We are all living in the era of globalization, and like it or not, it is going to change the way we practice epidemiology, the kinds of questions we ask, and the methods we use to answer them. Increasingly, pubic health problems are being shifted from rich countries to poor countries and from rich to poor populations within Western countries. There is increasing interest and concern about the situation in non-Western populations on the part of Western epidemiologists, with regards to collaborative research, skills transfer, and 'volunteerism' to enable the 'benefits' of Western approaches to epidemiology to be shared by the non-Western world. However, most existing collaborations benefit Western epidemiologists rather than the countries in which the research is conducted. Even when research in non-Western populations is conducted as a genuine collaboration, it can too often 'export failure' from the West. On the other hand, non-Western epidemiologists are increasingly developing new and innovative approaches to health research that are more appropriate to the global public health issues they are addressing. These include recognition of the importance of context and the importance of diversity and local knowledge, and a problem-based approach to addressing the major public health problems using appropriate technology. These debates formed the background for a plenary session on 'International Epidemiology and International Health' at the recent International Epidemiological Association (IEA) meeting in Montreal, and the papers from this session are presented here. The development of a truly global epidemiology can not only better address the public health problems in non-Western populations, but can shed light on the current limitations of epidemiology in addressing the major public health problems in the West.

Nurses' decision making in heart failure management based on heart failure certification status.

Science.gov (United States)

Albert, Nancy M; Bena, James F; Buxbaum, Denise; Martensen, Linda; Morrison, Shannon L; Prasun, Marilyn A; Stamp, Kelly D

Research findings on the value of nurse certification were based on subjective perceptions or biased by correlations of certification status and global clinical factors. In heart failure, the value of certification is unknown. Examine the value of certification based nurses' decision-making. Cross-sectional study of nurses who completed heart failure clinical vignettes that reflected decision-making in clinical heart failure scenarios. Statistical tests included multivariable linear, logistic and proportional odds logistic regression models. Of nurses (N = 605), 29.1% were heart failure certified, 35.0% were certified in another specialty/job role and 35.9% were not certified. In multivariable modeling, nurses certified in heart failure (versus not heart failure certified) had higher clinical vignette scores (p = 0.002), reflecting higher evidence-based decision making; nurses with another specialty/role certification (versus no certification) did not (p = 0.62). Heart failure certification, but not in other specialty/job roles was associated with decisions that reflected delivery of high-quality care. Copyright © 2018 Elsevier Inc. All rights reserved.

Panic Attack or Heart Attack?

Science.gov (United States)

... When in doubt about symptoms, seek care without delay to rule out heart disease. Heart disease affects your heart's ... which cause you concern, see your doctor without delay and ask for testing to rule out heart disease. 1 Gadolinium side effects could ...

Methodological exploratory study applied to occupational epidemiology

Energy Technology Data Exchange (ETDEWEB)

Carneiro, Janete C.G. Gaburo; Vasques, MOnica Heloisa B.; Fontinele, Ricardo S.; Sordi, Gian Maria A. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)]. E-mail: janetegc@ipen.br

2007-07-01

The utilization of epidemiologic methods and techniques has been object of practical experimentation and theoretical-methodological reflection in health planning and programming process. Occupational Epidemiology is the study of the causes and prevention of diseases and injuries from exposition and risks in the work environment. In this context, there is no intention to deplete such a complex theme but to deal with basic concepts of Occupational Epidemiology, presenting the main characteristics of the analysis methods used in epidemiology, as investigate the possible determinants of exposition (chemical, physical and biological agents). For this study, the social-demographic profile of the IPEN-CNEN/SP work force was used. The knowledge of this reference population composition is based on sex, age, educational level, marital status and different occupations, aiming to know the relation between the health aggravating factors and these variables. The methodology used refers to a non-experimental research based on a theoretical methodological practice. The work performed has an exploratory character, aiming a later survey of indicators in the health area in order to analyze possible correlations related to epidemiologic issues. (author)

Methodological exploratory study applied to occupational epidemiology

International Nuclear Information System (INIS)

Carneiro, Janete C.G. Gaburo; Vasques, MOnica Heloisa B.; Fontinele, Ricardo S.; Sordi, Gian Maria A.

