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Sample records for stockholm heart epidemiology

  1. Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low decision latitude? Results from Stockholm Heart Epidemiology Program (SHEEP).

    PubMed

    Hallqvist, J; Diderichsen, F; Theorell, T; Reuterwall, C; Ahlbom, A

    1998-06-01

    The objectives are to examine if the excess risk of myocardial infarction from exposure to job strain is due to interaction between high demands and low control and to analyse what role such an interaction has regarding socioeconomic differences in risk of myocardial infarction. The material is a population-based case-referent study having incident first events of myocardial infarction as outcome (SHEEP: Stockholm Heart Epidemiology Program). The analysis is restricted to males 45-64 yr of age with a more detailed analysis confined to those still working at inclusion. In total, 1047 cases and 1450 referents were included in the analysis. Exposure categories of job strain were formed from self reported questionnaire information. The results show that high demands and low decision latitude interact with a synergy index of 7.5 (95% C.I.: 1.8-30.6) providing empirical support for the core mechanism of the job strain model. Manual workers are more susceptible when exposed to job strain and its components and this increased susceptibility explains about 25-50% of the relative excess risk among manual workers. Low decision latitude may also, as a causal link, explain about 30% of the socioeconomic difference in risk of myocardial infarction. The distinction between the interaction and the causal link mechanisms identifies new etiologic questions and intervention alternatives. The specific causes of the increased susceptibility among manual workers to job strain and its components seem to be an interesting and important research question.

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

    PubMed Central

    Kolegard, S; Diderichsen, F; Reuterwall, C; Hallqvist, J

    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 (SHEEP). Setting: Cases (n=1631) were all incident first events of myocardial infarction during 1992–1994. The study base included all Swedish citizens aged 45–70 years, living in Stockholm metropolitan area during these years. The social context of all metropolitan parishes (n=89) was determined by routine statistics on 21 socioeconomic indicators. A factor analysis of the socioeconomic indicators resulted in three dimensions of socioeconomic deprivation, which were analysed separately as three different contextual exposures. Main results: The main characteristics of the extracted factors were; 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 the strongest contextual impact. The contextual effects among women showed a different pattern. In comparison with women living the most affluent areas according to the class structure index, women in the rest of Stockholm metropolitan area had nearly 70% higher risk of myocardial infarction after adjustment for individual social exposures. Conclusions: The results suggest that the socioeconomic context in area of living increases the risk of myocardial infarction. The increased risk in only partially explained by individual social factors (the compositional effect). PMID:11801617

  3. Epidemiological aspects of heart diseases

    PubMed Central

    Shi, Aimin; Tao, Ziqi; Wei, Peng; Zhao, Jing

    2016-01-01

    Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. Coronary heart disease (CHD) is the main cause of mortality in heart patients following stroke, rheumatic heart disease and myocardial infarctions. Approximately 80% of individuals succumb to CVDs, due to poor living conditions in low and middle income families and malnutrition. Infectious diseases, human immunodeficiency, tuberculosis, malaria, high blood pressure or hypertension, obesity and overweight, and nutritional disorders including smoking, excessive alcohol consumption, high salt and sugar intake, as well as other factors are responsible for CVDs and CHDs in young as well as elderly individuals. The focus of the present review are recent epidemiological aspects of CVD and CHD as well as the usefulness of a Mediterranean diet for heart patients and the prevention of heart diseases. PMID:27602082

  4. Heart Failure Epidemiology: European Perspective

    PubMed Central

    Guha, K; McDonagh, T

    2013-01-01

    Heart failure poses an increasing problem for global healthcare systems. The epidemiological data which has been accrued over the last thirty years has predominantly been accumulated from experience within North America and Europe. Initial large cohort, prospective longitudinal studies produced the first publications; however latterly the focus has shifted onto epidemiological data governing hospitalisation and mortality. The emphasis behind this shift has been the resource implications with regards to repetitive, costly and prolonged hospitalisation. The European experience in heart failure, though similar to North America has recently demonstrated differences in hospitalisation which may underlie the differences between healthcare system configuration. Heart failure however remains an increasing global problem and the endpoint of a variety of cardiovascular diseases. Allied with the fact of increasingly elderly populations and prior data demonstrating a steep rise in prevalent cases within more elderly populations, it is likely that the increasing burden of disease will continue to pose challenges for modern healthcare. Despite the predicted increase in the number of patients affected by heart failure, over the last thirty years, a clear management algorithm has evolved for the use of pharmacotherapies (neuro-hormonal antagonists), device based therapies (Implantable Cardioverting Defibrillator (ICD) and Cardiac Resynchronisation Therapy (CRT)) and mechanical therapies including left ventricular assist devices and cardiac transplantation. Though the management of such patients has been clearly delineated in national and international guidelines, the underuse of all available and appropriate therapies remains a significant problem. When comparing various epidemiological studies from different settings and timepoints, it should be remembered that rates of prevalence and incidence may vary depending upon the definition used, methods of accumulating information (with

  5. Molecular Epidemiology of Norovirus Infections in Stockholm, Sweden, during the Years 2000 to 2003: Association of the GGIIb Genetic Cluster with Infection in Children

    PubMed Central

    Lindell, Annika Tiveljung; Grillner, Lena; Svensson, Lennart; Wirgart, Benita Zweygberg

    2005-01-01

    The incidence of norovirus-associated gastroenteritis and the molecular epidemiology of norovirus strains were studied during three seasons (2000-2001, 2001-2002, and 2002-2003) among patients of all ages, mainly from the Stockholm region in Sweden. A total of 3,252 fecal samples were analyzed by reverse transcription-PCR. The incidences of norovirus infection among adults were 23, 26, and 30% during the three seasons studied and 18, 11, and 15% among children 0 to 15 years of age. During the first season, all norovirus strains detected by PCR were typed either by reverse line blot hybridization or nucleotide sequence analysis. During the two successive seasons, a total of 60 norovirus-positive strains from the beginning, peak, and end of the seasons were selected for nucleotide sequence analysis. We identified two dominant norovirus variants over the seasons: a new norovirus variant, recently described as the GGIIb genetic cluster, dominated among children during the first season, and during the following two seasons, a GGII-4 variant dominated. Our data suggest that norovirus infections are common, not only among adults, but also among children, and that some strains may predominantly affect children. PMID:15750066

  6. The changing epidemiology of congenital heart disease.

    PubMed

    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 failure and arrhythmias are the most prominent. Accordingly, these patients need frequent follow-up by physicians with specific knowledge in the field of congenital heart disease. However, planning of care for this population is difficult, because the number of patients currently living with congenital heart disease is difficult to measure. Birth prevalence estimates vary widely according to different studies, and survival rates have not been well recorded. Consequently, the prevalence of congenital heart disease is unclear, with estimates exceeding the number of patients currently seen in cardiology clinics. New developments continue to influence the size of the population of patients with congenital heart disease. Prenatal screening has led to increased rates of termination of pregnancy. Improved management of complications has changed the time and mode of death caused by congenital heart disease. Several genetic and environmental factors have been shown to be involved in the etiology of congenital heart disease, although this knowledge has not yet led to the implementation of preventative measures. In this Review, we give an overview of the etiology, birth prevalence, current prevalence, mortality, and complications of congenital heart disease.

  7. Epidemiology of acquired valvular heart disease.

    PubMed

    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.

  8. Epidemiology of congenital heart disease in Brazil

    PubMed Central

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

    2015-01-01

    Introduction Congenital heart disease is an abnormality in the structure or cardiocirculatory function, occurring from birth, even if diagnosed later. It can result in intrauterine death in childhood or in adulthood. Accounted for 6% of infant deaths in Brazil in 2007. Objective To estimate underreporting in the prevalence of congenital heart disease in Brazil and its subtypes. Methods The calculations of prevalence were performed by applying coefficients, giving them function rates for calculations of health problems. The study makes an approach between the literature and the governmental registries. It was adopted an estimate of 9: 1000 births and prevalence rates for subtypes applied to births of 2010. Estimates of births with congenital heart disease were compared with the reports to the Ministry of Health and were studied by descriptive methods with the use of rates and coefficients represented in tables. Results The incidence in Brazil is 25,757 new cases/year, distributed in: North 2,758; Northeast 7,570; Southeast 10,112; South 3,329; and Midwest 1,987. In 2010, were reported to System of Live Birth Information of Ministry of Health 1,377 cases of babies with congenital heart disease, representing 5.3% of the estimated for Brazil. In the same period, the most common subtypes were: ventricular septal defect (7,498); atrial septal defect (4,693); persistent ductus arteriosus (2,490); pulmonary stenosis (1,431); tetralogy of Fallot (973); coarctation of the aorta (973); transposition of the great arteries (887); and aortic stenosis 630. The prevalence of congenital heart disease, for the year of 2009, was 675,495 children and adolescents and 552,092 adults. Conclusion In Brazil, there is underreporting in the prevalence of congenital heart disease, signaling the need for adjustments in the methodology of registration. PMID:26107454

  9. The epidemiology of heart failure in adults with congenital heart disease.

    PubMed

    Rodriguez, Fred H; Marelli, Ariane J

    2014-01-01

    The impact of lifelong exposure to myocardial dysfunction in populations with congenital heart disease (CHD) is becoming increasingly recognized. Most children born with CHD now reach adulthood and the long-term sequelae of treatment are contributing to substantial comorbidity. The combination of structural changes present at birth with changes resulting from cardiac surgery can result in heart failure. This article reports on the current state of knowledge on the epidemiology of heart failure in this patient population.

  10. Epidemiology of coronary heart disease in women.

    PubMed

    Bello, Natalie; Mosca, Lori

    2004-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in women and a major cause of morbidity. Coronary heart disease (CHD) accounts for nearly half of all CVD deaths. Gender differences in CHD include a later age of onset for women, a greater prevalence of comorbid diseases, and differences in the initial manifestations of the disease. Traditional risk factors for CHD include tobacco use, hypertension, diabetes mellitus, dyslipidemia, obesity, sedentary lifestyle, and atherogenic diet. More recently identified risk factors in women include high sensitivity C-reactive protein (hsCRP), homocysteine, and lipoprotein (a). Appropriate management of risk factors is associated with a reduced incidence of CHD, yet poor implementation in women is widely documented. Barriers to optimal risk factor management in women should be identified and overcome in an effort to maximize the cardiovascular health of women.

  11. [Epidemiology and prognosis of heart failure].

    PubMed

    Edelmann, F

    2015-04-01

    Heart failure (HF) is a major and growing health problem in western communities. Recent data indicate that more than 50% of patients with the clinical syndrome of HF have a preserved left ventricular ejection fraction (HF with preserved ejection fraction, HFpEF). In contrast to the calculated expectations, the observed incidence of HF is rising. Despite the fact that the relative proportion of patients with preserved left ventricular function is also increasing, other factors, such as ageing of the population and the concomitant change of compound risk factors may also contribute to the actual rise in the incidence of HF. Patients with HF suffer from reduced exercise capacity, impaired quality of life and also from recurrent hospitalization due to HF. Over the past decades, an increase of recurrent HF events has been documented. In contrast to earlier reports in which HFpEF was considered to be more benign than HF with reduced ejection fraction (HFrEF), recent data suggest that once hospitalized for HF, patients with HFpEF and those with HFrEF have a comparable prognosis in terms of morbidity and mortality. Despite increasing clinical and economic relevance, no treatment has yet been shown to convincingly reduce mortality in HFpEF. In contrast, strategies for improving survival have now been established for HFrEF. The problem of HF will continue to be major challenge for the healthcare systems in western communities; therefore, consolidated clinical research is necessary to further improve therapeutic strategies for HFrEF and to generally establish treatment options for HFpEF.

  12. Honors in Stockholm.

    ERIC Educational Resources Information Center

    Morrison, Toni

    1996-01-01

    Includes the full text of Toni Morrison's acceptance speech for the 1996 Nobel Prize, awarded in Stockholm, Sweden. In the context of a modern day fable, Morrison investigates interwoven themes of language, creativity, and responsibility. Includes several photographs of the ceremony. (MJP)

  13. Particulate matter and heart disease: Evidence from epidemiological studies

    SciTech Connect

    Peters, Annette . E-mail: peters@gsf.de

    2005-09-01

    The association between particulate matter and heart disease was noted in the mid-nineties of last century when the epidemiological evidence for an association between air pollution and hospital admissions due to cardiovascular disease accumulated and first hypotheses regarding the pathomechanism were formulated. Nowadays, epidemiological studies have demonstrated coherent associations between daily changes in concentrations of ambient particles and cardiovascular disease mortality, hospital admission, disease exacerbation in patients with cardiovascular disease and early physiological responses in healthy individuals consistent with a risk factor profile deterioration. In addition, evidence was found that annual average PM{sub 2.5} exposures are associated with increased risks for mortality caused by ischemic heart disease and dysrhythmia. Thereby, evidence is suggesting not only a short-term exacerbation of cardiovascular disease by ambient particle concentrations but also a potential role of particles in defining patients' vulnerability to acute coronary events. While this concept is consistent with the current understanding of the factors defining patients' vulnerability, the mechanisms and the time-scales on which the particle-induced vulnerability might operate are unknown.

  14. Epidemiology and importance of renal dysfunction in heart failure patients.

    PubMed

    Giamouzis, Gregory; Kalogeropoulos, Andreas P; Butler, Javed; Karayannis, Georgios; Georgiopoulou, Vasiliki V; Skoularigis, John; Triposkiadis, Filippos

    2013-12-01

    Renal dysfunction (RD) is a frequent comorbid condition and a major determinant of outcomes in patients with heart failure (HF). It is likely that the etiology of RD in patients with HF is much more complex than we first thought and represents a matrix of independent, albeit interacting, pathophysiological pathways with effects on both the kidney and the heart that share a common denominator: aging and inflammation. Renal dysfunction in HF has been attributed, among others, to biochemical, hormonal, and hemodynamic factors, coupled with pharmacological interventions. Regardless of the cause, the development of RD or worsening renal function is common in patients with HF, and is associated with increased morbidity and mortality. There is increasing evidence, however, that transient increases in creatinine in the setting of acute HF are not prognostically important, whereas persistent deterioration does portend a higher mortality in this patient population. In addition, congestion seems to play an important role in the course of renal deterioration, and the combination of congestion and worsening renal function is the most significant clinical prognosticator in HF patients. This review aims to provide an update on the epidemiology and prognostic significance of RD in HF patients, in both the acute and the chronic setting.

  15. Epidemiological basis for the prevention of coronary heart disease

    PubMed Central

    Marmot, M. G.

    1979-01-01

    Epidemiological studies have laid the basis for a preventive approach to coronary heart disease (CHD). On balance, present evidence indicates that the following should form the basis of a preventive programme: low-fat diet, cessation of smoking, and control of blood pressure. Other factors likely to produce a beneficial effect on CHD occurrence include reduction of obesity and increased physical activity. Although psychosocial factors are most likely to be causally related to CHD, it is not possible at present to provide clear guidelines as to their role in a preventive programme. Trials are being conducted to investigate the possibility of preventing CHD by a variety of approaches: a doctor-centred approach or health education in certain sectors of a community or in whole communities. These trials have shown that it is possible to achieve behavioural changes and a reduction in the levels of risk factors in a proportion of the participants. It is not yet clear to what extent these changes in levels of risk factors in middle-aged people will lead to a reduction in the incidence of CHD. It can be calculated, however, that the greatest benefit is likely to come from approaches to prevention that involve the whole community, rather than only high-risk groups. PMID:314348

  16. Letter from Stockholm.

    PubMed

    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

  17. Epidemiology, Pathophysiology, and Prognosis of Heart Failure in Older Adults

    PubMed Central

    Rich, Michael W.

    2017-01-01

    Synopsis Heart failure is the quintessential cardiovascular syndrome of aging that results from common cardiovascular conditions in older adults in conjunction with age-associated changes in cardiovascular structure and function. To a large extent, heart failure is a geriatric syndrome in much the same way that dementia, falls, and frailty are geriatric syndromes. The incidence and prevalence of heart failure increase strikingly with age and make heart failure the most common reason for hospitalization among older adults. While outcomes for older adults with heart failure have improved over time, mortality, hospitalization, and rehospitalization rates remain high. PMID:17905375

  18. The Framingham Heart Study and the Epidemiology of Cardiovascular Diseases: A Historical Perspective

    PubMed Central

    Mahmood, Syed S.; Levy, Daniel; Vasan, Ramachandran S.; Wang, Thomas J.

    2014-01-01

    Summary On October 11, 2013, the Framingham Heart Study will celebrate 65 years since the examination of its first participant in 1948. During this period, the study has provided substantial insight into the epidemiology of cardiovascular disease and its risk factors. The origin of the study is closely linked to the cardiovascular health of President Franklin D. Roosevelt and his premature death from hypertensive heart disease and stroke in 1945. The present article describes the events leading to the founding of the Framingham Heart Study, and provides a brief historical overview of selected contributions from the study. PMID:24084292

  19. Congenital heart disease in Saudi Arabia: current epidemiology and future projections.

    PubMed

    Alabdulgader, A A A

    2006-01-01

    To provide an overview of the epidemiology of congenital heart disease, the results of epidemiological studies done in 4 regions of Saudi Arabia (August 1988-February 2000) and 2604 individuals with congenital heart disease were evaluated. Ventricular septal defect was the commonest lesion (33.9%) followed by atrial septal defect (18.1%). Overall, sex distribution was similar; for 3 conditions, more males than females were affected. Of 2269 (59%) presenting in the first year of life, 566 (24.9%) had neonatal congenital heart disease. Down syndrome was the commonest cause. Distribution of specific lesions and sex distribution was similar to findings from other parts of the world; however, the overall detection rate at 1 year of age was lower.

  20. Epidemiology of central sleep apnoea in heart failure.

    PubMed

    Naughton, Matthew T

    2016-03-01

    Central sleep apnoea occurs in about a third of patients with reduced systolic heart failure and is a marker of increased mortality. Such patients usually are older males with advanced heart failure (i.e., high pulmonary wedge pressure), often in atrial fibrillation, with evidence of hyperventilation (i.e., low PaCO2) in the absence of hypoxemia. Characteristically, ventilation waxes and wanes in a sinusoidal pattern, with mild hypoxemia, occurring in the lighter levels of sleep usually when supine. Snoring may also occur in central sleep apnoea, often at the peak of hyperventilation, sometimes contributing to the confusion or overlap with obstructive sleep apnoea. Central sleep apnoea is associated with orthopnoea, paroxysmal nocturnal dyspnoea and an oscillatory respiratory pattern with an incremental cardiopulmonary exercise study. Importantly, heart failure therapies (e.g., afterload reduction, diuresis, pacemakers, transplantation) attenuate central sleep apnoea. Night to night variability in severity of central sleep apnoea may occur with changes in patients' posture during sleep (less severe when sleeping on-side or upright).

  1. Epidemiology of coronary heart disease and acute coronary syndrome

    PubMed Central

    Perez-Quilis, Carme; Leischik, Roman; Lucia, Alejandro

    2016-01-01

    The aim of this review is to summarize the incidence, prevalence, trend in mortality, and general prognosis of coronary heart disease (CHD) and a related condition, acute coronary syndrome (ACS). Although CHD mortality has gradually declined over the last decades in western countries, this condition still causes about one-third of all deaths in people older than 35 years. This evidence, along with the fact that mortality from CHD is expected to continue increasing in developing countries, illustrates the need for implementing effective primary prevention approaches worldwide and identifying risk groups and areas for possible improvement. PMID:27500157

  2. Epidemiology of Heart Failure in Korea: Present and Future

    PubMed Central

    Lee, Jung Hoon; Lim, Nam-Kyoo

    2016-01-01

    Background and Objectives Heart failure (HF) is an important healthcare issue because of its high mortality, morbidity, and healthcare costs. The number of HF patients is increasing worldwide as a consequence of aging of the population. However, there are limited studies on the prevalence of HF in Korea. This study aimed to estimate the prevalence of HF, its comorbidities, and the projected population with HF in the future. Materials and Methods The prevalence and comorbidity estimates of HF were determined using data from the 2002-2013 National Sample Cohort based on the National Health Information Database. We calculated the projected prevalence of HF by multiplying the estimated prevalence in 2013 by the projected population counts for 2015-2040. Results The prevalence of HF in Korea was estimated to be 1.53% in 2013. The prevalence of HF in Korea is expected to increase by 2-fold, from 1.60% in 2015 to 3.35% in 2040. By 2040, more than 1.7 million Koreans are expected to have HF. In terms of comorbid diseases of HF, ischemic heart disease, hypertension, and diabetes mellitus were common (45.4%, 43.6%, and 49.1% in 2013, respectively). The prevalence rates of arrhythmia, valvular disease, and cardiomyopathy in HF patients were approximately 22.6%, 5.6%, and 3.1% in 2013, respectively. Conclusion This is the first nationwide report in Korea to demonstrate the prevalence and comorbidities of HF. These data may be used for the prevention and management of HF in Korea. PMID:27721857

  3. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study.

    PubMed

    Campbell Jenkins, Brenda W; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle

    2015-12-22

    The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs.

  4. Implementing a Graduate Certificate Program in Cardiovascular Epidemiology: The Jackson Heart Study

    PubMed Central

    Campbell Jenkins, Brenda W.; Addison, Clifton; Wilson, Gregory; Young, Lavon; Fields, Regina; Woodberry, Clevette; Payton, Marinelle

    2015-01-01

    The Jackson Heart Study (JHS) is committed to providing opportunities for expanding the understanding of the epidemiology, diagnosis, prevention, and treatment of cardiovascular diseases. The JHS Graduate Training and Education Center (GTEC) has initiated the Daniel Hale Williams Scholar (DHWS) program where students are afforded the opportunity to interact with epidemiologists and other biomedical scientists to learn to identify, predict, and prevent cardiovascular disease using the Jackson Heart Study data. This study describes the structured programs developed by JHS GTEC seeking to alleviate the shortage of trained professionals in cardiovascular epidemiology by training graduate students while they complete their academic degrees. The DHWS program provides: (1) an enrichment curriculum; (2) a learning community; (3) quarterly seminars; and (4) a Summer Institute. Students attend enrichment activities comprising: (1) Applied Biostatistics; (2) Cardiovascular Disease Epidemiology; (3) Social Epidemiology; (4) Emerging Topics; and (5) Research Writing. Training focuses on developing proficiency in cardiovascular health knowledge. The DHWS program is a unique strategy for incorporating rigorous academic and career-focused training to graduate students and has enabled the acquisition of competencies needed to impact cardiovascular disease management programs. PMID:26703701

  5. Epidemiology of "Heart Failure with Recovered Ejection Fraction": What do we do After Recovery?

    PubMed

    Kuttab, Johny S; Kiernan, Michael S; Vest, Amanda R

    2015-12-01

    Improvement in functional status, long-term survival, and quality of life has always been the goal of therapy in patients with heart failure with reduced ejection fraction. Neurohormonal modulating medications help patients achieve these goals and, in a subgroup of patients, can promote "reverse remodeling" resulting in the recovery of left ventricular systolic function. In the era of durable mechanical support, myocardial recovery that leads to explantation of the ventricular assist device occurs in a minority of cases. Optimal medical therapy appears to be a key component of achieving myocardial recovery, with recovery more likely in patients with a shorter duration of heart failure and a non-ischemic etiology. However, little is known about future management of patients who attain myocardial recovery, either with or without mechanical support. This review explores the epidemiology, physiology, cellular biology, and long-term outcomes for this subgroup of heart failure patients and outlines areas for future study.

  6. Stockholm Syndrome and Child Sexual Abuse

    ERIC Educational Resources Information Center

    Julich, Shirley

    2005-01-01

    This article, based on an analysis of unstructured interviews, identifies that the emotional bond between survivors of child sexual abuse and the people who perpetrated the abuse against them is similar to that of the powerful bi-directional relationship central to Stockholm Syndrome as described by Graham (1994). Aspects of Stockholm Syndrome…

  7. District cooling in Stockholm using sea water

    SciTech Connect

    Fermbaeck, G.

    1995-12-31

    In May this year Stockholm Energi started supplying properties in central Stockholm with cooling for comfort and for various processes from its new district cooling system. The project is unique in that most of the cooling energy is produced using cold water from the Baltic Sea. The following article describes the system and provides a summary of the considerations that resulted in venturing to invest in sea-water cooling for such a large project. There is also a description of the hydrological conditions that made the system feasible in Stockholm and some speculations about the possibilities to use cooled sea water elsewhere in the world.

  8. Cohort Profile: The Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology

    PubMed Central

    Tsao, Connie W; Vasan, Ramachandran S

    2015-01-01

    The Framingham Heart Study (FHS) has conducted seminal research defining cardiovascular disease (CVD) risk factors and fundamentally shaping public health guidelines for CVD prevention over the past five decades. The success of the Original Cohort, initiated in 1948, paved the way for further epidemiological research in preventive cardiology. Due to the keen observations suggesting the role of shared familial factors in the development of CVD, in 1971 the FHS began enroling the second generation cohort, comprising the children of the Original Cohort and the spouses of the children. In 2002, the third generation cohort, comprising the grandchildren of the Original Cohort, was initiated to additionally explore genetic contributions to CVD in greater depth. Additionally, because of the predominance of White individuals of European descent in the three generations of FHS participants noted above, the Heart Study enrolled the OMNI1 and OMNI2 cohorts in 1994 and 2003, respectively, aimed to reflect the current greater racial and ethnic diversity of the town of Framingham. All FHS cohorts have been examined approximately every 2–4 years since the initiation of the study. At these periodic Heart Study examinations, we obtain a medical history and perform a cardiovascular-focused physical examination, 12-lead electrocardiography, blood and urine samples testing and other cardiovascular imaging studies reflecting subclinical disease burden. The FHS has continually evolved along the cutting edge of cardiovascular science and epidemiological research since its inception. Participant studies now additionally include study of cardiovascular imaging, serum and urine biomarkers, genetics/genomics, proteomics, metabolomics and social networks. Numerous ancillary studies have been established, expanding the phenotypes to encompass multiple organ systems including the lungs, brain, bone and fat depots, among others. Whereas the FHS was originally conceived and designed to study the

  9. Cohort Profile: The Framingham Heart Study (FHS): overview of milestones in cardiovascular epidemiology.

    PubMed

    Tsao, Connie W; Vasan, Ramachandran S

    2015-12-01

    The Framingham Heart Study (FHS) has conducted seminal research defining cardiovascular disease (CVD) risk factors and fundamentally shaping public health guidelines for CVD prevention over the past five decades. The success of the Original Cohort, initiated in 1948, paved the way for further epidemiological research in preventive cardiology. Due to the keen observations suggesting the role of shared familial factors in the development of CVD, in 1971 the FHS began enroling the second generation cohort, comprising the children of the Original Cohort and the spouses of the children. In 2002, the third generation cohort, comprising the grandchildren of the Original Cohort, was initiated to additionally explore genetic contributions to CVD in greater depth. Additionally, because of the predominance of White individuals of European descent in the three generations of FHS participants noted above, the Heart Study enrolled the OMNI1 and OMNI2 cohorts in 1994 and 2003, respectively, aimed to reflect the current greater racial and ethnic diversity of the town of Framingham. All FHS cohorts have been examined approximately every 2-4 years since the initiation of the study. At these periodic Heart Study examinations, we obtain a medical history and perform a cardiovascular-focused physical examination, 12-lead electrocardiography, blood and urine samples testing and other cardiovascular imaging studies reflecting subclinical disease burden.The FHS has continually evolved along the cutting edge of cardiovascular science and epidemiological research since its inception. Participant studies now additionally include study of cardiovascular imaging, serum and urine biomarkers, genetics/genomics, proteomics, metabolomics and social networks. Numerous ancillary studies have been established, expanding the phenotypes to encompass multiple organ systems including the lungs, brain, bone and fat depots, among others. Whereas the FHS was originally conceived and designed to study the

  10. Newborns with congenital heart diseases: epidemiological data from a single reference center in Brazil

    PubMed Central

    Silva, Karina Peres; Rocha, Luciane Alves; Leslie, Ana Teresa Figueiredo Stochero; Guinsburg, Ruth; Silva, Célia Maria Camelo; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes; Araujo Júnior, Edward

    2014-01-01

    Summary Objective to describe the epidemiological data of the population born with the diagnosis of Congenital Heart Disease (CHD); to compare diagnoses made using fetal echocardiography with the findings from postnatal echocardiography or anatomopathological examination of the heart; and to evaluate mortality among newborns that underwent surgical treatment. Methods this was a cohort study with information gathered from the medical records of the pregnant women and their newborns diagnosed with CHD during the fetal or postnatal periods, between January 2008 and December 2012. Means, standard deviations and maximum and minimum values were calculated for the quantitative variables. Relative and absolute values were calculated for the qualitative variables. The heart malformations were categorized in four groups: complex lesions, significant lesions, minor lesions and others. Results we detected postnatal incidence of CHD of 1.9% at our service. The mean maternal age was 28.3 years and 10 (21.3%) of the pregnant women were ≥ 35 years old. The mean gestational age at the time of performing the fetal echocardiogram was 27.8 weeks. Mean gestational age at delivery was 38 weeks, and the mean weight of the newborns was 2,644.5 grams. Regarding the diagnosis of CHD, there were: 23 complex lesions (39%); 15 significant lesions (26%); 10 minor lesions (17%); 4 other lesions (7%) and 6 normal anatomies (10%). The diagnosis of CHD made on the fetus and postnatally coincided in 77.6% of the cases. A total of 27 patients (60%) underwent surgery, and the outcome was neonatal death in five cases. Conclusion we detected postnatal incidence of CHD of 1.9%, and it was more common among older pregnant women and with late detection in the intrauterine period. Complex heart diseases predominated, thus making it difficult to have a good result regarding neonatal mortality rates. PMID:25332754

  11. Descriptive epidemiology and short-term outcomes of heart failure hospitalisation in rural Haiti

    PubMed Central

    Kwan, Gene F; Jean-Baptiste, Waking; Cleophat, Philip; Leandre, Fèrnet; Louine, Martineau; Luma, Maxo; Benjamin, Emelia J; Mukherjee, Joia S; Bukhman, Gene; Hirschhorn, Lisa R

    2016-01-01

    Objective There is increasing attention to cardiovascular diseases in low-income countries. However, little is known about heart failure (HF) in rural areas, where most of the populations in low-income countries live. We studied HF epidemiology, care delivery and outcomes in rural Haiti. Methods Among adults admitted with HF to a rural Haitian tertiary care hospital during a 12-month period (2013–2014), we studied the clinical characteristics and short-term outcomes including length of stay, inhospital death and outpatient follow-up rates. Results HF accounted for 392/1049 (37%) admissions involving 311 individuals; over half (60%) were women. Mean age was 58.8 (SD 16.2) years for men and 48.3 (SD 18.8) years for women; 76 (41%) women were <40 years of age. Median length of stay was 10 days (first and second quartiles 7, 17), and inhospital mortality was 12% (n=37). Ninety nine (36%) of the 274 who survived their primary hospitalisation followed-up at the hospital’s outpatient clinic, and 18 (6.6%) were readmitted to the same hospital within 30 days postdischarge. Decreased known follow-up (p<0.01) and readmissions (p=0.03) were associated with increased distance between patient residence and hospital. Among the one-quarter (81) patients with echocardiograms, causes of HF included: non-ischaemic cardiomyopathy (64%), right HF (12%), hypertensive heart disease (7%) and rheumatic heart disease (5%). One-half of the women with cardiomyopathy by echocardiogram had peripartum cardiomyopathy. Conclusions HF is a common cause of hospitalisation in rural Haiti. Among diagnosed patients, HF is overwhelming due to non-atherosclerotic heart disease and particularly affects young adults. Implementing effective systems to improve HF diagnosis and linkage to essential outpatient care is needed to reduce long-term morbidity and mortality. PMID:26729609

  12. Gender differences and disparities in all-cause and coronary heart disease mortality: epidemiological aspects

    PubMed Central

    Barrett-Connor, Elizabeth

    2013-01-01

    This overview is primarily concerned with large recent prospective cohort studies of adult populations, not patients, because the latter studies are confounded by differences in medical and surgical management for men vs. women. When early papers are uniquely informative they are also included. Because the focus is on epidemiology, details of age, sex, sample size, and source as well as study methods are provided. Usually the primary outcomes were all-cause or coronary heart disease (CHD) mortality using baseline data from midlife or older adults. Fifty years ago few prospective cohort studies of all-cause or CHD mortality included women. Most epidemiologic studies that included community-dwelling adults did not include both sexes and still do not report men and women separately. Few studies consider both sex (biology) and gender (behavior and environment) differences. Lifespan studies describing survival after live birth are not considered here. The important effects of prenatal and early childhood biologic and behavioral factors on adult mortality are beyond the scope of this review. Clinical trials are not discussed. Overall, presumptive evidence for causality was equivalent for psychosocial and biological exposures, and these attributes were often associated with each other. Inconsistencies or gaps were particularly obvious for studies of sex or gender differences in age and optimal measures of body size for CHD outcomes, and in the striking interface of diabetes and people with the metabolic syndrome, most of whom have unrecognized diabetes. PMID:24054926

  13. Facts and numbers on epidemiology and pharmacological treatment of heart failure with preserved ejection fraction

    PubMed Central

    2015-01-01

    Abstract Heart failure with preserved ejection fraction (HFpEF) is a major and growing public health problem. Epidemiologic studies demonstrated that heart failure (HF) can be clinically diagnosed in patients with normal or preserved left ventricular ejection fraction. These patients are therefore termed as having HFpEF. In the past, this was often called diastolic HF. Because of the permanent increase of the prevalence of HFpEF during the past decades, HFpEF now accounts for more than 50% of the total HF population. There are uncertainties and debates regarding the definition, diagnosis, and pathophysiology with the consequence that all outcome trials performed so far used criteria for inclusion and exclusion that were not consistent. These trials also failed to document improved prognosis. Recent smaller proof‐of‐concept or Phase II clinical trials investigating different pathophysiological approaches with substances such as the neprilysin inhibitor–angiotensin receptor blocker− combination (LCZ 696), ranolazine, or ivabradine were successful to improve biomarkers, haemodynamics, or functional capacity. Future trials will need to document whether also prognosis can be improved. PMID:27708850

  14. Facts and numbers on epidemiology and pharmacological treatment of heart failure with preserved ejection fraction.

    PubMed

    Edelmann, Frank

    2015-06-01

    Heart failure with preserved ejection fraction (HFpEF) is a major and growing public health problem. Epidemiologic studies demonstrated that heart failure (HF) can be clinically diagnosed in patients with normal or preserved left ventricular ejection fraction. These patients are therefore termed as having HFpEF. In the past, this was often called diastolic HF. Because of the permanent increase of the prevalence of HFpEF during the past decades, HFpEF now accounts for more than 50% of the total HF population. There are uncertainties and debates regarding the definition, diagnosis, and pathophysiology with the consequence that all outcome trials performed so far used criteria for inclusion and exclusion that were not consistent. These trials also failed to document improved prognosis. Recent smaller proof-of-concept or Phase II clinical trials investigating different pathophysiological approaches with substances such as the neprilysin inhibitor-angiotensin receptor blocker- combination (LCZ 696), ranolazine, or ivabradine were successful to improve biomarkers, haemodynamics, or functional capacity. Future trials will need to document whether also prognosis can be improved.

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

    PubMed Central

    Moser, Melissa A.; Chun, Ock K.

    2016-01-01

    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. PMID:27529239

  16. Autism Spectrum Disorder Diagnoses in Stockholm Preschoolers

    ERIC Educational Resources Information Center

    Fernell, Elisabeth; Gillberg, Christopher

    2010-01-01

    The aims of this study were to estimate prevalence rates of children with autism spectrum disorder (ASD) diagnoses in a cohort of 6-year-old children with birth year 2002, referred to the Autism Centre for Young Children, serving the whole of Stockholm county and on the basis of the available data discuss clinical aspects of assessment,…

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

    PubMed Central

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

    2016-01-01

    Introduction 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. Methods and analysis 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. Ethics and dissemination 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

  18. Reviews Book: The Quantum Story: A History in 40 Moments Resource: Down2Earth Equipment: Irwin Signal Generator/Power Amplifier Book: Laboratory Experiments in Physics for Modern Astronomy Book: Heart of Darkness Book: The Long Road to Stockholm Book: The Address Book: Our Place in the Scheme of Things Equipment: TI-Nspire Datalogger/Calculator Web Watch

    NASA Astrophysics Data System (ADS)

    2013-07-01

    WE RECOMMEND The Quantum Story: A History in 40 Moments Dip into this useful and accessible guide to quantum theory Down2Earth Astronomical-science resource enables students to pursue real, hands-on science, whatever the weather Irwin Signal Generator/Power Amplifier Students enjoy the novelty factor of versatile, affordable kit Laboratory Experiments in Physics for Modern Astronomy Book of experiments would make good supplementary material Heart of Darkness: Unravelling the Mysteries of the Invisible Universe Accessible and distinctive account of cosmology impresses The Long Road to Stockholm: The Story of MRI—An Autobiography Fascinating book tells personal and scientific stories side by side WORTH A LOOK The Address Book: Our Place in the Scheme of Things Entertaining and well-written essays offer insights and anecdotes TI-Nspire Datalogger/Calculator Challenging interface gives this kit a steep learning curve, but once overcome, results are good WEB WATCH Light-beam app game leaves little impression, while astronomy and astrophysics projects provide much-needed resources

  19. The Hearts of Heroes: the epidemiology of cardiac disease in the UK Armed Forces.

    PubMed

    Cox, Andrew T; Boos, C J; Sharma, S

    2015-09-01

    When the general public look from the outside at the armed services, their impression is often one of earnest young men and women who are the pinnacle of physical fitness and health, and put their lives on the line for their country. There is usually sadness and respect for those killed on active operations, having put themselves in harm's way. Therefore, when the public discover that more than 1 in 10 deaths in the UK Armed Forces are due to cardiovascular disease, the air of sadness is invariably replaced with surprise and disbelief. These figures, while lower than those due to deaths in accidents, are approaching the numbers of those due to suicide in the armed services; yet deaths from cardiac disease are barely recognised by society, in spite of many of them being avoidable. This article reviews the epidemiology of cardiac disease in the UK Armed Forces, both in terms of morbidity and mortality. It outlines current understanding and gaps in the knowledge regarding the burden of cardiovascular disease in the military population. The particular demographics of the Armed Forces and its influence on cardiac disease burden are discussed. The role of inherited and congenital diseases in younger servicemen and women is highlighted, as is the trend that with increasing age, the burden of disease shifts to ischaemic heart disease, which becomes the dominant cause of both death and disability.

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

    PubMed

    Jauho, Mikko

    2017-02-24

    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.

  1. Pubertal stages 1980 of Stockholm schoolchildren.

    PubMed

    Lindgren, G

    1996-11-01

    In March 1980 a cross-sectional study of the pubertal developmental of a sample of Stockholm schoolchildren was conducted. Breast development (B1-B5), pubic hair (PH1-PH5) and axillary hair (AH1-AH3) were rated in 138 girls, and genitalia development (G1-G5), pubic hair (PH1-PH5) and axillary hair (AH1-AH3) were rated in 116 boys according to the Tanner method. The girls' and the boys' ratings were done by one female and one male medically qualified expert respectively. When relating social class to age of pubertal stage no significant differences were found. Median ages for entry to successive pubertal stages as well as centiles were calculated by logistic regression. Girls were somewhat earlier in their breast and pubic hair development than Stockholm girls investigated in earlier studies; however, somewhat later in their development of axillary hair. The boys entered G2 earlier than boys studied in 1970 but entered G5 at exactly the same age, 15.1 years. Boys entered PH2 somewhat later than 1970 boys, but again reached PH5 at exactly the same age, 15.5 years. The present study is based on a more recent and somewhat larger sample of children drawn from a wider area of Stockholm than the earlier studies. It is further suggested that these values be used in the proposed new height and weight reference values for youth in Sweden.

  2. Psychosocial factors in the epidemiology of coronary heart disease in women.

    PubMed

    Eaker, E D

    1989-03-01

    . This may also be due to a true lack of effect or may be the result of not being able to separate the various manifestations of CHD and perhaps to limited sample sizes of women, which leads to a lack of power to detect at true effect. In the field of coronary heart disease epidemiology, as more studies include women and ask questions that are meaningful to them, a clearer understanding of the possible psychosocial etiology of disease will be possible.(ABSTRACT TRUNCATED AT 400 WORDS)

  3. Critical review of the epidemiologic literature regarding the association between congenital heart defects and exposure to trichloroethylene.

    PubMed

    Bukowski, John

    2014-08-01

    The most recent Integrated Risk Information System review of trichloroethylene (TCE; CAS# 79-01-6) has suggested that congenital heart defects (CHD) are a critical endpoint associated with exposure to this solvent. This conclusion was drawn, at least partly, from epidemiologic data, including several relatively recent studies. The current article critically reviews this epidemiologic literature, focusing on study quality and consistency. Literature searches uncovered approximately a dozen studies that specifically addressed associations between TCE and congenital malformations in eight populations. Four of these reported positive associations between TCE and heart defects, with significant relative risks as high as 5-6 in some subgroups. However, each of the positive studies had substantial design or analytical flaws that could easily explain the results, thereby limiting the conclusions that can be drawn. Five studies found no positive association with TCE, and several of these reported substantially fewer cases than expected despite similar/higher exposures compared to positive studies, further detracting from causal conclusions. Overall, this epidemiologic literature provides no substantive or consistent evidence linking TCE to CHD.

  4. Epidemiology of heart failure in Spain over the last 20 years.

    PubMed

    Sayago-Silva, Inés; García-López, Fernando; Segovia-Cubero, Javier

    2013-08-01

    Heart failure is a major health care problem in Spain, although its precise impact is unknown due to the lack of data from appropriately designed studies. In contrast with the 2% prevalence of heart failure elsewhere in Europe and in the United States, studies in Spain report figures of 5%, probably because of methodological limitations. Heart failure consumes enormous quantities of health care resources; it is the first cause of hospitalization in persons aged 65 years or older and represents 3% of all hospital admissions and 2.5% of health care costs. There are two patterns of heart failure: one with preserved systolic function, more often associated with high blood pressure, and another with depressed systolic function, more often associated with ischemic heart disease. In 2010, heart failure accounted for 3% of all deaths in men and for 10% of all deaths in women. In recent years, the mortality rate from heart failure has gradually fallen. The rise in hospital admissions for heart failure and the decrease in mortality from this cause could partly be explained by temporary changes in diagnostic coding, but there is evidence that the reduced mortality could also be due to adherence to clinical practice guidelines.

  5. Evolution of Minimum Mortality Temperature in Stockholm, Sweden, 1901–2009

    PubMed Central

    Åström, Daniel Oudin; Tornevi, Andreas; Ebi, Kristie L.; Rocklöv, Joacim; Forsberg, Bertil

    2015-01-01

    Background: The mortality impacts of hot and cold temperatures have been thoroughly documented, with most locations reporting a U-shaped relationship with a minimum mortality temperature (MMT) at which mortality is lowest. How MMT may have evolved over previous decades as the global mean surface temperature has increased has not been thoroughly explored. Objective: We used observations of daily mean temperatures to investigate whether MMT changed in Stockholm, Sweden, from the beginning of the 20th century until 2009. Methods: Daily mortality and temperature data for the period 1901–2009 in Stockholm, Sweden, were used to model the temperature–mortality relationship. We estimated MMT using distributed lag nonlinear Poisson regression models considering lags up to 21 days of daily mean temperature as the exposure variable. To avoid large influences on the MMT from intra- and interannual climatic variability, we estimated MMT based on 30-year periods. Furthermore, we investigated whether there were trends in the absolute value of the MMT and in the relative value of the MMT (the corresponding percentile of the same-day temperature distribution) over the study period. Results: Our findings suggest that both the absolute MMT and the relative MMT increased in Stockholm, Sweden, over the course of the 20th century. Conclusions: The increase in the MMT over the course of the 20th century suggests autonomous adaptation within the context of the large epidemiological, demographical, and societal changes that occurred. Whether the rate of increase will be sustained with climate change is an open question. Citation: Oudin Åström D, Tornevi A, Ebi KL, Rocklöv J, Forsberg B. 2016. Evolution of minimum mortality temperature in Stockholm, Sweden, 1901–2009. Environ Health Perspect 124:740–744; http://dx.doi.org/10.1289/ehp.1509692 PMID:26566270

  6. Endotoxins in urban air in Stockholm, Sweden

    NASA Astrophysics Data System (ADS)

    Nilsson, S.; Merritt, A. S.; Bellander, T.

