1.  Title: Maternal mortality due to cardiac disease in Sri Lanka. Author: Haththotuwa HR; Attygalle D; Jayatilleka AC; Karunaratna V; Thorne SA Source: International Journal of Gynaecology and Obstetrics. 2009 Mar;104(3):194-8. Abstract: OBJECTIVE: To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths. METHODS: A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004. RESULTS: A total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100,000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care. CONCLUSION: Cardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths. Language: English Keywords: SRI LANKA | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | MATERNAL MORTALITY | HEART DISEASES | QUALITY OF HEALTH CARE | EXAMINATIONS AND DIAGNOSES | CAUSES OF DEATH | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Diseases | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 341384 |
| 2. Title: [Contraception in women with special problems] Kontrazeption bei Problemfallen. Author: Mueck A; Neulen J; Thaler C; Birkhauser M; Braendle W Source: therapeutische Umschau. Revue therapeutique. 2009 Feb;66(2):117-28. Abstract: Thromboembolic, cardiovascular and cerebrovascular events are age-dependent. They are extremely rare in young women. In contrast to the progestogen-only pills, oral contraceptives (OC) increase the risk of venous thrombosis. However, decisive ist the genetic predisposition. In healthy non-smokers of less than 35 years of age, the risk to suffer from a myocardial infarction or a cerebrovascular accident is not increased by OC. Risk factors play a major role in the etiology of cardiovascular dieases. A detailed personal and family history is therefore mandatory before OC are prescribed. Very rarely, blood pressure is increased by OC. Although the incidence of such an increase is very low, blood pressure has to be measured regularly in pill users. Inspite of a current opinion, weight increase is rare in OC users. It depends mainly on the individual predisposition. An increased water retention can be reduced by a combined OC containing a progestagen with an antimineralocorticoid activity. Changes in insulin and blood sugar induced by low-dose OC are minimal so that they have no clinical relevance. OC do not increase the incidence of diabetes. Adrenal and thyroid function are not influenced by OC, there is no increased incidence of prolactinomas. Asthma is no contraindication against OC. If there is a cycle-dependent aggravation of the disease, OC might be beneficial. OC have no side-effects on the eye or the ear. In women suffering from lupus erythematodes having no renal participation, no increased antiphospholipid-antibodies and showing a stable or inactve disease, low-dose OC might be used. Language: German Keywords: RESEARCH REPORT | RISK FACTORS | ORAL CONTRACEPTIVES | CARDIOVASCULAR EFFECTS | HEART DISEASES | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | CONTRACEPTIVE SAFETY | Biology | Contraceptive Methods | Contraception | Family Planning | Physiology | Diseases | Contraceptive Agents, Female | Contraceptive Agents | Progestational Hormones | Hormones | Endocrine System | Safety | Public Health | Health Document Number: 329570 |
| 3. Title: Cardiac manifestations of HIV infection: an African perspective. Author: Ntsekhe M; Mayosi BM Source: Nature Clinical Practice. Cardiovascular Medicine. 2009 Feb;6(2):120-7. Abstract: The pericardium, myocardium, coronary arteries and pulmonary arteries are the main targets for cardiac disease in people who are infected with HIV. Geography and access to highly active anti-retroviral therapy (HAART) have a major influence on which of these targets is affected. In sub-Saharan Africa, where tuberculosis is endemic and access to HAART is limited, the dominant forms of HIV-associated heart disease are pericardial tuberculosis and cardiomyopathy. However, in industrialized countries, where tuberculosis is rare and HAART is widely available, coronary artery disease is the main cause of death and disability in these patients. Observational data suggest that HAART, by preserving immune function, reduces the incidence of myopericardial disease and pulmonary hypertension. The result has been that, although optimal strategies to reduce