2007-01-01

The utilization of epidemiologic methods and techniques has been object of practical experimentation and theoretical-methodological reflection in health planning and programming process. Occupational Epidemiology is the study of the causes and prevention of diseases and injuries from exposition and risks in the work environment. In this context, there is no intention to deplete such a complex theme but to deal with basic concepts of Occupational Epidemiology, presenting the main characteristics of the analysis methods used in epidemiology, as investigate the possible determinants of exposition (chemical, physical and biological agents). For this study, the social-demographic profile of the IPEN-CNEN/SP work force was used. The knowledge of this reference population composition is based on sex, age, educational level, marital status and different occupations, aiming to know the relation between the health aggravating factors and these variables. The methodology used refers to a non-experimental research based on a theoretical methodological practice. The work performed has an exploratory character, aiming a later survey of indicators in the health area in order to analyze possible correlations related to epidemiologic issues. (author)

Valvular heart disease

OpenAIRE

Gelson, E; Gatzoulis, M; Johnson, M

2007-01-01

Valvular disease may be unmasked in pregnancy when physiological changes increase demands on the heart. Women with valvular heart disease require close follow-up during pregnancy, delivery, and postpartum

CDC Vital Signs-Heart Age

Centers for Disease Control (CDC) Podcasts

This podcast is based on the September 2015 CDC Vital Signs report. Your heart age is the age of your heart and blood vessels as a result of your risk factors for heart attack and stroke. If you smoke or have high blood pressure, your heart age will be much higher than your actual age. Learn what you can do to lower your heart age and keep it low.

Verification of Heart Disease: Implications for a New Heart Transplantation Allocation System.

Science.gov (United States)

Raeisi-Giglou, Pejman; Rodriguez, E Rene; Blackstone, Eugene H; Tan, Carmela D; Hsich, Eileen M

2017-12-01

This study sought to determine the accuracy of the pre-transplantation clinical diagnosis of heart disease in the United Network for Organ Sharing (UNOS) database. Because survival on the heart transplantation waitlist depends on underlying heart disease, a new allocation system will include the type of heart disease. Accuracy of the pre-transplantation clinical diagnosis and the effect of misclassification are unknown. We included all adults who received transplants at our center between January 2009 to December 2015. We compared the pre-transplantation clinical diagnosis at listing with pathology of the explanted heart and determined the potential effect of misclassification with the proposed allocation system. A total of 334 patients had the following clinical cardiac diagnoses at listing: 148 had dilated cardiomyopathy, 19 had restrictive cardiomyopathy, 103 had ischemic cardiomyopathy, 24 had hypertrophic cardiomyopathy, 11 had valvular disease, 16 had congenital heart disease (CHD), and 13 patients had a diagnosis of "other." Pathology of the explanted hearts revealed 82% concordance and 18% discordance (10% coding errors and 8% incorrect diagnosis). The most common incorrect diagnoses were sarcoidosis (66%), arrhythmogenic right ventricular dysplasia (60%), and other causes of predominately right-sided heart failure (33%). Among the misclassified diagnoses, 40% were listed as UNOS status 2, 8% remained at status 2 at transplantation, and only sarcoidosis and CHD were potentially at a disadvantage with the new allocation. There is high concordance between clinical and pathologic diagnosis, except for sarcoidosis and genetic diseases. Few misclassifications result in disadvantages to patients based on the new allocation system, but rare diseases like sarcoidosis remain problematic. To improve the UNOS database and enhance outcome research, pathology of the explanted hearts should be required post-transplantation. Copyright © 2017 American College of

Nuclear Heart Scan

Science.gov (United States)

... Home / Nuclear Heart Scan Nuclear Heart Scan Also known as Nuclear Stress Test , ... Learn More Connect With Us Contact Us Directly Policies Privacy Policy Freedom of Information Act (FOIA) Accessibility ...

