Rheumatic heart disease in India

A cross-sectional study was carried out in rural areas of Jawan Block, District Aligarh, Uttar Pradesh, India, covering a total population of 3760 drawn from 11 villages. The total number of confirmed cases of rheumatic heart disease was 24 with a prevalence rate of 6.4 per 1000 of the general rural population. The prevalence of rheumatic heart disease increased with age until the age of 25 years. Females were more prone to rheumatic heart disease compared to males. Socio-economic class had a direct impact on the occurrence of rheumatic heart disease.     

Renal stones and coronary heart disease

The relationship between risk factors for coronary heart disease (CHD) and renal stone disease has been studied in a population of more than 2000 middle-aged men. The only positive association found was a slight increase in diastolic BP among stone formers and a higher stone prevalence in untreated hypertensives. Furthermore, the prevalence of a history of renal stones in male survivors of myocardial infarction (MI) was similar to that found in the population study. An investigation of the vitamin D intake by means of a dietary questionnaire revealed no differences between stone formers, healthy controls and MI survivors. Contrary to other reports, the present study indicates that the risk factor profile for CHD in stone formers is similar to that in the general population.     

High-density lipoproteins and coronary heart disease

High-density lipoproteins (HDLs) play an important role in the process of reverse cholesterol transport, the pathway by which the cholesterol in extrahepatic tissues is transported through plasma to the liver for recycling or for excretion from the body in bile. The concentration of HDL cholesterol is a powerful inverse predictor of the development of coronary heart disease, leading to a widely held view that HDL protects against the development of atherosclerosis. The mechanism by which HDLs protect is unknown. To date, no studies have been designed specifically to test the proposition that increasing the concentration of HDL cholesterol translates into a reduction in coronary risk. Nevertheless, in a subgroup of the Helsinki Heart Study, it was found that a substantial proportion of the beneficial effect of gemfibrozil was explicable in terms of an increase in the concentration of HDL cholesterol.     

Chronotherapy for coronary heart disease

Traditionally the therapy for coronary heart disease has been focused on the "how-to" problem. However, the clustering of cardiovascular events around the specific time of the day has been clarified. To solve the problems of the clustering would give us the clue to treat the coronary heart disease timely and in time. Therefore, the research has been stressed to solve "when-to" problem. The circadian variabilities in coronary heart disease has been clarified to be the function of the biologic time. Therefore, three problems were discussed in this paper. 1) The circadian variabilities in biology should be assessed based on the biologic zero hour rather than the mid-night of the mechanical clock. Our concept of the biologic zero hours has been proposed to answer this problem. 2) Daily health care with circadian order and harmony for the prevention of the coronary risk factors should be recommended as the prevention of the acute coronary risk factors as the trigger mechanism of the cardiovascular events. 3) The chronotherapy to chronic coronary risk factors such as hypertension was discussed, In hypertension the anti-hypertensive therapy should be customized individually adjusting the circadian variability of blood pressure with the proper selection of agents and time of the administration.     

Fetal heart rate patterns in patients with intrauterine growth retardation

Electron microscopy of the absorption surface of the jejunal epithelium of the howler monkey Alouatta caraya showed the presence of core filaments implanted at the level of the terminal web in the microvilli. These microvilli are 5 to 7 mum long and up to 5 mum thick, their extraordinary development is attributed to a conditioned adaptation of the species to its feeding habits and nature of absorption.     

Endothelin and big endothelin in coronary heart disease and acute coronary syndromes

Endothelin (ET), the most potent endogenous vasoconstrictor with mitogenic potency, is generated from its precursor big-endothelin (BET) in a proteolytic process and discussed as a pathogenetic factor in coronary artery disease and in the acute coronary syndromes. Several studies documented elevated plasma endothelin concentrations in acute myocardial infarction, but conflicting results were reported in patients with stable and unstable angina. Only few studies determined big endothelin, although it half-life and plasma concentrations are higher in comparison to endothelin. ET and BET levels (Radioimmunoassay, Biomedica GmbH, Vienna) were determined in patients with stable angina (SAP, n = 20), unstable angina (IAP, n = 12), acute myocardial infarction (AMI, n = 12) and healthy subjects (NP, n = 11). The concentrations of ET and BET (median (minimum-maximum) in fmol/ml) of the patients with stable angina (SAP: ET 0.7 (0.3-1.1); BET 1.7 (0.7-2.9)), unstable angina (IAP: ET 1.0(0.5-1.7); BET 2.5 (1.3-4.1)) and acute myocardial infarction (AMI: ET 1.2 (0.6-2.3); BET 3.6 (3.2-5.3)) showed a significant difference compared to controls (NP: ET 0.5 (0.4-0.7); BET 1.4 (1.1-1.7)) (SAP vs. NP: ET p < 0.01; BET p < 0.05; IAP and AMI vs. NP: ET and BET p < 0.001). Also, the concentrations of the peptides differed significantly dependent on the clinical severity of coronary artery disease (AMI vs. SAP: ET and BET p < 0.001; AMI vs. IAP: BET p < 0.05; IAP vs. SAP: ET p < 0.05; BET p < 0.01). Twelve of 15 patients with big endothelin concentrations over 3 fmol/ml suffered acute myocardial infarction. Seven of 12 patients with AMI showed elevated ET and BET concentrations before the increase of creatinecinase. There was no correlation between number of risk factors per patient, cholesterin and subfractions, severity of CAD classified in one-two-three-vessel disease or coronary score according to modified criteria of the American Heart Association (AHA). We conclude that in patients with coronary artery disease endothelin and big endothelin levels are elevated and related to the clinical and not to the morphological severity of coronary artery disease. Big endothelin is the more sensitive parameter in comparison to endothelin and indicates a severe course of myocardial ischemia in patients with unstable angina. The development of assays with the possibility of a quick determination of the peptides may be valuable for risk stratification of acute coronary events.     

Sunlight, cholesterol and coronary heart disease

An anomaly of the tympanic segment of the facial nerve in an adult cadaver specimen is reported. The second portion of the facial nerve crossed between the stapedal pillars. The rarity of this anomaly, particularly in a well constituted temporal bone, is discussed.     

Addressing coronary heart disease risk in women

Contrary to popular perceptions, coronary heart disease (CHD) is a serious and widespread problem in US women. Public education, preventive interventions, and better data on CHD risk and prevention in women are needed.     

Nutrition in prevention of coronary heart disease

Medical conditions often have an important causal role in urinary incontinence in the elderly. Aside from causing functional impairments, such diseases directly may involve the genitourinary system--particularly its neurologic control--resulting in specific lower urinary tract pathophysiology. Knowledge of the specific effects that medical conditions may have on the genitourinary system and continence can assist the urologic specialist in determining the often complex cause(s) of UI in older persons.