vascular disease in this population continue to be sought and debated in industrialized nations, the focus of prevention and treatment strategies for HIV-related heart disease in developing countries has been to support the active campaigns to get universal access to HAART in the first place. Herein, we review the cardiac manifestations of HIV in sub-Saharan Africa. Language: English Keywords: AFRICA | SUMMARY REPORT | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | CARDIOVASCULAR EFFECTS | HEART DISEASES | HIV INFECTIONS | HYPERTENSION | Developing Countries | Viral Diseases | Diseases | Infections | Physiology | Biology | Vascular Diseases Document Number: 330530 |
| 4. Title: HIV-related lipodystrophy in Africa and Asia. Author: Womack J Source: AIDS Reader. 2009 Apr;19(4):131-9, 148-52. Abstract: This article reviews the medical literature for information about lipodystrophy in Africa and Asia. These 2 regions were selected because both are of particular interest to the declaration for universal access. Africa represents the epidemic's epicenter. Asia, especially India and China, will soon have HIV / AIDS prevalence rates that will outstrip those seen in the rest of the world combined. The methodology is summarized first: how articles were selected, the inclusion and exclusion criteria used, and how information was synthesized. The results and discussion focus on 3 specific areas: how lipodystrophy is defined and measured, the study populations, and the persons excluded from these studies. A summary of what is and what is not yet known about lipodystrophy in Africa and Asia is also included. Language: English Keywords: AFRICA | ASIA | LITERATURE REVIEW | UNAIDS | PERSONS LIVING WITH HIV/AIDS | LIPID METABOLIC EFFECTS | GLUCOSE METABOLISM EFFECTS | DIABETES | HEART DISEASES | RISK FACTORS | PREVENTION AND CONTROL | QUALITY OF LIFE | TREATMENT | OBSTACLES | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Lipids | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Health | Social Welfare | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Organization and Administration Document Number: 341055 |
| 5. Title: Host-pathogen evolution: Implications for the prevention and treatment of malaria, myocardial infarction and AIDS. Author: Foster HD Source: Medical Hypotheses. 2008;70(1):21-25. Abstract: Humans have evolved complex immune systems to protect against infection by pathogens. However, pathogens possess a remarkable genetic versatility that allows them to gain new vigour and so escape such population immunity. Conflicting pathogen-host objectives, therefore, lead to the evolutionary equivalent of an "arms race". Typically, in this struggle, pathogens attempt to deplete their host of specific nutrients that are essential for immune system function. After infection, the resulting deficiency of nutrient(s) may cause many of the disease symptoms and sequela. In malaria, Plasmodium falciparum, for example, depletes its host of Vitamin A, possibly resulting in blindness in some cases. However, 200,000 International Units of Vitamin A, given to children every three months can reduce significantly their susceptibility to malaria. This would seem to be a minimum child dosage for the treatment of the disease. In contrast, the Coxsackie B virus causes a selenium deficiency that may result in myocardial infarction or Keshan disease. However, table salt fortified with 15 ppm anhydrous sodium selenite can cause dramatic drops in the incidence of Keshan disease, while selenium supplementation also reduces re-infarction rates. HIV-1 depletes its host of four nutrients: selenium, cysteine, glutamine and tryptophan, resulting in symptoms known as AIDS. Open and closed clinical trials in South Africa, Zambia and Uganda, involving daily adult doses of 600 mcg L-selenomethione, and some 500 mg L-glutamine, hydroxytryptophan and N-acetyl cysteine, however, have shown that such supplementation can reverse the symptoms of AIDS and prevent HIV-1 infected patients declining into this disease. It is obvious, therefore, that supplementation of diet with specific nutrients can reduce infection by particular pathogens. In addition, if infection still occurs, their use as a treatment may prevent many of the symptoms and sequela commonly associated with diseases such as malaria, myocardial infarction and AIDS. (author's) Language: English Keywords: AFRICA, SUB SAHARAN | LITERATURE REVIEW | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | PARASITES | VITAMIN A | ADMINISTRATION AND DOSAGE | PARASITE CONTROL | MALARIA PREVENTION | MALARIA | TREATMENT | HIV INFECTIONS | HEART DISEASES | Developing Countries | Africa | Clinical Research | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Biology | Vitamins and Minerals | Physiology | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Parasitic Diseases Document Number: 325622 |