Aspectos clínico-epidemiológicos de la cardiopatía isquémica en San Juan y Martínez, 2009 Clinical and epidemiological aspects of ischemic heart disease in San Juan y Martinez, 2009

Directory of Open Access Journals (Sweden)

Guillermo Luís Herrera Miranda

2010-03-01

Full Text Available La cardiopatía isquémica es un problema de salud que cobra un gran número de vidas y es la causa de invalidez en la población mundial. Con el objetivo de identificar los aspectos clínicos epidemiológicos que caracterizan a la cardiopatía isquémica en 150 pacientes de 15 años y más, pertenecientes a tres consultorios médicos del Consejo Popular "Galope, San Juan y Martínez", en el periodo comprendido enero _ julio del año 2009, y por ser este el de mayor incidencia y prevalencia en el municipio se realizó una investigación descriptiva y transversal, que incluyó el interrogatorio, examen físico y electrocardiograma a la totalidad de la muestra, procesándose los datos a través del valor porcentual y Ji cuadrado en los casos necesarios. Se encontró un mayor número de hombres que mujeres en la muestra estudiada. En ambos grupos predominaron las edades superiores a 56 años. La cardiopatía isquémica sin angina fue la forma clínica que prevaleció, mientras que las alteraciones del segmento S-T predominaron entre los hallazgos electrocardiográficos. El hábito de fumar, el sedentarismo y la hipertensión arterial fueron los factores de riesgo más frecuentes en la serie. Los mismos se incrementaron a medida que aumento la edad, y todos predominaron de manera significativa en el grupo con cardiopatía isquémica. Se encontró una relación directamente proporcional entre los factores de riesgo asociados entre sí y la cardiopatía isquémica.Ischemic Heart Disease is a health problem that takes a great number of lives off and it is a cause of disability all over the world. The objective of this research was to identify clinical and epidemiological aspects that characterize ischemic heart disease in 150 patients (15 years or older, belonging to three doctor's offices in the Popular Council of "Galope", San Juan y Martinez, Pinar del Rio during January-July 2009. This place presents the greatest incidence and prevalence in the

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 - ...

Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease.

Science.gov (United States)

Bestetti, Reinaldo B; Restini, Carolina Baraldi A; Couto, Lucélio B

2016-07-01

The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

Energy Technology Data Exchange (ETDEWEB)

Bestetti, Reinaldo B., E-mail: rbestetti44@gmail.com; Restini, Carolina Baraldi A.; Couto, Lucélio B. [Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, SP (Brazil)

2016-07-15

The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

Directory of Open Access Journals (Sweden)

Reinaldo B. Bestetti

2016-01-01

Full Text Available Abstract The scientific construction of chronic Chagas heart disease (CCHD started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

Diagnostic value of CRP and Lp(a) in coronary heart disease.

Science.gov (United States)

Erbağci, Ayşe Binnur; Tarakçioğlu, Mehmet; Aksoy, Mehmet; Kocabaş, Ramazan; Nacak, Muradiye; Aynacioğlu, A Sükrü; Sivrikoz, Cumhur