    2011-01-01

    Endotoxins, i.e. components originating from the outer membrane in the cell wall of Gram-negative bacteria, activate the human immune system, which may result in airway symptoms such as shortness of breath and airway inflammation. Endotoxins are present in the environment, both outdoors and indoors, and stay airborne for a long time. In order to investigate the levels of endotoxins in urban air and the influence of traffic and meteorological factors, particles (PM 10 and PM 2.5) were collected at five sites in Stockholm, Sweden on four occasions per site between May and September 2009. Endotoxins were extracted from the filters and analysis was conducted with the Limulus Amebocyte Lysate (LAL)-assay. Endotoxins were present in urban air in Stockholm, albeit in low levels, and were similar to levels found in urban areas outside Sweden. To our knowledge, this is the northernmost location where endotoxins have been measured. The endotoxin levels found in PM 10 ranged from 0.020 to 0.107 EU m -3 with a geometric mean of 0.050 EU m -3 and the levels found in PM 2.5 ranged from 0.005 to 0.064 EU m -3 with a geometric mean of 0.015 EU m -3. No obvious effects of traffic or meteorological factors on endotoxin levels were observed, although a moderate correlation could be seen with soot. The small number of sampling sites is however a shortcoming of the present study. In future studies, more sites and sampling during all seasons would be preferable in order to get a better picture of the influence of different sources on endotoxin levels.

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

    PubMed

    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

  8. The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease

    PubMed Central

    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

  9. Clinical and epidemiological study of chronic heart involvment in Chagas' disease*

    PubMed Central

    Puigbó, J. J.; Rhode, J. R. Nava; Barrios, H. García; Suárez, J. A.; Yépez, C. Gil

    1966-01-01

    It has been estimated that, in vast areas of the American continent, there is a high prevalence of human infection by Trypanosoma cruzi. Such infection can lead to a variety of heart diseases, predominantly with involvement of the myocardium. The aim of the present work was to determine the prevalence of heart disease in two rural areas of Venezuela with a high endemicity of Chagas' disease and to try to determine the natural history of the disease. It is shown that a form of chronic myocardial disease in patients with positive specific serology and good functional capacity is highly prevalent. Electrocardiographic patterns typical of the initial and developing stages of the disease, as well as early abnormalities of the cardiac rhythm, are described and illustrated. The present work forms part of a longitudinal study still in progress. ImagesFIG. 2FIG. 8FIG. 9FIG. 6FIG. 7FIG. 3FIG. 5FIG. 4 PMID:4957485

  10. [Coronary heart disease in Mexico and the clinical epidemiological and preventive relevance].

    PubMed

    Chávez Domínguez, Rafael; Ramírez Hernández, Jorge A; Casanova Garcés, José Miguel

    2003-01-01

    Coronary heart disease is dominant among heart diseases in the population, a problem to control. Heart diseases have been first place in the general mortality for the last 20 years. The trend show an annual increase without control. Atherosclerosis is responsible for at least for one fourth of all deaths in the country. The combined data of mortality and morbidity, from hospital discharges or the whole country, disclose that one out of three die of acute myocardial infarction (AMI). While only 8% of all deaths registered were admitted to a hospital. Most, 92% were never admitted to any hospital for some reason. The estimated annual incidence of AMI cases is 140,000, on the basis of 3 cases surviving for each case death, accounted by the Death Certification System, which rounds 35,000. Standardized mortality rates of AMI in Mexico are greater than in USA o Canada creating a more concerned worry. The most probable explanation to that situation is lack of preventive care, which should also include the acute care and before reaching the hospital facilities. Running the same chances are hypertension crisis and strokes and diabetic complications. The appropriate care for critical situations might reduce significantly the cardiovascular mortality in the country, in a short and middle term. Prevention is not only for chronic conditions but for acute and critical situations. The programs of preventive care should also include cultural promotion and community awareness. The timely care is life and myocardium saving. The reinforcement of prior to hospital care reduces the delay for AMI adequate intervention. These activities agree quite well with the ongoing programs of CPR, organizing the surviving chain and the training programs for paramedical emergency technicians.

  11. Strategic Transformation of Population Studies: Recommendations of the Working Group on Epidemiology and Population Sciences From the National Heart, Lung, and Blood Advisory Council and Board of External Experts

    PubMed Central

    Roger, Véronique L.; Boerwinkle, Eric; Crapo, James D.; Douglas, Pamela S.; Epstein, Jonathan A.; Granger, Christopher B.; Greenland, Philip; Kohane, Isaac; Psaty, Bruce M.

    2015-01-01

    In 2013, the National Heart, Lung, and Blood Institute assembled a working group on epidemiology and population sciences from its Advisory Council and Board of External Experts. The working group was charged with making recommendations to the National Heart, Lung, and Blood Advisory Council about how the National Heart, Lung, and Blood Institute could take advantage of new scientific opportunities and delineate future directions for the epidemiology of heart, lung, blood, and sleep diseases. Seven actionable recommendations were proposed for consideration. The themes included 1) defining the compelling scientific questions and challenges in population sciences and epidemiology of heart, lung, blood, and sleep diseases; 2) developing methods and training mechanisms to integrate “big data” science into the practice of epidemiology; 3) creating a cohort consortium and inventory of major studies to optimize the efficient use of data and specimens; and 4) fostering a more open, competitive approach to evaluating large-scale longitudinal epidemiology and population studies. By building on the track record of success of the heart, lung, blood, and sleep cohorts to leverage new data science opportunities and encourage broad research and training partnerships, these recommendations lay a strong foundation for the transformation of heart, lung, blood, and sleep epidemiology. PMID:25743324

  12. An epidemiological study of coronary heart disease in different ethnic groups in Delhi urban population.

    PubMed

    Gopinath, N; Chadha, S L; Jain, P; Shekhawat, S; Tandon, R

    1995-01-01

    A community based epidemiologival survey of coronary heart disease (CHD) was carried out on a random urban sample of 13,560 adults of different ethnic groups in Delhi. CHD was diagnosed either on the basis of clinical history, supported by documentary evidence of treatment in hospital/home or on the ECG evidence in accordance with Minnesota Code. The prevalence rate of CHD on clinical basis per 1000 adults was the highest in Sikhs (47.3), lowest in Muslims (22.8) and identical in Hindus (31.8) and Christians (31.2). The prevalence rate/1000 of silent CHD on the basis of ECG was high in Muslims (89.5) and Sikhs (87.3), low in Christians (25.0) and intermediate in Hindus (60.0). The Sikhs showed the highest prevalence rate of myocardial infarct (MI) (15.5) and angina (AP) (31.8) compared to other communities. The prevalence rate of CHD on clinical basis was higher in males than females in all communities. The prevalence of silent CHD was higher in females in Hindus and Sikhs but in Muslims it was higher in men (94.8) than in women (85.2). The wide variations in prevalence rates of CHD in different ethnic groups cannot be explained satisfactorily on the basis of conventional risk factors and support the multifactorial etiological character of CHD.

  13. Epidemiology as a Guide to Clinical Decisions—II. Diet and Coronary Heart Disease

    PubMed Central

    Hulley, Stephen B.; Sherwin, Roger; Nestle, Marion; Lee, Philip R.

    1981-01-01

    Should clinicians prescribe fat-controlled diets to prevent coronary heart disease (CHD), and, if so, which patients should be given this advice? In this report, we use a three-step model to explain the hypothesis that dietary fats are a cause of CHD: dietary saturated fat and cholesterol raise serum cholesterol levels (step 1), which are a cause of subclinical coronary atherosclerosis (step 2), and, in turn, clinically manifest CHD (step 3). An evaluation of the scientific evidence for each step leads us to conclude that dietary fats definitely influence the level of serum cholesterol, and that serum cholesterol is probably a cause of atherosclerosis and CHD. To determine the clinical implications, we examined the potential of various foods to keep cholesterol levels lower, as well as the projected magnitude of reduction in CHD risk. The likelihood of benefit varies among patients, ranging from uncertain or trivial (for those with lower serum cholesterol levels, those who are free of other risk factors and the elderly) to substantial (for patients with higher serum cholesterol levels, those who have other risk factors and those who are young). This analysis supports an individualized approach to clinical management; each decision to prescribe a fat-controlled diet should be a judgment that depends on art—the therapeutic philosophy of each clinician and the particular needs of each patient—as well as on science. The implication for public health policies is that they should promote rather than a uniform eating pattern for all Americans, a uniform environment that enhances individual choices. This should include efforts to educate the medical profession and the public, and more comprehensive and informative foodlabeling practices. PMID:7257376

  14. Epidemiology of cardioprotective pharmacological agent use in stable coronary heart disease

    PubMed Central

    Sharma, Krishna Kumar; Mathur, Mukul; Gupta, Rakesh; Guptha, Soneil; Roy, Sanjeeb; Khedar, R.S.; Gupta, Nishant; Gupta, Rajeev

    2013-01-01

    Objective To determine use of class and type of cardioprotective pharmacological agents in patients with stable coronary heart disease (CHD) we performed a prescription audit. Methods A cross sectional survey was conducted in major districts of Rajasthan in years 2008–09. We evaluated prescription for classes (anti-platelets, β-blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), calcium channel blockers (CCB) and statins) and specific pharmacological agents at clinics of physicians in tertiary (n = 18), secondary (n = 69) and primary care (n = 43). Descriptive statistics are reported. Results Prescriptions of 2290 stable CHD patients were audited. Anti-platelet use was in 2031 (88.7%), β-blockers 1494 (65.2%), ACE inhibitors 1196 (52.2%), ARBs 712 (31.1%), ACE inhibitors – ARB combinations 19 (0.8%), either ACE inhibitors or ARBs 1908 (83.3%), CCBs 1023 (44.7%), statins 1457 (63.6%) and other lipid lowering agents in 170 (7.4%). Among anti-platelets aspirin–clopidogrel combination was used in 88.5%. Top three molecules in β-blockers were atenolol (37.8%), metoprolol (26.4%) and carvedilol (11.9%); ACE inhibitors ramipril (42.1%), lisinopril (20.3%) and perindopril (10.9%); ARB's losartan (47.7%), valsartan (22.3%) and telmisartan (14.9%); CCBs amlodipine (46.7%), diltiazem (29.1%) and verapamil (9.5%) and statins were atorvastatin (49.8%), simvastatin (28.9%) and rosuvastatin (18.3%). Use of metoprolol, ramipril, valsartan, diltiazem and atorvastatin was more at tertiary care, and atenolol, lisinopril, losartan, amlodipine and simvasatin in primary care (p < 0.01). Conclusions There is low use of β-blockers, ACE inhibitors, ARBs and statins in stable CHD patients among physicians in Rajasthan. Significant differences in use of specific molecules at primary, secondary and tertiary healthcare are observed. PMID:23809376

  15. Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: the Prospective Epidemiological Study of Myocardial Infarction (PRIME)

    PubMed Central

    Ducimetière, Pierre; Evans, Alun; Montaye, Michèle; Haas, Bernadette; Bingham, Annie; Yarnell, John; Amouyel, Philippe; Arveiler, Dominique; Kee, Frank; Bongard, Vanina; Ferrières, Jean

    2010-01-01

    Objective To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France. Design Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox’s proportional hazards regression analysis. Setting One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse). Participants 9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994. Main outcome measures Incident myocardial infarction and coronary death (“hard” coronary events), and incident angina pectoris. Results A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95

  16. Stockholm's Day-Care Centres: 1974-1984.

    ERIC Educational Resources Information Center

    Olsson, Nils-Olof; Sellebjerg, Asa

    The intention of this lavishly illustrated brochure is to show how a decade of expansion in day care services in Stockholm was organized and to depict the different types of centers built between 1974 and 1984 in response to a municipal directive to meet the huge need for day care services by building new centers. Introductory material provides a…

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

    PubMed Central

    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

    Background 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. Methods and results 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 (<1 year) HF admission. We analyzed 1year all-cause and HF hospitalizations, and all-cause mortality. Logistic regression was used to identify the independent predictors of each of those outcomes. A total of 88,195 patients were included. Mean age was 77 years, 55% were women. Comorbidities were frequent. Fourteen percent of patients had never been hospitalized, 71% had a remote HF hospitalization and 15% a recent hospitalization. At 1-year follow-up, all-cause and HF hospitalization were 53% and 8.8%, respectively. One-year all-cause mortality rate was 14%, and was higher in patients with a recent HF hospitalization (24%). The presence of diabetes mellitus, atrial fibrillation or chronic kidney disease was independently associated with all-cause and HF hospitalization and all-cause mortality. Hospital admissions and emergency department visits the previous year were also found to be independently associated with the three study outcomes. Conclusions Outcomes are different depending on the HF population studied. Some comorbidity, an all-cause hospitalization or emergency department visit the previous year were associated with a worse outcome. PMID:28235067

  18. Increasing tinea capitis prevalence in Stockholm reflects immigration.

    PubMed

    Hällgren, Jenny; Petrini, Björn; Wahlgren, Carl-Fredrik

    2004-12-01

    The aim was to describe the mycological and clinical data in children diagnosed with tinea capitis in a hospital setting in Stockholm. Information concerning demography, symptoms, mycology and treatment were obtained, retrospectively, from medical records of all children up to 15 years of age diagnosed with tinea capitis during two 3-year periods, 1989--1991 and 1999--2001, at the Pediatric Dermatology Unit of the Karolinska Hospital in Stockholm. Between 1989 and 1991, five children were diagnosed with tinea capitis. Between 1999 and 2001, there were 92 children, the vast majority (86%) being of foreign extraction, mostly African (83%). Trichophyton violaceum was the most prevalent pathogen, affecting 68% of the children. Of the anthropophilic infections, 62% were linked to relatives. In 71% of all positive cultures, microscopy was positive. The most common clinical findings were scaling of the scalp (80%), itching (54%) and patches of alopecia (52%). The treatment consisted of the oral antimycotics terbinafine (n = 48) or griseofulvin (n = 49). During the last decade there has been an increase in tinea capitis in Stockholm, most commonly caused by Trichophyton violaceum, corresponding with the increased immigration from Africa. Spread within the family seems to be of importance, and family members are preferably screened in an effort to prevent continued transmission. It is important to bear the diagnosis of tinea capitis in mind, especially as, untreated, some cases can develop permanent alopecia and may also cause further spreading of this infection.

  19. Upstream silver source mapping - a case study in Stockholm, Sweden.

    PubMed

    Amneklev, Jennie; Bergbäck, Bo; Sörme, Louise; Lagerkvist, Ragnar

    2014-01-01

    Silver (Ag) can be a problem for wastewater treatment plants (WWTP) and their capability to use sewage sludge as a soil fertilizer. Due to a high accumulation rate in soils, the levels of Ag in the incoming water at the WWTP must be reduced. This study aims to identify major diffuse emission sources in the technosphere through a comprehensive substance flow analysis of Ag in Stockholm, Sweden. Large inflows and stocks of Ag were present in electrical and electronic goods and appliances as well as in jewellery and silverware. The total inflow was 3.2 tonnes (4.2 g/person), the total stock was 100 tonnes (140 g/person) and the total outflow was 330 kg (430 mg/person). Major identified Ag sources with emissions ending up in the WWTP (total 26 kg, 34 mg/person) were food, amalgam and beauty products (via urine and faeces, 12 mg/person or 11% of incoming amount), and textiles (via washing, 17 mg/person or 16% of incoming amount). This study explains approximately 35% of the total 80 kg Ag in the incoming water at Henriksdal WWTP in Stockholm. Plastic, photography and beauty products were identified as possible sources of Ag that need to be examined further.

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

    PubMed

    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.

  1. Pollen Season Trends (1973-2013) in Stockholm Area, Sweden

    PubMed Central

    Lind, Tomas; Ekebom, Agneta; Alm Kübler, Kerstin; Östensson, Pia; Bellander, Tom

    2016-01-01

    In the present study, the phenological and quantitative changes in the pollen seasons between 1973 and 2013 in the Stockholm region of Sweden were studied for nine types of pollen (hazel, alder, elm, birch, oak, grass, mugwort, willow and pine). Linear regression models were used to estimate the long term trends in duration, start- and end-dates, peak-values and the yearly accumulated pollen sums of the pollen seasons. The pollen seasons of several arboreal plant species (e.g. birch, oak and pine) were found to start significantly earlier today compared to 41 years earlier, and have an earlier peak-date, while the season of other species seemed largely unaffected. However, the long term trends in the end-dates of pollen seasons differed between arboreal and herbaceous species. For herbaceous species (grass and mugwort), a significant change towards later end-dates was observed and the duration of season was found to have increased. A significant trend towards an earlier end-date was found in the majority of the arboreal plant species (i.e. elm, oak, pine and birch), but the length of the season seemed unaffected. A trend towards an increase in yearly concentrations of pollen was observed for several species; however the reasons for this phenomenon cannot be explained unambiguously by the present study design. The trend of increasing yearly mean air temperatures in the Stockholm area may be the reason to changed phenological patterns of pollen seasons. PMID:27898718

  2. VIRAL EPIDEMIOLOGIC SHIFT IN INFLAMMATORY HEART DISEASE: THE INCREASING INVOLVEMENT OF PARVOVIRUS B19 IN THE MYOCARDIUM OF PEDIATRIC CARDIAC TRANSPLANT PATIENTS

    PubMed Central

    Breinholt, John P.; Moulik, Mousumi; Dreyer, William J.; Denfield, Susan W.; Kim, Jeffrey J.; Jefferies, John L.; Rossano, Joseph W.; Gates, Corey M.; Clunie, Sarah K.; Bowles, Karla R.; Kearney, Debra L.; Bowles, Neil E.; Towbin, Jeffrey A.

    2010-01-01

    Background Detection of viral genome in rejecting cardiac transplant patients has been reported, with coxsackievirus and adenovirus causing premature graft failure. Recently, parvovirus B19 (PVB19) genome in myocardial samples has been increasingly reported but its role in cardiac pathology and effect on transplant graft survival are unknown. The objectives were to determine if changes in the viruses identified in the myocardium represent an epidemiologic shift in viral myocardial disease and whether PVB19 adversely affects transplant graft survival. Methods From 9/2002 to 12/2005, 99 children (3 weeks-18 years) with heart transplants had endomyocardial biopsies evaluated for the presence of viral genome utilizing nested PCR. Cellular rejection was assessed by histology of biopsies, while transplant coronary artery disease (TCAD) was diagnosed by coronary angiography or histopathology. Results Seven hundred biopsies were evaluated from 99 patients; 121 biopsies had viral genome with 100 (82.6%) positive for PVB19, 24 for Epstein-Barr virus (EBV; 7 positive for PVB19 and EBV), 3 for CMV and 1 for adenovirus. Presence of PVB19 genome did not correlate with rejection score, nor did higher viral copy number. Children with persistent PVB19 infection (>6 months; n=20), had early development of advanced TCAD (p<0.001). Conclusions PVB19 is currently the predominant virus detected in heart transplant surveillance biopsies, possibly representing an epidemiologic shift. While cellular rejection does not correlate with the presence or quantity of PVB19 genome in the myocardium, children with chronic PVB19 infection have increased risk for earlier TCAD, supporting the hypothesis that PVB19 negatively affects graft survival. PMID:20456978

  3. Role of radiation and non-radiation factors on the development of coronary heart disease in the Chornobyl clean-up workers: epidemiological study results.

    PubMed

    Krasnikova, L I; Buzunov, V O

    2014-09-01

    Objective. The objective of this study was to establish the risks for coronary heart disease in the Chornobyl clean-up workers with regard to a whole-body external radiation dose and non-radiation (biological, social-and-hygienic and behavioral) factors. Materials and methods. Risk-analysis was based on the cohort of the Chornobyl male clean-up workers 1986-1987 (8,625 men, including 3,623 with available whole-body external doses). Data of clinical-and-epidemiological registry, National Research Centre for Radiation Medicine were used for 1992-2013 monitoring period. We used the internal control group with radiation doses less than 0.05 Gy. Results. Statistically significant radiation risks in the Chornobyl clean-up workers were established for the coronary heart disease at doses 0.15-0.249 Gy, 0.25-0.99 Gy, 1 Gy and more (dose group 0.15-0.249 Gy RRY=1.9 (1.2; 3.1), ERR=4.6 (1.5; 14.9) Gy-1, EAR=64.2 cases per 1000 person-years, Gy); among exposed people aged 40 years and older - at doses 0.5-0.99 Gy (RRY=1.4 (1.05; 1.81), ERR=0.5 (0.03; 1.1) Gy-1, EAR=30.5 cases per 1000 person-years, Gy). Statistically significant risks for the disease under consideration were also identified with regard to non-radiation factors (smoking, improper physical training, adverse working conditions, diseases etc; age and psychoemotional overstrain were of a particular impact). Non-radiation factors are at most responsible for development of coronary heart disease. For this reason the control of potential confounding factors is required to assess the effect of the radiation factor both at a stage of comparison groups selection and analysis using the Mantel-Haenszel method.

  4. Epidemiologic burden of hospitalisation for congestive heart failure among adults aged ≥19 years in the Philippines

    PubMed Central

    Tumanan-Mendoza, Bernadette A; Mendoza, Victor L; Bermudez–Delos Santos, April Ann A; Punzalan, Felix Eduardo R; Pestaño, Noemi S; Natividad, Rudy Boy; Shiu, Louie Alfred; Macabeo, Renelene

    2017-01-01

    Objectives The study determined the prevalence of hospitalisation due to congestive heart failure (CHF) among adult patients aged 19 years and above in the Philippines and its 17 regions in 2014. It also determined the demographic profile of these patients, aetiology and type of CHF, comorbidities, duration of hospitalisation and the overall in-hospital mortality rate. Methods Data collection was done using the hospitalisation claims database of the Philippine Health Insurance Corporation (PhilHealth). All patient claims for CHF, that is, patients who were admitted from 1 January to 31 December 2014, were included. Descriptive statistics were utilised to obtain the results. Results The prevalence rate was 1.6% or 1648 cases of CHF for every 100 000 patient claims for medical conditions in 2014. The mean age was 52.6±15.1 years. There was no sex predilection. Only 22.67% of the hospitalisation claims for CHF listed possible specific aetiologies, the most common of which was hypertensive heart disease (86.7%). There were more cases of systolic compared to diastolic heart failure. The mean length of hospital stay was 5.9 days (+8.2) days (median 4 days), with an overall in-hospital mortality rate of 8.2%. Conclusions There were 16 cases of heart failure for every 1000 Filipino patients admitted due to a medical condition in 2014. Hypertension was possibly the most common aetiologic factor. Compared to western and Asia-Pacific countries, the local mortality rate was relatively higher.

  5. Design (and) principles of nuclear dynamics in Stockholm

    PubMed Central

    Shav-Tal, Yaron; Lammerding, Jan

    2015-01-01

    The structural organization of the nucleus and its content has drawn increasing interest in recent years, as it is has become evident that the spatial and temporal arrangement of the genome and associated structures plays a crucial role in transcriptional regulation and numerous other functions. Shining light on the dynamic nature of this organization, along with the processes controlling it, were the topics of the Wenner-Gren Foundations international symposium "Nuclear Dynamics: Design (and) Principles." The meeting, organized by Piorgiogio Percipalle, Maria Vartiainen, Neus Visa, and Ann-Kristin Östlund-Farrants, brought over 60 participants, including 20 international speakers, to Stockholm, Sweden from August 19–22, 2015 to share the latest developments in the field. Given the unpublished nature of many of the talks, we have focused on covering the discussed topics and highlighting the latest trends in this exciting and rapidly evolving field. PMID:26730816

  6. Comparison between RFLP and MIRU-VNTR Genotyping of Mycobacterium tuberculosis Strains Isolated in Stockholm 2009 to 2011

    PubMed Central

    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. PMID:24733167

  7. Racial differences in the association of coronary calcified plaque with left ventricular hypertrophy: the National Heart, Lung, and Blood Institute Family Heart Study and Hypertension Genetic Epidemiology Network.

    PubMed

    Tang, Weihong; Arnett, Donna K; Province, Michael A; Lewis, Cora E; North, Kari; Carr, J Jeffrey; Pankow, James S; Hopkins, Paul N; Devereux, Richard B; Wilk, Jemma B; Wagenknecht, Lynne

    2006-05-15

    Studies have reported a lower burden of calcified atherosclerotic plaque in coronary arteries in African-Americans than in whites. Findings from autopsy studies of sudden cardiac death have suggested a link between left ventricular hypertrophy and severity of coronary atherosclerosis. Echocardiograms and cardiac computed tomograms were analyzed in 334 African-American (84% hypertensive) and 196 white (66% hypertensive) adults with no history of coronary heart disease or revascularization procedures at study entry. The relation of coronary artery calcium (CAC) score to left ventricular mass and left ventricular mass indexed to body surface area was assessed by Spearman's correlations and mixed linear models. Covariates included age, gender, field center, weight, height, systolic blood pressure, number of antihypertensive medications, diabetes, total and high-density lipoprotein cholesterol levels, and current smoking and alcohol consumption. In African-Americans, a significant and independent association between CAC score and left ventricular mass or left ventricular mass indexed to body surface area was present with the 2 analytic strategies. Spearman's correlation coefficients for CAC score with left ventricular mass and left ventricular mass indexed to body surface area were 0.14 (p = 0.015) and 0.13 (p = 0.025), respectively, after multivariable adjustment. In whites, the associations of CAC score with measurements of left ventricular mass were weaker and only marginally significant in mixed linear models. In conclusion, these findings suggest that CAC reflects a different risk burden between African-Americans and whites, and future studies examining the prognostic implications of CAC in African-Americans should consider the potential association between CAC and left ventricular hypertrophy.

  8. 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

    PubMed Central

    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

  9. [Clinical and epidemiologic characteristics of ischemic heart disease in a group of physically handicapped individuals (blind and mute)].

    PubMed

    Stanić, R

    1993-01-01

    Our long clinical experience, with observations of some authors as well, indicate that the epidemic data of the prevalence of ischaemic heart disease (I.H.D.) is significantly reduced in some physically handicapped people (the blind and the deaf-mute) if we compare them with the similar ones who have not such anomalies. With no regard to patho-physiologic mechanism of such condition, 233 examinees of both sex, chosen by the method of accidental choice, were examined by clinical, ECG, and laboratory (non- invasive) methods and divided into three groups: the blind 81 (34.76%), the deaf-mute 76 (32.61%), and industrial workers 76 (32.61%) who were taken a as control group. The obtained results show that the incidence of I.H.D. (4,56%), and the control group 11 (8,36%), which, from the point of statistics, offer a significant piece of information.

  10. Maternal Folic Acid Supplementation and the Risk of Congenital Heart Defects in Offspring: A Meta-Analysis of Epidemiological Observational Studies

    NASA Astrophysics Data System (ADS)

    Feng, Yu; Wang, Song; Chen, Runsen; Tong, Xing; Wu, Zeyu; Mo, Xuming

    2015-02-01

    Epidemiological studies have reported conflicting results regarding the association between maternal folic acid supplementation and the risk of congenital heart defects (CHDs). However, a meta-analysis of the association between maternal folic acid supplementation and CHDs in offspring has not been conducted. We searched the MEDLINE and EMBASE databases for articles cataloged between their inceptions and October 10, 2014 and identified relevant published studies that assessed the association between maternal folate supplementation and the risk of CHDs. Study-specific relative risk estimates were pooled using random-effects or fixed-effects models. Out of the 1,606 articles found in our initial literature searches, a total of 1 randomized controlled trial, 1 cohort study, and 16 case-control studies were included in our final meta-analysis. The overall results of this meta-analysis provide evidence that maternal folate supplementation is associated with a significantly decreased risk of CHDs (RR = 0.72, 95% CI: 0.63-0.82). Statistically significant heterogeneity was detected (Q = 82.48, P < 0.001, I2 = 79.4%). We conducted stratified and meta-regression analyses to identify the origin of the heterogeneity among the studies, and a Galbraith plot was generated to graphically assess the sources of heterogeneity. This meta-analysis provides a robust estimate of the positive association between maternal folate supplementation and a decreased risk of CHDs.

  11. Depression, social support, and long-term risk for coronary heart disease in a 13-year longitudinal epidemiological study.

    PubMed

    Liu, Richard T; Hernandez, Evelyn M; Trout, Zoë M; Kleiman, Evan M; Bozzay, Melanie L

    2017-02-06

    Depression has been linked with long-term risk for a variety of physical health ailments, including coronary heart disease (CHD). Little is known about resilience factors that may attenuate this relationship. The current study assessed whether social support moderates the long-term risk for CHD associated with this disorder. Data were drawn from the Americans' Changing Lives study, a nationally representative longitudinal survey of adults in the United States. Participants (unweighted n=1636) completed initial assessments of functional social support, body mass index, recent history of major depression, CHD, hypertension, and diabetes. Participants were again assessed for CHD at a follow-up assessment 13 years later. Social support was found to moderate the relationship between depression and the occurrence of CHD 13 years later. Specifically, among individuals with low social support, depression was prospectively associated with CHD. In contrast, depression was not prospectively associated with CHD among individuals with high social support. The results indicate that social support may function as a resilience factor against the long-term cardiovascular risk associated with depression. Clinical interventions focusing on the development of social support systems are important not only for addressing depression itself, but also for associated long-term physical health outcomes.

  12. Age at immigration and crime in Stockholm using sibling comparisons.

    PubMed

    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.

  13. The Road to Stockholm - Nobel Prizes, Science, and Scientists

    NASA Astrophysics Data System (ADS)

    Hargittai, István

    2002-05-01

    The Nobel Prize is by far the highest recognition a scientist may receive and the only one with which the general public is familiar. Its prestige has reached improbable heights. At the same time a lot of myth surrounds the Nobel Prize, and this is compounded by the fact that people tend to view scientists with some bewilderment.This book introduces the process of selection of the laureates, discusses the ingredients for scientific discovery and for getting recognition. It reviews the decisive moments of scientific careers en route to the Nobel Prize, points to characteristic features of the laureates, the importance of mentors and venues in scientific careers and other components of success. It also covers some discoverers and discoveries for whom and for which the Nobel Prize never materialized.Whereas there is no general recipe for receiving the Nobel Prize, there are common features of successful scientific careers. The book reveals some information about the scientists' lives and careers that may guide other scientists in increasing their chances of becoming more effective and better recognized players--although it is not expected to help anyone to receive the Nobel Prize!For the general reader The Road to Stockholm reveals the human face of scientists and the human side of their endeavours. The Nobel Prize has served as inspiration for scientists and the general public for a hundred years: this book discusses its problems and celebrates its triumphs.

  14. Urban air pollution and lung cancer in Stockholm.

    PubMed

    Nyberg, F; Gustavsson, P; Järup, L; Bellander, T; Berglind, N; Jakobsson, R; Pershagen, G

    2000-09-01

    We conducted a population-based case-control study among men 40-75 years of age encompassing all cases of lung cancer 1985-1990 among stable residents of Stockholm County 1950-1990. Questionnaires to subjects or next-of-kin (primarily wives or children) elicited information regarding smoking and other risk factors, including occupational and residential histories. A high response rate (>85%) resulted in 1,042 cases and 2,364 controls. We created retrospective emission databases for NOx/NO2 and SO2 as indicators of air pollution from road traffic and heating, respectively. We estimated local annual source-specific air pollution levels using validated dispersion models and we linked these levels to residential addresses using Geographical Information System (GIS) techniques. Average traffic-related NO2 exposure over 30 years was associated with a relative risk (RR) of 1.2 (95% confidence interval 0.8-1.6) for the top decile of exposure, adjusted for tobacco smoking, socioeconomic status, residential radon, and occupational exposures. The data suggested a considerable latency period; the RR for the top decile of average traffic-related NO2 exposure 20 years previously was 1.4 (1.0-2.0). Little association was observed for SO2. Occupational exposure to asbestos, diesel exhaust, and other combustion products also increased the risk of lung cancer. Our results indicate that urban air pollution increases lung cancer risk and that vehicle emissions may be particularly important.

  15. Low-density-lipoprotein cholesterol concentrations and risk of incident diabetes: epidemiological and genetic insights from the Framingham Heart Study

    PubMed Central

    Andersson, Charlotte; Lyass, Asya; Larson, Martin G.; Robins, Sander J.; Vasan, Ramachandran S.

    2015-01-01

    Aims/hypothesis Statins and niacin (nicotinic acid) reduce circulating LDL-cholesterol (LDLC) levels by different mechanisms. Yet, both increase the risk of diabetes mellitus. Our objective was to relate blood LDL-C concentrations and a genetic risk score (GRS) for LDLC to the risk of incident diabetes in individuals not treated with lipid-modifying therapy. Methods We evaluated participants of the Framingham Heart Study who attended any of Offspring cohort examination cycles 3–8 and Third Generation cohort examination cycle 1 (N =14,120 person-observations, 6,011 unique individuals; mean age 50 ± 11 years, 56% women), who were not treated with lipid-modifying or antihypertensive medications and who were free from cardiovascular disease at baseline. Incident diabetes was assessed at the next examination. Results The GRS was significantly associated with LDL-C concentrations (sex- and age-adjusted estimated influence 0.24, p < 0.0001). On follow-up (mean 4.5 ± 1.5 years), 312 individuals (2.2%) developed new-onset diabetes. In multivariable models, a higher LDL-C concentration was associated with lower risk of diabetes (OR per SD increment 0.81, 95% CI 0.70, 0.93, p = 0.004). The GRS was associated with incident diabetes in similar direction and of comparable magnitude (OR per SD increment 0.85, 95% CI 0.76, 0.96, p = 0.009). Conclusions/interpretation Among individuals not treated with lipid-modifying therapy low LDL-C concentrations were associated with increased diabetes risk. These observations may contribute to our understanding of why lipid-lowering treatment may cause diabetes in some individuals. Additional studies are warranted to elucidate the molecular mechanisms underlying our observations. PMID:26409460

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

    PubMed

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

    2016-08-03

    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 NOx 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 NOx. We built a linear regression model for NOx, using a stepwise forward selection of covariates. The resulting model predicted observed NOx (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 NOx levels (routine urban NOx, less routine rural NOx). 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.Journal of Exposure Science and Environmental Epidemiology advance online publication, 3 August 2016; doi:10.1038/jes.2016.40.

  17. Sick Leave and Work Participation among Parents of Children with Autism Spectrum Disorder in the Stockholm Youth Cohort: A Register Linkage Study in Stockholm, Sweden

    ERIC Educational Resources Information Center

    McEvilly, Miranda; Wicks, Susanne; Dalman, Christina

    2015-01-01

    This population-based register study explored the association between having a child with/without autism spectrum disorder (ASD) and parental sick leave and work participation. Parents of children with ASD living in Stockholm, Sweden in 2006 were more likely to be on sick leave, not in the labor force, or earning low income when compared to…

  18. Understanding healthcare innovation systems: the Stockholm region case.

    PubMed

    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

  19. Genome-wide Studies of Verbal Declarative Memory in Nondemented Older People: The Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium

    PubMed Central

    Debette, Stéphanie; Ibrahim Verbaas, Carla A.; Bressler, Jan; Schuur, Maaike; Smith, Albert; Bis, Joshua C.; Davies, Gail; Wolf, Christiane; Gudnason, Vilmundur; Chibnik, Lori B.; Yang, Qiong; deStefano, Anita L.; de Quervain, Dominique J.F.; Srikanth, Velandai; Lahti, Jari; Grabe, Hans J.; Smith, Jennifer A.; Priebe, Lutz; Yu, Lei; Karbalai, Nazanin; Hayward, Caroline; Wilson, James F.; Campbell, Harry; Petrovic, Katja; Fornage, Myriam; Chauhan, Ganesh; Yeo, Robin; Boxall, Ruth; Becker, James; Stegle, Oliver; Mather, Karen A.; Chouraki, Vincent; Sun, Qi; Rose, Lynda M.; Resnick, Susan; Oldmeadow, Christopher; Kirin, Mirna; Wright, Alan F.; Jonsdottir, Maria K.; Au, Rhoda; Becker, Albert; Amin, Najaf; Nalls, Mike A.; Turner, Stephen T.; Kardia, Sharon L.R.; Oostra, Ben; Windham, Gwen; Coker, Laura H.; Zhao, Wei; Knopman, David S.; Heiss, Gerardo; Griswold, Michael E.; Gottesman, Rebecca F.; Vitart, Veronique; Hastie, Nicholas D.; Zgaga, Lina; Rudan, Igor; Polasek, Ozren; Holliday, Elizabeth G.; Schofield, Peter; Choi, Seung Hoan; Tanaka, Toshiko; An, Yang; Perry, Rodney T.; Kennedy, Richard E.; Sale, Michèle M.; Wang, Jing; Wadley, Virginia G.; Liewald, David C.; Ridker, Paul M.; Gow, Alan J.; Pattie, Alison; Starr, John M.; Porteous, David; Liu, Xuan; Thomson, Russell; Armstrong, Nicola J.; Eiriksdottir, Gudny; Assareh, Arezoo A.; Kochan, Nicole A.; Widen, Elisabeth; Palotie, Aarno; Hsieh, Yi-Chen; Eriksson, Johan G.; Vogler, Christian; van Swieten, John C.; Shulman, Joshua M.; Beiser, Alexa; Rotter, Jerome; Schmidt, Carsten O.; Hoffmann, Wolfgang; Nöthen, Markus M.; Ferrucci, Luigi; Attia, John; Uitterlinden, Andre G.; Amouyel, Philippe; Dartigues, Jean-François; Amieva, Hélène; Räikkönen, Katri; Garcia, Melissa; Wolf, Philip A.; Hofman, Albert; Longstreth, W.T.; Psaty, Bruce M.; Boerwinkle, Eric; DeJager, Philip L.; Sachdev, Perminder S.; Schmidt, Reinhold; Breteler, Monique M.B.; Teumer, Alexander; Lopez, Oscar L.; Cichon, Sven; Chasman, Daniel I.; Grodstein, Francine; Müller-Myhsok, Bertram; Tzourio, Christophe; Papassotiropoulos, Andreas; Bennett, David A.; Ikram, Arfan M.; Deary, Ian J.; van Duijn, Cornelia M.; Launer, Lenore; Fitzpatrick, Annette L.; Seshadri, Sudha; Mosley, Thomas H.

    2015-01-01

    BACKGROUND Memory performance in older persons can reflect genetic influences on cognitive function and dementing processes. We aimed to identify genetic contributions to verbal declarative memory in a community setting. METHODS We conducted genome-wide association studies for paragraph or word list delayed recall in 19 cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium, comprising 29,076 dementia-and stroke-free individuals of European descent, aged ≥45 years. Replication of suggestive associations (p < 5 × 10−6) was sought in 10,617 participants of European descent, 3811 African-Americans, and 1561 young adults. RESULTS rs4420638, near APOE, was associated with poorer delayed recall performance in discovery (p = 5.57 × 10−10) and replication cohorts (p = 5.65 × 10−8). This association was stronger for paragraph than word list delayed recall and in the oldest persons. Two associations with specific tests, in subsets of the total sample, reached genome-wide significance in combined analyses of discovery and replication (rs11074779 [HS3ST4], p = 3.11 × 10−8, and rs6813517 [SPOCK3], p = 2.58 × 10−8) near genes involved in immune response. A genetic score combining 58 independent suggestive memory risk variants was associated with increasing Alzheimer disease pathology in 725 autopsy samples. Association of memory risk loci with gene expression in 138 human hippocampus samples showed cis-associations with WDR48 and CLDN5, both related to ubiquitin metabolism. CONCLUSIONS This largest study to date exploring the genetics of memory function in ~ 40,000 older individuals revealed genome-wide associations and suggested an involvement of immune and ubiquitin pathways. PMID:25648963

  20. Maternal Parity and the Risk of Congenital Heart Defects in Offspring: A Dose-Response Meta-Analysis of Epidemiological Observational Studies

    PubMed Central

    Chen, Tao; Liu, Jin; Tong, Xing; Yang, Lei; Da, Min; Shen, Shutong; Fan, Changfeng; Wang, Song; Mo, Xuming

    2014-01-01

    Background Epidemiological studies have reported conflicting results regarding maternal parity and the risk of congenital heart defects (CHDs). However, a meta-analysis of the association between maternal parity and CHDs in offspring has not been conducted. Methods We searched MEDLINE and EMBASE for articles catalogued between their inception and March 8, 2014; we identified relevant published studies that assessed the association between maternal parity and CHD risk. Two authors independently assessed the eligibility of the retrieved articles and extracted data from them. Study-specific relative risk estimates were pooled by random-effects or fixed-effects models. From the 11272 references, a total of 16 case-control studies and 3 cohort studies were enrolled in this meta-analysis. Results The overall relative risk of CHD in parous versus nulliparous women was 1.01 (95% CI, 0.97–1.06; Q = 32.34; P = 0.006; I2 = 53.6%). Furthermore, we observed a significant association between the highest versus lowest parity number, with an overall RR = 1.20 (95% CI, 1.10–1.31; (Q = 74.61, P<0.001, I2 = 82.6%). A dose–response analysis also indicated a positive effect of maternal parity on CHD risk, and the overall increase in relative risk per one live birth was 1.06 (95% CI, 1.02–1.09); Q = 68.09; P<0.001; I2 = 80.9%). We conducted stratified and meta-regression analyses to identify the origin of the heterogeneity among studies. A Galbraith plot was created to graphically assess the sources of heterogeneity. Conclusion In summary, this meta-analysis provided a robust estimate of the positive association between maternal parity and risk of CHD. PMID:25295723

  1. Use of a genetic algorithm to improve the rail profile on Stockholm underground

    NASA Astrophysics Data System (ADS)

    Persson, Ingemar; Nilsson, Rickard; Bik, Ulf; Lundgren, Magnus; Iwnicki, Simon

    2010-12-01

    In this paper, a genetic algorithm optimisation method has been used to develop an improved rail profile for Stockholm underground. An inverted penalty index based on a number of key performance parameters was generated as a fitness function and vehicle dynamics simulations were carried out with the multibody simulation package Gensys. The effectiveness of each profile produced by the genetic algorithm was assessed using the roulette wheel method. The method has been applied to the rail profile on the Stockholm underground, where problems with rolling contact fatigue on wheels and rails are currently managed by grinding. From a starting point of the original BV50 and the UIC60 rail profiles, an optimised rail profile with some shoulder relief has been produced. The optimised profile seems similar to measured rail profiles on the Stockholm underground network and although initial grinding is required, maintenance of the profile will probably not require further grinding.

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

    PubMed

    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.

  3. Unemployment and dispensed prescribed antidepressants in Stockholm County 1998-09.

    PubMed

    Lundin, Andreas; Hansson, Anders

    2014-08-01

    The association between unemployment rates and population mental health has been studied with contradictory results. We examine the association between unemployment and antidepressants in Stockholm County. Age- and sex-specific monthly data on unemployment and dispensed prescribed antidepressants from January 1998 to January 2008 in Stockholm County were used. The association was studied with bivariate cointegration analysis with stationarity check of the residuals. We found that dispensing of antidepressants was inversely associated with unemployment. One interpretation is that antidepressants have not followed decreasing unemployment rates.