| 6. Title: Cardiovascular effects of medroxyprogesterone acetate and progesterone: a case of mistaken identity? Author: Hermsmeyer RK; Thompson TL; Pohost GM; Kaski JC Source: Nature Clinical Practice. Cardiovascular Medicine. 2008 Jul;5(7):387-95. Abstract: Heart disease presentation can differ between the sexes because nonobstructive coronary disease and angina unrelated to exercise are considerably more prevalent in women than in men. When the outcomes of large, randomized, controlled trials failed to demonstrate cardiac risk protection, many women and their physicians abandoned hormone replacement therapy as primary or secondary prevention for cardiovascular disease. We are concerned that the apparent blanket condemnation of steroids has not sufficiently distinguished between the cardiovascular actions of estrogen, progesterone and the synthetic progestin medroxyprogesterone acetate. The actions of active metabolites of progestins are not well understood and in some cases have not been explored. We intend to present what is known and what is not known about progesterone per se versus medroxyprogesterone acetate, particularly with regard to cardiovascular effects. This Review considers the mounting evidence that progesterone improves cardiovascular function and proposes its mechanism of action-restoration of a threshold level of progesterone as preventive of microvascular cardiac ischemia-and compares oral and transdermal routes of administration. We hope to stimulate research to determine whether progesterone, with or without estrogen, has a role in reducing cardiovascular risk and treating cardiovascular disease including myocardial ischemia in postmenopausal women. Language: English Keywords: UNITED STATES OF AMERICA | SUMMARY REPORT | WOMEN | HEART DISEASES | SEX FACTORS | PROGESTERONE | CONTRACEPTIVE AGENTS, PROGESTIN | CARDIOVASCULAR EFFECTS | Developed Countries | North America | Americas | Demographic Factors | Population | Diseases | Population Characteristics | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning Document Number: 328471 |
| 7. Peer Reviewed Title: Maternal obesity and neonatal congenital cardiovascular defects. Author: Khalil HS; Saleh AM; Subhani SN Source: International Journal of Gynecology and Obstetrics. 2008 Sep;102(3):232-236. Abstract: Objective: To determine whether isolated congenital heart defects (CHDs) were associated with maternal obesity. Method: In a retrospective study we compared the incidence and severity of isolated CHDs in the offspring of 428 women divided into 3 groups, one of women of normal weight (n=141), one of obese women (n=228), and one of morbidly obese women (n=59) according to their body mass index. Results: There were 143 mild (66.8%), 44 moderate (20.6%), and 27 complex (12.6%) forms of CHDs in the offspring and septal defects were the most common (61.7%). No significant differences were found among the 3 groups of women regarding the type or severity of CHDs in their respective offspring, or the corrective cardiac surgery required. Conclusion: No association was found between maternal weight and isolated CHDs in the offspring. Language: English Keywords: SAUDI ARABIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | INCIDENCE | PREGNANT WOMEN | INFANT, PREMATURE | OBESITY | HEART DISEASES | CONGENITAL ABNORMALITIES | Middle East | Developing Countries | Studies | Research Methodology | Measurement | Population Characteristics | Demographic Factors | Population | Infant | Youth | Age Factors | Body Weight | Physiology | Biology | Diseases | Neonatal Diseases and Abnormalities Document Number: 308278 |