2002-06-01

Increased lipoprotein (a) [Lp(a)] concentration was reported to be an independent risk factor for coronary heart disease (CHD). Recent epidemiological studies affirmed the value of C-reactive protein (CRP) as the strongest, univariate predictor of the cardiovascular events. We decided to establish cut-off levels providing maximum diagnostic efficiency for CHD. In this study we measured CRP and Lp(a) concentrations in patients with angiographically demonstrated CHD (group A, n: 120), patients without any angiographically demonstrable lesion (group B, n: 62) and a group of healthy subjects (group C, n: 41). Data were evaluated correcting for lipid and lipoprotein concentrations, diabetes mellitus, hypertension, smoking, age, and body mass index in men and women. ROC curve based cut-off values (comparing group A versus groups B and C) and associated diagnostic performances of the assays were evaluated. Significant increases were noted in serum CRP concentrations in men and women, in groups A vs. B,A vs. C, B vs. C. Lp(a) concentrations were not different among groups in men but were higher in group A vs. B and C in women. Optimal cut-off levels for CRP in women and men were found as 2.1 and 3.0 mg/l with the diagnostic values of 0.792 and 0.770, respectively. For Lp(a) optimal cut-off levels were found as 22.6 and 9.8 mg/dl with the diagnostic values of 0.612 and 0.596 in women and men, respectively. The CRP level is quite efficient for separation of patients from controls. Therefore keeping in mind the lack of specificity, the CRP level may be a useful tool in the diagnosis of coronary heart disease. However, the Lp(a) level is not efficient enough to support the use of Lp(a) measurement for management of coronary heart disease.

The NHLBI Retrovirus Epidemiology Donor Studies (REDS and REDS-II): Twenty years of research to advance blood product safety and availability

Science.gov (United States)

Kleinman, Steven; King, Melissa R; Busch, Michael P; Murphy, Edward L; Glynn, Simone A.

2012-01-01

The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989–2001, and the Retrovirus Epidemiology Donor Study-II (REDS-II), conducted from 2004–2012, were National Heart Lung and Blood Institute (NHLBI) funded multicenter programs focused on improving blood safety and availability in the United States. REDS-II also included international study sites in Brazil and China. The three major research domains of REDS/REDS-II have been infectious disease risk evaluation, blood donation availability, and blood donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging blood safety threats such as XMRV. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of HIV, HTLV I/II, HCV, HBV, WNV, CMV, HHV-8, B19V, malaria, CJD, influenza, and T. cruzi infections. Other analyses have characterized: blood donor demographics, motivations to donate, factors influencing donor return, behavioral risk factors, donors’ perception of the blood donation screening process, and aspects of donor deferral. In REDS-II, two large-scale blood donor protocols examined iron deficiency in donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these two REDS programs. In 2011, a new seven year program, the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III), was launched. REDS-III expands beyond donor-based research to include studies of blood transfusion recipients in the hospital setting, and adds a third country, South Africa, to the international program. PMID:22633182

Nutrition in Heart Failure

OpenAIRE

Reci Meseri

2013-01-01

Heart failure is defined as decreased ability of heart due to various reasons. It%u2019s seen 2-3% but the prevalence increases sharply after the age of seventy. The objectives of nutrition therapy in heart failure are to prevent from water retention and edema, to avoid from hard digestion and to offer a balanced diet. In order to avoid fluid retention and edema, daily sodium and fluid intake must be monitored carefully. Main dilemma of the heart failure patients is the obesity-cachexia dilem...

The impact on social capital of mobility disability and weight status: the Stockholm Public Health Cohort.

Science.gov (United States)

Norrbäck, Mattias; de Munter, Jeroen; Tynelius, Per; Ahlström, Gerd; Rasmussen, Finn

2015-04-01

People with mobility disability are more often overweight or obese and have lower social capital than people without mobility disability. It is unclear whether having a combination of mobility disability and overweight or obesity furthers negative development of social capital over time. To explore whether there were differences in social capital between normal-weight, overweight and obese people with or without mobility disability over a period of 8 years. We included 14,481 individuals (18-64 at baseline) from the Stockholm Public Health Cohort that started in 2002. Mobility disability, weight status, and social capital (structural: social activities, voting; cognitive: trust in authorities, and trust in people) were identified from self-reports. Risk ratios with 95% confidence intervals were estimated in multivariate longitudinal regression analyses. We found no significant differences in social activities and voting between the groups over time. However, when compared with the reference group, the groups with mobility disability had less trust in authorities and public institutions over time. Notably, obese people with mobility disability showed the largest decrease in trust in the police (RR = 2.29; 1.50-3.50), the parliament (RR = 2.00; 1.31-3.05), and local politicians (RR = 2.52; 1.61-3.94). People with mobility disability experience lower cognitive social capital over time than people without mobility disability. Being burdened by both mobility disability and obesity may be worse in terms of social capital than having just one of the conditions, especially regarding cognitive social capital. This finding is of public health importance, since social capital is related to health. Copyright © 2015 Elsevier Inc. All rights reserved.

