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PubMed2001

[Somatic diseases as cause of death of patients with active tuberculosis].

Two hundred and fifteen case histories were studied to clarify causes of death in patients with active tuberculosis who had died from it. Males accounted for the largest proportion (86%) (n = 185). Patients above 50 years were 63.3% (n = 136). Two thirds were patients with restrictive tuberculosis without destruction and bacterial isolation. A hundred and fifty (70%) and 30% patients died from somatic diseases and other causes (sequels to alcohol abuse, violent death, suicide, etc.), respectively. Of the somatic diseases, cardiovascular diseases head the list, cancer ranks next to it, nonspecific respiratory diseases occupy the third place.

Adult↗
PubMedDate not supplied

Cardiac arrest due to ventricular fibrillation as a complication occurRing during rigid bronchoscopic laser therapy.

Laser bronchoscopy is a usually well tolerated procedure for the treatment of obstructive lesions on the tracheobronchial tree, with a very low morbidity and mortality rate. Cardiovascular complications, including atrial and ventricular arrhythmias, and myocardial ischemia, have only rarely been reported during laser bronchoscopy. Cardiac arrhythmias during such a procedure are usually well tolerated but occasionally may be life threatening. Here we report a case of a young, female patient affected by Pulmonary Tuberculosis with a cicatricial stenosis of the left main bronchus who developed an episode of prolonged cardiac arrest due to ventricular fibrillation (and no signs of acute myocardial ischemia) during rigid broncoscopic laser-therapy. Underlying Coronary Artery Disease and other cardiac abnormalities were also excluded by subsequent cardiovascular examination. The clinical implications are also discussed.

Adult↗
PubMed1978

Mortality after long exposure to cummingtonite-grunerite.

Ore containing cummingtonite-grunerite has been mined to extract gold since 1876 in Lead, South Dakota. Each of the 1,321 men who were recorded as having worked 21 years or more with the Homestake Mine was allocated to one of 5 dust-exposure categories on the basis of work history and available information on environmental conditions. All except 9 men were traced to the end of 1973, when 652 were still living; the cause of death was ascertained for 657 of the 660 men who had died. Deaths from cerebrovascular accidents and malignant disease were close to the numbers expected and from accidents and other causes were fewer than expected, but in each of the 3 diagnostic groups--pneumoconiosis (mainly silicosis), tuberculosis, and heart disease--there were more than 30 excess deaths. A clear dust-exposure relationship was found for pneumoconiosis and respiratory tuberculosis--with relative risks for the 2 groups with greatest exposure to dust as compared to the 2 with least exposure, of 19.9 and 16.0, respectively, but there was no convincing evidence of an increase in respiratory cancer.

Adolescent↗
PubMed2006

Tuberculous hilar lymph nodes leading to tracheopulmonary artery fistula and pseudoaneurysm of pulmonary artery.

Tracheopulmonary artery fistula is an extremely rare condition. We report the case of an 80-year-old man who presented with massive hemoptysis. He was found to have tuberculous mediastinal lymph nodes that had eroded into the pulmonary artery and anterior tracheal wall, leading to a pseudoaneurysm of the right pulmonary artery and a tracheopulmonary artery fistula.

Aged, 80 and over↗
PubMed2005

Gene therapy in the cornea.

Technological advances in the field of gene therapy has prompted more than three hundred phase I and phase II gene-based clinical trials for the treatment of cancer, AIDS, macular degeneration, cardiovascular, and other monogenic diseases. Besides treating diseases, gene transfer technology has been utilized for the development of preventive and therapeutic vaccines for malaria, tuberculosis, hepatitis A, B and C viruses, AIDS, and influenza. The potential therapeutic applications of gene transfer technology are enormous. The cornea is an excellent candidate for gene therapy because of its accessibility and immune-privileged nature. In the last two decades, various viral vectors, such as adeno, adeno-associated, retro, lenti, and herpes simplex, as well as non-viral methods, were examined for introducing DNA into corneal cells in vitro, in vivo and ex vivo. Most of these studies used fluorescent or non-fluorescent marker genes to track the level and duration of transgene expression in corneal cells. However, limited studies were directed to evaluate prospects of gene-based interventions for corneal diseases or disorders such as allograft rejection, laser-induced post-operative haze, herpes simplex keratitis, and wound healing in animal models. We will review the successes and obstacles impeding gene therapy approaches used for delivering genes into the cornea.

Animals↗
PubMed2002

A social and demographic study of Tibetan refugees in India.