  4. Prevalence and risk factors for HTLV-II infection in 913 injecting drug users in Stockholm, 1994.

    PubMed

    Krook, A; Albert, J; Andersson, S; Biberfeld, G; Blomberg, J; Eklund, I; Engström, A; Julander, I; Käll, K; Martin, C; Stendahl, P; Struve, J; Sönnerborg, A

    1997-08-15

    The prevalence and risk factors for acquisition of human T-cell lymphotropic virus type I and II (HTLV-I and II) were investigated in a prospective study of 913 injecting drug users (IDUs) in Stockholm in 1994. Epidemiologic data were recorded, and blood samples were tested for antibodies against HTLV-I and HTLV-II; human immunodeficiency virus (HIV) types 1 and 2; and hepatitis A (HAV), B (HBV), C (HCV), and D (HDV). Positive serologic results for HTLV were confirmed by Western blot (WB) and polymerase chain reaction (PCR). Of the 905 participants with conclusive HTLV-II status, 29 (3.2%) were HTLV-II positive, and all but three were of Nordic descent. None was HTLV-I infected. One person was infected as early as 1981, before HIV had reached the IDU population in Sweden. The prevalence of HTLV-II infection was 12% among HIV-1-seropositive and 1.8% among HIV-1-seronegative participants. The overall seroprevalences were 14% for HIV-1, 0% for HIV-2, 41% for HAV, 75% for HBV, 92% for HCV, and 8% for HDV. Although amphetamine has been the main injecting drug in Sweden for several decades, heroin abuse combined with a debut of injecting drugs before 1975 was identified as the most important risk factor associated with HTLV-II infection. HAV and HIV seropositivity were also independent risk factors.

  5. Epidemiology of Cardiovascular Diseases.

    ERIC Educational Resources Information Center

    Jenkins, C. David

    1988-01-01

    Reviews epidemiological studies of cardiovascular diseases especially coronary heart disease (CHD), to document their major public health importance, changes in mortality during this century, and international comparisons of trends. Finds major risk factors for CHD are determined in large part by psychosocial and behavioral mechanisms. Asserts…

  6. Environment, United Nations Conference on the Human Environment (Stockholm, June 5-16, 1972).

    ERIC Educational Resources Information Center

    United Nations, Geneva (Switzerland). Centre for Economic and Social Information.

    Highlights of the United Nations Conference on the Human Environment, Stockholm, Sweden, June, 1972, are presented in this news brochure. Four sections are defined: Resolutions, Reports, Statements, and Speeches. The first, Resolutions, states the declaration of principles, recommendations for action, the action plan, and institutional and…

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

    ERIC Educational Resources Information Center

    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…

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

    ERIC Educational Resources Information Center

    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…

  9. Opportunities and Challenges for Building Alumni Networks in Sweden: A Case Study of Stockholm University

    ERIC Educational Resources Information Center

    Ebert, Karin; Axelsson, Leona; Harbor, Jon

    2015-01-01

    Because of the potential value of alumni involvement for student success, for connections to society and as a base for future philanthropy, there is growing interest in developing university alumni relations programmes in countries that do not have a long tradition in this area. This case study of Stockholm University describes the goals,…

  10. The Stockholm CREAtinine Measurements (SCREAM) project: protocol overview and regional representativeness

    PubMed Central

    Runesson, Björn; Gasparini, Alessandro; Qureshi, Abdul Rashid; Norin, Olof; Evans, Marie; Barany, Peter; Wettermark, Björn; Elinder, Carl Gustaf; Carrero, Juan Jesús

    2016-01-01

    Background We here describe the construction of the Stockholm CREAtinine Measurement (SCREAM) cohort and assess its coverage/representativeness of the Stockholm county in Sweden. SCREAM has the principal aims to estimate the burden and consequences of chronic kidney disease (CKD) and to identify inappropriate drug use (prescription of nephrotoxic, contraindicated or ill-dosed drugs). Methods SCREAM is a repository of laboratory data of individuals, residing or accessing healthcare in the region of Stockholm, who underwent creatinine assessments between 2006–11. Laboratory tests were linked to administrative databases with complete information on socioeconomic status, demographic data, healthcare utilization, diagnoses, vital status and dispensed prescription medicines. Results SCREAM identified 1 118 507 adult Stockholm citizens with available creatinine tests between 2006–11. This corresponded to 66% of the complete population in the region. Geographical coverage was uniform, ranging between 62 and 72% throughout its 26 municipalities. Population coverage was higher across older age strata (50% coverage for age range 18–44 years, >75% for 45–64 years and >90% coverage for ≥65 years). Of note, 97 and 98% of all individuals with a diagnosis of diabetes mellitus or cardiovascular disease, respectively, were captured by SCREAM. Further, 89% of all deaths registered in the period occurred in individuals with a creatinine test undertaken. Conclusion SCREAM represents the largest cohort to estimate the burden and healthcare implications of CKD in Sweden. The coverage and representativeness of the region of Stockholm was high and in accordance to both the commonness of creatinine assessment, and the medical indications for creatinine testing. The inclusion of individuals who sought medical care and had a creatinine test undertaken resulted in a slight over-representation of elderly and comorbid patients. PMID:26798472

  11. Satellite monitoring of urbanization and environmental impacts-A comparison of Stockholm and Shanghai

    NASA Astrophysics Data System (ADS)

    Haas, Jan; Furberg, Dorothy; Ban, Yifang

    2015-06-01

    This study investigates urbanization and its potential environmental consequences in Shanghai and Stockholm metropolitan areas over two decades. Changes in land use/land cover are estimated from support vector machine classifications of Landsat mosaics with grey-level co-occurrence matrix features. Landscape metrics are used to investigate changes in landscape composition and configuration and to draw preliminary conclusions about environmental impacts. Speed and magnitude of urbanization is calculated by urbanization indices and the resulting impacts on the environment are quantified by ecosystem services. Growth of urban areas and urban green spaces occurred at the expense of cropland in both regions. Alongside a decrease in natural land cover, urban areas increased by approximately 120% in Shanghai, nearly ten times as much as in Stockholm, where the most significant land cover change was a 12% urban expansion that mostly replaced agricultural areas. From the landscape metrics results, it appears that fragmentation in both study regions occurred mainly due to the growth of high density built-up areas in previously more natural/agricultural environments, while the expansion of low density built-up areas was for the most part in conjunction with pre-existing patches. Urban growth resulted in ecosystem service value losses of approximately 445 million US dollars in Shanghai, mostly due to the decrease in natural coastal wetlands while in Stockholm the value of ecosystem services changed very little. Total urban growth in Shanghai was 1768 km2 and 100 km2 in Stockholm. The developed methodology is considered a straight-forward low-cost globally applicable approach to quantitatively and qualitatively evaluate urban growth patterns that could help to address spatial, economic and ecological questions in urban and regional planning.

  12. Road Climate in Cities: A Study of the Stockholm Area, South-East Sweden

    NASA Astrophysics Data System (ADS)

    Gustavsson, Torbjörn; Bogren, Jörgen; Green, Cecilia

    2001-12-01

    The difference between air and road surface temperature in urban and rural areas is an important consideration when modelling the road climate. In this study the effect of the urban heat island in the Stockholm area on road climate is examined. Factors such as distance from the city centre, traffic and topography are analysed in order to assess their impact on the spatial variation of road and air temperature.

  13. [Hospital readmission after postpartum discharge of term newborns in two maternity wards in Stockholm and Marseille].

    PubMed

    Boubred, F; Herlenius, E; Andres, V; des Robert, C; Marchini, G

    2016-03-01

    The consequences of early postpartum discharge (EPPD, within 2 days after birth) on newborn health remain debated. Early discharge has been associated with increased neonatal morbidity. However, neonatal re-hospitalization can be prevented by careful follow-up during the 1st week after birth. We compared the early neonatal hospitalization of term newborns over 2 years in two hospitals: Karolinska University Hospital in Stockholm (n=7300 births), which allowed early discharge from 6h after birth with specific neonatal follow-up, and Marseille University Hospital (AP-HM) (n=4385) where postpartum discharge was more conventional after 72 h. During the study period, the EPPD rate was 41% vs. 2% in Stockholm and Marseille, respectively (P<0.001). Hospital readmission was comparable (5.6‰ vs. 7‰, P=0.2). The leading cause associated with hospitalization was icterus in Stockholm (76% vs. 26%, P<0.001) and feeding difficulties in Marseille (17% vs. 48%, P<0.001). In conclusion, close neonatal follow-up during the 1st week of life associated with restricted maternal and neonatal eligibility criteria for EPPD are required to prevent early neonatal re-hospitalization.

  14. Using geographic information systems to assess individual historical exposure to air pollution from traffic and house heating in Stockholm.

    PubMed Central

    Bellander, T; Berglind, N; Gustavsson, P; Jonson, T; Nyberg, F; Pershagen, G; Järup, L

    2001-01-01

    A specific aim of a population-based case-control study of lung cancer in Stockholm, Sweden, was to use emission data, dispersion models, and geographic information systems (GIS) to assess historical exposure to several components of ambient air pollution. Data collected for 1,042 lung cancer cases and 2,364 population controls included information on residence from 1955 to the end of follow-up for each individual, 1990-1995. We assessed ambient air concentrations of pollutants from road traffic and heating throughout the study area for three points in time (1960, 1970, and 1980) using reconstructed emission data for the index pollutants nitrogen oxides (NO(x)/NO(2)) and sulfur dioxide together with dispersion modeling. NO(2) estimates for 1980 compared well with actual measurements, but no independently measured (study-external) data were available for SO(2), precluding similar validation. Subsequently, we used linear intra- and extrapolation to obtain estimates for all other years 1955-1990. Eleven thousand individual addresses were transformed into geographic coordinates through automatic and manual procedures, with an estimated error of < 100 m for 90% of the addresses. Finally, we linked annual air pollution estimates to annual residence coordinates, yielding long-term residential exposure indices for each individual. There was a wide range of individual long-term average exposure, with an 11-fold interindividual difference in NO(2) and an 18-fold difference in SO(2). The 30-year average for all study subjects was 20 microg/m(3) NO(2) from traffic and 53 microg/m(3) SO(2) from heating. The results indicate that GIS can be useful for exposure assessment in environmental epidemiology studies, provided that detailed geographically related exposure data are available for relevant time periods. PMID:11445519

  15. Congenital heart defects and medical imaging.

    PubMed

    Gehin, Connie; Ragsdale, Lisa

    2013-01-01

    Radiologic technologists perform imaging studies that are useful in the diagnosis of congenital heart defects in infants and adults. These studies also help to monitor congenital heart defect repairs in adults. This article describes the development and functional anatomy of the heart, along with the epidemiology and anatomy of congenital heart defects. It also discusses the increasing population of adults who have congenital heart defects and the most effective modalities for diagnosing, evaluating, and monitoring congenital heart defects.

  16. Heart Health - Brave Heart

    MedlinePlus

    ... 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 ...

  17. Epidemiological and evolutionary characteristics of heart failure in patients with left bundle branch block – A Moroccan center-based study

    PubMed Central

    Bouqata, N.; Kheyi, J.; Miftah, F.; Sabor, H.; Bouziane, A.; Bouzelmat, H.; Chaib, A.; Benyass, A.; Moustaghfir, A.

    2014-01-01

    Background In patients with heart failure, left bundle branch block (LBBB) seems to be associated with an increased risk of cardiovascular mortality. Purpose The purpose of this study is to determine the in-hospital outcome of congestive heart failure patients with LBBB versus those without. Methods We conducted a prospective observational study at the Department of Intensive Care and Rhythmology at the Mohammed V Military Hospital of Rabat, where 330 patients were admitted for heart failure between January 2008 and September 2012. Screening out patients with missing data yielded a cohort of 274 patients. Among the 274 patients, only 110 had LBBB and a left ventricular ejection fraction lower than 50%. We randomly selected a subset of 110 patients diagnosed as non-LBBB to ensure a significant statistical comparison between LBBB and non-LBBB patients. We therefore considered two groups in our analysis: 110 heart failure (HF) patients with LBBB and 110 HF patients without LBBB. Patients with incomplete records were excluded. Results Male gender was dominant in both groups (82.7% vs. 66.7%, p = 0.005). Patients with LBBB had a higher prevalence of idiopathic dilated cardiomyopathy (39.1% vs. 4.8%, p < 0.001); and a higher prevalence of previous hospitalization for heart failure (64.5% vs. 23.3%, p < 0.001). The left ventricular ejection fraction was significantly lower in the group with LBBB (25.49% vs. 39.53%, p < 0.001). Age, cardiovascular risk factors, rhythmic and thromboembolic complications did not significantly differ. In patients with LBBB, 61.8% received cardiac resynchronization therapy performed both during the index hospital stay (50.9%) and previously (10.9%). Hospital outcome was marked by 20 in-hospital deaths in the group with LBBB and eight deaths in the group without LBBB (p = 0.008). Conclusion Our analysis emphasizes increased in-hospital mortality and higher disease severity, over a short period of stay, in heart failure patients with

  18. Heart Failure

    MedlinePlus

    ... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump enough ... failure often experience tiredness and shortness of breath. Heart Failure is Serious Heart failure is a serious and ...

  19. JPRS Report, Epidemiology

    DTIC Science & Technology

    2007-11-02

    Streptococcus Wave 20 Penicillin Limited Help [Stockholm DAGENS NYHETER, 20 Dec 88] 20 Norwegian Trend Compared More Deaths Expected [Kerstin...the AIDS Prevention and Cure Group of the State Hygiene Bureau. Chinese officials recently revealed that serum tests con- ducted on 67,200 people...sles, [passage omitted] SWEDEN Almost 30 Dead in Streptococcus Wave Penicillin Limited Help 54002452 Stockholm DAGENS NYHETER in Swedish 20

  20. Heart MRI

    MedlinePlus

    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

  1. Autism Spectrum Disorders in the Stockholm Youth Cohort: Design, Prevalence and Validity

    PubMed Central

    Idring, Selma; Rai, Dheeraj; Dal, Henrik; Dalman, Christina; Sturm, Harald; Zander, Eric; Lee, Brian K.; Serlachius, Eva; Magnusson, Cecilia

    2012-01-01

    Objective Reports of rising prevalence of autism spectrum disorders (ASD), along with their profound personal and societal burden, emphasize the need of methodologically sound studies to explore their causes and consequences. We here present the design of a large intergenerational resource for ASD research, along with population-based prevalence estimates of ASD and their diagnostic validity. Method The Stockholm Youth Cohort is a record-linkage study comprising all individuals aged 0–17 years, ever resident in Stockholm County in 2001–2007 (N = 589,114). ASD cases (N = 5,100) were identified using a multisource approach, involving registers covering all pathways to ASD diagnosis and care, and categorized according to co-morbid intellectual disability. Prospectively recorded information on potential determinants and consequences of ASD were retrieved from national and regional health and administrative registers. Case ascertainment was validated through case-note review, and cross validation with co-existing cases in a national twin study. Results The 2007 year prevalence of ASD in all children and young people was 11.5 per 1,000 (95% confidence interval 11.2–11.8), with a co-morbid intellectual disability recorded in 42.6% (41.0–44.2) of cases. We found 96.0% (92.0–98.4) of reviewed case-notes being consistent with a diagnosis of ASD, and confirmed ASD in 85.2% (66.2–95.8) of affected twins. Conclusions Findings from this contemporary study accords with recently reported prevalence estimates from Western countries at around 1%, based on valid case ascertainment. The Stockholm Youth Cohort, in light of the availability of extensive information from Sweden's registers, constitutes an important resource for ASD research. On-going work, including collection of biological samples, will enrich the study further. PMID:22911770

  2. Ten years after entry into force of the Stockholm Convention: What do air monitoring data tell about its effectiveness?

    PubMed

    Wöhrnschimmel, Henry; Scheringer, Martin; Bogdal, Christian; Hung, Hayley; Salamova, Amina; Venier, Marta; Katsoyiannis, Athanasios; Hites, Ronald A; Hungerbuhler, Konrad; Fiedler, Heidelore

    2016-10-01

    More than a decade ago, the Stockholm Convention on Persistent Organic Pollutants (POPs), one of the multilateral environmental agreements administered by the United Nations Environment Programme (UNEP), entered into force. The objective of this Convention is to protect human health and the environment by controlling the releases of POPs. According to its Article 16, the effectiveness of the Stockholm Convention shall be evaluated using comparable monitoring data on the presence of POPs as well as their regional and global environmental transport. Here, we present a time series analysis on atmospheric POP concentrations from 15 monitoring stations in North America and Europe that provide long-term data and have started operations between 1990 and 2003. We systematically searched for temporal trends and significant structural changes in temporal trends that might result from the provisions of the Stockholm Convention. We find that such structural changes do occur, but they are related mostly to effects of national regulations enforced prior to the implementation of the Stockholm Convention, rather than to the enforcement of the provisions laid out in the Convention. One example is that concentrations of polychlorinated biphenyls, many of which started to decrease rapidly during the 1990s. Also effects of chemical transport and fate, for instance the re-volatilization of POPs from secondary sources, are thought to be a cause of some of the observed structural changes. We conclude that a decade of air monitoring data has not been sufficient for detecting general and statistically significant effects of the Stockholm Convention. Based on these lessons, we present recommendations for the future operation of existing monitoring programs and advocate for a stricter enforcement of the provisions of the Stockholm Convention, in the current absence of proof for its effectiveness.

  3. Heart Failure in South America

    PubMed Central

    Bocchi, Edimar Alcides

    2013-01-01

    Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries. PMID:23597301

  4. Heart murmurs

    MedlinePlus

    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 ...

  5. A Multilevel Study on Ethnic and Socioeconomic School Stratification and Health-Related Behaviors among Students in Stockholm

    ERIC Educational Resources Information Center

    Olsson, Gabriella; Fritzell, Johan

    2015-01-01

    Background: This study examines the extent to which high alcohol consumption, drug use, and delinquency vary between schools with different socioeconomic characteristics, over and above the pupil's own sociodemographic background. Methods: Analyses are based on data on 5484 ninth-grade students distributed over 93 schools in Stockholm, from the…

  6. Interaction Domains and Suicide: A Population-Based Panel Study of Suicides in Stockholm, 1991-1999

    ERIC Educational Resources Information Center

    Hedstrom, Peter; Liu, Ka-Yuet; Nordvik, Monica K.

    2008-01-01

    This article examines how suicides influence suicide risks of others within two interaction domains: the family and the workplace. A distinction is made between dyad-based social-interaction effects and degree-based exposure effects. A unique database including all individuals who ever lived in Stockholm during the 1990s is analyzed. For about 5.6…

  7. Students' Accounts of School-Performance Stress: A Qualitative Analysis of a High-Achieving Setting in Stockholm, Sweden

    ERIC Educational Resources Information Center

    Låftman, Sara Brolin; Almquist, Ylva B.; Östberg, Viveca

    2013-01-01

    The aim of the study is to examine students' experiences of school performance as a stressor. Accounts of school-performance stress at both the individual level and in relation to group mechanisms are studied through qualitative interviews with eighth-grade students in a high-performing school in Stockholm, Sweden (n = 49). Using qualitative…

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

    ERIC Educational Resources Information Center

    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…

  9. Prevalence of heart failure with preserved ejection fraction in Latin American, Middle Eastern, and North African Regions in the I PREFER study (Identification of Patients With Heart Failure and PREserved Systolic Function: an epidemiological regional study).

    PubMed

    Magaña-Serrano, José A; Almahmeed, Wael; Gomez, Efrain; Al-Shamiri, Mostafa; Adgar, Djamila; Sosner, Philippe; Herpin, Daniel

    2011-11-01

    The aims of the present study were to estimate the prevalence of heart failure (HF) with preserved ejection fraction (HF-PEF) in patients with HF and to compare their clinical characteristics with those with reduced ejection fraction in non-Western countries. The left ventricular ejection fraction ≥ 45% if measured < 1 year before the visit was used to qualify the patients as having HF-PEF. Of the 2,536 consecutive outpatients with HF, 1990 (79%) had the EF values recorded. Of these patients, 1291 had HF-PEF, leading to an overall prevalence of 65% (95% confidence interval 63% to 67%). Compared to the patients with HF and a reduced ejection fraction, those with HF-PEF were more likely to be older (65 vs 62 years, p < 0.001), female (50% vs 28%, p < 0.001), and obese (39% vs 27%, p < 0.001). They more frequently had a history of hypertension (78% vs 53%, p < 0.001) and atrial fibrillation (29% vs 24%, p = 0.03) and less frequently had a history of myocardial infarction (21% vs 44%, p < 0.001). Only 29% of patients with HF-PEF and hypertension had optimal blood pressure control. Left ventricular hypertrophy was less frequent in those with HF-PEF (58% vs 69%, p < 0.001). The prevalence of HF-PEF was lower in the Middle East (41%), where coronary artery disease was more often found than in Latin America (69%) and North Africa (75%), where the rate of hypertension was greater. In conclusion, in the present diverse non-Western study, HF-PEF represented almost 2/3 of all HF cases in outpatients. HF-PEF mostly affects older patients, women, and the obese. Hypertension was the most frequently associated risk factor, highlighting the need for optimal blood pressure control.

  10. Endodontic Epidemiology

    PubMed Central

    Shahravan, Arash; Haghdoost, Ali Akbar

    2014-01-01

    Epidemiology is the study of disease distribution and factors determining or affecting it. Likewise, endodontic epidemiology can be defined as the science of studying the distribution pattern and determinants of pulp and periapical diseases; specially apical periodontitis. Although different study designs have been used in endodontics, researchers must pay more attention to study designs with higher level of evidence such as randomized clinical trials. PMID:24688577

  11. Creating partnership with the food industry in the Stockholm cancer prevention program.

    PubMed

    Kanström, L; Holm, L E; Haglund, B J

    1992-12-01

    To facilitate the supply of healthful foods in institutional kitchens and restaurants, the Stockholm Cancer Prevention Program (SCPP) produced a cookbook in collaboration with the food industry and the SCPP. Fifty different organizations participated in this work. The development of the cookbook was made in several steps and started with a recipe contest to engage chefs and employees in restaurants and institutional kitchens. Criteria for the recipes were that they should present low-fat/high-fiber meals. Complementary recipes were received from the food industry. All recipes were tested in 20 restaurants and institutional kitchens and 11,000 lunch guests assessed the palatability of the dishes. The cookbook was presented in conjunction with a food fair in 1989 and has until now been sold in about 4,000 copies. Production of a cookbook can thus be a focal point for involving food industry, restaurants and institutional kitchens in a community intervention program aiming at a change of dietary habits.

  12. Suicides in commuting railway systems: The case of Stockholm county, Sweden.

    PubMed

    Ceccato, Vania; Uittenbogaard, Adriaan

    2016-07-01

    The objective of this study is to understand the spatial and temporal dynamics of suicides in commuting railway environments. Data on suicides in Stockholm commuting railway from 2006 to 2013 was analysed. The study sets out to identify significant clusters in suicides then evaluate whether commuting railway environments affect variations in suicide rates. Fieldwork inspection, spatial cluster techniques (NNHC and Getis-Ord statistics) and regression models underlie the methodology of study. Findings show no seasonality was observed in suicide cases, but winter months concentrate a larger share of events. Suicides do not occur evenly throughout the day but tend to take place more often in weekdays. Modelling findings shows that suicide rates increase with speed trains and decrease where barriers along tracks are installed. Although high speed trains are still a motive of concern for suicide prevention, findings call for a whole railway-approach to safety - one that extends maintenance beyond the platforms and stations' vicinities.

  13. Recycling behaviour of householders living in multicultural urban area: a case study of Jarva, Stockholm, Sweden.

    PubMed

    Miafodzyeva, Sviatlana; Brandt, Nils; Andersson, Mari

    2013-05-01

    The recycling behaviour of multicultural householders was investigated in the urban area of Järva, northwest Stockholm, Sweden, which is home to a significant proportion of immigrants from different parts of the world. Different ethnic minorities currently make up an important proportion of the urban population in Sweden, but little is known about their recycling behaviour and attitudes. Using quantitative (questionnaire) and qualitative (interviews) methodology, possible determinants of recycling behaviour were investigated among Järva householders. It was found that attitude toward the importance of recycling had a positive correlation and was the main determinant of recycling behaviour among these householders. In contrast, environmental concern, satisfaction with the facilities provided, recycling confidence, community identity and socio-demographical factors showed no correlation with their recycling behaviour. Other results of the study indicated a need to investigate the specific behaviour of multicultural householders regarding source-separated collection and the recycling of hazardous, electronic and bulky wastes.

  14. Use of the Cultural Formulation in Stockholm: a qualitative study of mental illness experience among migrants.

    PubMed

    Scarpinati Rosso, Marco; Bäärnhielm, Sofie

    2012-04-01

    This paper explores the contributions of the Cultural Formulation (CF) interview to an overall understanding of patients, and focuses on the narratives of 23 newly referred patients with migrant backgrounds seeking help at a psychiatric outpatient clinic in Stockholm. Through text content analysis methods we identified five themes: displacement in space and time; mental illness as a physical disability; life events as etiological factors; concealing as a coping strategy; and being lost in a fragmented health care system. Findings indicate the need to contextualize symptoms for an in-depth comprehension of patients' phenomenology. Both clinical and policy implications are discussed. The findings suggest that a section on migration and acculturation should be added to the cultural formulation in the next edition of DSM.

  15. Screening for Stockholm Convention persistent organic pollutants in the Bosna River (Bosnia and Herzogovina).

    PubMed

    Harman, Christopher; Grung, Merete; Djedjibegovic, Jasmina; Marjanovic, Aleksandra; Sober, Miroslav; Sinanovic, Kemo; Fjeld, Eirik; Rognerud, Sigurd; Ranneklev, Sissel Brit; Larssen, Thorjørn

    2013-02-01

    The Stockholm Convention, which aspires to manage persistent organic pollutants (POPs) at the international level, was recently ratified in Bosnia and Herzegovina (BiH). Despite this fact, there is in general a paucity of data regarding the levels of POPs in the environment in BiH. In the present study, screening for POPs was conducted in one of the country's major rivers, the Bosna. A two-pronged approach was applied using passive samplers to detect the freely dissolved and bioavailable concentrations in the water phase and sediment analysis to provide an integrated measure of historical contamination. At several places along the river, the concentrations of polycyclic aromatic hydrocarbons (PAH) were high and exhibited potential for both chronic and acute effects to biota. River water also showed elevated concentrations of PAH, up to 480 ng L(-1) near the city of Doboj, and diagnostic ratios suggested combustion sources for the contamination present in both types of sample. The levels of the other contaminants measured-polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers--were generally low in the water phase. However, PCBs and some OCPs were present in river sediments at levels which breach the international criteria and thus suggest potential for ecological damage. Additionally, the levels of heptachlor breached these criteria in many of the sites investigated. This study presents the first screening data for some of these Stockholm Convention relevant compounds in BiH and reveals both low concentrations of some chemical groups, but significant point sources and historic contamination for others.

  16. Heart Transplant

    MedlinePlus

    ... including how to maximize your recovery at home. Congenital Heart Defects • Home • About Congenital Heart Defects • The ... Physical Activity Recommendations for Heart Health • Tools & Resources Congenital Heart Defect Publications If Your Child Has a ...

  17. Environmental epidemiology

    SciTech Connect

    Kopfler, F.C.; Craun, G.F.

    1986-01-01

    This volume is a compendium of peer-reviewed papers presented at the Symposium on Exposure Measurement and Evaluation Methods for Epidemiology, cosponsored in 1985 by the Health Effects Research Laboratory, USEPA, and the Division of Environmental Chemistry of the American Chemical Society. The book is divided into four sections: Use of Biological Monitoring to Assess Exposure, Epidemiologic Considerations for Assessing Exposure, Health and Exposure Data Bases, and Assessment of Exposure to Environmental Contaminants for Epidemiologic Studies. Both background papers and detailed reports of human studies are presented. The Biological Monitoring section contains reports of efforts to quantify adducts in blood and urine samples. In the section on Epidemiologic Considerations the feasibility of conducting epidemiologic studies of persons residing near hazardous waste sites and those exposed to arsenic in drinking water is described. The review of Data Bases includes government and industry water quality monitoring systems, the FDA Market Basket Study, major EPA air monitoring data, the National Database on Body Burden of Toxic chemicals, and the National Human Adipose Tissue Survey. Methods of assessing current exposure and estimating past exposure are detailed in the final section. Exposure to trichloroethylene in shower water, the relationship between water quality and cardiovascular disease, the contribution of environmental lead exposures to pediatric blood lead levels, and data from the TEAM study in which researchers compare indoor, outdoor, and breath analysis of air pollutant exposures are also discussed.

  18. Polygenic Epidemiology

    PubMed Central

    2016-01-01

    ABSTRACT Much of the genetic basis of complex traits is present on current genotyping products, but the individual variants that affect the traits have largely not been identified. Several traditional problems in genetic epidemiology have recently been addressed by assuming a polygenic basis for disease and treating it as a single entity. Here I briefly review some of these applications, which collectively may be termed polygenic epidemiology. Methodologies in this area include polygenic scoring, linear mixed models, and linkage disequilibrium scoring. They have been used to establish a polygenic effect, estimate genetic correlation between traits, estimate how many variants affect a trait, stratify cases into subphenotypes, predict individual disease risks, and infer causal effects using Mendelian randomization. Polygenic epidemiology will continue to yield useful applications even while much of the specific variation underlying complex traits remains undiscovered. PMID:27061411

  19. Epidemiological causality.

    PubMed

    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.

  20. Estimated Short-Term Effects of Coarse Particles on Daily Mortality in Stockholm, Sweden

    PubMed Central

    Johansson, Christer; Forsberg, Bertil

    2011-01-01

    Background: Although serious health effects associated with particulate matter (PM) with aerodynamic diameter ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5; fine fraction) are documented in many studies, the effects of coarse PM (PM2.5–10) are still under debate. Objective: In this study, we estimated the effects of short-term exposure of PM2.5–10 on daily mortality in Stockholm, Sweden. Method: We collected data on daily mortality for the years 2000 through 2008. Concentrations of PM10, PM2.5, ozone, and carbon monoxide were measured simultaneously in central Stockholm. We used additive Poisson regression models to examine the association between daily mortality and PM2.5–10 on the day of death and the day before. Effect estimates were adjusted for other pollutants (two-pollutant models) during different seasons. Results: We estimated a 1.68% increase [95% confidence interval (CI): 0.20%, 3.15%] in daily mortality per 10-μg/m3 increase in PM2.5–10 (single-pollutant model). The association with PM2.5–10 was stronger for November through May, when road dust is most important (1.69% increase; 95% CI: 0.21%, 3.17%), compared with the rest of the year (1.31% increase; 95% CI: –2.08%, 4.70%), although the difference was not statistically significant. When adjusted for other pollutants, particularly PM2.5, the effect estimates per 10 μg/m3 for PM2.5–10 decreased slightly but were still higher than corresponding effect estimates for PM2.5. Conclusions: Our analysis shows an increase in daily mortality associated with elevated urban background levels of PM2.5–10. Regulation of PM2.5–10 should be considered, along with actions to specifically reduce PM2.5–10 emissions, especially road dust suspension, in cities. PMID:22182596

  1. A food-borne outbreak of cryptosporidiosis among guests and staff at a hotel restaurant in Stockholm county, Sweden, September 2008.

    PubMed

    Insulander, M; de Jong, B; Svenungsson, B

    2008-12-18

    In September 2008, 21 cases of cryptosporidiosis occurred among guests and staff at a wedding reception in a hotel restaurant in Stockholm county, Sweden. The most probable source of the outbreak was bearnaise sauce containing chopped fresh parsley.

  2. Radiocarbon apportionment of fossil versus biofuel combustion sources of polycyclic aromatic hydrocarbons in the Stockholm metropolitan area.

    PubMed

    Mandalakis, Manolis; Gustafsson, Orjan; Reddy, Christopher M; Xu, Li

    2004-10-15

    Source-diagnostic markers and the isotopic composition of polycyclic aromatic hydrocarbons (PAHs) were examined in surface sediments from the greater Stockholm waterways to deduce the contribution from biomass sources to the environmental PAH load. The summed concentration of 20 PAHs ranged from 0.8 to 45.1 microg/g (dry weight) and exhibited a steep decline with increasing distance from the city center evidencing that sources within the metropolitan area of Stockholm dominate its PAH burden. Several diagnostic PAH ratios indicated an overwhelming predominance of pyrogenic sources over the petrogenic ones, while retene and 1,7-dimethylphenanthrene were unable to correctly evaluate the contribution from biomass combustion. The stable carbon isotope composition (delta13C) of individual PAHs ranged from -24.8 to -27.0% but also was proved inefficient to discriminate between different types of fuels due to the overlapping signals in various sources. The delta14C values of PAHs ranged between -550.4 and -934.1%, indicating a clear predominance of fossil fuel sources. By using an isotopic mass balance approach, we estimated that on average 17+/-9% of PAHs derived from biomass combustion. This radiocarbon apportionment, in conjunction with detailed energy statistics for the Stockholm region, revealed that the ambient PAH burden is roughly similar, per unit energy produced, from fossil fuels and biofuels. Societies' shifting energy policies toward a larger reliance on biofuels may thus not lead to further deterioration of air quality and respiratory ailments for the urban population.

  3. Heart Failure

    MedlinePlus

    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 ... Tiredness and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  4. Crisis communication: learning from the 1998 LPG near miss in Stockholm.

    PubMed

    Castenfors, K; Svedin, L

    2001-12-14

    The authors examine current trends in urban risks and resilience in relation to hazardous material transports in general, and crisis communication and the Stockholm liquefied petroleum gas (LPG) near miss in 1998 in particular. The article discusses how current dynamics affecting urban areas, such as the decay in terms of increased condensation and limited expansion alternatives combined with industry site contamination and transports of hazardous materials on old worn-out physical infrastructure, work together to produce high-risk factors and increase urban vulnerability in large parts of the world today. Crisis communication takes a particularly pronounced role in the article as challenges in communication and confidence maintenance under conditions of information uncertainty and limited information control are explored. The LPG near miss case illustrates a Swedish case of urban risk and the tight coupling to hazardous material transports. The case also serves as a current example of Swedish resilience and lack of preparedness in urban crises, with particular observations and lessons learned in regards to crisis communication.

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

    PubMed

    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.

  6. Local media monitoring in process evaluation. Experiences from the Stockholm Diabetes Prevention Programme.

    PubMed

    Andersson, Camilla Maria; Bjärås, Gunilla; Tillgren, Per; Ostenson, Claes-Göran

    2007-01-01

    We present a rationale and approach for longitudinal analyses of media coverage and content, and illustrate how media monitoring can be used in process evaluations. Within a community-based diabetes prevention project, the Stockholm Diabetes Prevention Program, we analyzed the frequency, prominence, and framing of physical activity in local newspapers of three intervention and two control municipalities. In total, 2,128 stories and advertisements related to physical activity were identified between the years 1997 and 2002. Although stories about physical activity were relatively few (n = 224), they were prominently located in all five local newspapers. Physical activity was framed rather similarly in the municipalities. Health aspects, however, were expressed to a greater extent in stories in two of the intervention municipalities. A limited portion (14%) of the articles could be linked directly to the program. It is not possible to assess to what extent the program has had a disseminating effect on the newspapers' health-related content in general, due to weaknesses of the process tracking system and limitations of the study design. Implications for the design is that an evaluative framework should be preplanned and include data collection about media relationships, media's interest in public health, media coverage prior to the program and coverage in other media for comparisons of general trends in the reporting. The material and the current database, however, provide a good basis for quantitative content analysis and qualitative discourse analysis to yield information on the type, frequency, and content of health reporting in local newspapers.

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

    PubMed

    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.

  8. Environmentally reformed travel habits during the 2006 congestion charge trial in Stockholm--a qualitative study.

    PubMed

    Henriksson, Greger; Hagman, Olle; Andréasson, Håkan

    2011-08-01

    Policy measures that reduce or replace road traffic can improve environmental conditions in most large cities. In Stockholm a congestion charge was introduced during a test period in 2006. This was a full-scale trial that proved to meet its targets by reducing traffic crossing the inner city segment during rush hours by 20%. Emissions of carbon dioxide and particles were also substantially reduced. This study, based on in-depth interviews with 40 inhabitants, analyses how and why new travel habits emerged. The results show that particular, sometimes unexpected, features of everyday life (habits, resources, opportunities, values, etc.) were crucial for adjustment of travel behaviour in relation to the policy instrument. One example was that those accustomed to mixing different modes of transport on a daily basis more easily adapted their travel in the targeted way. On a more general level, the results revealed that the policy measure could actually tip the scales for the individual towards trying out a new behaviour.

  9. Hepatitis B seroprevalence in persons attending youth clinics in Stockholm, Sweden in 2008.

    PubMed

    Stenkvist, J; Lidbrink, P; Olofsson, I; von Sydow, M; Lindh, G

    2012-11-01

    Sweden is a low endemicity country for hepatitis B virus (HBV). The previously reported prevalence of chronic HBV is <1% and of overall markers <5%. HBV is not included in the universal childhood vaccination programme. Instead, selected high-risk groups are targeted. Our aim was to examine the HBV seroprevalence in youth clinic clients in Stockholm and identify if this population might be a new target group for vaccination. In total, 515 clients aged 18-22 years were recruited. They completed a risk-assessment questionnaire and 464 (90%) had a serum specimen tested for HBV serology. Chronic HBV was found in 0.6% and 0.9% had previously been infected with HBV. A seroprevalence of 1.8% HBV markers was found among non-vaccinated persons. This is lower than reported from other countries and not different from the general population in Sweden. However, in persons originating from HBV endemic countries (n = 123), the prevalence was higher, 6.5%. Only 14% were vaccinated and the majority hence susceptible to HBV. The target groups are not reached by the present vaccination strategy. Youth clinics are ideal settings for catch-up vaccination.

  10. Interaction of methylation-related genetic variants with circulating fatty acids on plasma lipids: a meta-analysis of 7 studies and methylation analysis of 3 studies in the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium12

    PubMed Central

    Follis, Jack L; Smith, Caren E; Tanaka, Toshiko; Manichaikul, Ani W; Chu, Audrey Y; Samieri, Cecilia; Zhou, Xia; Guan, Weihua; Wang, Lu; Biggs, Mary L; Chen, Yii-Der I; Hernandez, Dena G; Borecki, Ingrid; Chasman, Daniel I; Rich, Stephen S; Ferrucci, Luigi; Irvin, Marguerite Ryan; Aslibekyan, Stella; Zhi, Degui; Tiwari, Hemant K; Claas, Steven A; Sha, Jin; Kabagambe, Edmond K; Lai, Chao-Qiang; Parnell, Laurence D; Lee, Yu-Chi; Amouyel, Philippe; Lambert, Jean-Charles; Psaty, Bruce M; King, Irena B; Mozaffarian, Dariush; McKnight, Barbara; Bandinelli, Stefania; Tsai, Michael Y; Ridker, Paul M; Ding, Jingzhong; Mstat, Kurt Lohmant; Liu, Yongmei; Sotoodehnia, Nona; Barberger-Gateau, Pascale; Steffen, Lyn M; Siscovick, David S; Absher, Devin; Arnett, Donna K; Ordovás, José M; Lemaitre, Rozenn N

    2016-01-01

    Background: DNA methylation is influenced by diet and single nucleotide polymorphisms (SNPs), and methylation modulates gene expression. Objective: We aimed to explore whether the gene-by-diet interactions on blood lipids act through DNA methylation. Design: We selected 7 SNPs on the basis of predicted relations in fatty acids, methylation, and lipids. We conducted a meta-analysis and a methylation and mediation analysis with the use of data from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) consortium and the ENCODE (Encyclopedia of DNA Elements) consortium. Results: On the basis of the meta-analysis of 7 cohorts in the CHARGE consortium, higher plasma HDL cholesterol was associated with fewer C alleles at ATP-binding cassette subfamily A member 1 (ABCA1) rs2246293 (β = −0.6 mg/dL, P = 0.015) and higher circulating eicosapentaenoic acid (EPA) (β = 3.87 mg/dL, P = 5.62 × 1021). The difference in HDL cholesterol associated with higher circulating EPA was dependent on genotypes at rs2246293, and it was greater for each additional C allele (β = 1.69 mg/dL, P = 0.006). In the GOLDN (Genetics of Lipid Lowering Drugs and Diet Network) study, higher ABCA1 promoter cg14019050 methylation was associated with more C alleles at rs2246293 (β = 8.84%, P = 3.51 × 1018) and lower circulating EPA (β = −1.46%, P = 0.009), and the mean difference in methylation of cg14019050 that was associated with higher EPA was smaller with each additional C allele of rs2246293 (β = −2.83%, P = 0.007). Higher ABCA1 cg14019050 methylation was correlated with lower ABCA1 expression (r = −0.61, P = 0.009) in the ENCODE consortium and lower plasma HDL cholesterol in the GOLDN study (r = −0.12, P = 0.0002). An additional mediation analysis was meta-analyzed across the GOLDN study, Cardiovascular Health Study, and the Multi-Ethnic Study of Atherosclerosis. Compared with the model without the adjustment of cg14019050 methylation, the model with such

  11. Digital Epidemiology

    PubMed Central

    Salathé, Marcel; Bengtsson, Linus; Bodnar, Todd J.; Brewer, Devon D.; Brownstein, John S.; Buckee, Caroline; Campbell, Ellsworth M.; Cattuto, Ciro; Khandelwal, Shashank; Mabry, Patricia L.; Vespignani, Alessandro

    2012-01-01

    Mobile, social, real-time: the ongoing revolution in the way people communicate has given rise to a new kind of epidemiology. Digital data sources, when harnessed appropriately, can provide local and timely information about disease and health dynamics in populations around the world. The rapid, unprecedented increase in the availability of relevant data from various digital sources creates considerable technical and computational challenges. PMID:22844241

  12. Heart attack

    MedlinePlus

    ... infarction; Non-ST - elevation myocardial infarction; NSTEMI; CAD - heart attack; Coronary artery disease - heart attack ... made up of cholesterol and other cells. A heart attack may occur when: A tear in the ...

  13. Heart palpitations

    MedlinePlus

    ... occur. Try deep relaxation or breathing exercises. Practice yoga, meditation, or tai chi. Get regular exercise. Do ... M. Editorial team. Images Heart chambers Heart beat Yoga Arrhythmia Read more Atrial Fibrillation Read more Heart ...

  14. Heart Transplantation

    MedlinePlus

    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 ...

  15. Heart Diseases

    MedlinePlus

    ... 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 ...

  16. Heart Failure in North America

    PubMed Central

    Blair, John E. A; Huffman, Mark; Shah, Sanjiv J

    2013-01-01

    Heart failure is a major health problem that affects patients and healthcare systems worldwide. Within the continent of North America, differences in economic development, genetic susceptibility, cultural practices, and trends in risk factors and treatment all contribute to both inter-continental and within-continent differences in heart failure. The United States and Canada represent industrialized countries with similar culture, geography, and advanced economies and infrastructure. During the epidemiologic transition from rural to industrial in countries such as the United States and Canada, nutritional deficiencies and infectious diseases made way for degenerative diseases such as cardiovascular diseases, cancer, overweight/obesity, and diabetes. This in turn has resulted in an increase in heart failure incidence in these countries, especially as overall life expectancy increases. Mexico, on the other hand, has a less developed economy and infrastructure, and has a wide distribution in the level of urbanization as it becomes more industrialized. Mexico is under a period of epidemiologic transition and the etiology and incidence of heart failure is rapidly changing. Ethnic differences within the populations of the United States and Canada highlight the changing demographics of each country as well as potential disparities in heart failure care. Heart failure with preserved ejection fraction makes up approximately half of all hospital admissions throughout North America; however, important differences in demographics and etiology exist between countries. Similarly, acute heart failure etiology, severity, and management differ between countries in North America. The overall economic burden of heart failure continues to be large and growing worldwide, with each country managing this burden differently. Understanding the inter-and within-continental differences may help improve understanding of the heart failure epidemic, and may aid healthcare systems in delivering

  17. Prevalence of Therapeutic Drug Monitoring for Antidepressants and Antipsychotics in Stockholm, Sweden: A Longitudinal Analysis

    PubMed Central

    Lindh, Jonatan D.

