[Two cases of acute cor pulmonale caused by postoperative embolism].
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Perhaps because of difficulties inherent in quantitation and evaluation, the possible influence of differences in personality factors and of socio-economic stresses has largely been ignored in epidemiological studies of coronary artery disease. This relationship is explored and it is shown that the major factors contributing to the development of coronary disease, including intimal damage, elevated plasma lipid content, altered hemodynamics and accelerated blood clotting, are each affected by certain types of such stresses. On the basis of the considerable clinical and experimental evidence cited, it is suggested that the increasing occupational stress unique to industrialized society plays a dominant role in the high incidence of clinical coronary heart disease.
A study was made of certain information from studies of the State Department of Public Health which bear upon the hypotheses that cigarette-smoking and physical exercise are factors in coronary artery disease. The data supported an association of the disease with cigarette smoking, but not with exercise. An incidental finding was a strong relationship between coronary heart disease and the beginning of the wearing of reading glasses or bifocals at an early age. In the present state of investigations aimed at determining the etiology of coronary artery disease it appears desirable to give serious consideration to multiple factors rather than seeking to find a single cause.
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A study was made of the incidence of certain types of disease among Seventh-day Adventists, a religious group of special interest because they refrain from smoking and drinking. Epidermoid cancer of the lung, previously shown to be related to smoking, was 10 times less common among Seventh-day Adventists than among the general population, even among those Seventh-day Adventists living in the Los Angeles area where all are exposed to smog. Similarly, cancers of the mouth, larynx, and esophagus, previously shown to be related not only to smoking but also to heavy drinking, were at least 10 times less common among Seventh-day Adventist men than among men of the general population. All other types of cancer, with the exception of cancer of the bladder and cervix, occurred among Seventh-day Adventists with the same frequency as in the general population. The latter occurred slightly less than in the general population. Myocardial infarction in Seventh-day Adventist males was less frequent and occurred at a later age than among males in the general population; while the age distribution of the disease among the Seventh-day Adventist females was similar to that of females in the general population.
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