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PubMed1986

Effect of intervention on coronary heart disease risk factors in some Norwegian counties.

Since 1974, a cardiovascular disease screening and intervention program has been carried out in three of the 19 Norwegian counties, namely Finnmark, Sogn og Fjordane, and Oppland. The program strategy was designed to affect both the general population and a defined high-risk group. Procedures were based upon the organization and implementation already well in place through the national tuberculosis prevention program established in the 1940s. The National Health Screening Service performed two screenings, three to five years apart, to identify cardiovascular disease risk factors in all county residents aged 35 to 49 years (age at first screening), and in representative samples of residents aged 20 to 34 years. After each screening, the local general practitioners and public health nurses were responsible for follow-up and intervention against risk factors among defined high-risk persons, as well as for intensified health education in the general population. Between the first and second screenings, a substantial reduction occurred in the level of smoking and in the mean level of total serum cholesterol. A risk score, including values for cholesterol, systolic blood pressure, and cigarette smoking, showed a reduction of approximately 20 percent (in males aged 35 to 49 years). A more detailed analysis of the Finnmark data revealed that the mean reduction was mainly due to a marked reduction within the high-risk group. This occurred particularly with mean cholesterol levels. Since the screening and intervention program was based upon the model established by the Oslo Study, it is reasonable to expect the county program to have had a similar preventive effect. This question will be addressed in future studies.

Adult↗
PubMed2006

Smoking, educational status and health inequity in India.

Health related behaviours, especially smoking and tobacco use, are major determinants of health and lead to health inequities. Smoking leads to acute respiratory diseases, tuberculosis and asthma in younger age groups and non communicable diseases such as chronic lung disease, cardiovascular diseases and cancer in middle and older age. We observed an inverse association of educational status with tobacco use (smoking and other forms) in western Indian State of Rajasthan. In successive cross-sectional epidemiological studies- the Jaipur Heart Watch (JHW)- in rural (JHWR; n=3148, men=1982), and urban subjects: JHW-1 (n=2212, men=1415), JHW-2 (n=1124, men=550) and JHW-3 (n=458, men=226), we evaluated various cardiovascular risk factors. The greatest tobacco consumption was observed among the illiterate and low educational status subjects (nil, 1-5, 6-10, >10 yr of formal education) as compared to more literate in men (JHW-R 60, 51, 46 and 36% respectively; JHW-1 44, 52, 30 and 18% JHW-2 54, 43, 29 and 24%; and JHW-3 50, 27, 25 and 25%) as well as women (Mantel Haenzel test, P for trend <0.05). In the illiterate subjects the odds ratios (OR) and 95 per cent confidence intervals (CI) for smoking or tobacco use as compared to the highest educational groups in rural (men OR 2.68, CI 2.02, 3.57; women OR 3.13, CI 1.22, 8.08) as well as larger urban studies- JHW-1 (men OR 2.47, CI 1.70, 3.60; women OR 13.78, CI 3.35, 56.75) and JHW-2 (men OR 3.81; CI 1.90, 7.66; women OR 13.73, CI 1.84, 102.45) were significantly greater (P<0.01). Smoking significantly correlated with prevalence of coronary heart disease and hypertension. Other recent Indian studies and national surveys report similar associations. Health ethicists argue that good education and health lead to true development in an underprivileged society. We propose that improving educational status, a major social determinant of health, can lead to appropriate health related behaviours and prevent the epidemics of non communicable diseases in developing countries.

Educational Status↗
PubMedDate not supplied

[Contribution of medical radiophotography in detection of non-tubercular intrathoracic diseases].

Concomittantly with the reduction of the tuberculous processes and with the transfer of the patients to pneumology sections radiophotographical detection of other pulmonary diseases has become more important. From the control of suspects the following data could be obtained: 8.5% cases of active tuberculosis, 21.46% cases with minimal lesions and with sequellae, 7,2% non-specific pneumopathies, 1.10% cardiovascular patients, 0.23% pleuro-pulmonary tumours and 0.51% cases with other affections.

Evaluation Studies as Topic↗
PubMed1985

[Medical research--are we in earnest?].

The need for extensive medical research in the RSA, with its four major population groups of widely divergent cultures, genetic compositions and developmental stages and living within a greatly varying geographical and climatic environment, is again emphasized. This country with its ills, such as tuberculosis and many other rampant infections and parasitic diseases, differing forms of cancer, high incidence of cardiovascular disease and of accidental death, should be seriously engaged in more meaningful medical research programmes. Despite a favourable governmental attitude towards research and effective and functional organizational structures including the South African Medical Research Council, there is a relatively small medical research community and a much less than optimal research effort. The major restrictions identified are those of the attitudes towards research of the public and the medical profession itself; these are reflected in the official low-priority ranking--12th among the 18 more important socio-economic sectors of research. This has led to a shortage of research manpower and funds.

Academies and Institutes↗
PubMed2000

[Central hemodynamics in pulmonary tuberculosis patients at reoperation].

Central hemodynamic parameters were studied in 12 phthisiopulmonological patients by integral rheography before, at the end, and 1, 2, 3, 7 days after surgery. Signs of cardiovascular failure with phenomena of "blood flow centralization" were revealed. With intensive care, these hemodynamic changes were most prominent on days 1, 2, and 3 after surgery and hemodynamic improvement occurred on day 7.