    2015-01-01

    Background: Although therapeutic drug monitoring (TDM) is considered an underused tool in psychiatric care, the prevalence of TDM is largely unknown. The aim of this study was to analyze the prevalence of TDM for antidepressants and antipsychotics during 2006–2013. Methods: The study population consisted of individuals ≥5 years of age residing in Stockholm County. The prevalence of TDM for each study year was calculated with the number of individuals in whom TDM had been performed as nominator (extracted from the TDM database at Karolinska University Laboratory) and the number of treated individuals as denominator (extracted from the Swedish Prescribed Drug Register). All data were obtained at the third and the fifth level of the anatomical therapeutic chemical classification system (pharmacological subgroup and chemical substance, respectively). The prevalence of TDM was compared between substances according to the level of TDM recommendation by guidelines. Results: For antidepressants, the prevalence of TDM decreased from 0.48% (95% confidence interval, 0.45%–0.52%) in 2006 to 0.36% (0.33%–0.39%) in 2013 (among 133,275 and 162,998 treated individuals, respectively). For antipsychotics, the prevalence of TDM increased from 2.3% (2.2%–2.5%) to 4.1% (3.9%–4.3%) (31,463 and 32,534 treated individuals). For both drug groups, TDM was more common in men than in women. The most frequently analyzed drugs were clozapine, perphenazine, zuclopenthixol, nortriptyline, and flupentixol. Although not reaching statistical significance, the TDM prevalence was greater for substances strongly recommended for TDM than for substances with a lower level of recommendation, median (interquartile range): 5.6% (2.8%–22%) versus 1.1% (0.2%–2.2%), P = 0.063. Conclusions: The prevalence of TDM is generally low, more frequent, and increasing for antipsychotics, and more frequent for men and substances where TDM is strongly recommended. PMID:25533882

  18. Residential surface soil guidance applied worldwide to the pesticides added to the Stockholm Convention in 2009 and 2011.

    PubMed

    Jennings, Aaron A; Li, Zijian

    2015-09-01

    Due to the widespread use of agricultural and residential pesticides, the potential for pesticide soil contamination is a worldwide concern. In response, regulatory jurisdictions in at least 54 nations have promulgated guidance values to specify the maximum allowable concentration of pesticides in soils. Guidance values may be found for more than 700 pesticides. A previous analysis examined the values applied to the original "dirty dozen" persistent organic pollutant (POP) pesticides that were addressed in the 2001 Stockholm Convention (Aldrin, Chlordane, DDT, Dieldrin, Endrin, Heptachlor, Mirex, and Toxaphene). Results are presented here for the "new POP" pesticides that were added to the Stockholm Convention in 2009 and 2011 (isomers of Hexachlorocyclohexane, Chlordecone, and isomers of Endosulfan). The guidance value extremes used worldwide for these pesticides vary by as much as 8.5 orders of magnitude and the randomness in their distributions resembles that of lognormal random variables. However, there are nonrandom value clusters in some distributions that may identify values around which consensuses are forming. The current value distributions imply that a wide range of human health risks are being accepted. Hopefully, the results presented will help regulatory jurisdictions and the regulated communities identify values that should be revised to be adequately protective of human health.

  19. Can I have a beer, please? A study of alcohol service to young adults on licensed premises in Stockholm.

    PubMed

    Wallin, Eva; Andreásson, Sven

    2004-12-01

    This study evaluated the effects of a community alcohol prevention program on the frequency of alcohol service to young adults at licensed premises in Stockholm, Sweden. We used a pretest (1996)-posttests (1998 and 2001) design with intervention and control areas. The multicomponent intervention combines training of serving staff in responsible beverage service, policy initiatives, and enforcement of existing alcohol regulations. Adolescents 18 years old (the legal drinking age on licensed premises in Sweden), but younger looking according to an expert panel, visited licensed premises in pairs, where each adolescent ordered a beer. At baseline in 1996, the adolescents made 600 attempts to order. At follow-up in 1998, the number of attempts to order was 252, and at the second follow-up in 2001, the adolescents made 238 attempts. We found no statistically significant differences between the intervention and control areas. Overall, the frequency of alcohol service to adolescents on licensed premises in these areas of Stockholm decreased significantly over time, from 45 to 41 and to 32%, in 1996, 1998, and 2001, respectively. The decrease in alcohol service in 2001 was statistically significant compared to the baseline in 1996. One explanation for this improvement could be more effective enforcement of existing alcohol laws in both the intervention and control areas. We also found that licensed premises that used doormen to screen potential customers were less likely to sell to minors.

  20. Urban Economies Resource Productivity and Decoupling: Metabolism Trends of 1996-2011 in Sweden, Stockholm, and Gothenburg.

    PubMed

    Kalmykova, Yuliya; Rosado, Leonardo; Patrício, João

    2015-07-21

    Resource productivity and evidence of economic decoupling were investigated on the basis of the time series in 1996-2011 of material flow analysis for Sweden, Stockholm, and Gothenburg. In the three cases, absolute reductions in CO2 emissions by about 20% were observed, energy consumption per capita decreased, while gross domestic product (GDP) per capita grew. The energy consumption of the residential and public sectors decreased drastically, while the transport energy consumption is still growing steadily. Decoupling of the economy as a whole (i.e., including materials) is not yet happening at any scale. The domestic material consumption (DMC) continues to increase, in parallel with the GDP. The rate of increase for DMC is slower than that for GDP in both Stockholm and Sweden as a whole (i.e., relative decoupling). The metabolism of the cities does not replicate the national metabolism, and the two cities each have their own distinct metabolism profiles. As a consequence, policy implications for each of the case studies were suggested. In general, because of the necessarily different roles of the two cities in the national economy, generic resource productivity benchmarks, such as CO2 per capita, should be avoided in favor of sectorial benchmarks, such as industry, transport, or residential CO2 per capita. In addition, the share of the city impacts caused by the provision of a service for the rest of the country, such as a port, could be allocated to the national economy.

  1. Heart pacemaker

    MedlinePlus

    ... PA: Elsevier Saunders; 2015:chap 37. Swerdlow CD, Wang PJ, Zipes DP. Pacemakers and implantable cardioverter-defibrillators. ... and lifestyle Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart ...

  2. Heart Block

    MedlinePlus

    ... not used to treat first-degree heart block. All types of heart block may increase your risk for other arrhythmias, such as atrial fibrillation (A-tre-al fih-brih-LA-shun). Talk with your doctor ...

  3. Heart Attack

    MedlinePlus

    ... a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get ... It's important to know the symptoms of a heart attack and call 9-1-1 if someone ...

  4. 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

    PubMed Central

    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

  5. 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.

    PubMed

    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

  6. Heart Failure in South Asia

    PubMed Central

    Sivadasan Pillai, Harikrishnan; Ganapathi, Sanjay

    2013-01-01

    South Asia (SA) is both the most populous and the most densely populated geographical region in the world. The countries in this region are undergoing epidemiological transition and are facing the double burden of infectious and non-communicable diseases. Heart failure (HF) is a major and increasing burden all over the world. In this review, we discuss the epidemiology of HF in SA today and its impact in the health system of the countries in the region. There are no reliable estimates of incidence and prevalence of HF (heart failure) from this region. The prevalence of HF which is predominantly a disease of the elderly is likely to rise in this region due to the growing age of the population. Patients admitted with HF in the SA region are relatively younger than their western counterparts. The etiology of HF in this region is also different from the western world. Untreated congenital heart disease and rheumatic heart disease still contribute significantly to the burden of HF in this region. Due to epidemiological transition, the prevalence of hypertension, diabetes mellitus, obesity and smoking is on the rise in this region. This is likely to escalate the prevalence of HF in South Asia. We also discuss potential developments in the field of HF management likely to occur in the nations in South Asia. Finally, we discuss the interventions for prevention of HF in this region PMID:23597297

  7. Shallow water radio-magnetotelluric (RMT) measurements in urban environment: A case study from Stockholm city

    NASA Astrophysics Data System (ADS)

    Mehta, Suman; Bastani, Mehrdad; Malehmir, Alireza; Wang, Shunguo; Pedersen, Laust

    2014-05-01

    The Radio-MagnetoTelluric (RMT) method uses the electromagnetic signal from distant radio transmitters in the frequency range 15 to 250 kHz. RMT applications in near-surface studies have already been well established. Two components of electric field and three components of magnetic field are measured. These measured components are related to each other via transfer functions which contain detailed information about the variation of electrical resistivity of the subsurface. The present study is carried out in the frame of TRUST (TRansparent Underground STructure) project supported by several research and public organizations as well as industry. The study area is located close to central Stockholm in Sweden where the Swedish traffic authority has planned to construct a 21-km long motorway to bypass the city. In order to reduce the impact on natural and cultural environments, 18 km of the motorway will be located in tunnels. The main objective of this study is thus to identify potential fracture zones and faults as well as the general geological settings. The proposed path of the tunnel partly passes under the Lake Mälaren at a depth of about 60 m. Thus a challenge was posed on the applicability of RMT method in shallow water environments. Successful applications of RMT measurements using the Uppsala University's EnviroMT system on land encouraged us to modify the system to acquire data over lake water especially in urban areas. Pioneered by the Geological Survey of Sweden (SGU), RMT data were collected over the Lake Mälaren in spring 2012. The prototype acquisition system did not only turn out to be appropriate for such a challenging environment, but it was also much more efficient as compared with land surveys. Fifty two lines including 1160 stations with an average spacing of 15 m were covered in three days. Cultural noise associated with the city-related environment had to be identified and filtered out before inversion could be carried out. Reliable estimates

  8. Psycholinguistics and Foreign Language Learning. Papers from a Conference (Stockholm, Sweden and Abo, Finland, October 25-26, 1982). Meddelanden fran Stiftelsens for Abo Akademi Forskningsinstitut Nr.86.

    ERIC Educational Resources Information Center

    Ringbom, Hakan, Ed.

    At irregular intervals, beginning in 1977, Swedish-Finnish conferences on contrastive and applied linguistics have been arranged in Stockholm and Turko/Abo. This volume presents most of the papers given at the 1982 conference. Papers include: "Free Recall of Mixed Language Lists. Error Patterns in Bilingual Memory" (Karin Aronsson, Anja Metsola,…

  9. To be a teacher, a tutor and a friend: the physician's role according to the Stockholm Diabetes Intervention Study (SDIS).

    PubMed

    Reichard, P

    1996-12-01

    The Stockholm Diabetes Intervention Study (SDIS) showed that lower blood glucose levels led to halted or retarded microvascular complications in patients with insulin-dependent (type 1) diabetes mellitus (IDDM). Modern education was combined with tutoring, which led to improved blood glucose control in a randomized group of patients. In this setting, the expert-physician met and expert-patient in a mutual effort to make the patient able to live his daily life according to the wishes he had, without too much special consideration to the diabetes. The goals of the treatment were thus to improve the daily quality of life of the patient while keeping the HbA1c sufficiently low to avoid severe complications. The physician has to accept a new role as a teacher and tutor, and as such a caring but still professional friend.

  10. Tradeoffs between environmental goals and urban development: the case of nitrogen load from the Stockholm County to the Baltic Sea.

    PubMed

    Jansson, Asa; Colding, Johan

    2007-12-01

    Urban dwellers depend on the generation of ecosystem services for their welfare. The city of Stockholm is growing, and a 25% increase in population is projected by 2030. The effects of urban development were estimated through the quantification of nitrogen (N) leakage to the Baltic Sea under two urban development scenarios. We found that total net N load will increase by 6% or 8%, depending on which growth scenario is applied, and population increase by itself will contribute at least 15% of the point source N leakage. Technical improvements in sewage treatment could, according to our results, decrease total N load to the Baltic Sea by 4%. Based on our results, we conclude that proactive measures such as spatial urban planning can provide a constructive tool for sustainable urban development on regional as well as national and international scales, depending on geographical context as well as the ecosystem services' scale of operation.

  11. Antibiotic susceptibility of Escherichia coli isolates from inpatients with urinary tract infections in hospitals in Addis Ababa and Stockholm.

    PubMed Central

    Ringertz, S.; Bellete, B.; Karlsson, I.; Ohman, G.; Gedebou, M.; Kronvall, G.

    1990-01-01

    A high level of antimicrobial resistance of bacteria has been detected at the Tikur Anbessa Hospital (TAH), Addis Ababa, for many years. In contrast, at the Karolinska Hospital (KH), Stockholm, the level of resistance is low. Reported are the results of an investigation of the correlation between antibiotic usage and the antimicrobial resistance rates of Escherichia coli isolates from patients with urinary tract infections in these hospitals. At TAH the strains of E. coli isolated were considerably more resistant to all seven antibiotics tested. The level of multiresistance was 63% at TAH and 7% at KH. There were no significant differences in the total amount of antibiotics used in the two hospitals, except for antituberculosis agents. The strain biotypes and antibiograms, together with the length of patients' hospitalization before a positive urine culture was obtained, suggest that the majority of the strains from TAH were of nosocomial origin. PMID:2189587

  12. Changes in conceptions and attitudes during five years of intensified conventional insulin treatment in the Stockholm Diabetes Intervention Study (SDIS).

    PubMed

    Reichard, P; Toomingas, B; Rosenqvist, U

    1994-01-01

    Previous studies have demonstrated that intensified treatment can result in lower blood glucose concentrations and retard microvascular complications. In the Stockholm Diabetes Intervention Study, 96 patients were followed for 5 years; 44 patients received intensified, conventional treatment and 52 patients received regular treatment. Changes in conceptions and attitudes that accompanied intensified treatment were evaluated with questionnaires and semistructured interviews. After education and personal tutoring, HbAlc was significantly lower in patients in the intensified treatment group compared with patients in the regular treatment group. Self-rated well-being and perceived ability to control the diabetes increased more in the patients in the intensified treatment group. Blood glucose testing became more important to the patients in the intensified treatment group, who used the blood glucose tests more frequently whenever necessary, and who acted on the test results. Microvascular complications were retarded or halted.

  13. Heart regeneration.

    PubMed

    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.

  14. Hypoplastic left heart syndrome

    MedlinePlus

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

  15. 14C-Based source assessment of soot aerosols in Stockholm and the Swedish EMEP-Aspvreten regional background site

    NASA Astrophysics Data System (ADS)

    Andersson, August; Sheesley, Rebecca J.; Kruså, Martin; Johansson, Christer; Gustafsson, Örjan

    2011-01-01

    Combustion-derived soot or black carbon (BC) in the atmosphere has a strong influence on both climate and human health. In order to propose effective mitigation strategies for BC emissions it is of importance to investigate geographical distributions and seasonal variations of BC emission sources. Here, a radiocarbon methodology is used to distinguish between fossil fuel and biomass burning sources of soot carbon (SC). SC is isolated for subsequent off-line 14C quantification with the chemothermal oxidation method at 375 °C (CTO-375 method), which reflects a recalcitrant portion of the BC continuum known to minimize inadvertent inclusion of any non-pyrogenic organic matter. Monitored wind directions largely excluded impact from the Stockholm metropolitan region at the EMEP-Aspvreten rural station 70 km to the south-west. Nevertheless, the Stockholm city and the rural stations yielded similar relative source contributions with fraction biomass ( fbiomass) for fall and winter periods in the range of one-third to half. Large temporal variations in 14C-based source apportionment was noted for both the 6 week fall and the 4 month winter observations. The fbiomass appeared to be related to the SC concentration suggesting that periods of elevated BC levels may be caused by increased wood fuel combustion. These results for the largest metropolitan area in Scandinavia combine with other recent 14C-based studies of combustion-derived aerosol fractions to suggest that biofuel combustion is contributing a large portion of the BC load to the northern European atmosphere.

  16. Modeling nutrient retention in the coastal zone of an eutrophic sea - a model study in the Stockholm Archipelago, Sweden

    NASA Astrophysics Data System (ADS)

    Almroth-Rosell, Elin; Edman, Moa; Eilola, Kari; Meier, Markus; Sahlberg, Jörgen

    2016-04-01

    This study shows that the Stockholm archipelago works as a filter for nutrients that enters the coastal zone from land. The filter capacity is high, but not effective enough to take care of all the nutrients that the system receives. At least 65 % and 72 % of the phosphorus (P) and nitrogen (N), respectively, is retained. The multi-basin one dimensional Swedish Coastal zone Model (SCM) that was used is based on the Swedish Coastal and Ocean Biogeochemical model (SCOBI) coupled to the equation solver PROgram for Boundary layers in the Environment (PROBE). An evaluation of model results showed that the nutrient, salinity and temperature dynamics in the SCM model are of good quality. To analyse the results the Stockholm archipelago was divided into three sub-areas: the inner, the intermediate and the outer archipelago. The analysis showed that the highest total amounts of P and N are retained in the outer archipelago where the surface area is largest. The area weighted retention of P and N, however, is highest in the smaller inner archipelago and decreases towards the open sea. A major part of the retention is permanent. For P sediment burial is the only permanent retention mechanism, but for N almost 92 % of the permanent retention is caused by benthic denitrification, less than 8 % by burial, while pelagic denitrification is below 1%. A reduction of the land load of nutrients (P reduced with 13 % and N with 20%) resulted in increased retention capacity of N and P and lowered the transport of N out from the archipelago. About 15 years after the reduction P is imported into the archipelago instead of being exported.

  17. Mutagenic effect of extracts from particulate matter collected with sediment traps in the archipelago of Stockholm and the open northern Baltic

    SciTech Connect

    Broman, D.; Naef, C.; Rannug, U. )

    1994-11-01

    The load of various hydrophobic organic compounds (HOCs) on the Baltic Sea aquatic environment is considerable. This investigation samples the water area around Stockholm, of special concern since it is one of the most densely populated urban areas in the Baltic region. Stockholm also houses several power plants, municipal waste incinerators, waste water treatment plants, ports and oil terminals. The runoff from a large lake also passes through the estuarine-like archipelago of Stockholm. Due to the high particulate-water partition coefficients (K[sub p]) of most ecotoxicologically relevant HOCs, particulate matter (PM) becomes very important for occurrence and distribution in the aquatic environment. This PM is the basic food source for important organisms in the benthic, pelagic and littoral parts of the aquatic ecosystem. The load of various HOCs such as petrogenic hydrocarbons (PHCs), various polynuclear aromatic compounds (PACs), and chlorinated hydrocarbons such as polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in association with PM in the aquatic environment of the Stockholm area is well documented. However, the ecotoxicological relevance of organic extracts of PM, including the above identified compounds and various unidentified HOCs, is not fully evaluated. To evaluate the genotoxic potential of extracts of PM, collected with sediment traps in the Stockholm water area and in the open northern Baltic, we used the Ames test on Salmonella typhimurium strain TA100, with and without a metabolizing system. After extraction and before the mutagenicity tests all PM samples were fractionated on an HPLC-system into three fractions containing aliphatic/monoaromatic-, diaromatic, (containing, e.g., PCDD/Fs and PCBs) and polyaromatic compounds (containing various PACs). The relative mutagenic potential of these fractions at the different sediment trap sampling stations are discussed and evaluated. 13 refs., 1 tab.

  18. The Changing Epidemiology of Pediatric Endocarditis.

    PubMed

    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.

  19. Global trends in infective endocarditis epidemiology.

    PubMed

    Yew, Haur Sen; Murdoch, David R

    2012-08-01

    The global epidemiology of infective endocarditis is becoming better understood with the initiation of multi-center collaborative studies and with an increasing number of case series being reported from countries outside North America and Europe. However, there are still many knowledge gaps and a lack of population-based data. For endocarditis in developed countries, the role of rheumatic heart disease as a predisposing factor is diminishing; the population is increasingly elderly, staphylococci are becoming much more important pathogens, and proportionally more are healthcare-associated. In developing countries, the epidemiology of infective endocarditis remains similar to North America and Europe from the middle of the twentieth century, affecting a younger age group, is often associated with rheumatic heart disease, and is predominantly caused by streptococci.

  20. International Lymphoma Epidemiology Consortium

    Cancer.gov

    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.

  1. Epidemiology of Alcoholism.

    ERIC Educational Resources Information Center

    Helzer, John E.

    1987-01-01

    Reviews the application of epidemiology to alcoholism. Discusses measurement and diagnostic issues and reviews studies of the prevalence of alcoholism, its risk factors, and the contributions of epidemiology to our knowledge of treatment and prevention. (Author/KS)

  2. [Dermato-epidemiology].

    PubMed

    Apfelbacher, C J; Diepgen, T L; Weisshaar, E

    2011-11-01

    Dermato-epidemiology is an important scientific discipline which investigates skin diseases using epidemiological methods. Epidemiology is the science of the distribution and determinants of disease in specified populations. We describe fundamental terms of dermato-epidemiology (measures of disease occurrence, measures of risk), different study types (observational studies, interventional studies), the selection of statistical tests, bias and confounding as well as the principles of evidence-based dermatology, and give illustrative examples.

  3. Heart transplant

    MedlinePlus

    ... catheterization Tests to look for cancer Tissue and blood typing , to help make sure your body will not reject the donated heart Ultrasound of your neck and legs You will ... heart pump enough blood to the body. Most often, this is a ...

  4. Heart Anatomy

    MedlinePlus

    ... español An Incredible Machine Bonus poster (PDF) The Human Heart Anatomy Blood The Conduction System The Coronary Arteries The Heart Valves The Heartbeat Vasculature of the Arm Vasculature of the Head Vasculature of the Leg Vasculature of the Torso ...

  5. Cancer Epidemiology Matters Blog

    Cancer.gov

    The Cancer Epidemiology Matters blog helps foster a dialogue between the National Cancer Institute's (NCI) Epidemiology and Genomics Research Program (EGRP), extramural researchers, and other individuals, such as clinicians, community partners, and advocates, who are interested in cancer epidemiology and genomics.

  6. Hepatitis C infection among injection drug users in Stockholm Sweden: prevalence and gender.

    PubMed

    Lidman, Christer; Norden, Lillebil; Kåberg, Martin; Käll, Kerstin; Franck, Johan; Aleman, Soo; Birk, Markus

    2009-01-01

    Hepatitis C virus (HCV) infection is widespread among injection drug users. Young women seem to be at higher risk of acquiring HCV. To optimize future intervention and prevention measures, we studied the epidemiology of human immunodeficiency virus (HIV), hepatitis B (HBV), and HCV infection among men and women. Inclusion criteria for this cross-sectional multicentre study were: history of ever injecting drugs, age > 18 y, and no previous HIV diagnosis. In 310 participants, plasma/serum samples were analysed for HBV, HIV and HCV (anti-HCV, HCV-RNA, and HCV genotype). HCV antibodies were noted in 268 (86.5%) participants, of whom 207 (77.0%) also had detectable HCV-RNA. Genotypes 1 and 3 dominated, at 35.9% and 33.0%, respectively. Women acquired HCV (but not HBV) to a significantly higher degree (RR 2.97, 95% confidence interval 1.11-7.93) during the first y of injecting drugs. They also recovered spontaneously from HCV infection more frequently (RR 2.49, 95% CI 1.28-4.53). The HCV prevalence of about 50% within 2 y after initiation of injection drug use underlines the need for early intervention efforts. Possible causes for higher HCV prevalence and the implications of favourable spontaneous recovery rates among women should be considered when designing intervention and prevention measures.

  7. Epidemiology, Clinical Presentation, and Outcomes of Kawasaki Disease Among Hospitalized Children in an Inner City Hospital Before and After Publication of the American Academy of Pediatrics/American Heart Association Guidelines for Treatment of Kawasaki Disease: An 11-Year Period.

    PubMed

    Sehgal, Swati; Chen, Xinguang; Ang, Jocelyn Y

    2015-11-01

    The effect of 2004 Kawasaki disease (KD) guidelines on diagnosis and outcome of KD is lacking. We studied the epidemiology of KD in our region and compared the incidence, presentation, and outcome of KD before and after publication of the guidelines. A retrospective chart review was conducted for patients admitted with a diagnosis of KD. Demographics, laboratory data, and clinical data were collected. Comparison was made between 2 groups: prepublication (2000-2004) and postpublication (2005-2009) of guidelines. A total of 312 children were included; 64% were African American, 23% White, and 2% Asian; 61% were boys; 79% were complete KD, and 66% were in winter/spring. There was a significant increase in KD cases over the 11 years. There was no significant difference in clinical findings and outcome between the 2 groups. KD admissions in our region significantly increased during the postpublication period. There was no difference in clinical presentation, laboratory findings, or outcome between the 2 groups.

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

    PubMed

    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.

  9. Chlamydia trachomatis among Youth - Testing Behaviour and Incidence of Repeat Testing in Stockholm County, Sweden 2010-2012

    PubMed Central

    Marrone, Gaetano; De Costa, Ayesha

    2016-01-01

    Background Widespread testing and screening for genital Chlamydia trachomatis is often advocated as an important method to halt the epidemic. Sweden has long tradition of opportunistic screening services. Nevertheless infections rates have continued to rise over the past two decades, despite increased access to testing and treatment services. Methods In this retrospective cohort study we describe the testing behavior for genital Chlamydia trachomatis among youth in Stockholm County, with a focus on repeated testing. Specifically we (a) study positivity rates among single and repeat testers, we (b) estimate the incidence of repeat testing and the rates of infection in repeat testing episodes, and we (c) estimate time to repeat testing and factors associated with repeat testing. All youth (aged ≥12 and <26) that tested for Chlamydia trachomatis in one of 33 Youth Health Clinics in Stockholm County between 1 January 2010 and 31 December 2012 were included in the study. Results The cohort comprised a total of 65,951 individuals who did 119,699 tests during the study period. 42% of youth were repeat testers, the incidence of repeat testing was 35.0/100 person years. The overall baseline prevalence was 7.9%. Positivity rates of baseline tests among repeat testers were nearly twice as high among single testers of either sex. These were 17.1% and 9.8% among male repeat and single testers respectively. The corresponding rates for women were 9.4% and 4.3%. Positivity rates among repeat tests did not decline compared to the overall baseline positivity. Baseline test result and sex significantly influenced the occurrence of repeat testing. Conclusion Among repeat testers we found high rates of Chlamydia trachomatis both at baseline and at repeat tests which suggests the possibility that this group might be continuing to engage in unsafe sexual practices. Given the extent of repeat testing and the high positivity rates on repeat testing, further research among this group is

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

    PubMed Central

    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 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. PMID:27633090

  11. Wine and heart health

    MedlinePlus

    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 ...

  12. What Causes Heart Failure?

    MedlinePlus

    ... Topics Arrhythmia Congenital Heart Defects Coronary Heart Disease Heart Valve Disease High Blood Pressure Send a link to NHLBI ... with the heart’s structure are present at birth. Heart valve disease . Occurs if one or more of your heart ...

  13. What Is Heart Failure?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Heart Failure? Heart failure is a condition in which the heart can' ... force. Some people have both problems. The term "heart failure" doesn't mean that your heart has stopped ...

  14. Heart Attack

    MedlinePlus

    ... yourself MedlinePlus for More Information National Institute on Aging Related Topics Heart Failure High Blood Cholesterol High ... us | Customer Support | site map National Institute on Aging | U.S. National Library of Medicine | National Institutes of ...

  15. Hearts Wish.

    ERIC Educational Resources Information Center

    Jones, Lethonee A.

    1989-01-01

    Investigates characteristics and themes in 102 drawings by sexually abused children. Themes of the drawings included genitalia, the absence of specific body parts, phallic symbols, inappropriate smiles, distorted body images, kinetic activity, prominent hands and fingers, and hearts. (RJC)

  16. Heart Failure

    MedlinePlus

    ... for people who can't tolerate ACE inhibitors. Beta blockers. This class of drugs not only slows your ... rhythms and lessen your chance of dying unexpectedly. Beta blockers may reduce signs and symptoms of heart failure, ...

  17. What Is a Heart Murmur?

    MedlinePlus

    ... Heart Murmur Related Topics Anemia Congenital Heart Defects Heart Valve Disease Holes in the Heart How the Heart Works ... heart defect that is present since birth or heart valve disease. Depending on the heart problem causing the abnormal ...

  18. Heart failure

    PubMed Central

    2011-01-01

    Introduction 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. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of multidisciplinary interventions for heart failure? What are the effects of exercise in people with heart failure? What are the effects of drug treatments for heart failure? What are the effects of devices for treatment of heart failure? What are the effects of coronary revascularisation for treatment of heart failure? What are the effects of drug treatments in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium

  19. Meta-epidemiology.

    PubMed

    Bae, Jong-Myon

    2014-01-01

    The concept of meta-epidemiology has been introduced with considering the methodological limitations of systematic review for intervention trials. The paradigm of meta-epidemiology has shifted from a statistical method into a new methodology to close gaps between evidence and practice. Main interest of meta-epidemiology is to control potential biases in previous quantitative systematic reviews and draw appropriate evidences for establishing evidence-base guidelines. Nowadays, the network meta-epidemiology was suggested in order to overcome some limitations of meta-epidemiology. To activate meta-epidemiologic studies, implementation of tools for risk of bias and reporting guidelines such as the Consolidated Standards for Reporting Trials (CONSORT) should be done.

  20. Patterns of suicide and other trespassing fatalities on state-owned railways in greater Stockholm; implications for prevention.

    PubMed

    Rådbo, Helena; Andersson, Ragnar

    2012-03-01

    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.

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

    PubMed Central

    Rådbo, Helena; Andersson, Ragnar

    2012-01-01

    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. PMID:22690162

  2. Real-world traffic emission factors of gases and particles measured in a road tunnel in Stockholm, Sweden

    NASA Astrophysics Data System (ADS)

    Kristensson, Adam; Johansson, Christer; Westerholm, Roger; Swietlicki, Erik; Gidhagen, Lars; Wideqvist, Ulla; Vesely, Vaclav

    Measurements in a road tunnel in Stockholm, Sweden give the real-world traffic emission factors for a number of gaseous and particle pollutants. These include 49 different polycyclic aromatic hydrocarbons (PAH), CO, NO X, benzene, toluene, xylenes, aldehydes, elements and inorganic/organic carbon contained in particles, the sub-micrometer aerosol number size distribution, PM 2.5 and PM 10. The exhaust pipe emission factors are divided with the help of automated traffic counts into the two pollutant sources, the heavy-duty vehicles (HDV) and light-duty vehicles (LDV). The LDV fleet contains 95% petrol cars and the total fleet contains about 5% HDV. When data permitted, the emission factors were further calculated at different vehicle speeds. The current work shows that average CO, NO X and benzene emission factors amounted to 5.3, 1.4 and 0.017 g veh -1 km -1, respectively. Since the mid-90s CO and benzene decreased by about 15%, carbonyls by about a factor 2, whereas NO X did not change much. PAH emission factors were 2-15 times higher than found during dynamometer tests. Most particles are distributed around 20 nm diameter and the LDV fleet contributes to about 65% of both PM and particle number. In general, the gaseous emissions are higher in Sweden than in USA and Switzerland, foremost due to the lower fraction catalytic converters in Sweden. The PM and number emissions of particles are also slightly higher in the Swedish tunnel.

  3. Metal emissions from brake linings and tires: case studies of Stockholm, Sweden 1995/1998 and 2005.

    PubMed

    Hjortenkrans, David S T; Bergbäck, Bo G; Häggerud, Agneta V

    2007-08-01

    Road traffic has been highlighted as a major source of metal emissions in urban areas. Brake linings and tires are known emission sources of particulate matter to air; the aim of the current study was to follow the development of metal emissions from these sources over the period 1995/ 1998-2005, and to compare the emitted metal quantities to other metal emission sources. Stockholm, Sweden was chosen as a study site. The calculations were based on material metal concentrations, traffic volume, particle emission factors, and vehicle sales figures. The results for metal emissions from brake linings/tire tread rubber in 2005 were as follows: Cd 0.061/0.47 kg/year, Cu 3800/5.3 kg/year, Pb 35/3.7 kg/year, Sb 710/0.54 kg/year, and Zn 1000/4200 kg/ year. The calculated Cu and Zn emissions from brake linings were unchanged in 2005 compared to 1998, indicating that brake linings still remain one of the main emission sources for these metals. Further, brake linings are a source of antimony. In contrast, Pb and Cd emissions have decreased to one tenth compared to 1998. The results also showed that tires still are one of the main sources of Zn and Cd emissions in the city.

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

    PubMed

    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.

  5. [Molecular epidemiology in the epidemiological transition].

    PubMed

    Tapia-Conyer, R

    1997-01-01

    The epidemiological transition describes the changes in the health profile of populations where infectious diseases are substituted by chronic or non-communicable diseases. Even in industrialized countries, infectious diseases emerge as important public health problems and with a very important association with several type of neoplasm. Molecular epidemiology brings in new tools for the study of the epidemiological transition by discovering infectious agents as etiology of diseases, neither of both new. Much has been advanced in the understanding of the virulence and resistance mechanism of different strains, or improving the knowledge on transmission dynamics and dissemination pathways of infectious diseases. As to the non-communicable diseases, molecular epidemiology has enhanced the identification of endogenous risk factors link to alterations, molecular changes in genetic material, that will allow a more detail definition of risk and the identification of individual and groups at risk of several diseases. The potential impact of molecular epidemiology in other areas as environmental, lifestyles and nutritional areas are illustrated with several examples.

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

    NASA Astrophysics Data System (ADS)

    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

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

    NASA Astrophysics Data System (ADS)

    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

  8. Heart failure

    PubMed Central

    2010-01-01

    Introduction 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. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug treatments, and of drug and invasive treatments, for heart failure? What are the effects of angiotensin-converting enzyme inhibitors in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 85 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium channel blockers, cardiac resynchronisation therapy, digoxin (in people already receiving diuretics and angiotensin-converting enzyme inhibitors), exercise, hydralazine plus isosorbide dinitrate, implantable cardiac

  9. Healthy Heart Quizzes

    MedlinePlus

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

  10. [Epidemiology and public policies].

    PubMed

    Barata, Rita Barradas

    2013-03-01

    The present essay deals with the relation between epidemiology and public policies, highlighting the epidemiology position in the public health field, analyzing the impact of public policies over epidemiological profile and contributions from epidemiology to the lay down, implementation and evaluation of public health policies. In the first title, the essay debates the links between the epidemiology and public health field, the social determinants and political action framework proposed by the WHO's Commission on Social Determinants of Health, and different approaches of health policies. In the second title the essay analyses the reduction of child stunting in Brazil as an example of public policies that impact epidemiological profile. The third title presents three strategic topics for the application of public health policies: reduction of social inequalities in health, health promotion and regulation of products and services that have impact over health. The fourth title discusses the possibilities and difficulties to combine the epidemiological knowledge in the lay down, implementation and evaluation of public policies and, finally, material examples of such relation between epidemiology and public policies are presented.

  11. Vaccine epidemiology: A review

    PubMed Central

    Lahariya, Chandrakant

    2016-01-01

    This review article outlines the key concepts in vaccine epidemiology, such as basic reproductive numbers, force of infection, vaccine efficacy and effectiveness, vaccine failure, herd immunity, herd effect, epidemiological shift, disease modeling, and describes the application of this knowledge both at program levels and in the practice by family physicians, epidemiologists, and pediatricians. A case has been made for increased knowledge and understanding of vaccine epidemiology among key stakeholders including policy makers, immunization program managers, public health experts, pediatricians, family physicians, and other experts/individuals involved in immunization service delivery. It has been argued that knowledge of vaccine epidemiology which is likely to benefit the society through contributions to the informed decision-making and improving vaccination coverage in the low and middle income countries (LMICs). The article ends with suggestions for the provision of systematic training and learning platforms in vaccine epidemiology to save millions of preventable deaths and improve health outcomes through life-course. PMID:27453836

  12. [Epidemiology and heterogeny].

    PubMed

    Breilh, J; Granda, E

    1989-01-01

    The innovation of epidemiology plays a crucial role in the development of the health sciences. The authors emphasize the importance of epistemological analysis related to scientific and technical production. They focus on the theoretical and methodological contributions of the principal Latin American groups in the field of epidemiology, stating their main accomplishments, issues and potentials. When reviewing those conceptual and practical innovations, the authors analyse the effects of broader historical conditions on scientific work. To them, Latin American contemporary innovative epidemiological research and production have developed clearly differentiated principles, methods and technical projections which have led to a movement of critical or 'social' epidemiology. The functionalist approach of conventional epidemiology, characterized by an empiricist viewpoint, is being overcome by a more rigorous and analytical approach. This new epidemiological approach, in which the authors as members of CEAS (Health Research and Advisory Center) are working, has selectively incorporated some of the technical instruments of conventional epidemiology, subordinating them to a different theoretical and logical paradigm. The new framework of this group explains the need to consider the people's objective situation and necessities, when constructing scientific interpretations and planning technical action. In order to accomplish this goal, epidemiological reasoning has to reflect the unity of external epidemiological facts and associations, the so-called phenomenological aspect of health, with the underlying determinants and conditioning processes or internal relations, which are the essence of the health-disease production and distribution process. Epidemiological analysis is considered not only as a problem of empirical observation but as a process of theoretical construction, in which there is a dynamic fusion of deductive and inductive reasoning.(ABSTRACT TRUNCATED AT 250

  13. Simple, heart-smart substitutions

    MedlinePlus

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

  14. Women's Heart Disease: Heart Attack Symptoms

    MedlinePlus

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

  15. Heart Health: The Heart Truth Campaign 2009

    MedlinePlus

    ... 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) ...

  16. Women's Heart Disease: Heart Disease Risk Factors

    MedlinePlus

    ... 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 ...

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

    MedlinePlus

    ... 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 ...

  18. Heart Attack

    MedlinePlus

    ... to the heart.Usually, a blockage starts with atherosclerosis. Atherosclerosis is the buildup of fatty deposits (called plaque) ... Americans and native Hawaiians are at greater risk.Atherosclerosis (hardening of the arteries)Lack of exerciseStressObesitySex (Gender)-- ...

  19. Heart Truth

    MedlinePlus

    ... trademark of the U.S. Department of Health and Human Services and American Heart Association. Skip footer links and go to content Twitter Facebook YouTube Google+ SITE INDEX | ACCESSIBILITY | ... OIG | CONTACT US National Institutes of Health Department of Health and Human Services USA.gov

  20. Socio-economic analysis of the risk management of hexabromocyclododecane (HBCD) in China in the context of the Stockholm Convention.

    PubMed

    Zhu, Jing; Liu, Jian-Guo; Hu, Jian-xin; Yi, Shan

    2016-05-01

    Socio-economic analysis (SEA) plays an important role in decision-making on risk management actions for certain chemicals under Multilateral Environmental Agreements (MEAs) in developing countries. This paper showed the first holistic and quantitative SEA case study on that by developing a country-specific SEA framwork and methodologies and applying the case of HBCD phase-out in China under the Stockholm Convention on Persistent Organic Pollutants (POPs). The study indicates that, under the possible scenarios of 10 years and 5 years , the economic costs of HBCD phase-out in China would be between 9.032 and 19.021 billion RMB. Although the total economic costs seems to be significant, it would only have a marginal impact on the house building industry with a likely cost increase by about 0.07‰-0.14‰. Meanwhile, the HBCD phase-out may render significant environmental and health benefits, including about 23-29 tons of HBCD release prevented to the environment, 1.142-1.469 million tons of potentially HBCD contained hazardous wastes avoided, along with significant reduction from 58% up to almost 100% in local environmental concentrations of HBCD, and about 0.0996-0.128 million workers at risk avoided and at least 3.067-4.033 billion RMB of the health care savings. While the scenario of phasing out HBCD over 10 years would be less costly than the scenario of that over 5 years, the later scenario suggested much greater environmental and health benefits for China.

  1. Epidemiologic evidence of cardiovascular effects of particulate air pollution.

    PubMed Central

    Dockery, D W

    2001-01-01

    In the past decade researchers have developed a body of epidemiologic evidence showing increased daily cardiovascular mortality and morbidity associated with acute exposures to particulate air pollution. Associations have been found not only with cardiovascular deaths reported on death certificates but also with myocardial infarctions and ventricular fibrillation. Particulate air pollution exposure has been associated with indicators of autonomic function of the heart including increased heart rate, decreased heart rate variability, and increased cardiac arrhythmias. Several markers of increased risk for sudden cardiac death have also been associated with such exposures. These epidemiologic studies provide early guidance to possible pathways of particulate air pollution health effects, which can only be addressed fully in toxicologic and physiologic studies. PMID:11544151

  2. Heart disease and diet

    MedlinePlus

    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 ...

  3. Coronary heart disease

    MedlinePlus

    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 ...

  4. What Is Heart Surgery?

    MedlinePlus

    ... Another type of heart surgery is called off-pump, or beating heart, surgery. It's like traditional open- ... heart-lung bypass machine isn't used. Off-pump heart surgery is limited to CABG. Surgeons can ...

  5. Anatomy of the Heart

    MedlinePlus

    ... picture of the outside of a normal, healthy, human heart. Heart Exterior Figure A shows the location of ... picture of the inside of a normal, healthy, human heart. Heart Interior Figure A shows the location of ...

  6. Diabetic Heart Disease

    MedlinePlus

    ... be coronary heart disease (CHD), heart failure, and diabetic cardiomyopathy. Diabetes by itself puts you at risk for heart disease. Other risk factors include Family history of heart disease Carrying extra ...

  7. Heart disease - resources

    MedlinePlus

    Resources - heart disease ... The following organizations are good resources for information on heart disease: American Heart Association -- www.heart.org Centers for Disease Control and Prevention -- www.cdc.gov/heartdisease

  8. Epidemiology: Then and Now.

    PubMed

    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.

  9. HIV and Nonischemic Heart Disease.

    PubMed

    Manga, Pravin; McCutcheon, Keir; Tsabedze, Nqoba; Vachiat, Ahmed; Zachariah, Don

    2017-01-03

    Human immunodeficiency virus (HIV)-associated heart disease encompasses a broad spectrum of diseases. HIV infection may involve the pericardium, myocardium, coronary arteries, pulmonary vasculature, and valves, as well as the systemic vasculature. Access to combination antiretroviral therapy, as well as health resources, has had a significant influence on the prevalence and severity of the effects on each cardiac structure. Investigations over the recent past have improved our understanding of the epidemiology and pathophysiology of HIV-associated cardiovascular disease. This review will focus on our current understanding of pathogenesis and risk factors associated with HIV infection and heart disease, and it will discuss relevant advances in diagnosis and management of these conditions.

  10. Pediatric heart surgery

    MedlinePlus

    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 ...

  11. Criticality in epidemiology

    NASA Astrophysics Data System (ADS)

    Stollenwerk, Nico; Jansen, Vincent A. A.

    For a long time criticality has been considered in epidemiological models. We review the body of theory developed over the last twenty five years for the simplest models. It is at first glance difficult to imagine that an epidemiological system operates at a very fine tuned critical state as opposed to any other parameter region. However, the advent of self-organized criticality has given hints in how to interpret large fluctuations observed in many natural systems including epidemiological systems. We show some scenarios where criticality has been observed (e.g., measles under vaccination) and where evolution towards a critical state can explain fluctuations (e.g., meningococcal disease.)