Epidemiology of Schizophrenia: Review of Findings and Myths

OpenAIRE

Messias, Erick; Chen, Chuan-Yu; Eaton, William W.

2007-01-01

By describing patterns of disease distribution within populations, identifying risk factors, and finding associations, epidemiological studies have contributed to our current understanding of schizophrenia. Advanced paternal age and the association with auto-immune diseases are some of the newly described epidemiological finding in schizophrenia epidemiology, shaping our current definition of schizophrenia. Though early intervention strategies have gained momentum, primary prevention of schiz...

Atrial fibrillation, ischaemic heart disease, and the risk of death in patients with heart failure

DEFF Research Database (Denmark)

Pedersen, Ole Dyg; Søndergaard, Peter; Nielsen, Tonny

2006-01-01

AIMS: Atrial fibrillation (AF) is a risk factor for death in patients with a myocardial infarction, but highly variable results are reported in patients with heart failure. We studied the prognostic impact of AF in heart failure patients with and without ischaemic heart disease. METHODS AND RESULTS......), 1.02-1.23, P=0.018]. There was a significant interaction between the importance of AF and the presence of ischaemic heart disease (P=0.034). In patients with AF at the time of discharge and ischaemic heart disease, HR was 1.25 (95% CI: 1.09-1.42) and P... and without ischaemic heart disease, HR was 1.01 (95% CI: 0.88-1.16) and P=0.88. CONCLUSION: AF is associated with increased risk of death only in patients with ischaemic heart disease. This finding may explain the variable results of studies of the prognosis associated with AF in heart failure....

The Total Artificial Heart in End-Stage Congenital Heart Disease.

Science.gov (United States)

Villa, Chet R; Morales, David L S

2017-01-01

The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic (systemic right ventricle, single ventricle, surgically altered anatomy, valve dysfunction, etc.) and physiologic constraints (diastolic dysfunction). The total artificial heart (TAH), which has right and left sided pumps that can be arranged in a variety of orientations, can accommodate the anatomic variation present in CHD patients. This review provides an overview of the potential use of the TAH in patients with CHD.

Heart Motion Prediction in Robotic-Assisted Beating Heart Surgery: A Nonlinear Fast Adaptive Approach

Directory of Open Access Journals (Sweden)

Fan Liang

2013-01-01

Full Text Available Off-pump Coronary Artery Bypass Graft (CABG surgery outperforms traditional on-pump surgery because the assisted robotic tools can alleviate the relative motion between the beating heart and robotic tools. Therefore, it is possible for the surgeon to operate on the beating heart and thus lessens post surgery complications for the patients. Due to the highly irregular and non-stationary nature of heart motion, it is critical that the beating heart motion is predicted in the model-based track control procedures. It is technically preferable to model heart motion in a nonlinear way because the characteristic analysis of 3D heart motion data through Bi-spectral analysis and Fourier methods demonstrates the involved nonlinearity of heart motion. We propose an adaptive nonlinear heart motion model based on the Volterra Series in this paper. We also design a fast lattice structure to achieve computational-efficiency for real-time online predictions. We argue that the quadratic term of the Volterra Series can improve the prediction accuracy by covering sharp change points and including the motion with sufficient detail. The experiment results indicate that the adaptive nonlinear heart motion prediction algorithm outperforms the autoregressive (AR and the time-varying Fourier-series models in terms of the root mean square of the prediction error and the prediction error in extreme cases.

The Palm-Heart Diameter: A Prospective Simple Screening Tool for Identifying Heart Enlargement

Directory of Open Access Journals (Sweden)

Adegbenro Omotuyi John Fakoya