Hemodynamics↗
PubMed1989

[Tuberculosis and its sequelae as a cause of death of patients in a multi-profile hospital].

The intravital diagnosis was established only in 20 patients (19.2 percent) out of 104 persons who died from tuberculosis and its sequelae over the last 20 years at the general hospital. The diagnostic errors were mainly accounted for by the difficulties in the recognition of the acute and generalized patterns of tuberculosis, by grave condition of the patients admitted to the hospital, by predominance among the patients of elderly persons with a number of concomitant diseases, by inadequate examination of the patients (the lack of x-ray, bacteriological and instrumental studies) as well as by the lack of attention on the part of internists to the clinical manifestations of tuberculosis today.

Adult↗
PubMed2001

[Tuberculosis of the elderly (above the age of 75) in national hospitals].

In Japan tuberculosis is becoming rapidly the disease of the elderly. We studied the background, the type and level of hospital cares needed, and the outcome of patients with pulmonary tuberculosis (sputum smear and/or culture positive) above the age of 75 who were admitted to 8 national hospitals during the period from January 1 to December 31, 1997. The study included 150 patients (male: 109, female: 41, mean age: 81.6), of whom 25% needed care in a single-bed room, 84.3% had underlying diseases (cardiovascular diseases: 43.3%, malignant diseases: 20.9%, neuro-psychiatric diseases: 13.4%), and 47.6% needed cares mainly in feeding and excretions. 92 patients (62.6%) improved and 45 patients (30.6%) died, of whom the cause of death was directly related to tuberculosis in 42. The mean hospital stay was 4.7 months. However, in 42 patients whose cause of death was related to tuberculosis, 66% died within 3 months, while in 102 patients who were discharged 71% stayed more than 3 months. The same comparison was done in 508 patients with bacteriologically proven tuberculosis above the age of 75 admitted to National Tokyo Hospital during the period from 1990 to 1999. The result was almost the same, among 133 patients died in the hospital 60% died within 3 months, while in 375 patients who were discharged hospital stay was more than 3 months in 70%. In the near future, the elderly will occupy more than 25% of the beds of the tuberculosis ward in Japan and most of them have underlying diseases other than tuberculosis. Because tuberculosis, once the disease of the young, is becoming rapidly the disease of the elderly, it is imperative for us to make necessary adjustments to meet this inevitable trend.

Aged↗
PubMed1990

Therapeutic priorities of Canadian internists.

We surveyed 175 members of the Canadian Society of Internal Medicine to determine how they would rank seven commonly used treatments as to their clinical usefulness. A total of 70% of the respondents judged that the treatment of severe hypertension was the most beneficial. Coronary artery bypass surgery and treatment with acetylsalicylic acid for transient ischemic attacks were ranked next most useful. Cholestyramine therapy for hypercholesterolemia, the treatment of mild hypertension, isoniazid therapy for inactive tuberculosis and carotid endarterectomy in patients with mild stroke formed the final cluster. Except for treatment of severe hypertension there was a wide variation in the physicians' enthusiasm for the various treatments. Possible explanations for this variation include physicians' lack of awareness of the results of clinical trials, the wide range of risk reductions found in various trials of the same therapy, an unwillingness by physicians to generalize from clinical trials to individual patients, individual physicians' placement of different values on the morbidity associated with various diseases, and the fact that physicians may rarely explicitly compare the usefulness of therapies. In general, the number of patients needed to be treated to save one life better reflected the physicians' judgements than did the relative risk reduction.

Attitude of Health Personnel↗
PubMedDate not supplied

[Donato G Alarcón, founder of institutions devoted to respiratory diseases in Mexico].

Dr. Donato G. Alarcón was the founder director of the National Institute of Respiratory Diseases recently named "Ismael Cosío Villegas ", officially established on December 31, 1935. He was also the first president of the Mexican Society of Tuberculosis Studies, and the first director of its journal: the Mexican Journal of Tuberculosis and Respiratory Diseases, both starting in 1939 and the first general director of the National Committee of Fight Against Tuberculosis. In Mexico only Dr. Donato G. Alarcón, in the respiratory diseases, and Dr. Ignacio Chávez, in the cardiovascular diseases, took the initial responsability of the three equivalent institutions: the National Institute, the Society of Specialists and the journal of the specialty. He was also the first pulmonologist elected director of the National Academy of Medicine of Mexico and director of the Faculty of Medicine of the National Autonomous University of Mexico.

Academies and Institutes↗
PubMed1975

Calcification of the heart and great vessels.

Calcification of the heart and great vessels is secondary to those diseases which cause a significant alteration of tissue matrix. Metabolic derangements can cause microscopic calcification of heart muscle, but this has not been demonstrated conclusively roentgenographically. The deposition of calcium may follow a single event or be the result of a longstanding process. The etiology and roentgen appearance of calcium deposition in the various tissues which comprise the heart and great vessels are reveiwed. The common as well as the rare cases are considered; if possible, each entity is demonstrated roentgenographically. In addition, an attempt is made to reciew various points of view, which at times are conflicting. The prognostic importance of cardiac, aortic, or pulmonary arterial calcification is underscored whenever possible.

Adolescent↗