  12. Heart Research

    NASA Technical Reports Server (NTRS)

    1991-01-01

    James Antaki and a group of researchers from the University of Pittsburgh School of Medicine used many elements of the Technology Utilization Program while looking for a way to visualize and track material points within the heart muscle. What they needed were tiny artificial "eggs" containing copper sulfate solution, small enough (about 2 mm in diameter) that they would not injure the heart, and large enough to be seen in Magnetic Resonance Imaging (MRI) images; they also had to be biocompatible and tough enough to withstand the beating of the muscle. The group could not make nor buy sufficient containers. After reading an article on microspheres in NASA Tech Briefs, and a complete set of reports on microencapsulation from the Jet Propulsion Laboratory (JPL), JPL put Antaki in touch with Dr.Taylor Wang of Vanderbilt University who helped construct the myocardial markers. The research is expected to lead to improved understanding of how the heart works and what takes place when it fails.

  13. Epidemiology of Lice

    ERIC Educational Resources Information Center

    Juranek, Dennis D.

    1977-01-01

    Research into the epidemiology of lice indicates that infestation is uncommon in blacks, more common in females than males, significantly higher in low income groups, and transmission is by way of articles of clothing. (JD)

  14. Epidemiology & Genomics Research Program

    Cancer.gov

    The Epidemiology and Genomics Research Program, in the National Cancer Institute's Division of Cancer Control and Population Sciences, funds research in human populations to understand the determinants of cancer occurrence and outcomes.

  15. EPIDEMIOLOGY AND EXPOSURE ASSESSMENT

    EPA Science Inventory

    Research collaborations between the National Health and Environmental Effects Research Laboratory (NHEERL) and the National Exposure Research Laboratory (NERL) centered on the development and application of exposure analysis tools in environmental epidemiology include the El Paso...

  16. Cancer Epidemiology Cohorts

    Cancer.gov

    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.

  17. Factors affecting non-tailpipe aerosol particle emissions from paved roads: On-road measurements in Stockholm, Sweden

    NASA Astrophysics Data System (ADS)

    Hussein, Tareq; Johansson, Christer; Karlsson, Hans; Hansson, Hans-Christen

    A large fraction of urban PM 10 concentrations is due to non-exhaust traffic emissions. In this paper, a mobile measurement system has been used to quantify the relative importance of road particle emission and suspension of accumulated dust versus direct pavement wear, tire type (studded, friction, and summer), pavement type, and vehicle speed. Measurements were performed during May-September on selected roads with different pavements and traffic conditions in the Stockholm region. The highest particle mass concentrations were always observed behind the studded tire and the lowest were behind the summer tire; studded-to-summer ratios were 4.4-17.3 and studded-to-friction ratios were 2.0-6.4. This indicates that studded tires lead to higher emissions than friction and summer tires regardless to the asphalt type. By comparing with measurements in a road simulator, it could be estimated that the pavement wear due to the friction tires was 0.018-0.068 of the suspension of accumulated road dust. Likewise for studded tires road-wear was estimated to be 1.2-4.8 the suspension of accumulated dust. This indicates that wear due to friction tires is very small compared to the suspension of accumulated dust and that suspension due to studded tires may sometimes be as large as the wear of the road. But this will vary depending on, e.g. the amount of dust accumulated on the roads. An important dependence on vehicle speed was also observed. During May, the particle mass concentrations behind the studded tire at vehicle speed 100 km h -1 were about 10 times higher than that at 20 km h -1. The speed dependence was not so pronounced in September, which could be due to less accumulated dust on the roads. The particle number size distribution of the emissions due to road wear by studded tire was characterized by a clear increase in number concentrations of the coarse fraction of aerosol particles, with a geometric mean diameter between 3 and 5 μm. The size distribution of the

  18. A randomised controlled trial for overweight and obese parents to prevent childhood obesity - Early STOPP (STockholm Obesity Prevention Program)

    PubMed Central

    2011-01-01

    Background Overweight and obesity have a dramatic negative impact on children's health not only during the childhood but also throughout the adult life. Preventing the development of obesity in children is therefore a world-wide health priority. There is an obvious urge for sustainable and evidenced-based interventions that are suitable for families with young children, especially for families with overweight or obese parents. We have developed a prevention program, Early STOPP, combating multiple obesity-promoting behaviors such unbalanced diet, physical inactivity and disturbed sleeping patterns. We also aim to evaluate the effectiveness of the early childhood obesity prevention in a well-characterized population of overweight or obese parents. This protocol outlines methods for the recruitment phase of the study. Design and methods This randomized controlled trial (RCT) targets overweight and/or obese parents with infants, recruited from the Child Health Care Centers (CHCC) within the Stockholm area. The intervention starts when infants are one year of age and continues until they are six and is regularly delivered by a trained coach (dietitian, physiotherapist or a nurse). The key aspects of Early STOPP family intervention are based on Swedish recommendations for CHCC, which include advices on healthy food choices and eating patterns, increasing physical activity/reducing sedentary behavior and regulating sleeping patterns. Discussion The Early STOPP trial design addresses weaknesses of previous research by recruiting from a well-characterized population, defining a feasible, theory-based intervention and assessing multiple measurements to validate and interpret the program effectiveness. The early years hold promise as a time in which obesity prevention may be most effective. To our knowledge, this longitudinal RCT is the first attempt to demonstrate whether an early, long-term, targeted health promotion program focusing on healthy eating, physical activity

  19. Congenital Heart Defects (For Parents)

    MedlinePlus

    ... heart, lungs, and blood vessels make up the circulatory system . The heart is the central pump of this ... Heart Defects Getting an EKG (Video) Your Heart & Circulatory System Heart Murmurs Mitral Valve Prolapse Movie: Heart & Circulatory ...

  20. A report from the 46th Annual Meeting of the European Association for the Study of Diabetes (September 20-24, 2010 - Stockholm, Sweden).

    PubMed

    Rabasseda, X

    2011-01-01

    Old and modern architecture go hand in hand along the many waterfronts in Stockholm, just as old (established) and new (investigational) drugs for treating diabetes shared time and space at the oral and poster sessions during the 2010 European Association for the Study of Diabetes (EASD) meeting in Älfsjö. Old and new drugs shared the spotlight at the meeting, the main declared objective of which was to promote excellence in diabetes care through research and education. Although it is important to attend the EASD meeting in order to obtain information on what's new firsthand-new drugs, new indications, new treatment modalities... as well as news on negative aspects and limitations of drug therapy-not all healthcare professionals can attend so many annual meetings, and those who can, cannot attend many of the parallel sessions, and thus alternative sources of information are needed. Indeed, education has a major role in the management and prevention of diabetes, obesity and related disorders, all of which carry a high cardiovascular risk, but if educating patients and the general population is essential, so is informing healthcare professionals about new therapies and new findings related with the management of diabetes. In line with the previously stated attendance limitations and alternative sources of information-or education-this is the scope of the following report, which complements other information on subjects discussed during the EASD meeting in Stockholm available online through other channels.

  1. Prevalence of hepatitis B virus markers and exposure to occupational risks likely to be associated with acquisition of hepatitis B virus among health care workers in Stockholm.

    PubMed

    Struve, J; Aronsson, B; Frenning, B; Forsgren, M; Weiland, O

    1992-03-01

    The prevalence of hepatitis B virus (HBV) markers and exposure to risks possibly associated with HBV transmission were investigated in 797 health care workers (HCW) from Stockholm. Altogether, 31/797 (3.9%) persons were positive for at least one HBV marker, 8.0, 7.9 and 6.4% respectively of children's nurses, laboratory assistants and psychiatric assistant nurses. A history of exposure to needle-stick injuries from any patient, was more often obtained from HCW with HBV markers than from HCW without such markers. The prevalence of HBV markers increased with age and duration of occupation in health care. Most HCW had been exposed to at least one occupational risk for HBV transmission early in their professional careers. Although the risk of acquiring HBV at present is low, the virus constitutes a potential occupational hazard for non-vaccinated HCW in Stockholm, a risk which may increase in the future since the number of chronic HBsAg carriers is increasing in Sweden.

  2. Adult Congenital Heart Disease: Scope of the Problem.

    PubMed

    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.

  3. Epidemiology of the arterial stiffness.

    PubMed

    Breithaupt-Grögler, K; Belz, G G

    1999-06-01

    Aortic stiffening is as much an important risk factor in cardiovascular morbidity and mortality, as it serves as reliable surrogate marker for clinical endpoints like myocardial and cerebrovascular incidents. Elevated aortic stiffness induces high systolic blood pressure, augmented pulse pressure with increased ventricular afterload, reduced subendocardial blood flow and augmented pulsatile stress in the peripheral arteries. Factors with relevant impact on the epidemiology of arterial stiffness are widely spread. 3 major groups of parameters influencing the stiffness of the aorta and the large arteries have been studied and described up to now: (i) physiological properties like age, gender, body height, pressure, hormonal state, genetic factors; (ii) environmental factors like nutrition (fish-, salt-, garlic consumption), smoking, performance of sports and aerobic capacity; (iii) diseases like hypertension, hypercholesterolemia, diabetes, coronary heart disease, cerebrovascular disease, renal failure, Marfan-syndrome, growth hormone deficiency. Close association between several of these factors impedes analyzing them independently from each other. Age and blood pressure were found to be the most prominent predictors of arterial stiffness in normal as well as in disease populations. Physiological and environmental factors can modulate these effects of aging, diseases generally seem to amplify them.

  4. Against Popperized epidemiology.

    PubMed

    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.

  5. The epidemiology of male infertility.

    PubMed

    Winters, Brian R; Walsh, Thomas J

    2014-02-01

    The purpose of this review is to integrate understanding of epidemiology and infertility. A primer on epidemiologic science and an example disease for which the design of epidemiologic investigations is readily apparent are provided. Key features of infertility that limit epidemiologic investigation are described and a survey of available data on the epidemiology of infertility provided. Finally, the work that must be completed to move this area of research forward is proposed, and, with this new perspective of "infertility as a disease," improvements envisioned in public health that may be gained through improved understanding of the epidemiology of male infertility.

  6. Right heart ventriculography

    MedlinePlus

    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 ...

  7. Left heart catheterization

    MedlinePlus

    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 ...

  8. Heart disease and women

    MedlinePlus

    ... disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, ... the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and ...

  9. Honolulu Heart Program

    ClinicalTrials.gov

    2016-04-13

    Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Heart Failure, Congestive; Myocardial Infarction; Asthma; Emphysema; Lung Diseases, Obstructive; Aortic Aneurysm, Abdominal; Bronchitis; Dementia; Hypertension; Chronic Obstructive Pulmonary Disease; Heart Failure

  10. Heart Attack Recovery FAQs

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Heart Attack Recovery FAQs Updated:Sep 19,2016 Most people ... recovery. View an animation of a heart attack . Heart Attack Recovery Questions and Answers What treatments will I ...

  11. Heart Surgery Terms

    MedlinePlus

    ... the hearts of humans who have died (cadavers). Angina pectoris The discomfort experienced by individuals when their heart ... performed during symptoms suggestive of coronary artery disease angina pectoris , abnormalities may confirm the diagnosis of ischemic heart ...

  12. Heart disease and depression

    MedlinePlus

    ... 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 ...

  13. Getting a New Heart

    MedlinePlus

    ... About Heart Transplants American Society of Transplantation 1120 Route 73, Suite 200 Mount Laurel, NJ 08054 Phone: ... of heart disease; these patients have no other choice. The best treatment for your heart failure will ...

  14. Heart failure - medicines

    MedlinePlus

    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 ...

  15. Heart Failure in Sub-Saharan Africa

    PubMed Central

    Bloomfield, Gerald S; Barasa, Felix A; Doll, Jacob A; Velazquez, Eric J

    2013-01-01

    The heart failure syndrome has been recognized as a significant contributor to cardiovascular disease burden in sub-Saharan African for many decades. Seminal knowledge regarding heart failure in the region came from case reports and case series of the early 20th century which identified infectious, nutritional and idiopathic causes as the most common. With increasing urbanization, changes in lifestyle habits, and ageing of the population, the spectrum of causes of HF has also expanded resulting in a significant burden of both communicable and non-communicable etiologies. Heart failure in sub-Saharan Africa is notable for the range of etiologies that concurrently exist as well as the healthcare environment marked by limited resources, weak national healthcare systems and a paucity of national level data on disease trends. With the recent publication of the first and largest multinational prospective registry of acute heart failure in sub-Saharan Africa, it is timely to review the state of knowledge to date and describe the myriad forms of heart failure in the region. This review discusses several forms of heart failure that are common in sub-Saharan Africa (e.g., rheumatic heart disease, hypertensive heart disease, pericardial disease, various dilated cardiomyopathies, HIV cardiomyopathy, hypertrophic cardiomyopathy, endomyocardial fibrosis, ischemic heart disease, cor pulmonale) and presents each form with regard to epidemiology, natural history, clinical characteristics, diagnostic considerations and therapies. Areas and approaches to fill the remaining gaps in knowledge are also offered herein highlighting the need for research that is driven by regional disease burden and needs. PMID:23597299

  16. The effects of exercise capacity and sedentary lifestyle on haemostasis among middle-aged women with coronary heart disease.

    PubMed

    Nagy, Edit; Janszky, Imre; Eriksson-Berg, Margita; Al-Khalili, Faris; Schenck-Gustafsson, Karin

    2008-11-01

    Previous studies have established a link/relationship between haemostatic factors and increased risk of cardiovascular disease. In addition, physical conditioning is associated with lower coronary heart disease risk. The purpose of this study was to assess the association between physical exercise and haemostatic factors among middle-aged women surviving an acute coronary event. The Stockholm Female Coronary Risk Study included 292 women aged < 65 years, resident in the greater Stockholm area, who were hospitalized for an acute coronary syndrome. Extensive clinical screening including exercise testing, and blood tests were performed 3-6 months after the coronary event. Self-reported physical activity was assessed by a WHO questionnaire. Patients on warfarin treatment were excluded from our analyses. Haemostatic factors were generally higher among physically inactive patients when compared to physically active women in our univariate models. Exercise capacity had a statistically significant relationship with factor VII antigen (p = 0.039) and vWFag (p = 0.038) even in our multiadjusted analyses. Physical inactivity and poor physical fitness are associated with a potentially prothrombotic blood profile in middle aged women with coronary heart disease.

  17. Phylogenetically resolving epidemiologic linkage

    PubMed Central

    Romero-Severson, Ethan O.; Bulla, Ingo; Leitner, Thomas

    2016-01-01

    Although the use of phylogenetic trees in epidemiological investigations has become commonplace, their epidemiological interpretation has not been systematically evaluated. Here, we use an HIV-1 within-host coalescent model to probabilistically evaluate transmission histories of two epidemiologically linked hosts. Previous critique of phylogenetic reconstruction has claimed that direction of transmission is difficult to infer, and that the existence of unsampled intermediary links or common sources can never be excluded. The phylogenetic relationship between the HIV populations of epidemiologically linked hosts can be classified into six types of trees, based on cladistic relationships and whether the reconstruction is consistent with the true transmission history or not. We show that the direction of transmission and whether unsampled intermediary links or common sources existed make very different predictions about expected phylogenetic relationships: (i) Direction of transmission can often be established when paraphyly exists, (ii) intermediary links can be excluded when multiple lineages were transmitted, and (iii) when the sampled individuals’ HIV populations both are monophyletic a common source was likely the origin. Inconsistent results, suggesting the wrong transmission direction, were generally rare. In addition, the expected tree topology also depends on the number of transmitted lineages, the sample size, the time of the sample relative to transmission, and how fast the diversity increases after infection. Typically, 20 or more sequences per subject give robust results. We confirm our theoretical evaluations with analyses of real transmission histories and discuss how our findings should aid in interpreting phylogenetic results. PMID:26903617

  18. Epidemiology of Down Syndrome

    ERIC Educational Resources Information Center

    Sherman, Stephanie L.; Allen, Emily G.; Bean, Lora H.; Freeman, Sallie B.

    2007-01-01

    Down syndrome (DS) is the most commonly identified genetic form of mental retardation and the leading cause of specific birth defects and medical conditions. Traditional epidemiological studies to determine the prevalence, cause, and clinical significance of the syndrome have been conducted over the last 100 years. DS has been estimated to occur…

  19. Phylogenetically resolving epidemiologic linkage

    SciTech Connect

    Romero-Severson, Ethan O.; Bulla, Ingo; Leitner, Thomas

    2016-02-22

    The use of phylogenetic trees in epidemiological investigations has become commonplace, but their epidemiological interpretation has not been systematically evaluated. Here, we use an HIV-1 within-host coalescent model to probabilistically evaluate transmission histories of two epidemiologically linked hosts. Previous critique of phylogenetic reconstruction has claimed that direction of transmission is difficult to infer, and that the existence of unsampled intermediary links or common sources can never be excluded. The phylogenetic relationship between the HIV populations of epidemiologically linked hosts can be classified into six types of trees, based on cladistic relationships and whether the reconstruction is consistent with the true transmission history or not. We show that the direction of transmission and whether unsampled intermediary links or common sources existed make very different predictions about expected phylogenetic relationships: (i) Direction of transmission can often be established when paraphyly exists, (ii) intermediary links can be excluded when multiple lineages were transmitted, and (iii) when the sampled individuals’ HIV populations both are monophyletic a common source was likely the origin. Inconsistent results, suggesting the wrong transmission direction, were generally rare. In addition, the expected tree topology also depends on the number of transmitted lineages, the sample size, the time of the sample relative to transmission, and how fast the diversity increases after infection. Typically, 20 or more sequences per subject give robust results. Moreover, we confirm our theoretical evaluations with analyses of real transmission histories and discuss how our findings should aid in interpreting phylogenetic results.

  20. Phylogenetically resolving epidemiologic linkage

    DOE PAGES

    Romero-Severson, Ethan O.; Bulla, Ingo; Leitner, Thomas

    2016-02-22

    The use of phylogenetic trees in epidemiological investigations has become commonplace, but their epidemiological interpretation has not been systematically evaluated. Here, we use an HIV-1 within-host coalescent model to probabilistically evaluate transmission histories of two epidemiologically linked hosts. Previous critique of phylogenetic reconstruction has claimed that direction of transmission is difficult to infer, and that the existence of unsampled intermediary links or common sources can never be excluded. The phylogenetic relationship between the HIV populations of epidemiologically linked hosts can be classified into six types of trees, based on cladistic relationships and whether the reconstruction is consistent with the truemore » transmission history or not. We show that the direction of transmission and whether unsampled intermediary links or common sources existed make very different predictions about expected phylogenetic relationships: (i) Direction of transmission can often be established when paraphyly exists, (ii) intermediary links can be excluded when multiple lineages were transmitted, and (iii) when the sampled individuals’ HIV populations both are monophyletic a common source was likely the origin. Inconsistent results, suggesting the wrong transmission direction, were generally rare. In addition, the expected tree topology also depends on the number of transmitted lineages, the sample size, the time of the sample relative to transmission, and how fast the diversity increases after infection. Typically, 20 or more sequences per subject give robust results. Moreover, we confirm our theoretical evaluations with analyses of real transmission histories and discuss how our findings should aid in interpreting phylogenetic results.« less

  1. Heart failure and Alzheimer′s disease

    PubMed Central

    Cermakova, P; Eriksdotter, M; Lund, L H; Winblad, B; Religa, P; Religa, D

    2015-01-01

    It has recently been proposed that heart failure is a risk factor for Alzheimer′s disease. Decreased cerebral blood flow and neurohormonal activation due to heart failure may contribute to the dysfunction of the neurovascular unit and cause an energy crisis in neurons. This leads to the impaired clearance of amyloid beta and hyperphosphorylation of tau protein, resulting in the formation of amyloid beta plaques and neurofibrillary tangles. In this article, we will summarize the current understanding of the relationship between heart failure and Alzheimer′s disease based on epidemiological studies, brain imaging research, pathological findings and the use of animal models. The importance of atherosclerosis, myocardial infarction, atrial fibrillation, blood pressure and valve disease as well as the effect of relevant medications will be discussed. PMID:25041352

  2. [Analytical epidemiology of urolithiasis].

    PubMed

    Kodama, H; Ohno, Y

    1989-06-01

    In this paper, urolithiasis is reviewed from the standpoint of analytical epidemiology, which examines a statistical association between a given disease and a hypothesized factor with an aim of inferring its causality. Factors incriminated epidemiologically for stone formation include age, sex, occupation, social class (level of affluence), season of the year and climate, dietary and fluid intake and genetic prodisposition. Since some of these factors are interlinked, they are broadly classified into five categories and epidemiologically looked over here. Genetic predisposition is essentially endorsed by the more frequent episodes of stone formation in the family members of stone formers, as compared to non-stone formers. Nevertheless, some environmental factors (likely to be dietary habits) shared by family members are believed to be relatively more important than genetic predisposition. A hot, sunny climate may influence stone formation through inducing dehydration with increased perspiration and increased solute concentration with decreased urine volume, coupled with inadequate liquid intake, and possibly through the greater exposure to ultraviolet radiation which eventually results in an increased vitamin D production, conceivably correlated with seasonal variation in calcium and oxalate excretion to the urine. Urinary tract infections are importantly involved in the formation of magnesium ammonium phosphate stones in particular. The association with regional water hardness is still in controversy. Excessive intake of coffee, tea and alcoholic beverages seemingly increase the risk of renal calculi, though not consistently confirmed. Many dietary elements have been suggested by numerous clinical and experimental investigations, but a few elements are substantiated by analytical epidemiological investigations. An increased ingestion of animal protein and sugar and a decreased ingestion of dietary fiber and green-yellow vegetables are linked with the higher

  3. Causation in epidemiology

    PubMed Central

    Parascandola, M; Weed, D

    2001-01-01

    Causation is an essential concept in epidemiology, yet there is no single, clearly articulated definition for the discipline. From a systematic review of the literature, five categories can be delineated: production, necessary and sufficient, sufficient-component, counterfactual, and probabilistic. Strengths and weaknesses of these categories are examined in terms of proposed characteristics of a useful scientific definition of causation: it must be specific enough to distinguish causation from mere correlation, but not so narrow as to eliminate apparent causal phenomena from consideration. Two categories—production and counterfactual—are present in any definition of causation but are not themselves sufficient as definitions. The necessary and sufficient cause definition assumes that all causes are deterministic. The sufficient-component cause definition attempts to explain probabilistic phenomena via unknown component causes. Thus, on both of these views, heavy smoking can be cited as a cause of lung cancer only when the existence of unknown deterministic variables is assumed. The probabilistic definition, however, avoids these assumptions and appears to best fit the characteristics of a useful definition of causation. It is also concluded that the probabilistic definition is consistent with scientific and public health goals of epidemiology. In debates in the literature over these goals, proponents of epidemiology as pure science tend to favour a narrower deterministic notion of causation models while proponents of epidemiology as public health tend to favour a probabilistic view. The authors argue that a single definition of causation for the discipline should be and is consistent with both of these aims. It is concluded that a counterfactually-based probabilistic definition is more amenable to the quantitative tools of epidemiology, is consistent with both deterministic and probabilistic phenomena, and serves equally well for the acquisition and the

  4. Heart failure.

    PubMed

    Braunwald, Eugene

    2013-02-01

    Despite major improvements in the treatment of virtually all cardiac disorders, heart failure (HF) is an exception, in that its prevalence is rising, and only small prolongations in survival are occurring. An increasing fraction, especially older women with diabetes, obesity, and atrial fibrillation exhibit HF with preserved systolic function. Several pathogenetic mechanisms appear to be operative in HF. These include increased hemodynamic overload, ischemia-related dysfunction, ventricular remodeling, excessive neurohumoral stimulation, abnormal myocyte calcium cycling, excessive or inadequate proliferation of the extracellular matrix, accelerated apoptosis, and genetic mutations. Biomarkers released as a consequence of myocardial stretch, imbalance between formation and breakdown of extracellular matrix, inflammation, and renal failure are useful in the identification of the pathogenetic mechanism and, when used in combination, may become helpful in estimating prognosis and selecting appropriate therapy. Promising new therapies that are now undergoing intensive investigation include an angiotensin receptor neprilysin inhibitor, a naturally-occurring vasodilator peptide, a myofilament sensitizer and several drugs that enhance Ca++ uptake by the sarcoplasmic reticulum. Cell therapy, using autologous bone marrow and cardiac progenitor cells, appears to be promising, as does gene therapy. Chronic left ventricular assistance with continuous flow pumps is being applied more frequently and successfully as destination therapy, as a bridge to transplantation, and even as a bridge to recovery and explantation. While many of these therapies will improve the care of patients with HF, significant reductions in prevalence will require vigorous, multifaceted, preventive approaches.

  5. Epidemiology of urolithiasis: an update

    PubMed Central

    Trinchieri, Alberto

    2008-01-01

    Background & Aim. Changing socio-economic conditions generated changes in the prevalence, incidence and distribution for age, sex and type of urolithiasis in terms of both the site and the chemical-physical composition of the calculi. In the latter part of the 20th century the prevalence of upper urinary tract stones was increasing in Western countries whereas endemic infantile bladder stone disease was fairly widespread in huge areas of developing countries. The aim of this paper was to update previous epidemiological reports of urolithiasis by reviewing the more recent literature. Methods. Citations were extracted using PubMed database from January 2003 through December 2007 on the basis of the key words epidemiology AND urinary calculi. Results. An increase in the prevalence and incidence of urolithiasis was described in Germany whereas data from the United States were contradictory with stone disease rates increased only for women with a change of male-to-female ratio. Prevalence figures of stone disease observed in some developing country in tropical regions were similar to rates of Western countries with incidence of renal colic particularly high in warm months. African Americans had a reduced risk of stone disease compared to other racial groups but in renal stone patients all racial groups demonstrated a similarity in the incidence of underlying metabolic abnormalities. Upper urinary tract stones in children were associated more frequently with metabolic disturbances rather than with urinary tract anomalies and infection. Endemic childhood bladder stones are still present in some developing countries. Dietary risk factors for stone disease were shown different by age and sex. In particular in younger women dietary calcium, phytate and fluid intake were associated with a reduced risk of stone formation whereas animal protein and sucrose increased the risk of stone incidence. In older adults there was no association between dietary calcium and stone formation

  6. Hypoplastic left heart syndrome (image)

    MedlinePlus

    Hypoplastic left heart syndrome is a congenital heart condition that occurs during the development of the heart in the ... womb. During the heart's development, parts of the left side of the heart (mitral valve, left ventricle ...

  7. The impact of water supply and sanitation on area differentials in the decline of diarrhoeal disease mortality among infants in Stockholm 1878-1925.

    PubMed

    Macassa, Gloria; De Leon, Antonio Ponce; Burström, Bo

    2006-01-01

    This study analyses the impact of improved water supply and sanitation on the level and rate of decline of child diarrhoea mortality in Stockholm 1878-1925. Previous studies have failed to demonstrate an effect of improved water supply on the risk of diarrhoea mortality at the individual level. Using data on access to water and sanitation from a household survey in 1895 and mortality rates and sociodemographic information from individual data 1878-1925 to analyse area differentials in diarrhoea mortality, it was found that the proportion having their own latrine in the household was associated with lower mortality risk in 1895-1900, while the proportion having water in the household was associated with lower diarrhoea mortality risk during the mortality decline until 1925. Population effects of improved water and sanitation on diarrhoea mortality may be better measured at area level than at individual level.

  8. Equitable child health interventions: the impact of improved water and sanitation on inequalities in child mortality in Stockholm, 1878 to 1925.

    PubMed

    Burström, Bo; Macassa, Gloria; Oberg, Lisa; Bernhardt, Eva; Smedman, Lars

    2005-02-01

    Today, many of the 10 million childhood deaths each year are caused by diseases of poverty--diarrhea and pneumonia, for example, which were previously major causes of childhood death in many European countries. Specific analyses of the historical decline of child mortality may shed light on the potential equity impact of interventions to reduce child mortality. In our study of the impact of improved water and sanitation in Stockholm from 1878 to 1925, we examined the decline in overall and diarrhea mortality among children, both in general and by socioeconomic group. We report a decline in overall mortality and of diarrhea mortality and a leveling out of socioeconomic differences in child mortality due to diarrheal diseases, but not of overall mortality. The contribution of general and targeted policies is discussed.

  9. Molecular Epidemiology of Foodborne Pathogens

    NASA Astrophysics Data System (ADS)

    Chen, Yi; Brown, Eric; Knabel, Stephen J.

    The purpose of this chapter is to describe the basic principles and advancements in the molecular epidemiology of foodborne pathogens. Epidemiology is the study of the distribution and determinants of infectious diseases and/or the dynamics of disease transmission. The goals of epidemiology include the identification of physical sources, routes of transmission of infectious agents, and distribution and relationships of different subgroups. Molecular epidemiology is the study of epidemiology at the molecular level. It has been defined as "a science that focuses on the contribution of potential genetic and environmental risk factors, identified at the molecular level, to the etiology, distribution and prevention of diseases within families and across populations".

  10. Pediatric heart surgery - discharge

    MedlinePlus

    ... get enough calories to heal and grow. After heart surgery, most babies and infants (younger than 12 to 15 months) can take ... valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... open heart surgery References Bernstein D. General principles ...

  11. Advanced Heart Failure

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:Feb 9,2017 When heart failure (HF) ... content was last reviewed on 04/06/2015. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  12. 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.

    PubMed

    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.

  13. Congenital complete heart block.

    PubMed Central

    Agarwala, B.; Sheikh, Z.; Cibils, L. A.

    1996-01-01

    Congenital complete heart block in utero has become diagnosed more frequently with the clinical use of fetal echocardiography. The fetus with complete heart block may remain asymptomatic or may develop congestive heart failure. Congenital complete heart block is more frequently seen in infants of mothers with systemic lupus erythematosus, both clinically manifested and subclinical systemic lupus erythematosus with positive antibodies (SS-A and SS-B antibodies). At birth, the neonate with complete heart block may remain asymptomatic and may not require a pacemaker to increase the heart rate. The indications for a pacemaker in neonates with complete heart block have been discussed. Both in-utero and neonatal management of congenital complete heart block are discussed to manage congestive heart failure in a fetus. Four patients with congenital complete heart block are presented covering a broad spectrum of clinical presentation, diagnosis, and management both in the fetal and neonatal period. Images Figure 1 PMID:8961692

  14. Epidemiology and moral philosophy.

    PubMed Central

    Westrin, C G; Nilstun, T; Smedby, B; Haglund, B

    1992-01-01

    To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research. PMID:1460647

  15. [Epidemiological situation of Chad].

    PubMed

    Korzeniewski, Krzysztof

    2008-10-01

    Chad, the land located in Central Africa nowadays is one of the poorest countries in the world, what is connected with catastrophic demographic indicators and numerous cases of infectious diseases among local population as well as external and internal refugees. Epidemiologic profile is dominated by vector-, water-, food-borne, respiratory, and sexually transmitted diseases. Environmental factors, such as an effect of high temperature, sand and dust storms also pose essential threat. This is related to location of majority of Chad territory in the area of Sahara and Sahel. The article presents information concerning current epidemiological hazards encountered by visitors in this country. This knowledge is essential for Polish health service and armed forces in the context of forming of EUFOR mission in Chad with participation of our soldiers.

  16. Epidemiology of colorectal cancer

    PubMed Central

    Marley, Andrew R; Nan, Hongmei

    2016-01-01

    Colorectal cancer is currently the third deadliest cancer in the United States and will claim an estimated 49,190 U.S. lives in 2016. The purpose of this review is to summarize our current understanding of this disease, based on nationally published statistics and information presented in peer-reviewed journal articles. Specifically, this review will cover the following topics: descriptive epidemiology (including time and disease trends both in the United States and abroad), risk factors (environmental, genetic, and gene-environment interactions), screening, prevention and control, and treatment. Landmark discoveries in colorectal cancer risk factor research will also be presented. Based on the information reviewed for this report, we suggest that future U.S. public health efforts aim to increase colorectal cancer screening among African American communities, and that future worldwide colorectal cancer epidemiology studies should focus on researching nutrient-gene interactions towards the goal of improving personalized treatment and prevention strategies. PMID:27766137

  17. The leukemias: Epidemiologic aspects

    SciTech Connect

    Linet, M.S.

    1984-01-01

    Particularly geared to physicians and cancer researchers, this study of the epidemiology and etiology of leukemia analyzes the four major leukemia subtypes in terms of genetic and familial determinant factors and examines the incidence, distribution and frequency of reported leukemia clusters. Linet discusses the connection between other types of malignancies, their treatments, and the subsequent development of leukemia and evaluates the impact on leukemia onset of such environmental factors as radiation therapy, drugs, and occupational hazards.

  18. Epidemiology of venous thromboembolism.

    PubMed Central

    Coon, W W

    1977-01-01

    This review of the epidemiology of venous thromboembolism includes estimates of incidence and prevalence of venous thrombosis and its sequelae, a discussion geographical, annual and seasonal variations and data concerning possible risk factors. Selection of patients at increased risk for development of deep venous thrombosis or pulmonary embolism for specific diagnostic screening or for prophylactic therapy with low-dose heparin may be a more effective approach to lowering morbidity and mortality from this disease. PMID:329779

  19. Epidemiology of epilepsy.

    PubMed

    Abramovici, S; Bagić, A

    2016-01-01

    Modern epidemiology of epilepsy maximizes the benefits of advanced diagnostic methods and sophisticated techniques for case ascertainment in order to increase the diagnostic accuracy and representativeness of the cases and cohorts studied, resulting in better comparability of similarly performed studies. Overall, these advanced epidemiologic methods are expected to yield a better understanding of diverse risk factors, high-risk populations, seizure triggers, multiple and poorly understood causes of epilepsy, including the increasing and complex role of genetics, and establish the natural course of treated and untreated epilepsy and syndromes - all of which form the foundation of an attempt to prevent epileptogenesis as the primary prophylaxis of epilepsy. Although data collection continues to improve, epidemiologists still need to overcome definition and coding variability, insufficient documentation, as well as the interplay of socioeconomic factors and stigma. As most of the 65-70 million people with epilepsy live outside of resource-rich countries, extensive underdiagnosis, misdiagnosis, and undertreatment are likely. Epidemiology will continue to provide the necessary information to the medical community, public, and regulators as the foundation for improved health policies, targeted education, and advanced measures of prevention and prognostication of the most common severe brain disorder.

  20. [Schistosomiasis epidemiology (author's transl)].

    PubMed

    Picq, J J; Roux, J

    1980-01-01

    Schistosomiasis are, with three hundred million of infested people, the second world endemy, after malaria. For each of the four species, the distribution areas, the life cycle and the main epidemiological features are recalled in the first chapter. In the five following chapters, the authors consider the human or animal reservoirs of virus, the importance of these diseases towards public health, the gasteropod molluscs acting as intermediate hosts, and the problems of immunity in man. The concepts of "schistosomian infection" and "schistosomian disease" are exposed as well as the differences affecting the various strains of schistosomes and snails intermediate hosts. The authors emphasize the value of quantitative parasitological techniques and sero-immunological methods for epidemiological surveys. They underline the difficulties met in the evaluation of the effect of these diseases upon public health. The main causes inducing the duration of the endemy and those responsible for its extension are studied. The value of mathematic patterns is briefly discussed. Quantitative data compiled through epidemiological surveys should improve the use of the various means presently available for controling schistosomiasis.

  1. Current Epidemiology and Outcome of Infective Endocarditis

    PubMed Central

    Muñoz, Patricia; Kestler, Martha; De Alarcon, Arístides; Miro, José María; Bermejo, Javier; Rodríguez-Abella, Hugo; Fariñas, Maria Carmen; Cobo Belaustegui, Manuel; Mestres, Carlos; Llinares, Pedro; Goenaga, Miguel; Navas, Enrique; Oteo, José Antonio; Tarabini, Paola; Bouza, Emilio

    2015-01-01

    Abstract The aim of the study was to describe the epidemiologic and clinical characteristics and identify the risk factors of short-term and 1-year mortality in a recent cohort of patients with infective endocarditis (IE). From January 2008, multidisciplinary teams have prospectively collected all consecutive cases of IE, diagnosed according to the Duke criteria, in 25 Spanish hospitals. Overall, 1804 patients were diagnosed. The median age was 69 years (interquartile range, 55–77), 68.0% were men, and 37.1% of the cases were nosocomial or health care-related IE. Gram-positive microorganisms accounted for 79.3% of the episodes, followed by Gram-negative (5.2%), fungi (2.4%), anaerobes (0.9%), polymicrobial infections (1.9%), and unknown etiology (9.1%). Heart surgery was performed in 44.2%, and in-hospital mortality was 28.8%. Risk factors for in-hospital mortality were age, previous heart surgery, cerebrovascular disease, atrial fibrillation, Staphylococcus or Candida etiology, intracardiac complications, heart failure, and septic shock. The 1-year independent risk factors for mortality were age (odds ratio [OR], 1.02), neoplasia (OR, 2.46), renal insufficiency (OR, 1.59), and heart failure (OR, 4.42). Surgery was an independent protective factor for 1-year mortality (OR, 0.44). IE remains a severe disease with a high rate of in-hospital (28.9%) and 1-year mortality (11.2%). Surgery was the only intervention that significantly reduced 1-year mortality. PMID:26512582

  2. JPRS Report, Epidemiology.

    DTIC Science & Technology

    2007-11-02

    director of the institute, as saying that surveillance of mortality in different areas showed that heart disease, cerebrovascular disease and cancer are...and HBeAg and accidentally exposed grown-ups. If HBIG is given instantly as passive prophy- laxis and then vaccine injection as active immunization

  3. Heart failure with preserved ejection fraction

    PubMed Central

    ElGuindy, Ahmed; Yacoub, Magdi H

    2012-01-01

    Abstract Heart failure with preserved ejection fraction (HFpEF) has recently emerged as a major cause of cardiovascular morbidity and mortality. Contrary to initial beliefs, HFpEF is now known to be as common as heart failure with reduced ejection fraction (HFrEF) and carries an unacceptably high mortality rate. With a prevalence that has been steadily rising over the past two decades, it is very likely that HFpEF will represent the dominant heart failure phenotype over the coming few years. The scarcity of trials in this semi-discrete form of heart failure and lack of unified enrolment criteria in the studies conducted to date might have contributed to the current absence of specific therapies. Understanding the epidemiological, pathophysiological and molecular differences (and similarities) between these two forms of heart failure is cornerstone to the development of targeted therapies. Carefully designed studies that adhere to unified diagnostic criteria with the recruitment of appropriate controls and adoption of practical end-points are urgently needed to help identify effective treatment strategies. PMID:25610841

  4. Risks for Heart Valve Problems

    MedlinePlus

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

  5. Ionizing radiation and heart risks.

    PubMed

    Bhattacharya, Souparno; Asaithamby, Aroumougame

    2016-10-01

    Cardiovascular disease and cancer are the two leading causes of morbidity and mortality worldwide. As advancements in radiation therapy (RT) have significantly increased the number of cancer survivors, the risk of radiation-induced cardiovascular disease (RICD) in this group is a growing concern. Recent epidemiological data suggest that accidental or occupational exposure to low dose radiation, in addition to therapeutic ionizing radiation, can result in cardiovascular complications. The progression of radiation-induced cardiotoxicity often takes years to manifest but is also multifaceted, as the heart may be affected by a variety of pathologies. The risk of cardiovascular disease development in RT cancer survivors has been known for 40 years and several risk factors have been identified in the last two decades. However, most of the early work focused on clinical symptoms and manifestations, rather than understanding cellular processes regulating homeostatic processes of the cardiovascular system in response to radiation. Recent studies have suggested that a different approach may be needed to refute the risk of cardiovascular disease following radiation exposure. In this review, we will focus on how different radiation types and doses may induce cardiovascular complications, highlighting clinical manifestations and the mechanisms involved in the pathophysiology of radiation-induced cardiotoxicity. We will finally discuss how current and future research on heart development and homeostasis can help reduce the incidence of RICD.

  6. Epidemiology of iodine deficiency.

    PubMed

    Vanderpump, Mark P

    2017-04-01

    Iodine is an essential component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) produced by the thyroid gland. Iodine deficiency impairs thyroid hormone production and has adverse effects throughout life, particularly early in life as it impairs cognition and growth. Iodine deficiency remains a significant problem despite major national and international efforts to increase iodine intake, primarily through the voluntary or mandatory iodization of salt. Recent epidemiological data suggest that iodine deficiency is an emerging issue in industrialized countries, previously thought of as iodine-sufficient. International efforts to control iodine deficiency are slowing, and reaching the third of the worldwide population that remains deficient poses major challenges.

  7. Epidemiologic research in Antarctica

    NASA Technical Reports Server (NTRS)

    1990-01-01

    A study of epidemiology of respiratory viruses that was begun in the early 1960's is described. Locations selected for the study included a Wisconsin University housing village, a second grade school population, individual volunteers who associated socially, married couples, and the winter-over population at McMurdo Bay and at Scott Base in the Antarctic. It was concluded that most rhinovirus transmission is through aerosolized particles. Air filtration and careful nasal sanitation with virucidal tissues are determined to be effective in blocking rhinovirus transmission and should be useful in both isolated space colonies and in ordinary earth-bound populations.

  8. Epidemiology of tuberculosis immunology.

    PubMed

    Fox, G J; Menzies, D

    2013-01-01

    Immunological impairment plays a major role in the epidemiology of TB. Globally, the most common causes of immunological impairment are malnutrition, diabetes, HIV/AIDS, aging, and smoking. With the notable exception of HIV, each factor leads to relatively mild immunological impairment in individuals. However, as these conditions affect a significant proportion of the population, they contribute substantially to the incidence of TB at a global scale. Understanding immunological impairment is central to understanding the global TB pandemic, and vital to the development of effective disease control strategies.

  9. Epidemiology of Brain Tumors.

    PubMed

    McNeill, Katharine A

    2016-11-01

    Brain tumors are the commonest solid tumor in children, leading to significant cancer-related mortality. Several hereditary syndromes associated with brain tumors are nonfamilial. Ionizing radiation is a well-recognized risk factor for brain tumors. Several industrial exposures have been evaluated for a causal association with brain tumor formation but the results are inconclusive. A casual association between the common mutagens of tobacco, alcohol, or dietary factors has not yet been established. There is no clear evidence that the incidence of brain tumors has changed over time. This article presents the descriptive epidemiology of the commonest brain tumors of children and adults.

  10. Heart transplantation in adult congenital heart disease.

    PubMed

    Burchill, Luke J

    2016-12-01

    Heart failure (HF) in adult congenital heart disease (ACHD) is vastly different to that observed in acquired heart disease. Unlike acquired HF in which pharmacological strategies are the cornerstone for protecting and improving ventricular function, ACHD-related HF relies heavily upon structural and other interventions to achieve these aims. patients with ACHD constitute a small percentage of the total adult heart transplant population (∼3%), although the number of ACHD heart transplant recipients is growing rapidly with a 40% increase over the last two decades. The worldwide experience to date has confirmed heart transplantation as an effective life-extending treatment option in carefully selected patients with ACHD with end-stage cardiac disease. Opportunities for improving outcomes in patients with ACHD-related HF include (i) earlier recognition and referral to centres with combined expertise in ACHD and HF, (ii) increased awareness of arrhythmia and sudden cardiac death risk in this population, (iii) greater collaboration between HF and ACHD specialists at the time of heart transplant assessment, (iv) expert surgical planning to reduce ischaemic time and bleeding risk at the time of transplant, (v) tailored immunosuppression in the post-transplant period and (vi) development and validation of ACHD-specific risk scores to predict mortality and guide patient selection. The purpose of this article is to review current approaches to diagnosing and treating advanced HF in patients with ACHD including indications, contraindications and clinical outcomes after heart transplantation.