The social and demographic characteristics of approximately 65,000 Tibetan refugees in India were determined from data collected 1994-1996. Approximately 55,000 refugees were living in 37 settlements widely distributed around India. The remaining 10,000 refugees were monks living in monasteries associated with some of the settlements, mostly in the south of India. In the settlements, a community-based surveillance system was established and data were collected by trained community health workers in house to house visits. In the monasteries, data were collected by the community health workers in monthly interviews with a designated liaison monk at each monastery. These data indicated little immigration of new civilian refugees in the past 10 years into the settlements but a steady influx of new monks into the monasteries. The age distribution in the settlements showed a prominent mode in the 15-25 year age range, a declining birth rate, and an increasing proportion of elderly. In general, refugees born in India were educated through secondary school, while refugees born in Tibet were often illiterate. The principle occupations were education involving 27% (including students), farming, 16%. and sweater selling, 6.5%; another 6.5% were too young or too old for employment, and only 2.4% were unemployed. The overall crude birth rate was determined to be relatively low at 16.8/1000. although this may underestimate the true figure. Infant mortality varied from 20 to 35/1000 live births in the different regions. Child vaccination programs cover less than 50% of the population. The burden of illness in this society was mainly characterized by diarrhoea. skin infections, respiratory infections, fevers, and, among the elderly. joint pains and cardiovascular problems. Although calculated death rates were unrealistically low, due to under-reporting, causes of death, derived from "verbal autopsies", were mainly cancer, tuberculosis, accidents, cirrhosis and heart disease in order of decreasing frequency. Overall, the sociodemographic and health characteristics of this population appear to be in transition from those typical of the least developed countries to those typical of middle income and more affluent societies.

Adolescent↗
PubMed1994

[True aneurysm of the ascending aorta in HIV disease].

A 31-year-old male who presented with a true aneurysm of the ascending aorta had for 5 years been seropositive for HIV-1 following intravenous drug abuse. Elective aneurysmectomy was refused. Controls by computerized tomography and echocardiography gave evidence of a progressive dilatation during the following 8 months. In February 1992 a further increase of the aneurysm with severe thoracic pain necessitated an emergency graft implantation. Histopathology of the resected aorta revealed a granulomatous giant cell mesaortitis. The postoperative course was uneventful and the patient remained free of cardiovascular symptoms, but died 25 months later due to multiple HIV-associated opportunistic infections. The differential diagnosis (Marfan's syndrome, vasculitis due to tuberculosis, syphilis and other infectious agents, rheumatological diseases, HIV-associated vasculitis) and the etiopathological considerations are discussed.

Adult↗
PubMed2006

The promise of nanotechnology for heart, lung and blood diseases.

Nanotechnology offers a broad range of opportunities for improving the diagnosis and therapy for heart, lung and blood diseases, and drug delivery represents an area of particular promise. For cardiovascular disease, the treatment of atherosclerotic plaque and prevention of restenosis following stent placement offer attractive targets for nanotechnology. In lung disease, nanotechnology may provide novel treatments for a broad range of intractable pulmonary diseases, including bacterial biofilms, fungal infections, and tuberculosis. For haematopoietic diseases, targeted delivery of drugs to lymphocytes may represent a strategy for reducing systemic cytotoxicity. This editorial discusses some of the more promising targets for nanotechnology-based treatment of heart, lung and blood diseases.

Cardiovascular Diseases↗
PubMed1996

Human immunodeficiency virus and AIDS in Uganda.

HIV-1 infection, initially described as "slim disease", was first recognized in Uganda in 1982, and is now a predominant health problem. Approximately 1.5 million Ugandans are now infected, largely through heterosexual transmission. In many areas half of adult deaths are now caused by HIV. Seroprevalence rates in urban antenatal clinics have been dropping in the last several years, as have rates in young adults in two rural community cohorts where the epidemic is long established. Tuberculosis cases and admissions have increased dramatically. Among the clinical manifestations of HIV in Uganda, epidemic Kaposi sarcoma, cryptococcal meningitis, suspected toxoplasmosis and cardiomyopathy, as well as atypical or extrapulmonary tuberculosis are seen with increasing frequency. Mother to child transmission of HIV accounts for about 10% of total cases, with a transmission rate of 26% in two studies. Epidemiological and clinical research programs are well developed in Uganda, especially in areas of tuberculosis, maternal and paediatric HIV infection and sexually transmitted infections. Societal openness, a multisectoral approach by the government and innovative programmes, including large-scale HIV testing and counselling and the pioneering work of The AIDS Support Organization (TASO), distinguish the Ugandan response to the epidemic.

AIDS-Related Opportunistic Infections↗
PubMed2004

[Efficiency of an intensive stage of chemotherapy for tuberculosis in elderly and senile patients].