  11. How Can I Live with Heart Failure?

    MedlinePlus

    ... Understand Your Risk for Congenital Heart Defects Symptoms & Diagnosis of Congenital Heart Defects Care & Treatment for Congenital Heart Defects Congenital Heart Defects Tools & Resources Heart Attack About Heart Attacks Warning Signs of a Heart ...

  12. Heart failure among Indigenous Australians: a systematic review

    PubMed Central

    2012-01-01

    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 suggest that undiagnosed

  13. Heart PET scan

    MedlinePlus

    Heart nuclear medicine scan; Heart positron emission tomography; Myocardial PET scan ... Udelson JE, Dilsizian V, Bonow RO. Nuclear cardiology. In: Mann DL, ... A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, ...

  14. Inflammation and Heart Disease

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Inflammation and Heart Disease Updated:Oct 12,2016 Understand the risks of ... inflammation causes cardiovascular disease, inflammation is common for heart disease and stroke patients and is thought to be ...

  15. Heart disease - risk factors

    MedlinePlus

    Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. ...

  16. Heart bypass surgery

    MedlinePlus

    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 - ...

  17. Problem: Heart Valve Regurgitation

    MedlinePlus

    ... Options • Recovery and Healthy Living Goals • Personal Stories Heart Valve Disease Symptoms Dr. Robert Bonow describes the symptoms that may alert you to heart valve disease. Support Network: You're Not Alone Popular Articles ...

  18. Nuclear Heart Scan

    MedlinePlus

    ... into your blood and travels to your heart. Nuclear heart scans use single photon emission computed tomography (SPECT) or cardiac positron emission tomography (PET) to detect the energy from the tracer to make pictures of your ...

  19. Congenital Heart Defects

    MedlinePlus

    ... Treatment can include medicines, catheter procedures, surgery, and heart transplants. The treatment depends on the type of the defect, how severe it is, and a child's age, size, and general health. NIH: National Heart, Lung, and Blood Institute

  20. Heart failure - discharge

    MedlinePlus

    ... Heart failure - overview Heart pacemaker High blood pressure Implantable cardioverter-defibrillator Smoking - tips on how to quit ... ask your doctor How to read food labels Implantable cardioverter defibrillator - discharge Low-salt diet Mediterranean diet ...

  1. Menopause and Heart Disease

    MedlinePlus

    ... minutes, you can get your own personal heart score and life plan. Live better with Life's Simple ... and wellness. Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Target Heart Rates ...

  2. Know Your Heart's Numbers

    MedlinePlus

    ... of body fat based on height and weight), waist circumference, blood sugar and weight. The telephone survey of ... for heart health. Just 36 percent knew that waist circumference is important measure of heart disease risk. The ...

  3. Heart attack - discharge

    MedlinePlus

    ... syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. ... disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice ...

  4. Tachycardia | Fast Heart Rate

    MedlinePlus

    ... heart disease and stroke. Start exploring today ! Printable Arrhythmia Information Sheets What is Arrhythmia? What is Atrial ... Card See all Answers by Heart patient sheets Arrhythmia • Home • About Arrhythmia Introduction Atrial Fibrillation Bradycardia Conduction ...

  5. Types of Heart Surgery

    MedlinePlus

    ... conditions that make open-heart surgery very risky. Arrhythmia Treatment An arrhythmia (ah-RITH-me-ah) is a problem with ... rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, ...

  6. American Heart Association

    MedlinePlus

    ... Educator CPR & ECC Shop Causes Advocate Giving Media American Heart Association Check out Scientific Sessions 2016 news -- translated for ... do not always represent the views of the American Heart Association. Keep color fresh and vibrant by knowing how ...

  7. Overview of Heart Tumors

    MedlinePlus

    ... the heart. Most heart tumors are metastatic cancer. Did You Know... Noncancerous tumors can be as deadly ... slow the tumor's growth. Resources In This Article Did You Know 1 Did You Know... Table 2 ...

  8. Men and Heart Disease

    MedlinePlus

    ... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ...

  9. Heart Disease Risk Factors

    MedlinePlus

    ... this? Submit What's this? Submit Button Related CDC Web Sites Division for Heart Disease and Stroke Prevention ... this? Submit What's this? Submit Button Related CDC Web Sites Division for Heart Disease and Stroke Prevention ...

  10. Heart failure - tests

    MedlinePlus

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... An echocardiogram (Echo) is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain ...

  11. How the Heart Works

    MedlinePlus

    ... Your heart is at the center of your circulatory system. This system consists of a network of blood ... the walls contract, blood is pumped into your circulatory system. Inlet and outlet valves in your heart chambers ...

  12. Heart and Stroke Encyclopedia

    MedlinePlus

    ... Venous Thromboembolism Aortic Aneurysm More The Heart and Stroke Encyclopedia Click a letter below to get a ... dozens of cardiovascular terms from our Heart and Stroke Encyclopedia and get links to in-depth information. ...

  13. Heart Murmurs (For Kids)

    MedlinePlus

    ... Dictionary of Medical Words En Español What Other Kids Are Reading Taking Care of Your Ears Taking ... Getting an X-ray Heart Murmurs KidsHealth > For Kids > Heart Murmurs Print A A A What's in ...

  14. About Heart Attacks

    MedlinePlus

    ... called plaque. This slow process is known as atherosclerosis . When a plaque in a heart artery breaks, ... called plaque. This slow process is known as atherosclerosis . When a plaque in a heart artery breaks, ...

  15. Congenital heart disease

    MedlinePlus

    ... defect - heartbeat Patent ductus arteriosis (PDA) - series References Fraser CD, Carberry KE. Congenital heart disease. In: Townsend ... ASD) Coarctation of the aorta Ellis-van Creveld syndrome Fetal alcohol syndrome Hypoplastic left heart syndrome Marfan ...

  16. Pericarditis - after heart attack

    MedlinePlus

    ... medlineplus.gov/ency/article/000166.htm Pericarditis - after heart attack To use the sharing features on this page, ... occur in the days or weeks following a heart attack . Causes Two types of pericarditis can occur after ...

  17. [Understanding heart failure].

    PubMed

    Boo, José Fernando Guadalajara

    2006-01-01

    Heart failure is a disease with several definitions. The term "heart failure" is used by has brougth about confusion in the terminology. For this reason, the value of the ejection fraction (< 0.40 or < 0.35) is used in most meganalyses on the treatment of heart failure, avoiding the term "heart failure" that is a confounding concept. In this paper we carefully analyze the meaning of contractility, ventricular function or performance, preload, afterload, heart failure, compensation mechanisms in heart failure, myocardial oxygen consumption, inadequate, adequate and inappropriate hypertrophy, systole, diastole, compliance, problems of relaxation, and diastolic dysfunction. Their definitions are supported by the original scientific descriptions in an attempt to clarify the concepts about ventricular function and heart failure and, in this way, use the same scientific language about the meaning of ventricular function, heart failure, and diastolic dysfunction.

  18. Global epidemiology of sporotrichosis.

    PubMed

    Chakrabarti, Arunaloke; Bonifaz, Alexandro; Gutierrez-Galhardo, Maria Clara; Mochizuki, Takashi; Li, Shanshan

    2015-01-01

    Sporotrichosis is an endemic mycosis caused by the dimorphic fungus Sporothrix schenckii sensu lato. It has gained importance in recent years due to its worldwide prevalence, recognition of multiple cryptic species within the originally described species, and its distinctive ecology, distribution, and epidemiology across the globe. In this review, we describe the current knowledge of the taxonomy, ecology, prevalence, molecular epidemiology, and outbreaks due to S. schenckii sensu lato. Despite its omnipresence in the environment, this fungus has remarkably diverse modes of infection and distribution patterns across the world. We have delved into the nuances of how sporotrichosis is intimately linked to different forms of human activities, habitats, lifestyles, and environmental and zoonotic interactions. The purpose of this review is to stimulate discussion about the peculiarities of this unique fungal pathogen and increase the awareness of clinicians and microbiologists, especially in regions of high endemicity, to its emergence and evolving presentations and to kindle further research into understanding the unorthodox mechanisms by which this fungus afflicts different human populations.

  19. Molecular Epidemiology of Amebiasis

    PubMed Central

    Ali, Ibne Karim M.; Clark, C. Graham; Petri, William A.

    2008-01-01

    Entamoeba histolytica, the causative agent of human amebiasis, remains a significant cause of morbidity and mortality in developing countries and is responsible for up to 100,000 deaths worldwide each year. Entamoeba dispar, morphologically indistinguishable from E. histolytica, is more common in humans in many parts of the world. Similarly Entamoeba moshkovskii, which was long considered to be a free-living ameba, is also morphologically identical to E. histolytica and E. dispar, and is highly prevalent in some E. histolytica endemic countries. However, the only species to cause disease in humans is E. histolytica. Most old epidemiological data on E. histolytica are unusable as the techniques employed do not differentiate between the above three Entamoeba species. Molecular tools are now available not only to diagnose these species accurately but also to study intra-species genetic diversity. Recent studies suggest that only a minority of all E. histolytica infections progress to development of clinical symptoms in the host and there exist population level differences between the E. histolytica strains isolated from the asymptomatic and symptomatic individuals. Nevertheless the underlying factors responsible for variable clinical outcome of infection by E. histolytica remain largely unknown. We anticipate that the recently completed E. histolytica genome sequence and new molecular techniques will rapidly advance our understanding of the epidemiology and pathogenicity of amebiasis. PMID:18571478

  20. The Epidemiology of Sarcopenia.

    PubMed

    Dodds, Richard Matthew; Roberts, Helen Clare; Cooper, Cyrus; Sayer, Avan Aihie

    2015-01-01

    The aim of this review is to describe the epidemiology of sarcopenia, specifically prevalence, health outcomes, and factors across the life course that have been linked to its development. Sarcopenia definitions involve a range of measures (muscle mass, strength, and physical performance), which tend to decline with age, and hence sarcopenia becomes increasingly prevalent with age. Less is known about prevalence in older people in hospital and care homes, although it is likely to be higher than in community settings. The range of measures used, and the cutpoints suggested for each, presents a challenge for comparing prevalence estimates between studies. The importance of sarcopenia is highlighted by the range of adverse health outcomes that strength and physical performance (and to a lesser extent, muscle mass) have been linked to. This is shown most strikingly by the finding of increased all-cause mortality rates among those with weaker grip strength and slower gait speed. A life course approach broadens the window for our understanding of the etiology of sarcopenia and hence the potential intervention. An example is physical activity, with increased levels across midadulthood appearing to increase muscle mass and strength in early old age. Epidemiologic studies will continue to make an important contribution to our understanding of sarcopenia and possible avenues for intervention and prevention.

  1. How Is Heart Failure Diagnosed?

    MedlinePlus

    ... in a pocket, or hung around your neck. Nuclear Heart Scan A nuclear heart scan shows how well blood is flowing ... blood is reaching your heart muscle. During a nuclear heart scan, a safe, radioactive substance called a ...

  2. Congenital Heart Disease in Adults

    MedlinePlus

    ... and genetics may play a role. Why congenital heart disease resurfaces in adulthood Some adults may find that ... in following adults with congenital heart disease. Congenital heart disease and pregnancy Women with congenital heart disease who ...

  3. Living with Heart Valve Disease

    MedlinePlus

    ... page from the NHLBI on Twitter. Living With Heart Valve Disease Heart valve disease is a lifelong condition. However, ... all of your medicines as prescribed. Pregnancy and Heart Valve Disease Mild or moderate heart valve disease during pregnancy ...

  4. Heart Disease and Stroke Prevention

    MedlinePlus

    ... Heart disease and stroke prevention Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about healthy eating ... to top More information on Heart disease and stroke prevention Read more from womenshealth.gov A Lifetime ...

  5. Life After a Heart Attack

    MedlinePlus

    ... from the NHLBI on Twitter. Life After a Heart Attack Many people survive heart attacks and live active, ... a few weeks. Anxiety and Depression After a Heart Attack After a heart attack, many people worry about ...

  6. What Is a Heart Attack?

    MedlinePlus

    ... from the NHLBI on Twitter. What Is a Heart Attack? Español A heart attack happens when the flow ... This Content: NEXT >> Featured Video What is a heart attack? 05/22/2014 Describes how a heart attack ...

  7. What Happens After Heart Surgery?

    MedlinePlus

    ANSWERS by heart Treatments + Tests What Happens After Heart Surgery? What are the ICU and CCU? In a ... doctors. This is where patients go after open-heart surgery or a heart attack. You’re watched around ...

  8. Heart Disease in Women

    MedlinePlus

    ... 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 ...

  9. The Heart of Coaching

    ERIC Educational Resources Information Center

    Docheff, Dennis M.; Gerdes, Dan

    2015-01-01

    This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…

  10. Heart Valve Diseases

    MedlinePlus

    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 ...

  11. Working Model Hearts

    ERIC Educational Resources Information Center

    Brock, David

    2009-01-01

    Despite student interest, the heart is often a poorly understood topic in biology. To help students understand this vital organ's physiology, the author created this investigation activity involving the mammalian heart and its role in the circulatory system. Students design, build, and demonstrate working artificial "hearts" to exhibit what they…

  12. Heart bypass surgery

    MedlinePlus Videos and Cool Tools

    Heart bypass surgery begins with an incision made in the chest, with the breastbone cut exposing the heart. Next, a portion of the saphenous vein is ... used to bypass the blocked arteries in the heart. The venous graft is sewn to the aorta ...

  13. Cancer and the heart

    SciTech Connect

    Kapoor, A.S.

    1986-01-01

    This book contains 28 chapters. Some of the titles are: Computed tomography of neoplastic disease of the pericardium; Radiation therapy and the heart; Valvular involvement in cancer; Smoking, lung cancer, and coronary heart disease; Carcinoid heart disease; Cardiac amyloidosis; and Anemia of cancer and its cardiac effects.

  14. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1984-01-01

    CPI's human-implantable automatic implantable defibrillator (AID) is a heart assist system, derived from NASA's space circuitry technology, that can prevent erratic heart action known as arrhythmias. Implanted AID, consisting of microcomputer power source and two electrodes for sensing heart activity, recognizes onset of ventricular fibrillation (VF) and delivers corrective electrical countershock to restore rhythmic heartbeat.

  15. Prevalence and correlates of heart disease among adults in Singapore.

    PubMed

    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.

  16. CEDR: Comprehensive Epidemiologic Data Resource

    SciTech Connect

    Not Available

    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.

  17. Epidemiology of infections in women.

    PubMed

    Risser, Jan M H; Risser, William L; Risser, Amanda L

    2008-12-01

    This article describes the epidemiologic profiles of sexually transmitted infections seen in US women. We present a brief description of the infectious agent, describe the epidemiology of the infection among women in terms of race/ethnicity and age (if those data are available), and present what is known about the behavioral risk factors associated with acquisition.

  18. Cancer Epidemiology Data Repository (CEDR)

    Cancer.gov

    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.

  19. The future of genetic epidemiology.

    PubMed

    Morton, N E

    1992-12-01

    Starting from a broad definition of genetic epidemiology, current developments in association, segregation, and linkage analysis of complex inheritance are considered together with integration of genetic and physical maps and resolution of genetic heterogeneity. Mitochondrial inheritance, imprinting, uniparental disomy, pregressive amplification, and gonadal mosaicism are some of the novel mechanisms discussed, with speculation about the future of genetic epidemiology.

  20. The new epidemiology of nephrolithiasis.

    PubMed

    Shoag, Jonathan; Tasian, Greg E; Goldfarb, David S; Eisner, Brian H

    2015-07-01

    Historically nephrolithiasis was considered a disease of dehydration and abnormal urine composition. However, over the past several decades, much has been learned about the epidemiology of this disease and its relation to patient demographic characteristics and common systemic diseases. Here we review the latest epidemiologic studies in the field.

  1. The Epidemiology of Sarcoma

    PubMed Central

    2012-01-01

    Sarcomas account for over 20% of all pediatric solid malignant cancers and less than 1% of all adult solid malignant cancers. The vast majority of diagnosed sarcomas will be soft tissue sarcomas, while malignant bone tumors make up just over 10% of sarcomas. The risks for sarcoma are not well-understood. We evaluated the existing literature on the epidemiology and etiology of sarcoma. Risks for sarcoma development can be divided into environmental exposures, genetic susceptibility, and an interaction between the two. HIV-positive individuals are at an increased risk for Kaposi’s sarcoma, even though HHV8 is the causative virus. Radiation exposure from radiotherapy has been strongly associated with secondary sarcoma development in certain cancer patients. In fact, the risk of malignant bone tumors increases as the cumulative dose of radiation to the bone increases (p for trend <0.001). A recent meta-analysis reported that children with a history of hernias have a greater risk of developing Ewing’s sarcoma (adjusted OR 3.2, 95% CI 1.9, 5.7). Bone development during pubertal growth spurts has been associated with osteosarcoma development. Occupational factors such as job type, industry, and exposures to chemicals such as herbicides and chlorophenols have been suggested as risk factors for sarcomas. A case-control study found a significant increase in soft tissue sarcoma risk among gardeners (adjusted OR 4.1, 95% CI 1.00, 14.00), but not among those strictly involved in farming. A European-based study reported an increased risk in bone tumors among blacksmiths, toolmakers, or machine-tool operators (adjusted OR 2.14, 95% CI 1.08, 4.26). Maternal and paternal characteristics such as occupation, age, smoking status, and health conditions experienced during pregnancy also have been suggested as sarcoma risk factors and would be important to assess in future studies. The limited studies we identified demonstrate significant relationships with sarcoma risk, but many of

  2. [Epidemiology of viral hepatitis].

    PubMed

    Kaić, Bernard; Vilibić-Cavlek, Tatjana; Filipović, Sanja Kurecić; Nemeth-Blazić, Tatjana; Pem-Novosel, Iva; Vucina, Vesna Visekruna; Simunović, Aleksandar; Zajec, Martina; Radić, Ivan; Pavlić, Jasmina; Glamocanin, Marica; Gjenero-Margan, Ira

    2013-10-01

    Understanding the country-specific epidemiology of disease, which may vary greatly among countries, is crucial for identifying the most appropriate preventive and control measures. An overview of the local epidemiology of viral hepatitis in Croatia is given in this paper. The overall prevalence of hepatitis B in Croatia is low (less than 2% HBsAg carriers in the general population). Hepatitis B incidence and prevalence began to decline significantly following the introduction of universal hepatitis B vaccination in 1999. Information on HBsAg seroprevalence is derived from routine testing of certain subpopulations (pregnant women, blood donors) and seroprevalence studies mostly targeted at high-risk populations. Universal childhood vaccination against hepatitis B remains the main preventive measure. We recommend testing for immunity one to two months after the third dose of hepatitis B vaccine for health-care workers. The incidence and prevalence of hepatitis C have also been declining in the general population. The main preventive measures are ensuring safety of blood products, prevention of drug abuse, and harm reduction programs for intravenous drug users. Hepatitis A incidence has declined dramatically since fifty years ago, when thousands of cases were reported annually. In the last five years, an average of twenty cases have been reported per year. The reduction of hepatitis A is a consequence of improved personal and community hygiene and sanitation. Hepatitis D has not been reported in Croatia. The risk of hepatitis D will get to be even smaller as the proportion of population vaccinated against hepatitis B builds up. Hepatitis E is reported only sporadically in Croatia, mostly in persons occupationally in contact with pigs and in travelers to endemic countries. In conclusion, Croatia is a low prevalence country for hepatitides A, B and C. Hepatitis D has not been reported to occur in Croatia and there are only sporadic cases of hepatitis E. Since hepatitis

  3. Heart failure as a general pandemic in Asia.

    PubMed

    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.

  4. Heart Failure: A Primer.

    PubMed

    Lee, Christopher S; Auld, Jonathan

    2015-12-01

    Heart failure is a complex and multisystem clinical syndrome that results from impaired ventricular contractility and/or relaxation. Hypertension, diabetes mellitus, and coronary artery disease are common antecedents to heart failure. The main pathogenic mechanisms involved in heart failure include sympathetic nervous and renin-angiotensin-aldosterone system activation, as well as inflammation. A detailed history and physical examination and additional diagnostic tests may be needed to diagnose heart failure. Most treatment strategies target neurohormonal systems. Nonpharmacologic interventions and effective engagement in self-care are also important in overall heart failure management. Therapeutic strategies are geared toward prolonging life and optimizing quality of life.

  5. Epidemiological evidence in forensic pharmacovigilance.

    PubMed

    Persaud, Nav; Healy, David

    2012-01-01

    Until recently epidemiological evidence was not regarded as helpful in determining cause and effect. It generated associations that then had to be explained in terms of bio-mechanisms and applied to individual patients. A series of legal cases surrounding possible birth defects triggered by doxylamine (Bendectin) and connective tissue disorders linked to breast implants made it clear that in some instances epidemiological evidence might have a more important role, but the pendulum swung too far so that epidemiological evidence has in recent decades been given an unwarranted primacy, partly perhaps because it suits the interests of certain stakeholders. Older and more recent epidemiological studies on doxylamine and other antihistamines are reviewed to bring out the ambiguities and pitfalls of an undue reliance on epidemiological studies.

  6. Mid-season real-time estimates of seasonal influenza vaccine effectiveness in persons 65 years and older in register-based surveillance, Stockholm County, Sweden, and Finland, January 2017

    PubMed Central

    Hergens, Maria-Pia; Baum, Ulrike; Brytting, Mia; Ikonen, Niina; Haveri, Anu; Wiman, Åsa; Nohynek, Hanna; Örtqvist, Åke

    2017-01-01

    Systems for register-based monitoring of vaccine effectiveness (VE) against laboratory-confirmed influenza (LCI) in real time were set up in Stockholm County, Sweden, and Finland, before start of the 2016/17 influenza season, using population-based cohort studies. Both in Stockholm and Finland, an early epidemic of influenza A(H3N2) peaked in week 52, 2016. Already during weeks 48 to 50, analyses of influenza VE in persons 65 years and above showed moderately good estimates of around 50%, then rapidly declined by week 2, 2017 to 28% and 32% in Stockholm and Finland, respectively. The sensitivity analyses, where time since vaccination was taken into account, could not demonstrate a clear decline, neither by calendar week nor by time since vaccination. Most (68%) of the samples collected from vaccinated patients belonged to the 3C.2a1 subclade with the additional amino acid substitution T135K in haemagglutinin (64%) or to subclade 3C.2a with the additional haemagglutinin substitutions T131K and R142K (36%). The proportion of samples containing these alterations increased during the studied period. These substitutions may be responsible for viral antigenic change and part of the observed VE drop. Another possible cause is poor vaccine immunogenicity in older persons. Improved influenza vaccines are needed, especially for the elderly. PMID:28251891

  7. Mid-season real-time estimates of seasonal influenza vaccine effectiveness in persons 65 years and older in register-based surveillance, Stockholm County, Sweden, and Finland, January 2017.

    PubMed

    Hergens, Maria-Pia; Baum, Ulrike; Brytting, Mia; Ikonen, Niina; Haveri, Anu; Wiman, Åsa; Nohynek, Hanna; Örtqvist, Åke

    2017-02-23

    Systems for register-based monitoring of vaccine effectiveness (VE) against laboratory-confirmed influenza (LCI) in real time were set up in Stockholm County, Sweden, and Finland, before start of the 2016/17 influenza season, using population-based cohort studies. Both in Stockholm and Finland, an early epidemic of influenza A(H3N2) peaked in week 52, 2016. Already during weeks 48 to 50, analyses of influenza VE in persons 65 years and above showed moderately good estimates of around 50%, then rapidly declined by week 2, 2017 to 28% and 32% in Stockholm and Finland, respectively. The sensitivity analyses, where time since vaccination was taken into account, could not demonstrate a clear decline, neither by calendar week nor by time since vaccination. Most (68%) of the samples collected from vaccinated patients belonged to the 3C.2a1 subclade with the additional amino acid substitution T135K in haemagglutinin (64%) or to subclade 3C.2a with the additional haemagglutinin substitutions T131K and R142K (36%). The proportion of samples containing these alterations increased during the studied period. These substitutions may be responsible for viral antigenic change and part of the observed VE drop. Another possible cause is poor vaccine immunogenicity in older persons. Improved influenza vaccines are needed, especially for the elderly.

  8. [Epidemiology of tuberculosis].

    PubMed

    Mjid, M; Cherif, J; Ben Salah, N; Toujani, S; Ouahchi, Y; Zakhama, H; Louzir, B; Mehiri-Ben Rhouma, N; Beji, M

    2015-01-01

    Tuberculosis is a contagious disease caused by Mycobacterium tuberculosis. It represents, according to World Health Organization (WHO), one of the most leading causes of death worldwide. With nearly 8 million new cases each year and more than 1 million deaths per year, tuberculosis is still a public health problem. Despite of the decrease in incidence, morbidity and mortality remain important partially due to co-infection with human immunodeficiency virus and emergence of resistant bacilli. All WHO regions are not uniformly affected by TB. Africa's region has the highest rates of morbidity and mortality. The epidemiological situation is also worrying in Eastern European countries where the proportion of drug-resistant tuberculosis is increasing. These regional disparities emphasize to develop screening, diagnosis and monitoring to the most vulnerable populations. In this context, the Stop TB program, developed by the WHO and its partner's, aims to reduce the burden of disease in accordance with the global targets set for 2015.

  9. Heat illness. I. Epidemiology.

    PubMed

    Ellis, F P

    1976-01-01

    Reliable information on the epidemiology of heat illness has come, until recently, mainly from the armed forces and, to a lesser extent, from some industries and civil communities. Data from the records of the British Army, Royal Navy, Royal Air Force, Indian Armed Forces, U.S. Army and forces engaged in the Arab-Israeli wars, from the South African gold mining corporations and Persian Gulf oil tankers, and from civilian communities, mainly in the U.S.A., are reviewed and discussed with particular reference to the classification of heat illness and definition of the terms used, and the effects on acclimatized and non-acclimatized personnel and on other sections of the civilian communities most at risk, i.e. the old and very young. This section concludes with an outline of the classification of acute heat illnesses from 1899 to the eighth revision of the WHO International Classification of Diseases in 1967.

  10. Epidemiology of gliomas.

    PubMed

    Ostrom, Quinn T; Gittleman, Haley; Stetson, Lindsay; Virk, Selene M; Barnholtz-Sloan, Jill S

    2015-01-01

    Gliomas are the most common type of primary intracranial tumors. Some glioma subtypes cause significant mortality and morbidity that are disproportionate to their relatively rare incidence. A very small proportion of glioma cases can be attributed to inherited genetic disorders. Many potential risk factors for glioma have been studied to date, but few provide explanation for the number of brain tumors identified. The most significant of these factors includes increased risk due to exposure to ionizing radiation, and decreased risk with history of allergy or atopic disease. The potential effect of exposure to cellular phones has been studied extensively, but the results remain inconclusive. Recent genomic analyses, using the genome-wide association study (GWAS) design, have identified several inherited risk variants that are associated with increased glioma risk. The following chapter provides an overview of the current state of research in the epidemiology of intracranial glioma.

  11. [Epidemiology of obesity].

    PubMed

    Möhr, M

    1977-05-15

    In the GDR about 20% of the males and 40% of the females were estimated to be obese. In the country obesity is more spread than in the town. Increased disablement of obese persons leads to reduction of the national income. With higher expenses for nutrition the frequency of obestiy increases. Hypophages and hyperphages are differently distributed in persons with normal weight and obese ones, so that the average establishments do not reflect the differentiated situation in nutrition. Obesity correlates with the type of structure; with increasing obesity dominate pyknomorphous tendencies of growth. Also in normal weight pyknomorphous persons have a higher proportion of fat. We should speak of obesity in such a case, when, taking into consideration biological differentiations, the normal proportion of the fat in the body is increased by more than 1/3. For epidemiological serial examinations the degrees of relative weight basing on optimum weight are a favourable basis for the classification of obesity.

  12. EPIDEMIOLOGY OF PARACOCCIDIOIDOMYCOSIS.

    PubMed

    Martinez, Roberto

    2015-09-01

    The epidemiological characteristics of paracoccidioidomycosis were reviewed and updated. The new endemic areas in Brazil were discussed in the section regarding the geographic distribution of the mycosis. Subclinical infection with Paracoccidioides brasiliensis was discussed on the basis of skin test surveys with antigens of the fungus, seroepidemiological studies, and disease cases outside Latin America. Large case series permitted a comparison of the prevalence of the mycosis in different regions, its estimated incidence and risk factors for the development of the disease. Aspects modulating the expression of the clinical forms of paracoccidioidomycosis are also presented. This review also deals with diseases associated with the mycosis, opportunistic paracoccidioidomycosis, lethality, mortality and infection and disease in animals.

  13. EPIDEMIOLOGY OF PARACOCCIDIOIDOMYCOSIS

    PubMed Central

    MARTINEZ, Roberto

    2015-01-01

    SUMMARY The epidemiological characteristics of paracoccidioidomycosis were reviewed and updated. The new endemic areas in Brazil were discussed in the section regarding the geographic distribution of the mycosis. Subclinical infection with Paracoccidioides brasiliensis was discussed on the basis of skin test surveys with antigens of the fungus, seroepidemiological studies, and disease cases outside Latin America. Large case series permitted a comparison of the prevalence of the mycosis in different regions, its estimated incidence and risk factors for the development of the disease. Aspects modulating the expression of the clinical forms of paracoccidioidomycosis are also presented. This review also deals with diseases associated with the mycosis, opportunistic paracoccidioidomycosis, lethality, mortality and infection and disease in animals. PMID:26465364

  14. Self-directed and interpersonal male violence in adolescence and young adulthood: a 30-year follow up of a Stockholm cohort.

    PubMed

    Rojas, Yerko

    2012-01-01

    In line with Wilkinson's theory on inequality and health, this study simultaneously analyses self-directed and interpersonal violence among men in a Stockholm birth cohort born in 1953 with respect to their early life experiences of stress, their lack of social connectedness and their relative deprivation. Multinomial logistic regressions with cluster-robust variance estimates were used. Self-directed violence was found to be related to self-rated loneliness and non-membership of voluntary associations but not to a lack of friendship in school at the age of 12-13, while the opposite was shown to be true for interpersonal violence. Growing up in a family that received means-tested social assistance at least once during the period 1953-1965 was taken as an objective indicator of relative deprivation and proved to be correlated with both self-directed and interpersonal violence. Disadvantaged social comparison at the age of 12-13, taken as a subjective indicator of relative deprivation, was only statistically related to a subsequent risk of interpersonal violence. It is suggested that different types of social connectedness and relative deprivation, respectively, explain these different patterns of violence. Furthermore, the study speculates on the possibility of frequent social comparison itself being a factor to consider when trying understanding violence in general.

  15. Addiction research centres and the nurturing of creativity: Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden.

    PubMed

    Stenius, Kerstin; Ramstedt, Mats; Olsson, Börje

    2010-03-01

    The Centre for Social Research on Alcohol and Drugs (SoRAD) was established as a national research centre and department within the Faculty of Social Science at Stockholm University in 1997, following a Government Report and with the aim to strengthen social alcohol and drug research. Initially, core funding came from the Swedish Council for Working Life and Social Research and from the Ministry of Health and Social Affairs for several long-term projects. Today, SoRAD, with 25 senior and junior researchers, has core funding from the university but most of its funding comes from external national and international grants. Research is organized under three themes: consumption, problems and norms, alcohol and drug policy and societal reactions, treatment and recovery processes. SoRADs scientific approach, multi-disciplinarity, a mix of qualitative and quantitative methods and international comparisons was established by the centre's first leader, Robin Room. Regular internal seminars are held and young researchers are encouraged to attend scientific meetings and take part in collaborative projects. SoRAD researchers produce government-funded monthly statistics on alcohol consumption and purchase, and take part in various national government committees, but SoRADs research has no clear political or bureaucratic constraints. One of the future challenges for SoRAD will be the proposed system for university grants allocation, where applied social science will have difficulties competing with basic biomedical research if decisions are based on publication and citation measures.

  16. Scale issues in the assessment of ecological impacts using a GIS-based habitat model - A case study for the Stockholm region

    SciTech Connect

    Gontier, Mikael . E-mail: gontier@kth.se

    2007-07-15

    Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) provide two interlinked platforms for the assessment of impacts on biodiversity caused by human developments. Although it might be too early to draw conclusions on the efficiency of SEA to assess such impacts, a number of persistent problems have been identified in the case of EIA. Some of these shortcomings concern the lack of proper prediction and impact quantification, and the inadequate/insufficient assessment of cumulative effects. A number of problems are related to the scale(s) at which the assessment is performed. SEA may provide a more adequate framework than EIA to discuss scale-related issues (i.e. cumulative impacts) but it also requires the use of adapted tools. This paper presents a case study where a GIS-based habitat model for the lesser spotted woodpecker is tested, validated and applied to a planning scenario in the Stockholm region in Sweden. The results show that the method adopted offers great prospects to contribute to a better assessment of biodiversity-related impacts. Even though some limitations remain in the form of data requirement and interpretation of the results, the model produced continuous, quantified predictions over the study area and provided a relevant basis for the assessment of cumulative effects. Furthermore, this paper discusses potential conflicts between different scales involved in the assessment - related to administrative boundaries, ecological processes, data availability, the method adopted to perform the assessment and temporal aspects.

  17. Acute hepatitis B and hepatitis D co-infection in the Stockholm region in the 1970s and 1980s--a comparison.

    PubMed

    Lindh, G; Mattsson, L; von Sydow, M; Weiland, O

    1990-01-01

    The frequency and clinical features of acute hepatitis B virus (HBV) infection with and without a hepatitis D virus (HDV) co-infection was investigated retrospectively in the Stockholm region during two different time periods, September 1977-October 1978 and November 1984-October 1986. Totally, 31/229 (14%) patients with acute HBV infection had a HDV co-infection. No change in the frequency of co-infections, 12% and 15%, respectively, was observed between the 1970s and 1980s. Among the 31 HDV co-infected patients 74% were intravenous drug addicts. Totally 23/66 (35%) intravenous drug addicts with acute HBV infection had HDV co-infection. Clinically a biphasic rise of the serum levels of alanine aminotransferase and bilirubin was noted among 63% of the HDV co-infected patients but only among 8% of the solely HBV infected patients (p less than 0.001). A clinically more severe hepatitis was seen significantly more often among the HDV co-infected patients than among the solely HBV infected.

  18. Epidemiology of dental caries.

    PubMed

    Winter, G B

    1990-01-01

    The most recent epidemiological data on the prevalence of dental caries in children indicate a halting of the increasing levels in many developing countries and a continuing decrease in many highly industrialized countries of the world. However, a further fall in caries levels predicted for 5-yr-old children in the U.K. has not occurred and the decline in caries may have begun to level out. 'Polarization' of caries to a minority of high-risk individuals is occurring in the developed world, with 20-25% of children accounting for more than 50% of the disease. Socio-economic factors are important in determining the proportion of high-risk children in these countries. The multifactorial aetiology of caries allows a number of different interpretations to account for changes in the prevalence of the disease with time, in both the developing and developed countries. These changes are variously ascribed to alterations in dietary habits, especially the consumption of sugar; variations in the patterns of oral hygiene; increased contact with trace elements, especially fluoride, in the environment; changes in the ecology and/or virulence of oral and dental plaque microflora and alterations in the oral protective mechanisms including the immune status. The epidemiological evidence available on the relationship of all these social, environmental and other factors to changes in the prevalence levels of caries does not, however, fully explain all the changes that have been observed. The claim that caries is no longer a public health problem is premature, as it ignores the still high proportion of individuals with tooth decay throughout the world.

  19. Epidemiology of abortion.

    PubMed

    Tyler C

    1976-06-01

    This brief summary presents information on the epidemiology of abortion requested by IPPF. In 1975, 8% of the world's population lived in areas where the law prohibits abortion completely, and 27% lived in areas where abortions are severely restricted. Over 2 years, 40,000 hospitalizations for abortion complications were reported in such countries, with 168 deaths. 21% of women hospitalized for a diagnosis related to abortion died. In Latin America, hospitalization and death because of illegal abortion led to epidemiological studies. In Chile, surveys indicate that 1/4 women has had an abortion. Colombia data state that 10 women die/week from abortion complications. Bangladesh identified 31 abortion deaths. When related to live births occurring in the area from which the deaths were reported, the abortion mortality ratio was 19/1000,000 live births. Data from Romania showed that before 1966, when abortion was legal, there were fewer than 100 reported deaths. After 1966, when abortion was restricted, crude birth rate increased from 15-40/1000 total population. During the following 4 years, the birth rate dropped until it was below 25, but concomitant deaths due to abortion increased. In 1965, 64 abortion-related deaths occurred, whereas by 1971, abortion-related deaths increased to 364. In North America abortion deaths and number of illegal abortions decreased dramatically after 1973, when abortion became legal in the U.S. In 1972, illegal abortions led to the deaths of 41 women, but in 1974 only 5 such deaths occurred. If women with unplanned or unwanted pregnancies all underwent abortion within the 1st 8 weeks of pregnancy, 90% of the deaths due to legal abortion could be prevented.

  20. Changing Landscape of Congenital Heart Disease.

    PubMed

    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

  1. Influence of diabetes mellitus on heart failure risk and outcome

    PubMed Central

    Bauters, Christophe; Lamblin, Nicolas; Mc Fadden, Eugène P; Van Belle, Eric; Millaire, Alain; de Groote, Pascal

    2003-01-01

    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. PMID:12556246

  2. Cardiovascular Disease Risk Factors, Type 2 Diabetes Mellitus, and the Framingham Heart Study

    PubMed Central

    Fox, Caroline S.

    2010-01-01

    Type 2 diabetes is a common disorder and an important risk factor for cardiovascular disease (CVD). The Framingham Heart Study (FHS) is a population-based epidemiologic study that has contributed to our knowledge of CVD and its risk factors. This review will focus on the contemporary contributions of the FHS to the field of diabetes epidemiology, including data on diabetes trends, genetics, and future advances in population-based studies. PMID:21130952

  3. Epidemiological aspects of ageing.

    PubMed

    Khaw, K T

    1997-12-29

    A major societal challenge is to improve quality of life and prevent or reduce disability and dependency in an ageing population. Increasing age is associated with increasing risk of disability and loss of independence, due to functional impairments such as loss of mobility, hearing and vision; a major issue must be how far disability can be prevented. Ageing is associated with loss of bone tissue, reduction in muscle mass, reduced respiratory function, decline in cognitive function, rise in blood pressure and macular degeneration which predispose to disabling conditions such as osteoporosis, heart disease, dementia and blindness. However, there are considerable variations in different communities in terms of the rate of age-related decline. Large geographic and secular variations in the age-adjusted incidence of major chronic diseases such as stroke, hip fracture, coronary heart disease, cancer, visual loss from cataract, glaucoma and macular degeneration suggest strong environmental determinants in diet, physical activity and smoking habit. The evidence suggests that a substantial proportion of chronic disabling conditions associated with ageing are preventable, or at least postponable and not an inevitable accompaniment of growing old. Postponement or prevention of these conditions may not only increase longevity, but, more importantly, reduce the period of illnesses such that the majority of older persons may live high-quality lives, free of disability, until very shortly before death. We need to understand better the factors influencing the onset of age-related disability in the population, so that we have appropriate strategies to maintain optimal health in an ageing population.

  4. Heart transplantation: review

    PubMed Central

    Mangini, Sandrigo; Alves, Bárbara Rubim; Silvestre, Odílson Marcos; Pires, Philippe Vieira; Pires, Lucas José Tachotti; Curiati, Milena Novaes Cardoso; Bacal, Fernando

    2015-01-01

    ABSTRACT Heart transplantation is currently the definitive gold standard surgical approach in the treatment of refractory heart failure. However, the shortage of donors limits the achievement of a greater number of heart transplants, in which the use of mechanical circulatory support devices is increasing. With well-established indications and contraindications, as well as diagnosis and treatment of rejection through defined protocols of immunosuppression, the outcomes of heart transplantation are very favorable. Among early complications that can impact survival are primary graft failure, right ventricular dysfunction, rejection, and infections, whereas late complications include cardiac allograft vasculopathy and neoplasms. Despite the difficulties for heart transplantation, in particular, the shortage of donors and high mortality while on the waiting list, in Brazil, there is a great potential for both increasing effective donors and using circulatory assist devices, which can positively impact the number and outcomes of heart transplants. PMID:26154552

  5. Epidemiology and outcomes of patients with invasive mould infections: a retrospective observational study from a single centre (2005-2009).

    PubMed

    Klingspor, Lena; Saaedi, Baharak; Ljungman, Per; Szakos, Attila

    2015-08-01

    Invasive mould infection (IMI) is an important cause of morbidity and mortality in immunocompromised patients. However, Swedish epidemiology data are lacking. The aim of this study was to investigate the epidemiology and outcome of IMI. Cases of proven/probable IMI at Karolinska University Hospital, Stockholm, from 2005 to 2009, were included. A total of 100 patients with 104 episodes of IMI were enrolled. Identified isolates included 101 mould isolates. The majority of the isolates were Aspergillus spp. (74.3%), followed by Mucorales spp. (13.9%), Fusarium spp. (4.9%) and other mould spp. (6.9%). In 13% of the episodes, more than one mould caused the IMI. The lung was most often affected (88.5%). The most frequent underlying disease was haematological malignancies (70%). Following diagnosis, 83.7% initially received antifungal monotherapy, 9.6% received combination therapy and 6.7% no treatment. The overall 90-day and 1-year overall survival was 49% and 46% respectively. Survival at 90 days post diagnosis was 71.4% in the solid tumour cohort, 62.5% in patients with solid organ transplants, 43.5% in haematological malignancy (HMs) and 37% in those undergoing allogeneic haematopoietic stem cell transplantation (HSCT). Overall survival was poor in the studied cohort, but is variable among different host categories, with particular opportunities for improvement in patients with underlying HMs and allogeneic HSCT.

  6. Swan-Ganz - right heart catheterization

    MedlinePlus

    ... Congenital heart disease Heart failure Kidney disease Leaky heart valves (valvular regurgitation) Shock It may also be done ... flow problems, such as heart failure or shock Heart valve disease Lung disease Structural problems with the heart, ...

  7. Microtia: epidemiology and genetics.

    PubMed

    Luquetti, Daniela V; Heike, Carrie L; Hing, Anne V; Cunningham, Michael L; Cox, Timothy C

    2012-01-01

    Microtia is a congenital anomaly of the ear that ranges in severity from mild structural abnormalities to complete absence of the ear, and can occur as an isolated birth defect or as part of a spectrum of anomalies or a syndrome. Microtia is often associated with hearing loss and patients typically require treatment for hearing impairment and surgical ear reconstruction. The reported prevalence varies among regions, from 0.83 to 17.4 per 10,000 births, and the prevalence is considered to be higher in Hispanics, Asians, Native Americans, and Andeans. The etiology of microtia and the cause of this wide variability in prevalence are poorly understood. Strong evidence supports the role of environmental and genetic causes for microtia. Although some studies have identified candidate genetic variants for microtia, no causal genetic mutation has been confirmed. The application of novel strategies in developmental biology and genetics has facilitated elucidation of mechanisms controlling craniofacial development. In this paper we review current knowledge of the epidemiology and genetics of microtia, including potential candidate genes supported by evidence from human syndromes and animal models. We also discuss the possible etiopathogenesis in light of the hypotheses formulated to date: Neural crest cells disturbance, vascular disruption, and altitude.

  8. Epidemiology of delayed ejaculation

    PubMed Central

    Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea

    2016-01-01

    A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency. PMID:27652226

  9. Staphylococcal epidemiology in Antarctica.

    PubMed

    Cameron, A S

    1970-03-01

    An investigation of staphylococcal epidemiology was undertaken at an Australian National Antarctic Research Expedition station during 1965-1966. It concerned the carriage of staphylococci by the men and their dogs, and the occurrence of staphylococci in the station environment. The year-long study indicated that coagulase-negative strains survived better in the Antarctic environment than coagulase-positive strains. It was demonstrated that naturally acquired coagulase-positive strains could not maintain colonization on forearm skin under the usual cold exposure experienced at Mawson station, though coagulase-negative skin strains appeared to thrive during the winter. Staphylococcus albus and S. aureus were able to persist in the anterior nares, despite the sometimes lower temperatures recorded in this micro-climate, probably because of the greater humidity and denser populations found there. The majority of the nasal carriers of S. aureus were persistent carriers, only two men in 27 being found to be occasional carriers of nasal strains, which was consistent with the observation that transfer of this pathogen from man to man is not common under Antarctic conditions. Half of the 27 sledge dogs at the station were found to carry coagulase-positive staphylococci but this did not appear to be of pathological significance to their human handlers. The local inanimate environment, including mess hut, sleeping huts and sleeping bags used on expeditions, was searched for contamination by S. aureus but none was detected.

  10. Global Epidemiology of Tuberculosis

    PubMed Central

    Glaziou, Philippe; Sismanidis, Charalambos; Floyd, Katherine; Raviglione, Mario

    2015-01-01

    Despite the availability of effective chemotherapy, tuberculosis (TB) killed 1.3 million people in 2012. Alongside HIV, it remains a top cause of death from an infectious disease. Global targets for reductions in the epidemiological burden of TB have been set for 2015 and 2050 within the context of the Millennium Development Goals (MDGs) and by the Stop TB Partnership. Achieving these targets is the focus of national and international efforts in TB control, and showing whether or not they are achieved is of major importance to guide future and sustainable investments. This article provides a short overview of sources of data to estimate TB disease burden; presents estimates of TB incidence, prevalence, and mortality in 2012 and an assessment of progress toward the 2015 targets for reductions in these indicators based on trends since 1990 and projections up to 2015; analyzes trends in TB notifications and in the implementation of the Stop TB Strategy; and considers prospects for elimination of TB after 2015. PMID:25359550

  11. Shigellosis: Epidemiology in India

    PubMed Central

    Taneja, Neelam; Mewara, Abhishek

    2016-01-01

    Shigellosis is one of the major causes of diarrhoea in India. The accurate estimates of morbidity and mortality due to shigellosis are lacking, though it is endemic in the country and has been reported to cause many outbreaks. The limited information available indicates Shigella to be an important food-borne pathogen in India. S. flexneri is the most common species, S. sonnei and non-agglutinable shigellae seem to be steadily surfacing, while S. dysenteriae has temporarily disappeared from the northern and eastern regions. Antibiotic-resistant strains of different Shigella species and serotypes have emerged all over the world. Especially important is the global emergence of multidrug resistant shigellae, notably the increasing resistance to third generation cephalosporins and fluoroquinolones, and also azithromycin. This calls for a continuous and strong surveillance of antibiotic resistance across the country for periodic updation of the local antibiograms. The prevention of shigellosis is desirable as it will substantially reduce the morbidity associated with diarrhoea in the country. Public health measures like provision of safe water and adequate sanitation are of immense importance to reduce the burden of shigellosis, however, the provision of resources to develop such an infrastructure in India is a complex issue and will take time to resolve. Thus, the scientific thrust should be focused towards development of a safe and affordable multivalent vaccine. This review is focused upon the epidemiology, disease burden and the therapeutic challenges of shigellosis in Indian perspective. PMID:27487999

  12. Tuberculosis: Epidemiology and Control

    PubMed Central

    Sulis, Giorgia; Roggi, Alberto; Matteelli, Alberto; Raviglione, Mario C.

    2014-01-01

    Tuberculosis (TB) is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with somewhere prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO) has recently launched a new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035. This strategy is based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation. This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere. PMID:25408856

  13. Epidemiology of Lung Cancer

    PubMed Central

    Brock, Malcolm V.; Ford, Jean G.; Samet, Jonathan M.; Spivack, Simon D.

    2013-01-01

    Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. PMID:23649439

  14. Epidemiology of severe trauma.

    PubMed

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions.

  15. The epidemiology of favism.

    PubMed

    Belsey, M A

    1973-01-01

    Favism is a potential obstacle to the use of the fava bean in the development of a locally produced, inexpensive weaning food for the Middle East and North Africa. The purposes of this study were to define the epidemiology of favism, to evaluate the advisability of using the fava bean in a weaning food, and to suggest ways of avoiding or eliminating the toxic factor in the bean. Field observations, locally acquired data, and a literature review suggested that the use of the fava bean in a weaning food would be hazardous, but that the hazard might be overcome by using certain strains of the bean or, more particularly, by using old dried beans. The disease is usually directly related in time to the harvesting and availability of fresh beans, but it is also associated with fresh dried beans. On the basis of the age distribution of the disease, patterns of bean consumption, and local food taboos it appears that the toxic factor is concentrated in the skin of the bean, that it is heat-stable, that in dried beans it decreases with age, and that it crosses into the breast milk of lactating mothers. It also appears that disease expression may be a result of the interaction of several host factors, such as nutritional status and the consumption of other foods. These observations are consistent with the results of laboratory studies, which incriminate vicine, divicine, and DOPA in the etiology of favism.

  16. The epidemiology of favism

    PubMed Central

    Belsey, Mark A.

    1973-01-01

    Favism is a potential obstacle to the use of the fava bean in the development of a locally produced, inexpensive weaning food for the Middle East and North Africa. The purposes of this study were to define the epidemiology of favism, to evaluate the advisability of using the fava bean in a weaning food, and to suggest ways of avoiding or eliminating the toxic factor in the bean. Field observations, locally acquired data, and a literature review suggested that the use of the fava bean in a weaning food would be hazardous, but that the hazard might be overcome by using certain strains of the bean or, more particularly, by using old dried beans. The disease is usually directly related in time to the harvesting and availability of fresh beans, but it is also associated with fresh dried beans. On the basis of the age distribution of the disease, patterns of bean consumption, and local food taboos it appears that the toxic factor is concentrated in the skin of the bean, that it is heat-stable, that in dried beans it decreases with age, and that it crosses into the breast milk of lactating mothers. It also appears that disease expression may be a result of the interaction of several host factors, such as nutritional status and the consumption of other foods. These observations are consistent with the results of laboratory studies, which incriminate vicine, divicine, and DOPA in the etiology of favism. PMID:4541143

  17. Rosacea: current state of epidemiology.

    PubMed

    Tan, Jerry; Berg, Mats

    2013-12-01

    Case definitions are critical in epidemiologic research. However, modern disease indicators must now consider complex data from gene-based research along with traditional clinical parameters. Rosacea is a skin disorder with multiple signs and symptoms. In individuals, these features may be multiple or one may predominate. While studies on the epidemiology of rosacea have previously been sparse, there has been a recent increase in research activity. A broader body of epidemiological information that includes a greater variety of countries beyond Northern Europe and general population-based demographics is needed. As there are operational issues in current case definitions of rosacea subtypes--rationalization and standardization--universal consistent applications in future research is also imperative. Further improvement in disease definition combining new research information along with clinical pragmatism should increase the accuracy of rosacea case ascertainment and facilitate further epidemiological research.

  18. Metabolomics and Epidemiology Working Group

    Cancer.gov

    The Metabolomics and Epidemiology (MetEpi) Working Group promotes metabolomics analyses in population-based studies, as well as advancement in the field of metabolomics for broader biomedical and public health research.

  19. Genomic Resources for Cancer Epidemiology

    Cancer.gov

    This page provides links to research resources, complied by the Epidemiology and Genomics Research Program, that may be of interest to genetic epidemiologists conducting cancer research, but is not exhaustive.

  20. Sample Cancer Epidemiology Grant Applications

    Cancer.gov

    The National Cancer Institute frequently receives questions from investigators for examples of successfully funded grant applications. Several investigators agreed to let the Epidemiology and Genomics Research Program post excerpts of their grant applications online.

  1. Heart Rate Monitors

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Under a NASA grant, Dr. Robert M. Davis and Dr. William M. Portnoy came up with a new type of electrocardiographic electrode that would enable long term use on astronauts. Their invention was an insulated capacitive electrode constructed of a thin dielectric film. NASA subsequently licensed the electrode technology to Richard Charnitski, inventor of the VersaClimber, who founded Heart Rate, Inc., to further develop and manufacture personal heart monitors and to produce exercise machines using the technology for the physical fitness, medical and home markets. Same technology is on both the Home and Institutional Model VersaClimbers. On the Home Model an infrared heart beat transmitter is worn under exercise clothing. Transmitted heart rate is used to control the work intensity on the VersaClimber using the heart rate as the speedometer of the exercise. This offers advantages to a full range of users from the cardiac rehab patient to the high level physical conditioning of elite athletes. The company manufactures and markets five models of the 1*2*3 HEART RATE monitors that are used wherever people exercise to accurately monitor their heart rate. Company is developing a talking heart rate monitor that works with portable headset radios. A version of the heart beat transmitter will be available to the manufacturers of other aerobic exercise machines.

  2. Texas Heart Institute

    MedlinePlus

    ... Texas Heart Institute, The University of Texas Health Science Center at Houston, MD Anderson Cancer Center, and The University of Houston. Held most ... for Physicians Fellowships & Residencies School ...

  3. [Sociocultural epidemiology: an essential aproach].

    PubMed

    Hersch-Martínez, Paul

    2013-01-01

    The necessity of an inclusive epidemiological approach, capable to attend the diverse dimensions involved in health damage as a reflective phenomenon of society is analyzed. The range of perspectives involved requires an inclusive methodological scope and applicative channels, in order to deal with sanitary realities systematically related to culture and social organization. Some constitutive elements of sociocultural epidemiology are underlined, shaping an operative proposal that can enhance the relationship between disciplines and sectors regarding specific outstanding public health problems.

  4. Anabolic androgenic steroids--use and correlates among gym users--an assessment study using questionnaires and observations at gyms in the Stockholm region.

    PubMed

    Leifman, Håkan; Rehnman, Charlotta; Sjöblom, Erika; Holgersson, Stefan

    2011-07-01

    The purpose of this study was to estimate the prevalence of anabolic androgenic steroid (AAS) use and offers to use among gym users in Stockholm County (Sweden), and to conduct a comparison of concordance in estimates of AAS and supplements at gyms between two data collection methods. A questionnaire was distributed to members at 36 training facilities and 1,752 gym users participated in the study. An observation study was conducted as covert participant observations at 64 gyms. According to the questionnaire, 3.9% of men reported life time use of AAS, 1.4% use during the past 12 months and 0.4% AAS use during past 30 days. Not only were there similar patterns found in the two methods, i.e., similar age and gender distributions for AAS use, but analyses of concordance showed that gyms with a higher prevalence of self-reported AAS-use and supplement use (questionnaire) showed a significantly higher proportion of observer-assessed AAS users. Analyses of individual predictors showed that AAS users were almost always young men, regular weight trainers and more often users of drugs and nutritional supplements. The higher prevalence of AAS use among gym users than in the general population makes the former an appropriate target group for AAS prevention. The connection between supplements, drugs and AAS use suggests that effective AAS prevention need to focus on several risk factors for AAS use. The clear resemblance in estimates between the observation and questionnaire data strengthen the credibility of the two methods.

  5. Polybrominated diphenyl ethers listed as Stockholm Convention POPs, other brominated flame retardants and heavy metals in e-waste polymers in Nigeria.

    PubMed

    Sindiku, Omotayo; Babayemi, Joshua; Osibanjo, Oladele; Schlummer, Martin; Schluep, Mathias; Watson, Alan; Weber, Roland

    2015-10-01

    Polybrominated diphenyl ethers (PBDEs) were the first brominated persistent organic pollutants (POPs) listed in the Stockholm Convention. Parties to the convention are currently establishing inventories for developing action plans for the environmentally sound management of PBDE-containing materials. The major use of commercial octabromodiphenyl ether (c-OctaBDE) has been in casings from cathode ray tube (CRT) TVs and computer monitors. Large quantities of used e-waste and electronic equipment have been exported to developing countries with Nigeria being a major importer in Africa. The casings from 382 TVs and computers imported from major world regions to Nigeria were sampled in backyards and waste dumps. The samples were screened with X-ray flourescence (XRF) for bromine and analysed by gas chromatography/ electron capture detection (GC/ECD) for brominated flame retardants (BFRs). A high proportion of the CRT casings (61 %) contained more than 10,000 ppm bromine from BFRs. Decabromodiphenyl ether (DecaBDE) was the major flame retardant used in TV sets and tetrabromobisphenol A (TBBPA) for computer CRTs.The screening suggests that average PBDE levels (of c-OctaBDE + DecaBDE) in Nigerian-stockpiled CRT casings were 1.1 % for TV and 0.13 % for PC CRTs. These are above the Restriction of Hazardous Substances (RoHS) limit and should be separated for RoHS compliant recycling. The Nigerian e-waste inventory of 237,000 t of CRT plastic would therefore contain approx. 594 t c-OctaBDE and 1,880 t of DecaBDE. In Nigeria, as for most developing countries, there is currently no adequate e-waste management, plastic separation or destruction capacity. The data highlight the urgent need to develop environmentally sound management for this large material flow.

  6. Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

    PubMed Central

    2011-01-01

    Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735). Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree. PMID:21771291

  7. The impact of market oriented reforms on choice and information: a case study of cataract surgery in outer London and Stockholm.

    PubMed

    Fotaki, M

    1999-05-01

    In the early 1990s, a set of market-oriented reforms was introduced into health care systems of the UK and Sweden, two exemplary cases of reliance on planned budgeting and integrated provision of services. In the pursuit of increased efficiency, several County Councils in Sweden have followed the public competition model, while in the UK internal market reforms were introduced. It was expected that the separation of functions of planners and purchasers from those of providers, which were to be freely chosen by the former, would achieve higher allocative efficiency but also enhance users' satisfaction with care. This paper uses cataract surgery as a case study to trace the impact of competition among providers on choice and information. Qualitative research methods were employed to record the perception of changes in their type and amount as it was given to both purchasers and patients. A set of open ended and standardised questionnaires was designed to elicit the views of all actors involved and to measure the likely transformations. Four study sites from Outer London were selected representing the diversity of responses, and the only existing large provider of eye services to Stockholm County Council was used. The analysis of the data showed that the quasi-market reforms have resulted in a change of attitude of providers. Some improvements in the amount and type of information given to purchasers and patients could also be detected, although as far as direct users were concerned, the demand has not been fully satisfied. However, the impact on choice available to patients and purchasers alike seemed to be adverse, an effect that was particularly strong in the UK case.

  8. Complications in IDDM are caused by elevated blood glucose level: the Stockholm Diabetes Intervention Study (SDIS) at 10-year follow up.

    PubMed

    Reichard, P; Pihl, M; Rosenqvist, U; Sule, J

    1996-12-01

    Blood glucose values close to normal reduce the microvascular complications of insulin-dependent diabetes mellitus. The Stockholm study of this effect continued after the initial 7.5-year period in order to see what happened when intensively treated patients were left to control their own treatment while treatment was intensified in the control group. Forty-three patients with insulin-dependent diabetes randomised to intensified conventional treatment (ICT) and 48 patients randomised to standard treatment (ST) were followed-up for 10 years. Vascular complications, treatment side-effects and well-being were studied. Risk factors for complications were sought. HbA1c (normal range 3.9-5.7%) was reduced from 9.5 +/- 1.4% (mean +/- SD) in the ICT group and 9.4 +/- 1.2% in the ST group to a mean (during 10 years) of 7.2 +/- 0.6% and 8.3 +/- 1.0%, respectively (p < 0.001). Serious retinopathy (63 vs 33%, p = 0.003), nephropathy (26 vs 7%, p = 0.012) and symptoms of neuropathy (32 vs 14%, p = 0.041) were more common in the ST group after 10 years. HbA1c and age were the only risk factors for complications. Self-reported well-being increased to a greater degree and severe hypoglycaemia was more common in the ICT group. Cognitive function after 10 years was similar in both treatment groups, and was not related to the number of severe hypoglycaemic episodes. Intensified insulin treatment leads to reduced long-term complications and increased well-being without causing undue side-effects.

  9. Nuts and Your Heart: Eating Nuts for Heart Health

    MedlinePlus

    Diseases and Conditions Heart disease Eating nuts helps your heart. Discover how walnuts, almonds and other nuts can help lower your cholesterol when ... a healthy diet may be good for your heart. Nuts contain unsaturated fatty acids and other nutrients. ...

  10. Dimensional analysis of heart rate variability in heart transplant recipients

    SciTech Connect

    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.

  11. Epidemiology of hip fractures.

    PubMed

    Kannus, P; Parkkari, J; Sievänen, H; Heinonen, A; Vuori, I; Järvinen, M

    1996-01-01

    There were an estimated 1.66 million hip fractures world-wide in 1990. According to the epidemiologic projections, this worldwide annual number will rise to 6.26 million by the year 2050. This rise will be in great part due to the huge increase in the elderly population of the world. However, the age-specific incidence rates of hip fractures have also increased during the recent decades and in many countries this rise has not leveled off. In the districts where this increase has either showed or leveled off, the change seems to especially concern women's cervical fractures. In men, the increase has continued unabated almost everywhere. Reasons for the age-specific increase are not known: increase in the age-adjusted incidence of falls of the elderly individuals with accompanying deterioration in the age-adjusted bone quality (strength, mineral density) may partially explain the phenomenon. The growth of the elderly population will be more marked in Asia, Latin America, the Middle East, and Africa than in Europe and North America, and it is in the former regions that the greatest increments in hip fracture are projected so that these regions will account for over 70% of the 6.26 million hip fractures in the year 2050. The incidence rates of hip fractures vary considerably from population to population and race to race but increase exponentially with age in every group. Highest incidences have been described in the whites of Northern Europe (Scandinavia) and North America. In Finland, for example, the 1991 incidence of hip fractures was 1.1% for women and 0.7% for men over 70 years of age. Among elderly nursing home residents, the figures can be as high as 6.2% and 4.9%. The lifetime risk of a hip fracture is 16%-18% in white women and 5%-6% in white men. At the age of 80 years, every fifth woman and at the age of 90 years almost every second woman has suffered a hip fracture. Since populations are aging worldwide, the mean age of the hip fracture patients are

  12. Epidemiological determinants of psoriasis.

    PubMed

    Islam, M T; Paul, H K; Zakaria, S M; Islam, M M; Shafiquzzaman, M

    2011-01-01

    A cross-sectional study was conducted on 102 cases having clinical manifestation of psoriasis with a view to evaluate the epidemiological determinants of psoriasis. Psoriasis constituted 1.49% of the total dermatological disorder. Seventy patients (68.6%) were males and thirty two (31.4%) were females with a male to female ratio of 2.18:1. The mean age was 30.76±13.17 years in male and 26.94±14.94 years in female. Sixteen (15.7%) patients had one or more family member having psoriasis with male and female in equal frequency. Regarding precipitating factors, psoriasis was developed after trauma in 4.9%, infection 3.9%, stressful life events 6.9% and drugs 2.9%; and was exacerbated after trauma in 5.9%, infection 5.9%, stressful life events 35.3% and drugs 12.7%. The disease showed improvement in summer (27.5%) and found deteriorated in winter (47.1%). Sunlight had beneficial effect in 33.3% of cases. During pregnancy improvement was observed in 50% but flare up in 22.2% of cases. Fifty percent of patients were smokers, 41.2% were non-smokers and 13.7% were ex-smokers. Forty percent had Body Mass Index (BMI) between 22 to 26 Kg/m², 40.2% had less than 22 Kg/m² and 15.7% had above 26 Kg/m². It was concluded that the prevalence of psoriasis among dermatological patients was similar to results reported in Turkey and in Northern India. The precipitating factors, such as smoking, stressful life events, infection, trauma, sunlight, pregnancy, drugs, and seasonal variations could influence the development of psoriasis and affect its clinical expression.

  13. Epidemiology of Spondyloarthritis

    PubMed Central

    Stolwijk, Carmen; van Tubergen, Astrid; Reveille, John D.

    2014-01-01

    Synopsis Spondyloarthritis (SpA) represents a group of interrelated diseases with common clinical features and a close association with HLA-B27. Figures on the incidence and prevalence of diseases vary highly dependent on methodological differences between studies, the case definition used to classify disease and on the prevalence of HLA-B27 in the population studied. When summarizing the available literature, incidence rates of SpA are mainly based on the ESSG criteria and range between 0.48 and 63/100.000 while prevalence rates vary between 0.01 and 2.5%. For ankylosing spondylitis (AS), the most widely recognized representative of the SpA group of diseases, incidence rates of 0.44-7.3/100.000 and prevalence rates of 0.007-1.7% have been described in studies that were based on the (modified) New York criteria to classify cases. The incidence of psoriatic arthritis (PsA) varied from 3.6 up to 23.1/100.000 in different studies and prevalence between <0.1% and 0.4%, using a variety of classification criteria. The incidence of ReA has been estimated between 0.6 up to 28/100.000 in studies based on different source populations and different case definitions. The newly proposed criteria for axial SpA and peripheral SpA present an attractive new approach to facilitate classification of the SpA into two main subtypes and the axial SpA criteria allow earlier detection of patents with inflammatory back pain. It should be emphasized that these criteria were developed for use in a (specialized) clinical setting and not for large epidemiological studies. PMID:23083748

  14. Women's Heart Foundation

    MedlinePlus

    ... by Dr. Stephen Sinatra - "Should I take a Statin?" - TED TALK by Dr. Noel Bairey Merz - discusses new heart diagnostics for women - TED TALK by Dr. Joel Furhman - discusses how to eat to prevent and reverse heart disease - Women get their own stroke guidelines - AHA - Speak ...

  15. Mapping the Heart

    ERIC Educational Resources Information Center

    Hulse, Grace

    2012-01-01

    In this article, the author describes how her fourth graders made ceramic heart maps. The impetus for this project came from reading "My Map Book" by Sara Fanelli. This book is a collection of quirky, hand-drawn and collaged maps that diagram a child's world. There are maps of her stomach, her day, her family, and her heart, among others. The…

  16. Heart imaging method

    DOEpatents

    Collins, H. Dale; Gribble, R. Parks; Busse, Lawrence J.

    1991-01-01

    A method for providing an image of the human heart's electrical system derives time-of-flight data from an array of EKG electrodes and this data is transformed into phase information. The phase information, treated as a hologram, is reconstructed to provide an image in one or two dimensions of the electrical system of the functioning heart.

  17. Target Heart Rates

    MedlinePlus

    ... Terms and Conditions and Privacy Policy Lower Your Sodium in 21 Days! Learn how you can lower your sodium and change your salty ways in 21 Days! Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Target Heart Rates 4 Heart ...

  18. Anxiety and Heart Disease

    DTIC Science & Technology

    2003-01-01

    disability among women and men in the United States. By the year 2020, CHD is projected to be the number one cause of death worldwide.( American Heart Association , 2002...combined.( American Heart Association , 2002) The effect of various demographic (e.g., age, gender) and clinical (e.g., presence of comorbidities

  19. The total artificial heart.

    PubMed

    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.

  20. The total artificial heart

    PubMed Central

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

    2015-01-01

    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. PMID:26793338

  1. Diabetic Heart Disease

    MedlinePlus

    ... cardiomyopathy (KAR-de-o-mi-OP-ah-thee). Coronary Heart Disease In CHD, a waxy substance called plaque (plak) ... DHD tend to have less success with some heart disease treatments, such as coronary artery bypass grafting and percutaneous coronary intervention , also ...

  2. Human heart by art.

    PubMed

    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.

  3. Music and the heart.

    PubMed

    Koelsch, Stefan; Jäncke, Lutz

    2015-11-21

    Music can powerfully evoke and modulate emotions and moods, along with changes in heart activity, blood pressure (BP), and breathing. Although there is great heterogeneity in methods and quality among previous studies on effects of music on the heart, the following findings emerge from the literature: Heart rate (HR) and respiratory rate (RR) are higher in response to exciting music compared with tranquilizing music. During musical frissons (involving shivers and piloerection), both HR and RR increase. Moreover, HR and RR tend to increase in response to music compared with silence, and HR appears to decrease in response to unpleasant music compared with pleasant music. We found no studies that would provide evidence for entrainment of HR to musical beats. Corresponding to the increase in HR, listening to exciting music (compared with tranquilizing music) is associated with a reduction of heart rate variability (HRV), including reductions of both low-frequency and high-frequency power of the HRV. Recent findings also suggest effects of music-evoked emotions on regional activity of the heart, as reflected in electrocardiogram amplitude patterns. In patients with heart disease (similar to other patient groups), music can reduce pain and anxiety, associated with lower HR and lower BP. In general, effects of music on the heart are small, and there is great inhomogeneity among studies with regard to methods, findings, and quality. Therefore, there is urgent need for systematic high-quality research on the effects of music on the heart, and on the beneficial effects of music in clinical settings.

  4. Morphogenesis of univentricular hearts.

    PubMed Central

    Anderson, R H; Becker, A E; Wilkinson, J L; Gerlis, L M

    1976-01-01

    Two main theories exist for the explanation of univentricular hearts. One states that the bulboventricular septum becomes realigned to form the interventricular septum, and that univentricular hearts are a consequence of failure of this realignment. The other states that bulboventricular and interventricular septa are different structures, and that the univentricular heart results from failure of formation of the posterior interventricular septum. Four hearts are described in which both the posterior septum and an anterior bulboventricular septum are present. In each heart, therefore, the right ventricular sinus is separated both from the left ventricular sinus and from a discrete outlet chamber which supports the pulmonary artery. It is argued that these findings militate strongly against theories proposing reorientation of the bulboventricular septum to form the definitive interventricular septum. They support strongly the concept that the definitive right ventricle is formed in part from the bulbus and in part from the primitive ventricle. On the basis of these findings, it is suggested that the distinctive feature of the univentricular heart is absence of the posterior septum. Such hearts can properly be termed 'primitive ventricle'. It is also suggested that hearts with atretic or straddling valves should be included within this category. Images PMID:1275986

  5. Cyanotic heart disease

    MedlinePlus

    ... the body and flows through the heart and lungs. Blood that is low in oxygen (blue blood) returns ... the way blood flows through the heart and lungs. This causes non-oxygenated blood to be pumped out to the body without ...

  6. Patterns of Heart Attacks

    DTIC Science & Technology

    2010-06-01

    36 5.1 Pattern of gradually increasing occurrence of COPD .............................................. 37 5.2 Pattern of...deaths [1]. According to the Heart Disease and Stroke Statistics - 2010 Update from the American Heart Association, the estimated annual incidence of MI...7]. The study combined the insurance claims from the Medicare and the Manitoba Health Services Commission claims database with hospitalization

  7. How do patients with heart failure with preserved ejection fraction die?

    PubMed

    Chan, Michelle M Y; Lam, Carolyn S P

    2013-06-01

    Understanding how patients with heart failure with preserved ejection fraction (HFPEF) die provides insight into the natural history and pathophysiology of this complex syndrome, thereby allowing better prediction of response to therapy in designing clinical trials. This review summarizes the current state of knowledge surrounding mortality rates, modes of death, and prognostic factors in HFPEF. Despite the lack of uniform reporting, the following conclusions may be drawn from previous studies. The mortality burden of HFPEF is substantial, ranging from 10% to 30% annually, and higher in epidemiological studies than in clinical trials. Mortality rates compared with heart failure with reduced ejection fraction (HFREF) appear to be strongly influenced by the type of study, but are clearly elevated compared with age- and co-morbidity-matched controls without heart failure. The majority of deaths in HFPEF are cardiovascular deaths, comprising 51-60% of deaths in epidemiological studies and ∼70% in clinical trials. Among cardiovascular deaths, sudden death and heart failure death are the leading cardiac modes of death in HFPEF clinical trials. Compared with HFREF, the proportions of cardiovascular deaths, sudden death, and heart failure deaths are lower in HFPEF. Conversely, non-cardiovascular deaths constitute a higher proportion of deaths in HFPEF than in HFREF, particularly in epidemiological studies, where this difference may be related to fewer coronary heart deaths in HFPEF. Key mortality risk factors, including age, gender, body mass index, burden of co-morbidities, and coronary artery disease, offer some explanation for the differences in mortality rates observed across studies.

  8. Acute Decompensated Heart Failure

    PubMed Central

    Joseph, Susan M.; Cedars, Ari M.; Ewald, Gregory A.; Geltman, Edward M.; Mann, Douglas L.

    2009-01-01

    Hospitalizations for acute decompensated heart failure are increasing in the United States. Moreover, the prevalence of heart failure is increasing consequent to an increased number of older individuals, as well as to improvement in therapies for coronary artery disease and sudden cardiac death that have enabled patients to live longer with cardiovascular disease. The main treatment goals in the hospitalized patient with heart failure are to restore euvolemia and to minimize adverse events. Common in-hospital treatments include intravenous diuretics, vasodilators, and inotropic agents. Novel pharmaceutical agents have shown promise in the treatment of acute decompensated heart failure and may simplify the treatment and reduce the morbidity associated with the disease. This review summarizes the contemporary management of patients with acute decompensated heart failure. PMID:20069075

  9. Living with Diabetic Heart Disease

    MedlinePlus

    ... from the NHLBI on Twitter. Living With Diabetic Heart Disease Diabetic heart disease (DHD) increases the likelihood of earlier and more ... also tend to have less success from certain heart disease treatments, such as coronary artery bypass grafting and ...

  10. Guidelines for Better Heart Health

    MedlinePlus

    ... Home Current Issue Past Issues Guidelines for Better Heart Health Past Issues / Winter 2007 Table of Contents For ... Heart Association (AHA) released new guidelines for preventing heart disease and stroke ... health. Those guidelines, still in effect today, adopted the ...

  11. What Causes Heart Valve Disease?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Causes Heart Valve Disease? Heart conditions and other disorders, age-related changes, ... valve disease. Other Conditions and Factors Linked to Heart Valve Disease Many other conditions and factors are linked to ...

  12. Signs of a Heart Attack

    MedlinePlus

    ... attack Heart Health and Stroke Signs of a heart attack Related information Make the Call. Don't Miss ... to top More information on Signs of a heart attack Read more from womenshealth.gov Make the Call, ...

  13. What Are Congenital Heart Defects?

    MedlinePlus

    ... heart disease. Google+ Hangout on the first large-scale gene sequencing analysis of congenital heart disease 05/ ... in the journal Nature, about the first large-scale sequencing analysis of congenital heart disease. This NHLBI- ...

  14. Types of Congenital Heart Defects

    MedlinePlus

    ... heart disease. Google+ Hangout on the first large-scale gene sequencing analysis of congenital heart disease 05/ ... in the journal Nature, about the first large-scale sequencing analysis of congenital heart disease. This NHLBI- ...

  15. Preparing Children for Heart Surgery

    MedlinePlus

    ... Physical Activity Recommendations for Heart Health • Tools & Resources Web Booklets on Congenital Heart Defects These online publications ... to you or your child’s defect and concerns. Web Booklet: Adults With Congenital Heart Defects Web Booklet: ...

  16. EPA Heathy Heart Program Webinar

    EPA Pesticide Factsheets

    EPA is raising awareness of heart disease and its link to air pollution and other environmental factors as a partner in the Million Hearts, a national initiative to prevent 1 million heart attacks and strokes by 2017.

  17. Substances and Heart Rhythm Disorders

    MedlinePlus

    ... that trigger the heartbeat. Caffeine, Diet and Heart Arrhythmias Caffeine is the most common substance linked with abnormal heart rhythms ( arrhythmias ). Some people feel heart palpitations (fast heartbeats) when ...

  18. Data and Statistics: Heart Failure

    MedlinePlus

    ... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... to Prevent and Control Chronic Diseases Million Hearts® Web Sites with More Information About Heart Failure For ...

  19. Illegal Drugs and Heart Disease

    MedlinePlus

    ... vessels and heart valves. Many drugs, such as cocaine, heroin and various forms of amphetamine, affect the ... heart attacks, seizures, and respiratory arrest More about Cocaine - the "perfect heart-attack drug" The powdered form ...

  20. [Heart disease or sick at heart].

    PubMed

    Nager, F

    1993-02-27

    It is attempted to draw attention to the demanding and complementary reality of the modern cardiologist by confronting cardiology and cordiology (symbolistic theory of the heart). After a short survey of the symbolic and mythological world of the heart, the question of compatibility between the apparently opposing poles of cardiologic curative technology and cordiologic emotionalism is posed. With respect to the comprehensive cardiology of tomorrow, it is crucial whether the modern cardiac specialist will be capable of a difficult quadruple synthesis, namely: (1) the harmonious interaction between a rational basic position (raison de la mathématique) and an irrational-emotional standpoint (raison du coeur), (2) the increasing closeness of science and humanity, (3) the balanced care and culture of technology and medical language, and (4) the increasing harmony of male and female norms. Future cardiology must follow the call of the complementary, which reflects the apparent contrast between the scientific and the poetic heart; between having a symbolic heart condition and being heartsick.

  1. [Treatment of advanced heart failure in women: heart transplantation and ventricular assist devices].

    PubMed

    Cipriani, Manlio; Macera, Francesca; Verde, Alessandro; Bruschi, Giuseppe; del Medico, Marta; Oliva, Fabrizio; Martinelli, Luigi; Frigerio, Maria

    2012-05-01

    Women candidates for heart transplantation are definitely less than men, just 20% of all patients transplanted; even in the INTERMACS registry they represent only 21% of all ventricular assist devices (VAD) implanted. The reasons for this big difference are discussed in this article. Why women are less frequently assessed for unconventional therapies? Are they sicker or just less regarded? Our experience and the literature show us clear epidemiological, clinical and treatment differences that could lead to a lower prevalence of end-stage disease in women of an age suitable for unconventional therapies. Once on the transplant list, women wait less than men for a heart transplant, because they present with more severe disease, have a lower body mass index and undergo less VAD implants. After transplantation women's survival is comparable to men's, although they usually complain of a lower quality of life. Females receive less often a VAD than men. The main reasons for this include presentation with advanced heart failure at an older age than men, worse outcomes related to small body surface area, and lower survival rates on VAD when implanted as bridge to heart transplantation.

  2. Epidemiology of Alzheimer's disease. Issues of etiology and validity.

    PubMed

    Fratiglioni, L

    1993-01-01

    This thesis concerns the epidemiology of Alzheimer's disease (AD) and some aspects of the validity of such studies. AD is a common and chronic dementing disorder among elderly people. Due to the lack of treatment and to the invalidating nature, the social impact of this disease is high in all the societies in which the proportion of elderly is increasing. Three studies on AD etiology have been performed. The first is a case-control study on early-onset AD and a wide range of putative risk factors. The cases were gathered from a clinical study on AD carried out in Italy. The information on the exposure obtained from a next-of-kin of 116 cases was compared with the information similarly collected from the next-of-kin of 116 hospital and 97 population controls. The other two etiological studies deal with late-onset AD and are a prevalence study on sociodemographic variables and a case-control study on selected putative risk factors. These two studies were performed within a population-based study on ageing and dementia that is ongoing in Stockholm, Sweden. The study on sociodemographic variables included 116 AD cases among 1810 people. The case-control study compared the information obtained by the informants of 98 AD cases and 266 controls. The main results of these three investigations are: (1) The prevalence of AD increases with age, even in advanced ages. (2) The prevalence of AD does not vary by gender and education. (3) The main risk factor for both early- and late-onset AD is the familial aggregation of dementia (relative risk of 2.6 and 3.2, respectively). (4) A second risk factor for early-onset AD may be the advanced age of the mother at index delivery, but this result needs confirmation. No other risk factors reported by others emerged in our study. (5) High relative risks were found for alcohol consumption and manual work in late-onset AD. Manual work could be an indicator of occupational exposures as well as life conditions or life habits. Although both

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

    ERIC Educational Resources Information Center

    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…

  4. Pathophysiology and epidemiology of peripartum cardiomyopathy.

    PubMed

    Hilfiker-Kleiner, Denise; Sliwa, Karen

    2014-06-01

    Cardiovascular diseases are a major cause of complications in pregnancy worldwide, and the number of patients who develop cardiac problems during pregnancy is increasing. Peripartum cardiomyopathy (PPCM) is a potentially life-threatening heart disease that emerges towards the end of pregnancy or in the first months postpartum, in previously healthy women. Symptoms and signs of PPCM are similar to those in patients with idiopathic dilated cardiomyopathy. The incidence varies geographically, most likely because of socioeconomic and genetic factors. The syndrome is associated with a high morbidity and mortality, and diagnosis is often delayed. Various mechanisms have been investigated, including the hypothesis that unbalanced peripartum or postpartum oxidative stress triggers the proteolytic cleavage of the nursing hormone prolactin into a potent antiangiogenic, proapoptotic, and proinflammatory 16 kDa fragment. This theory provides the basis for the discovery of disease-specific biomarkers and promising novel therapeutic targets. In this Review, we describe the latest understanding of the epidemiology, pathophysiology, and novel treatment strategies for patients with PPCM.

  5. Prevention of coronary heart disease: a nonhormonal approach.

    PubMed

    Lewis, Vivian; Hoeger, Kathleen

    2005-05-01

    Coronary heart disease (CHD) is a common and serious health problem facing women as they move beyond the reproductive years. Until recently, many postmenopausal women and their physicians relied heavily on hormone therapy to prevent cardiovascular disease, neglecting the well-recognized nonhormonal aspects of cardiovascular health. Simple lifestyle changes--exercise, diet, weight control, and avoidance of tobacco--can significantly reduce the chance of heart disease and its major risk factors, which are essentially the same for men and women. As with men, obesity, hypertension, hyperlipidemia, and diabetes are the major risk factors for heart disease in women. This review discusses the epidemiologic studies linking these risk factors to CHD in women, the guidelines for screening, and a brief overview of treatment recommendations.

  6. Heart rate turbulence.

    PubMed

    Cygankiewicz, Iwona

    2013-01-01

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

  7. The epidemiology of rheumatoid arthritis.

    PubMed

    Gabriel, S E

    2001-05-01

    Studies of the descriptive epidemiology of RA indicate a population prevalence of 0.5% to 1% and a highly variable annual incidence (12-1200 per 100,000 population) depending on gender, race/ethnicity, and calendar year. Secular trends in RA incidence over time have been shown in several studies, supporting the hypothesis of a host-environment interaction. People with RA have a significantly increased risk of death compared with age- and sex-matched controls without RA from the same community. The determinants of this excess mortality remain unclear; however, reports suggest increased risk from gastrointestinal, respiratory, cardiovascular, infectious, and hematologic diseases among RA patients compared with controls. Despite extensive epidemiologic research, the etiology of RA is unknown. Several risk factors have been suggested as important in the development or progression of RA. These include genetics, infectious agents, oral contraceptives, smoking, and formal education. Epidemiologic research is an essential contributor to our understanding of RA.

  8. Multiple Sclerosis Epidemiology in Europe.

    PubMed

    Bezzini, Daiana; Battaglia, Mario A

    2017-01-01

    Multiple sclerosis is characterized by a non-homogeneous distribution around the world. Some authors in past described a latitude gradient, with increasing risk from the equator to North and South Poles, but this theory is still controversial. Regarding Europe, there are many articles in the literature concerning the epidemiology of this disease but, unfortunately, they are not always comparable due to different methodologies, they do not cover all countries in the continent, and most of them reported data of small areas and rarely at a national level. In 2012 there were 20 national registries that could help to describe the epidemiology of the disease and, in addition, there is an European Register for Multiple Sclerosis that collect data from already existing national or regional MS registries and databases. Another valid alternative to obtain epidemiological data, also at national level, in a routinely and cost-saving way is through administrative data that are of increasing interest in the last years.

  9. Transfusion recipient epidemiology and outcomes research: possibilities for the future.

    PubMed

    Hillyer, Christopher D; Blumberg, Neil; Glynn, Simone A; Ness, Paul M

    2008-08-01

    The National Heart, Lung, and Blood Institute (NHLBI) supports major research programs related to the field of transfusion medicine, which encompass blood banking, the practice of transfusion medicine itself, and cellular therapies. Specific programmatic elements have included 1) the Transfusion Medicine/Hemostasis Clinical Trials Network (TMH CTN) charged with conducting clinical trials in transfusion medicine and hemostasis; 2) the Retrovirus Epidemiology Donor Study-II (REDS-II), which includes domestic and international efforts dedicated to blood donor safety and blood availability issues; 3) the Specialized Centers of Clinically Oriented Research (SCCOR) in Transfusion Biology and Medicine that include two major projects, the Biologic and Immunologic Aspects of Transfusion Medicine Program and the Transfusion and Lung Injury Program, and 4) the Transfusion Therapy Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair (FOCUS), a Phase III clinical trial that has as its major goal to determine whether a more aggressive transfusion strategy in surgery patients with cardiovascular disease (or risk factors) is associated with improved functional recovery and decreased risk of adverse postoperative outcomes. Notably, none of these programs supports epidemiologic and clinical outcomes research focused on transfusion recipients. Thus, on October 31, 2007, a Working Group on Transfusion Recipient Epidemiology and Outcomes Research was convened by the NHLBI. This group was asked to discuss the current status of the field, identify critical research needs, and make recommendations to the NHLBI program staff.

  10. Determination of semi-volatile and particle-associated polycyclic aromatic hydrocarbons in Stockholm air with emphasis on the highly carcinogenic dibenzopyrene isomers

    NASA Astrophysics Data System (ADS)

    Masala, Silvia; Lim, Hwanmi; Bergvall, Christoffer; Johansson, Christer; Westerholm, Roger

    2016-09-01

    The concentrations of polycyclic aromatic hydrocarbons (PAHs) have been determined in the gaseous phase and in various particulate matter (PM) size fractions at different locations in and outside of Stockholm, Sweden, representative of street level, urban and rural background. The focus has been on the seldom determined but highly carcinogenic dibenzopyrene isomers (DBPs) dibenzo[a,l]pyrene, dibenzo[a,e]pyrene, dibenzo[a,i]pyrene and dibenzo[a,h]pyrene. PAHs with 3 rings were found to be mainly associated with the vapor phase (>90%) whereas PAHs with 5-6 rings were mostly associated with particulate matter (>92%) and the 4-ringed PAHs partitioned between the two phases. PAH abundance was determined to be in the order street level > urban background > rural background with the PM10 street level 2010 mean of benzo[a]pyrene (B[a]P) reaching 0.24 ng/m3, well below the EU annual limit value of 1 ng/m3. In addition, higher PAH concentrations were found in the sub-micron particle fraction (PM1) as compared to the super-micron fraction (PM1-10) with the abundance in PM1 varying between 57 and 86% of the total PAHs. The B[a]P equivalent concentrations derived for DB[a,l]P and total DBPs exceeded 1-2 and 2-4 times, respectively, that of B[a]P at the four sampling sites; therefore underestimation of the cancer risk posed by PAHs in air could be made if the DBPs were not considered in risk assessment using the toxic equivalency approach, whilst the high correlation (p < 0.001) found in the relative concentrations supports the use of B[a]P as a marker substance for assessment of the carcinogenic risk associated to PAHs. However, the big difference in concentration ratios of B[a]P and the DBPs between the present study and some literature data calls for further research to evaluate the temporal and spatial invariance of the B[a]P/DBP ratios.

  11. PM 2.5, soot and NO 2 indoor-outdoor relationships at homes, pre-schools and schools in Stockholm, Sweden

    NASA Astrophysics Data System (ADS)

    Wichmann, J.; Lind, T.; Nilsson, M. A.-M.; Bellander, T.