A hundred new cases of active pulmonary tuberculosis whose age was 60 to 87 years were treated by the intensive chemotherapy regimen recommended by the WHO. Most (n = 78) patients satisfactorily tolerated the intensive stage, fully completed the regimen, and made up a study group (Group 1). Group 2 comprised the remaining 22 patients who had, due to its poor tolerance, to transfer to their individual regimen. The higher incidence of significant cardiovascular diseases in Group 2 patients is the only significant difference between these two identified groups. The advantages of the standard chemotherapy regimen are the more rapid elimination of symptoms of tuberculous intoxication; the earlier and more frequent disappearance of Mycobacterium tuberculosis from the sputum even with the primary drug resistance of the causative agent; as well as a more frequent closure of decay cavities. The findings make it possible to recommend a wider use of the standard intensive chemotherapy regimens for elderly and senile patients with tuberculosis.

Age Factors↗
PubMed1968

Ethiopian cardiovascular studies. Case-finding by mass miniature radiography.

No large series of patients with cardiovascular disease has yet been reported from Ethiopia, where only limited means for investigation are at present available. The authors therefore studied the types of heart disease detected by mass miniature radiography in a largely self-selected population at the Addis Ababa Tuberculosis Centre, and examined the value of this method of cardiac case-finding. Rheumatic heart disease occurred in 34.8% of patients, but syphilitic aortitis, hypertension, "cardiomyopathy" and tuberculous pericarditis were also common. Endomyocardial fibrosis was not seen; this may be a further significant fact in the search for its cause. Mass miniature radiography is valuable for detecting symptomatic patients with the cardiovascular diseases mentioned above. The technique described in this paper could be used in other developing countries as it uses a single method of screening for 2 groups of diseases.

Adolescent↗
PubMed2004

Coronary artery calcification detected by a mobile helical computed tomography unit and future cardiovascular death: 4-year follow-up of 6120 asymptomatic Japanese.

In the present study, we performed a prospective follow-up study in a population which underwent chest computed tomography (CT) screening. A total of 6120 participants underwent a chest CT medical examination for lung cancer and tuberculosis in Nagano Prefecture, Japan, between 1996 and 1997. Computed tomography scanning was performed from the apex of the lung to the diaphragm at a tube voltage of 120 kV and a tube current of 50 mA. We measured the CT density of the coronary arteries in 5-7 slices where coronary arteries were detected. The CT density threshold for determining coronary artery calcification (CAC) was above +110 HU. In 2000, we investigated the number of deaths due to cardiac and noncardiac disease among the participants. Of the 6120 participants, 14 died of cardiac disease (9, myocardial infarction; 4, heart failure; and 1, angina pectoris) and 64 died of other diseases. Coronary artery calcification was detected in 10 of the patients who died of cardiac disease, and in 31 of those who died of other diseases. The prevalence of CAC was higher in the former than in the latter (71.4% vs 48.4%, P = 0.084). The relative risk of CAC for cardiac death was 2.66 (95% confidence interval: 0.76, 9.37). The findings of this study suggested that CAC detected in a mass chest CT screening by a mobile helical CT unit was predictive of future cardiovascular death.

Calcinosis↗
PubMed2006

Does adenosine deaminase play a key role in coronary artery disease.

Adenosine deaminase (ADA) is an enzyme which catalyzes adenosine to inosine. Patients who inherently lack the enzyme have defects in both humoral and cellular immunity. ADA plays an important role in many immunity mediate diseases, such as asthma, Graves' disease and tuberculosis. Coronary artery disease (CAD) has been considered as an inflammatory and immunizing disease recently. However, there are few reports about the effect of ADA in cardiovascular fields. In fact, ADA may play a key role in the immunity, inflammation and other aspects of CAD. This hypothesis is potentially based on three aspects of evolution. First, ADA inhibitors attenuate the elevation of proinflammatory factors, which shows ADA mediate in the inflammation response. ADA also has effect on the activation of complement system by the deamination of adenosine. Thus, ADA has a role in CAD by affecting inflammation process. Second, many effects produced by ADA are caused by the metabolism of adenosine. It is known that adenosine can inhibit the invasion of the neutrophil so as to attenuate the ischemic/reperfusion injury . Adenosine can increase coronary artery blood flow during active stress and hypoxia to balance the oxygen supply and demand. Adenosine can also account for the majority of basal vascular endothelial growth factor (VEGF) mRNA and protein expression in cultured myocardial vascular smooth muscle cells under normoxic conditions to stimulate the angiogenesis. If adenosine is rapidly metabolized by the high level of ADA, the advantages of adenosine will lost. Finally, adenosine is catalyzed to inosine, which can produce superoxide radicals and exaggerate the ischemic/reperfusion injury. In conclusion ADA can have a crucial role in CAD, if design and development of therapeutic strategies against ADA is guaranteed, an innovational therapeutic approach to CAD can be realized.

Adenosine Deaminase↗