    2010-11-01

    In developed nations people spend about 90% of their time indoors. The relationship between indoor and outdoor air pollution levels is important for the understanding of the health effects of outdoor air pollution. Although other studies describe both the outdoor and indoor atmospheric environment, few excluded a priori major indoor sources, measured the air exchange rate, included more than one micro-environment and included the presence of human activity. PM 2.5, soot, NO 2 and the air exchange rate were measured during winter and summer indoors and outdoors at 18 homes (mostly apartments) of 18 children (6-11-years-old) and also at the six schools and 10 pre-schools that the children attended. The three types of indoor environments were free of environmental tobacco smoke and gas appliances, as the aim was to asses to what extent PM 2.5, soot and NO 2 infiltrate from outdoors to indoors. The median indoor and outdoor PM 2.5 levels were 8.4 μg m -3 and 9.3 μg m -3, respectively. The median indoor levels for soot and NO 2 were 0.66 m -1 × 10 -5 and 10.0 μg m -3, respectively. The respective outdoor levels were 0.96 m -1 × 10 -5 and 12.4 μg m -3. The median indoor/outdoor (I/O) ratios were 0.93, 0.76 and 0.92 for PM 2.5, soot and NO 2, respectively. Their infiltration factors were influenced by the micro-environment, ventilation type and air exchange rate, with aggregated values of 0.25, 0.55 and 0.64, respectively. Indoor and outdoor NO 2 levels were strongly associated ( R2 = 0.71), followed by soot ( R2 = 0.50) and PM 2.5 ( R2 = 0.16). In Stockholm, the three major indoor environments occupied by children offer little protection against combustion-related particles and gases in the outdoor air. Outdoor PM 2.5 seems to infiltrate less, but indoor sources compensate.

  12. Heart Truth for Women: If You Have Heart Disease

    MedlinePlus

    THE FOR WO MEN TRUTH THE HEART TRUTH FoR WoMEN: iF You HAVE HEART DisEAsE If you have heart disease, or think you do, it’s vital to take action to protect your heart health. Fortunately, there’s a lot you can do. ...

  13. Heart to Heart Art: Empowering Homeless Children and Youth

    ERIC Educational Resources Information Center

    Shepard, Jerri; Booth, Deborah

    2009-01-01

    This article describes Heart to Heart Art, an after-school program developed for homeless children and youth at the YWCA in Spokane, Washington. Pre-service teacher candidates from a local university create meaningful activities that engage homeless students in visual art, music, drama, cooking, and community service. Heart to Heart Art was…

  14. Redefining the role of biomarkers in heart failure trials: expert consensus document.

    PubMed

    Kramer, Frank; Sabbah, Hani N; Januzzi, James J; Zannad, Faiez; Peter van Tintelen, J; Schelbert, Erik B; Kim, Raymond J; Milting, Hendrik; Vonk, Richardus; Neudeck, Brien; Clark, Richard; Witte, Klaus; Dinh, Wilfried; Pieske, Burkert; Butler, Javed; Gheorghiade, Mihai

    2017-03-23

    Heart failure is a growing cardiovascular disease with significant epidemiological, clinical, and societal implications and represents a high unmet need. Strong efforts are currently underway by academic and industrial researchers to develop novel treatments for heart failure. Biomarkers play an important role in patient selection and monitoring in drug trials and in clinical management. The present review gives an overview of the role of available molecular, imaging, and device-derived digital biomarkers in heart failure drug development and highlights capabilities and limitations of biomarker use in this context.

  15. Epidemiology, molecular epidemiology and evolution of bovine respiratory syncytial virus.

    PubMed

    Sarmiento-Silva, Rosa Elena; Nakamura-Lopez, Yuko; Vaughan, Gilberto

    2012-11-30

    The bovine respiratory syncytial virus (BRSV) is an enveloped, negative sense, single-stranded RNA virus belonging to the pneumovirus genus within the family Paramyxoviridae. BRSV has been recognized as a major cause of respiratory disease in young calves since the early 1970s. The analysis of BRSV infection was originally hampered by its characteristic lability and poor growth in vitro. However, the advent of numerous immunological and molecular methods has facilitated the study of BRSV enormously. The knowledge gained from these studies has also provided the opportunity to develop safe, stable, attenuated virus vaccine candidates. Nonetheless, many aspects of the epidemiology, molecular epidemiology and evolution of the virus are still not fully understood. The natural course of infection is rather complex and further complicates diagnosis, treatment and the implementation of preventive measures aimed to control the disease. Therefore, understanding the mechanisms by which BRSV is able to establish infection is needed to prevent viral and disease spread. This review discusses important information regarding the epidemiology and molecular epidemiology of BRSV worldwide, and it highlights the importance of viral evolution in virus transmission.

  16. Prevalence of heart disease demonstrated in 60 years of the Arquivos Brasileiros de Cardiologia.

    PubMed

    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.

  17. Heart Surgery: MedlinePlus Health Topic

    MedlinePlus

    ... disease, or peripheral arterial disease. NIH: National Heart, Lung, and Blood Institute Start Here Cardiac Procedures and Surgeries (American Heart Association) What Is Heart Surgery? (National Heart, Lung, and Blood Institute) Latest News Taking Statins May Boost Heart ...

  18. Heart, front view (image)

    MedlinePlus

    ... the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen ... carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen ...

  19. [Heart involvement in sarcoglycanopathies].

    PubMed

    Fayssoil, A; Nardi, O; Orlikowski, D; Annane, D

    2012-11-01

    Sarcoglycanopathies (SG) are autosomic recessive muscular dystrophies, secondary to mutations of the sarcoglycan complex. Clinical pictures include muscle weakness affecting mainly the proximal limb girdle musculature. We review heart involvement in this group of disease.

  20. Sleepless Nights, Unhealthy Hearts?

    MedlinePlus

    ... heart attack or stroke, a research review from China suggests. "We found that difficulty initiating sleep, difficulty ... fully understood, said He, a graduate student at China Medical University in Shenyang. However, the study doesn' ...

  1. Heart Truth for Latinas

    MedlinePlus

    ... salt and other forms of sodium, getting regular physical activity, maintaining a healthy weight, and, if you drink ... are physically inactive—they do no spare-time physical activity. Regular physical activity lowers your risk of heart ...

  2. Keeping Hearts Pumping

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A collaboration between NASA, Dr. Michael DeBakey, Dr. George Noon, and MicroMed Technology, Inc., resulted in a life-saving heart pump for patients awaiting heart transplants. The MicroMed DeBakey VAD functions as a "bridge to heart transplant" by pumping blood throughout the body to keep critically ill patients alive until a donor heart is available. Weighing less than 4 ounces and measuring 1 inch by 3 inches, the pump is approximately one-tenth the size of other currently marketed pulsatile VADs. This makes it less invasive and ideal for smaller adults and children. Because of the pump's small size, less than 5 percent of the patients implanted developed device-related infections. It can operate up to 8 hours on batteries, giving patients the mobility to do normal, everyday activities.The MicroMed DeBakey VAD is a registered trademark of MicroMed Technology, Inc.

  3. Types of Heart Block

    MedlinePlus

    ... is less serious than Mobitz type II. The animation below shows how your heart's electrical system works. ... block. Click the "start" button to play the animation. Written and spoken explanations are provided with each ...

  4. Heart failure overview

    MedlinePlus

    ... heart failure: Fast or difficult breathing Leg swelling (edema) Neck veins that stick out (are distended) Sounds ( ... pacemaker High blood pressure Implantable cardioverter-defibrillator Pulmonary edema Stable angina Ventricular assist device Patient Instructions ACE ...

  5. Heart Diseases and Disorders

    MedlinePlus

    ... damage the heart muscle or valves. Electrical Disorders Arrhythmias that start in the heart’s upper chambers, the ... low blood count) or hyperthyroidism (overactive thyroid gland). Arrhythmias that originate in the heart’s lower chambers, the ...

  6. What Causes Heart Block?

    MedlinePlus

    ... of congenital heart block occurs in babies whose mothers have autoimmune diseases, such as lupus. People who have these diseases make proteins called antibodies that attack and damage the body's tissues or ...

  7. Open heart surgery

    MedlinePlus

    ... Cornwell LD, Bakaeen FG. Acquired heart disease: coronary insufficiency. In: Townsend CM Jr, Beauchamp RD, Evers BM, ... Pulmonary atresia Tetralogy of Fallot Total anomalous pulmonary venous return Ventricular septal defect Review Date 4/13/ ...

  8. Hypertensive heart disease

    MedlinePlus

    ... DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier ... Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, ...

  9. Heart bypass surgery - discharge

    MedlinePlus

    ... Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest . 2012;141(2 ... surgery Heart failure - overview High blood cholesterol levels Smoking - ...

  10. Heart pacemaker - discharge

    MedlinePlus

    ... please enable JavaScript. A pacemaker is a small, battery-operated device that senses when your heart is ... pacemaker is placed under your skin. These include: Battery powered cordless tools (such as screwdrivers and drills) ...

  11. Caffeine and Heart Disease

    MedlinePlus

    ... a Healthy Heart Healthy Kids Our Kids Programs Childhood Obesity What is childhood obesity? Overweight in Children BMI in Children Is Childhood Obesity an Issue in Your Home? Addressing your Child's ...

  12. Alcohol and Heart Health

    MedlinePlus

    ... a Healthy Heart Healthy Kids Our Kids Programs Childhood Obesity What is childhood obesity? Overweight in Children BMI in Children Is Childhood Obesity an Issue in Your Home? Addressing your Child's ...

  13. Meditation and Heart Health

    MedlinePlus

    ... a Healthy Heart Healthy Kids Our Kids Programs Childhood Obesity What is childhood obesity? Overweight in Children BMI in Children Is Childhood Obesity an Issue in Your Home? Addressing your Child's ...

  14. Protein and Heart Health

    MedlinePlus

    ... a Healthy Heart Healthy Kids Our Kids Programs Childhood Obesity What is childhood obesity? Overweight in Children BMI in Children Is Childhood Obesity an Issue in Your Home? Addressing your Child's ...

  15. Target Heart Rate Calculator

    MedlinePlus

    ... try exercising within the upper range of your target zone. (If just beginning an exercise program, consult your doctor first.) Source: National Heart, Lung, and Blood Institute ... Information Cancer Prevention & Detection Cancer Basics Signs & Symptoms of Cancer Treatments & Side ...

  16. Heart attack first aid

    MedlinePlus

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... of patients with unstable angina/non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 ...

  17. Living with Heart Failure

    MedlinePlus

    ... help you in the future. Follow Your Treatment Plan Treatment can relieve your symptoms and make daily ... or nurse about getting flu and pneumonia vaccines. Plan Ahead If you have heart failure, it's important ...

  18. Left heart ventricular angiography

    MedlinePlus

    ... pressure when the catheter is inserted. Occasionally, a flushing sensation or a feeling that you need to ... E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  19. Problem: Heart Valve Stenosis

    MedlinePlus

    ... valve . Learn about the different types of stenosis: Aortic stenosis Tricuspid stenosis Pulmonary stenosis Mitral stenosis Outlook for ... Disease "Innocent" Heart Murmur Problem: Valve Stenosis - Problem: Aortic Valve Stenosis - Problem: Mitral Valve Stenosis - Problem: Tricuspid Valve Stenosis - ...

  20. Heart valve surgery - discharge

    MedlinePlus

    ... surgery - minimally invasive Aortic valve surgery - open Bicuspid aortic valve Endocarditis Heart valve surgery Mitral valve prolapse Mitral valve surgery - minimally invasive Mitral valve surgery - open Pulmonary valve stenosis Smoking - tips on how to quit Patient Instructions ...

  1. Heart Disease (For Kids)

    MedlinePlus

    ... a variety of problems, including high blood pressure , hardening of the arteries, chest pain, heart attacks, and ... teer-ee-oh-skluh-ROW-sus): also called hardening of the arteries, arteriosclerosis means the arteries become ...

  2. Heart transplant - slideshow

    MedlinePlus

    ... ency/presentations/100086.htm Heart transplant - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  3. Congenital Heart Information Network

    MedlinePlus

    ... Baemayr for The Congenital Heart Information Network Exempt organization under Section 501(c)3. Copyright ©1996 - 2016 C.H.I.N. All rights reserved TX4-390-685 Original site design and HTML by Panoptic Communications

  4. Heart failure in pregnancy.

    PubMed

    Rutherford, John D

    2012-12-01

    With increasing maternal age and the presence of comorbid conditions such as hypertension, cardiovascular assessment and monitoring is the responsibility of all clinicians caring for pregnant patients. Furthermore, there are specific conditions, such as mitral stenosis, peripartum cardiomyopathy, and preeclampsia, that can be associated with heart failure and secondary maternal (and fetal) mortality and morbidity. The important causes of heart failure in pregnancy are discussed.

  5. Heart Rate Monitor

    NASA Technical Reports Server (NTRS)

    1984-01-01

    In the mid 70's, NASA saw a need for a long term electrocardiographic electrode suitable for use on astronauts. Heart Rate Inc.'s insulated capacitive electrode is constructed of thin dielectric film applied to stainless steel surface, originally developed under a grant by Texas Technical University. HRI, Inc. was awarded NASA license and continued development of heart rate monitor for use on exercise machines for physical fitness and medical markets.

  6. Risks for Heart Disease & Stroke

    MedlinePlus

    ... for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes happen every year in the United States. You ... some of your risks for heart disease and stroke, but you can manage many of your risks ...

  7. Heart valve surgery - series (image)

    MedlinePlus

    There are four valves in the heart: aortic valve, mitral valve, tricuspid valve, and pulmonary valve. The valves are designed to control the direction of blood flow through the heart. The opening and closing of the heart valves produce the heart-beat sounds.

  8. Decompensated heart failure

    PubMed Central

    Mangini, Sandrigo; Pires, Philippe Vieira; Braga, Fabiana Goulart Marcondes; Bacal, Fernando

    2013-01-01

    ABSTRACT Heart failure is a disease with high incidence and prevalence in the population. The costs with hospitalization for decompensated heart failure reach approximately 60% of the total cost with heart failure treatment, and mortality during hospitalization varies according to the studied population, and could achieve values of 10%. In patients with decompensated heart failure, history and physical examination are of great value for the diagnosis of the syndrome, and also can help the physician to identify the beginning of symptoms, and give information about etiology, causes and prognosis of the disease. The initial objective of decompensated heart failure treatment is the hemodynamic and symptomatic improvement preservation and/or improvement of renal function, prevention of myocardial damage, modulation of the neurohormonal and/or inflammatory activation and control of comorbidities that can cause or contribute to progression of the syndrome. According to the clinical-hemodynamic profile, it is possible to establish a rational for the treatment of decompensated heart failure, individualizing the proceedings to be held, leading to reduction in the period of hospitalization and consequently reducing overall mortality. PMID:24136770

  9. [Heart failure and comorbidities].

    PubMed

    Boully, Clémence; Hanon, Olivier

    2015-03-01

    Heart failure is a frequent disease in the elderly. Its clinical presentation is less typical and the prognosis more severe than in younger subjects because heart failure occurs in patients with multiple comorbidities. A comprehensive geriatric assessment should therefore be performed to detect the vulnerabilities and manage the comorbidities. The main diseases associated with heart failure are dementia, depression, malnutrition, atrial fibrillation, coronary artery disease, orthostatic hypotension, renal failure, anemia and iron deficiency. Comorbidities worsen heart failure and makes its treatment more difficult. The identification and treatment of comorbidities improve the prognosis in terms of mortality but especially in terms of quality of life. Caution with drugs is necessary because of pharmacokinetic or pharmacodynamic changes related to aging and the comorbidities. In this context, clinical and laboratory monitoring should be increased, mostly during an acute event (acute heart failure, infection, dehydration, fall, new therapy…). Therefore, the follow-up of elderly patients with heart failure requires a multidisciplinary approach that involves close cooperation between cardiologists, geriatricians, general practitioners, nurses, and pharmacists.

  10. Mitochondrial DNA and Cancer Epidemiology Workshop

    Cancer.gov

    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.

  11. About the Epidemiology and Genomics Research Program

    Cancer.gov

    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.

  12. Glossary for econometrics and epidemiology.

    PubMed

    Gunasekara, F Imlach; Carter, K; Blakely, T

    2008-10-01

    Epidemiologists and econometricians are often interested in similar topics-socioeconomic position and health outcomes-but the different languages that epidemiologists and economists use to interpret and discuss their results can create a barrier to mutual communication. This glossary defines key terms used in econometrics and epidemiology to assist in bridging this gap.

  13. Brain Tumor Epidemiology Consortium (BTEC)

    Cancer.gov

    The Brain Tumor Epidemiology Consortium is an open scientific forum organized to foster the development of multi-center, international and inter-disciplinary collaborations that will lead to a better understanding of the etiology, outcomes, and prevention of brain tumors.

  14. Quantifying Uncertainty in Epidemiological Models

    SciTech Connect

    Ramanathan, Arvind; Jha, Sumit Kumar

    2012-01-01

    Modern epidemiology has made use of a number of mathematical models, including ordinary differential equation (ODE) based models and agent based models (ABMs) to describe the dynamics of how a disease may spread within a population and enable the rational design of strategies for intervention that effectively contain the spread of the disease. Although such predictions are of fundamental importance in preventing the next global pandemic, there is a significant gap in trusting the outcomes/predictions solely based on such models. Hence, there is a need to develop approaches such that mathematical models can be calibrated against historical data. In addition, there is a need to develop rigorous uncertainty quantification approaches that can provide insights into when a model will fail and characterize the confidence in the (possibly multiple) model outcomes/predictions, when such retrospective analysis cannot be performed. In this paper, we outline an approach to develop uncertainty quantification approaches for epidemiological models using formal methods and model checking. By specifying the outcomes expected from a model in a suitable spatio-temporal logic, we use probabilistic model checking methods to quantify the probability with which the epidemiological model satisfies the specification. We argue that statistical model checking methods can solve the uncertainty quantification problem for complex epidemiological models.

  15. Real-time real-world analysis of seasonal influenza vaccine effectiveness: method development and assessment of a population-based cohort in Stockholm County, Sweden, seasons 2011/12 to 2014/15.

    PubMed

    Leval, Amy; Hergens, Maria Pia; Persson, Karin; Örtqvist, Åke

    2016-10-27

    Real-world estimates of seasonal influenza vaccine effectiveness (VE) are important for early detection of vaccine failure. We developed a method for evaluating real-time in-season vaccine effectiveness (IVE) and overall seasonal VE. In a retrospective, register-based, cohort study including all two million individuals in Stockholm County, Sweden, during the influenza seasons from 2011/12 to 2014/15, vaccination status was obtained from Stockholm's vaccine register. Main outcomes were hospitalisation or primary care visits for influenza (International Classification of Disease (ICD)-10 codes J09-J11). VE was assessed using Cox multivariate stratified and non-stratified analyses adjusting for age, sex, socioeconomic status, comorbidities and previous influenza vaccinations. Stratified analyses showed moderate VE in prevention of influenza hospitalisations among chronically ill adults ≥ 65 years in two of four seasons, and lower but still significant VE in one season; 53% (95% confidence interval (CI): 33-67) in 2012/13, 55% (95% CI: 25-73) in 2013/14 and 18% (95% CI: 3-31) in 2014/15. In conclusion, seasonal influenza vaccination was associated with substantial reductions in influenza-specific hospitalisation, particularly in adults ≥ 65 years with underlying chronic conditions. With the use of population-based patient register data on influenza-specific outcomes it will be possible to obtain real-time estimates of seasonal influenza VE.

  16. Cancer Epidemiology Matters Blog - 2012 Archive

    Cancer.gov

    The Cancer Epidemiology Matters blog helps foster a dialogue between the National Cancer Institute's (NCI) Epidemiology and Genomics Research Program (EGRP), extramural researchers, and other individuals, such as clinicians, community partners, and advocates, who are interested in cancer epidemiology and genomics.

  17. Cancer Epidemiology Matters Blog - 2013 Archive

    Cancer.gov

    The Cancer Epidemiology Matters blog helps foster a dialogue between the National Cancer Institute's (NCI) Epidemiology and Genomics Research Program (EGRP), extramural researchers, and other individuals, such as clinicians, community partners, and advocates, who are interested in cancer epidemiology and genomics.

  18. Cancer Epidemiology Matters Blog - 2014 Archive

    Cancer.gov

    The Cancer Epidemiology Matters blog helps foster a dialogue between the National Cancer Institute's (NCI) Epidemiology and Genomics Research Program (EGRP), extramural researchers, and other individuals, such as clinicians, community partners, and advocates, who are interested in cancer epidemiology and genomics.

  19. Cancer Epidemiology Matters Blog - 2015 Archive

    Cancer.gov

    The Cancer Epidemiology Matters blog helps foster a dialogue between the National Cancer Institute's (NCI) Epidemiology and Genomics Research Program (EGRP), extramural researchers, and other individuals, such as clinicians, community partners, and advocates, who are interested in cancer epidemiology and genomics.

  20. In vino veritas: alcohol and heart disease.

    PubMed

    Hill, Joseph A

    2005-03-01

    Numerous epidemiological studies, numbering nearly 100, have documented an inverse association between alcohol consumption and vascular risk. The preponderance of evidence supports an independent beneficial effect of mild-to-moderate alcoholic beverage consumption on risk of coronary heart disease (CHD). However, it is important to remember that observational data cannot prove causation; unmeasured or incompletely controlled confounding factors cannot be excluded. That said, most authorities now attribute a causal role to the relationship: moderate alcohol consumption reduces the risk of CHD, and current research centers on the mechanistic underpinnings and whether patterns of drinking are important. Here, I review the association between alcohol use and CHD risk, explore putative mechanisms, and make recommendations.

  1. The Spectrum of Epidemiology Underlying Sudden Cardiac Death

    PubMed Central

    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

  2. Childhood Brain Tumor Epidemiology: A Brain Tumor Epidemiology Consortium Review

    PubMed Central

    Johnson, Kimberly J.; Cullen, Jennifer; Barnholtz-Sloan, Jill S.; Ostrom, Quinn T.; Langer, Chelsea E.; Turner, Michelle C.; McKean-Cowdin, Roberta; Fisher, James L.; Lupo, Philip J.; Partap, Sonia; Schwartzbaum, Judith A.; Scheurer, Michael E.

    2014-01-01

    Childhood brain tumors are the most common pediatric solid tumor and include several histological subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors. PMID:25192704

  3. [Heart failure and anemia].

    PubMed

    Reda, S; Motloch, L J; Hoppe, U C

    2013-09-01

    Chronic heart failure has an age-dependent prevalence of 2% and is therefore one of the most frequent diseases in western societies. A reduced hemoglobin concentration according to the definition of the World Health Organization is a common comorbidity affecting more than half of all heart failure patients. Elderly patients, patients suffering from renal impairment and women are more likely to develop anemia but a definitive etiology of anemia is only identified in the minority of cases. Anemia is associated with a poor clinical status and a greater risk of hospitalization and is a predictive factor for increased mortality. The incidence of anemia appears to increase with a poorer functional class. Intravenous iron therapy improves the exercise capacity in patients with systolic heart failure and iron deficiency and is currently being recommended for patients with persistent symptoms despite optimal medical and device therapy. However, erythropoietin-stimulating agents as a treatment for anemia in chronic heart failure have failed to improve clinical outcome in a large randomized trial. In patients with heart failure but with maintained ejection fraction, anemia is also associated with a poor prognosis. Specific therapeutic recommendations for these patients are still not available.

  4. Deaths from heart failure: using coarsened exact matching to correct cause-of-death statistics

    PubMed Central

    2010-01-01

    Background Incomplete information on death certificates makes recorded cause-of-death data less useful for public health monitoring and planning. Certifying physicians sometimes list only the mode of death without indicating the underlying disease or diseases that led to the death. Inconsistent cause-of-death assignment among cardiovascular causes of death is of particular concern. This can prevent valid epidemiologic comparisons across countries and over time. Methods We propose that coarsened exact matching be used to infer the underlying causes of death where only the mode of death is known. We focus on the case of heart failure in US, Mexican, and Brazilian death records. Results Redistribution algorithms derived using this method assign the largest proportion of heart failure deaths to ischemic heart disease in all three countries (53%, 26%, and 22% respectively), with larger proportions assigned to hypertensive heart disease and diabetes in Mexico and Brazil (16% and 23% vs. 7% for hypertensive heart disease, and 13% and 9% vs. 6% for diabetes). Reassigning these heart failure deaths increases the US ischemic heart disease mortality rate by 6%. Conclusions The frequency with which physicians list heart failure in the causal chain for various underlying causes of death allows for inference about how physicians use heart failure on the death certificate in different settings. This easy-to-use method has the potential to reduce bias and increase comparability in cause-of-death data, thereby improving the public health utility of death records. PMID:20388206

  5. Heart transplantation in adults with congenital heart disease.

    PubMed

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

    2017-02-22

    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.

  6. Dietary cholesterol, heart disease risk and cognitive dissonance.

    PubMed

    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.

  7. [Epidemiology of HTN in dialysis].

    PubMed

    Simon, P

    2007-10-01

    Increased cardio-vascular morbidity-mortality in dialysed patients is particularly due to an insufficiency of blood pressure control. Previous epidemiological surveys show that prevalence of dialysis hypertension is high, from 55 to 85% according to period and mean age of the studied population, despite an improvement of dialysis strategies during the last decade. Control of hypertension is not better in peritoneal dialysis than in haemodialysis. Antihypertensive drugs are administered to 3/4 of dialysed patients. Dialysis strategies which increase the number of sessions per week or the duration of each session in conventional haemodialysis improve the volume control and consequently the blood pressure. Atherosclerosis, cause or consequence of hypertension in dialysed elderly patients, more and more old, lead to adapt treatment strategies in order to prevent hypotension, which is also, a major risk factor of morbidity-mortality in dialysed patients (reverse epidemiology).

  8. Epidemiology of idiopathic pulmonary fibrosis

    PubMed Central

    Ley, Brett; Collard, Harold R

    2013-01-01

    Idiopathic pulmonary fibrosis is a chronic fibrotic lung disease of unknown cause that occurs in adults and has a poor prognosis. Its epidemiology has been difficult to study because of its rarity and evolution in diagnostic and coding practices. Though uncommon, it is likely underappreciated both in terms of its occurrence (ie, incidence, prevalence) and public health impact (ie, health care costs and resource utilization). Incidence and mortality appear to be on the rise, and prevalence is expected to increase with the aging population. Potential risk factors include occupational and environmental exposures, tobacco smoking, gastroesophageal reflux, and genetic factors. An accurate understanding of its epidemiology is important, especially as novel therapies are emerging. PMID:24348069

  9. "Epidemiological criminology": coming full circle.

    PubMed

    Akers, Timothy A; Lanier, Mark M

    2009-03-01

    Members of the public health and criminal justice disciplines often work with marginalized populations: people at high risk of drug use, health problems, incarceration, and other difficulties. As these fields increasingly overlap, distinctions between them are blurred, as numerous research reports and funding trends document. However, explicit theoretical and methodological linkages between the 2 disciplines remain rare. A new paradigm that links methods and statistical models of public health with those of their criminal justice counterparts is needed, as are increased linkages between epidemiological analogies, theories, and models and the corresponding tools of criminology. We outline disciplinary commonalities and distinctions, present policy examples that integrate similarities, and propose "epidemiological criminology" as a bridging framework.

  10. Heart rate monitoring mobile applications

    PubMed Central

    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. PMID:28293594

  11. [Epidemiology of burns in France].

    PubMed

    Latarjet, Jacques; Ravat, François

    2012-01-01

    As with most traumas, the epidemiology of the "burn" health-event has long been neglected by public health doctors and rarely considered by burns specialists. There were therefore few verified data and many approximations and preconceived ideas. The gathering of information recently undertaken in France enables the reliability of the data to be improved and the diagnostic and demographic elements relating to hospitalised patients with burns to be established.

  12. Current Epidemiology of Genitourinary Trauma

    PubMed Central

    McGeady, James B.; Breyer, Benjamin N.

    2013-01-01

    Synopsis This article reviews recent publications evaluating the current epidemiology of urologic trauma. It begins by providing a brief explanation of databases that have been recently used to study this patient population, then proceeds to discuss each genitourinary organ individually, discussing the most relevant and up to date information published for each one. The conclusion of the article briefly discusses possible future research and development areas pertaining to the topic. PMID:23905930

  13. Congestive Heart Failure.

    PubMed

    Scott, Michael C; Winters, Michael E

    2015-08-01

    Patients with acute decompensated heart failure are usually critically ill and require immediate treatment. However, most are not volume overloaded. Emergency department (ED) management is based on rapid initiation of noninvasive positive-pressure ventilation and aggressive titration of nitrates. Afterload reduction with an angiotensin-converting enzyme inhibitor can be considered. A diuretic should not be administered before optimal preload and afterload reduction has been achieved. Short-term inotropic therapy can be considered in select patients with cardiogenic shock and acute decompensated heart failure (ADHF) who fail to respond to standard therapy.

  14. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Medrad utilized NASA's Apollo technology to develop a new device called the AID implantable automatic pulse generator which monitors the heart continuously, recognizes the onset of ventricular fibrillation and delivers a corrective electrical shock. AID pulse generator is, in effect, a miniaturized version of the defibrillator used by emergency squads and hospitals to restore rhythmic heartbeat after fibrillation, but has the unique advantage of being permanently available to the patient at risk. Once implanted, it needs no specially trained personnel or additional equipment. AID system consists of a microcomputer, a power source and two electrodes which sense heart activity.

  15. Towards defining heart failure in adults with congenital heart disease.

    PubMed

    Bolger, Aidan P; Gatzoulis, Michael A

    2004-12-01

    Injury to the myocardium disrupts geometric integrity and results in changes to intracardiac pressure, wall stress and tension, and the pattern of blood flow through the heart. Significant disruption to pump function results in heart failure which is defined in terms of symptoms: breathlessness and fatigue, signs of salt and water retention, and neurohormonal activation. This syndrome most commonly occurs in the context of injury due to ischaemic heart disease and dilated cardiomyopathy but because patients with congenital heart disease (CHD) are born with sometimes gross distortions of cardiac anatomy they too are subject to the forces that drive heart failure. This paper explores the available data relating to the clinical and neurohormonal manifestations of heart failure in patients with congenital heart disease and describes how, by additionally exploring events at a cellular level, we may be able to arrive at a definition of heart failure relevant to this population.

  16. Causal diagrams in systems epidemiology

    PubMed Central

    2012-01-01

    Methods of diagrammatic modelling have been greatly developed in the past two decades. Outside the context of infectious diseases, systematic use of diagrams in epidemiology has been mainly confined to the analysis of a single link: that between a disease outcome and its proximal determinant(s). Transmitted causes ("causes of causes") tend not to be systematically analysed. The infectious disease epidemiology modelling tradition models the human population in its environment, typically with the exposure-health relationship and the determinants of exposure being considered at individual and group/ecological levels, respectively. Some properties of the resulting systems are quite general, and are seen in unrelated contexts such as biochemical pathways. Confining analysis to a single link misses the opportunity to discover such properties. The structure of a causal diagram is derived from knowledge about how the world works, as well as from statistical evidence. A single diagram can be used to characterise a whole research area, not just a single analysis - although this depends on the degree of consistency of the causal relationships between different populations - and can therefore be used to integrate multiple datasets. Additional advantages of system-wide models include: the use of instrumental variables - now emerging as an important technique in epidemiology in the context of mendelian randomisation, but under-used in the exploitation of "natural experiments"; the explicit use of change models, which have advantages with respect to inferring causation; and in the detection and elucidation of feedback. PMID:22429606

  17. Onychomycosis in Israel: epidemiological aspects.

    PubMed

    Segal, Rina; Shemer, Avner; Hochberg, Malca; Keness, Yoram; Shvarzman, Rima; Mandelblat, Marina; Frenkel, Michael; Segal, Esther

    2015-03-01

    Onychomycosis is a fungal infection treated orally for prolonged periods of treatment, caused primarily by Dermatophytes, Candida species and non-dermatophyte moulds (NDMs). The prevalence of specific aetiology may differ in dependence of environmental, geographic and demographic factors, and may affect management of the infection. The objective of this survey was to analyse epidemiologic parameters of onychomycosis in Israel. Data of a cohort of 27,093 patients were collected from six centres during a 2- and 10-year period. The diagnosis was based on microscopy of KOH/calcofluor mounts of nail scrapings and culture isolation. A positive result indicates isolation of a fungus in culture. Data were analysed for each centre and expressed as range for the whole cohort, using the spss v18 software. Analysis included three epidemiologic parameters: fungal aetiology in toe- and fingernails; association with gender; association with age group. Dermatophytes were the major causative agents and Trichophyton rubrum the most frequent isolate. Candida species were more frequent in women fingernails; frequency increased with age and C. parapsilosis the most frequent species. NDMs were isolated at low rate and Aspergillus terreus was the most frequent isolate. This is a first large cohort of onychomycosis patients from Israel analysed by defined epidemiological parameters.

  18. Natural history of tuberculosis. Epidemiology.

    PubMed

    Grzybowski, S

    1991-12-01

    This Symposium honours the achievements of Dr Karel Styblo. In this presentation, specific epidemiologic insights are reviewed. Studies of the epidemiology of tuberculosis in Eskimos showed a picture of tuberculosis at the height of the epidemic. Very high incidence was observed in young people who experienced a high fatality rate. Application of specific control measures were accompanied by rapid decline in rates, greater than observed in any other human population, demonstrating that tuberculosis could be brought under control by specific intervention. Studies of the natural trend of tuberculosis in South India showed that, even in the absence of intervention, a decline was observed in the rates of this disease. In the absence of chemotherapy, 50 per cent of cases die within 5 years, 30 per cent recover spontaneously and 20 per cent remain sputum positive. Studies of the efficacy of BCG in Madras, enabled to study the impact of efficient case-finding associated with poor treatment results showing that such a situation multiplies the number of surviving, infectious cases in the community and, thus, actually deteriorates the epidemiological situation. These various basic studies have shown both how to create success and how to create failure in tuberculosis programmes.

  19. Chocolate Consumption is Inversely Associated with Prevalent Coronary Heart Disease: The National Heart, Lung, and Blood Institute Family Heart Study

    PubMed Central

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

    2010-01-01

    Background and Aims 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. Methods We studied in a cross-sectional design 4,970 participants aged 25 to 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. Results 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 <0.0001) adjusting for age, sex, family CHD risk group, energy intake, education, non-chocolate candy intake, linolenic acid intake, smoking, alcohol intake, exercise, and fruit and vegetables. 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)]. Conclusions These data suggest that consumption of chocolate is inversely related with prevalent CHD in a general population. PMID:20858571

  20. Radiation-induced cardiovascular diseases: Is the epidemiologic evidence compatible with the radiobiologic data?

    SciTech Connect

    Schultz-Hector, Susanne . E-mail: susanne.schultz-hector@helmholtz.de; Trott, Klaus-Ruediger Prof.

    2007-01-01

    The Life Span Study of Japanese atomic bomb survivors demonstrates that radiation exposure significantly increased the risk of developing ischemic heart disease, in particular myocardial infarction. Similarly, epidemiologic investigations in very large populations of patients who had received postoperative radiotherapy for breast cancer or for peptic ulcer demonstrate that radiation exposure of the heart with an average equivalent single dose of approximately 2 Gy significantly increased the risk of developing ischemic heart disease more than 10 years after irradiation. These epidemiologic findings are compatible with radiobiologic data on the pathogenesis of radiation-induced heart disease in experimental animals. The critical target structure appears to be the endothelial lining of blood vessels, in particular arteries, leading to early functional alterations such as pro-inflammatory responses and other changes, which are slowly progressive. Research should concentrate on the interaction of these radiation-induced endothelial changes with the early stages of age-related atherosclerosis to develop criteria for optimizing treatment plans in radiotherapy and also potential interventional strategies.

  1. Developing a heatwave early warning system for Sweden: evaluating sensitivity of different epidemiological modelling approaches to forecast temperatures.

    PubMed

    Åström, Christofer; Ebi, Kristie L; Langner, Joakim; Forsberg, Bertil

    2014-12-23

    Over the last two decades a number of heatwaves have brought the need for heatwave early warning systems (HEWS) to the attention of many European governments. The HEWS in Europe are operating under the assumption that there is a high correlation between observed and forecasted temperatures. We investigated the sensitivity of different temperature mortality relationships when using forecast temperatures. We modelled mortality in Stockholm using observed temperatures and made predictions using forecast temperatures from the European Centre for Medium-range Weather Forecasts to assess the sensitivity. We found that the forecast will alter the expected future risk differently for different temperature mortality relationships. The more complex models seemed more sensitive to inaccurate forecasts. Despite the difference between models, there was a high agreement between models when identifying risk-days. We find that considerations of the accuracy in temperature forecasts should be part of the design of a HEWS. Currently operating HEWS do evaluate their predictive performance; this information should also be part of the evaluation of the epidemiological models that are the foundation in the HEWS. The most accurate description of the relationship between high temperature and mortality might not be the most suitable or practical when incorporated into a HEWS.

  2. Developing a Heatwave Early Warning System for Sweden: Evaluating Sensitivity of Different Epidemiological Modelling Approaches to Forecast Temperatures

    PubMed Central

    Åström, Christofer; Ebi, Kristie L.; Langner, Joakim; Forsberg, Bertil

    2014-01-01

    Over the last two decades a number of heatwaves have brought the need for heatwave early warning systems (HEWS) to the attention of many European governments. The HEWS in Europe are operating under the assumption that there is a high correlation between observed and forecasted temperatures. We investigated the sensitivity of different temperature mortality relationships when using forecast temperatures. We modelled mortality in Stockholm using observed temperatures and made predictions using forecast temperatures from the European Centre for Medium-range Weather Forecasts to assess the sensitivity. We found that the forecast will alter the expected future risk differently for different temperature mortality relationships. The more complex models seemed more sensitive to inaccurate forecasts. Despite the difference between models, there was a high agreement between models when identifying risk-days. We find that considerations of the accuracy in temperature forecasts should be part of the design of a HEWS. Currently operating HEWS do evaluate their predictive performance; this information should also be part of the evaluation of the epidemiological models that are the foundation in the HEWS. The most accurate description of the relationship between high temperature and mortality might not be the most suitable or practical when incorporated into a HEWS. PMID:25546283

  3. Mendelian randomization: can genetic epidemiology help redress the failures of observational epidemiology?

    PubMed

    Ebrahim, Shah; Davey Smith, George

    2008-02-01

    Establishing causal relationships between environmental exposures and common diseases is beset with problems of unresolved confounding, reverse causation and selection bias that may result in spurious inferences. Mendelian randomization, in which a functional genetic variant acts as a proxy for an environmental exposure, provides a means of overcoming these problems as the inheritance of genetic variants is independent of-that is randomized with respect to-the inheritance of other traits, according to Mendel's law of independent assortment. Examples drawn from exposures and outcomes as diverse as milk and osteoporosis, alcohol and coronary heart disease, sheep dip and farm workers' compensation neurosis, folate and neural tube defects are used to illustrate the applications of Mendelian randomization approaches in assessing potential environmental causes of disease. As with all genetic epidemiology studies there are problems associated with the need for large sample sizes, the non-replication of findings, and the lack of relevant functional genetic variants. In addition to these problems, Mendelian randomization findings may be confounded by other genetic variants in linkage disequilibrium with the variant under study, or by population stratification. Furthermore, pleiotropy of effect of a genetic variant may result in null associations, as may canalisation of genetic effects. If correctly conducted and carefully interpreted, Mendelian randomization studies can provide useful evidence to support or reject causal hypotheses linking environmental exposures to common diseases.

  4. Heart Health: Learn the Truth About Your Heart

    MedlinePlus

    ... 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 ...

  5. Women's Heart Disease: Join the Heart Truth Community

    MedlinePlus

    ... 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 ...

  6. Million Hearts: Key to Collaboration to Reduce Heart Disease

    ERIC Educational Resources Information Center

    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…

  7. How Will I Recover from My Heart Attack?

    MedlinePlus

    ... Understand Your Risk for Congenital Heart Defects Symptoms & Diagnosis of Congenital Heart Defects Care & Treatment for Congenital Heart Defects Congenital Heart Defects Tools & Resources Heart Attack About Heart Attacks Warning Signs of a Heart ...

  8. [Specificities of heart failure in the elderly].

    PubMed

    Hanon, Olivier

    2013-06-01

    Heart failure (HF) is frequent in the elderly population and is associated with high mortality, prolonged and frequent hospitalisations. In old patients with multiple comorbid diseases, clinical symptoms of HF are less typical and the prognosis is poorer. Comprehensive geriatric assessment, using simple tests to evaluate cognitive function, falls, depression, malnutrition, dependency, comorbidities, context of life and social conditions, is needed in order to screen concomitant diseases and loss of autonomy. Because of lack of specific studies on octogenarians, most recommendations for HF treatment in this population have been extrapolated from data based on younger populations. Epidemiological studies show that recommended HF therapies as angiotensin converting enzyme inhibitors and beta-blockers are underused in elderly patients with HF. Reasons for this under prescription are various and include the absence of well-defined therapeutic strategy especially in case of preserved ejection fraction, the existence of comorbidities and the fear of adverse events. Special precautions for the use of HF drugs must be followed because of the comorbidities and age-related changes in drug pharmacokinetics or pharmacodynamics. Increase of drug dose must be closely monitored for adverse reactions. Overall, the therapeutic strategy must not be based on the subject's age, but rather on the individual analysis taking into account the severity of the heart disease, the geriatric assessment, the life expectancy and the quality of life. Clinical and laboratory monitoring should be intensified, especially in case of acute episode (infection, dehydration, introduction of a new treatment, fall…). Therefore, monitoring of heart failure in the elderly, involves multidisciplinary collaboration between cardiologists, geriatricians, general practitioners, pharmacists and paramedical team.

  9. Panic Attack or Heart Attack?

    MedlinePlus

    ... with echocardiography. It is a good first-line test for a woman with symptoms and risk factors for heart disease. Echocardiography uses sound waves technology to give detailed information about the heart muscle, ...

  10. Heart failure - fluids and diuretics

    MedlinePlus

    ... In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook ... In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook ...

  11. Give your heart a workout

    MedlinePlus

    Exercise - heart workout; CAD prevention - workout; Cardiovascular disease prevention - workout ... Exercise helps your heart in several ways. Burns calories. This can help you lose extra pounds (kilograms) or stay at a healthy weight. ...

  12. Ejection Fraction Heart Failure Measurement

    MedlinePlus

    ... Thromboembolism Aortic Aneurysm More Ejection Fraction Heart Failure Measurement Updated:Feb 15,2017 The ejection fraction (EF) is an important measurement in determining how well your heart is pumping ...

  13. Angioplasty and stent placement - heart

    MedlinePlus

    ... syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ... disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice ...

  14. Thrombolytic drugs for heart attack

    MedlinePlus

    ... syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ... infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice ...

  15. All about Heart Rate (Pulse)

    MedlinePlus

    ... Giving for Heart.org Media for Heart.org Arrhythmia About Arrhythmia Why Arrhythmia Matters Understand Your Risk for Arrhythmia Symptoms, Diagnosis & Monitoring of Arrhythmia Prevention & Treatment of ...

  16. Heart Disease: Know Your Risk

    MedlinePlus

    A project of the U.S. Department of Health and Human Services Office on Women's Health Skip ... Heart disease risk factors you can't control Other possible heart disease risk factors Stroke: Know your ...

  17. Hispanics and Heart Disease, Stroke

    MedlinePlus

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