| 8. Title: Pregnancy and contraception in congenital heart disease: what women are not told [letter] Author: Kovacs AH; Harrison JL; Colman JM; Sermer M; Siu SC Source: Journal of the American College of Cardiology. 2008 Aug 12;52(7):577-8. Abstract: As increased numbers of patients with congenital heart disease (CHD) survive to adulthood, more women with CHD are reaching reproductive age. Contraception and pregnancy have now become important issues in this population; however, both can be associated with increased risks in women with CHD (1). Other issues, such as adverse fetal outcomes in these women and transmission of CHD to offspring must be addressed. Current guidelines for the care of adults with CHD recommend proactive counseling regarding issues of contraception and pregnancy (2-5). The objective of this study was to evaluate whether women with CHD have adequate knowledge regarding risks of contraception and pregnancy. (author's) Language: English Keywords: CANADA | RESEARCH REPORT | QUESTIONNAIRES | COHORT ANALYSIS | WOMEN | HEART DISEASES | CONGENITAL ABNORMALITIES | PREGNANCY | PREGNANCY COMPLICATIONS | CONTRACEPTION | RISK FACTORS | RISK ASSESSMENT | KNOWLEDGE | North America, Northern | Americas | Developed Countries | Research Methodology | Demographic Factors | Population | Diseases | Neonatal Diseases and Abnormalities | Reproduction | Family Planning | Biology | Evaluation | Sociocultural Factors Document Number: 328224 |
| 9. Peer Reviewed Title: Risk of hyperkalemia in women taking ethinylestradiol/drospirenone and other oral contraceptives. Author: Loughlin J; Seeger JD; Eng PM; Foegh M; Clifford CR; Cutone J; Walker AM Source: Contraception. 2008 Nov;78(5):377-83. Abstract: BACKGROUND: The oral contraceptive ethinyl estradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) contains a progestin component that possesses potassium-sparing diuretic activity similar to spironolactone. We sought to determine whether EE/DRSP use might lead to adverse effects possibly attributable to hyperkalemia. STUDY DESIGN: This was a matched cohort study in which we identified oral contraceptive (OC) initiators between July 2001 and June 2004 within a large, US health plan. We matched EE/DRSP initiators to other OC initiators in a 1:2 ratio on the basis of a prediction model (propensity score) of EE/DRSP initiation that incorporated dozens of characteristics. We identified insurance claims mentioning hyperkalemia, related clinical outcomes (electrolyte disturbances, arrhythmia, syncope, myocardial infarction) and verified the underlying condition through medical record review. RESULTS: There were 22,429 EE/DRSP initiators matched to 44,858 other OC initiators, with an average follow-up of 7.6 months. A composite clinical surrogate hyperkalemia end point occurred with equal frequency in the compared groups [118 cases in EE/DRSP and 260 in comparators; rate ratio (RR) 0.9, 95% confidence interval (CI) 0.7-1.1]. The individual hyperkalemia surrogate end points exhibited similar results. One EE/DRSP initiator and four comparators were diagnosed specifically with hyperkalemia (RR 0.5, 95% CI 0.0-4.9). The results were not different when we accounted for changes in OC use during follow-up. CONCLUSION: EE/DRSP initiators are no more likely than other OC initiators to experience hyperkalemia or related clinical outcomes which could be caused by hyperkalemia during follow-up. Language: English Keywords: UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | LONGITUDINAL STUDIES | WOMEN | ORAL CONTRACEPTIVES, SIDE EFFECTS | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | RISK ASSESSMENT | LOW-DOSE PROGESTINS | HEALTH INSURANCE | HEART DISEASES | SODIUM ION LEVEL | USFDA | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods | Evaluation | Contraceptive Agents, Progestin | Financial Activities | Economic Factors | Diseases | Hemic System | Physiology | Biology | USPHS | Government Agencies | Organizations | Political Factors | Sociocultural Factors Document Number: 329152 |
| 10. Title: Early life exposure and its effects on health in the Puerto Rican elderly population. Author: McEniry M; Palloni A; Davila AL; Garcia Gurucharri A Source: Madison, Wisconsin, University of Wisconsin-Madison, Center for Demography and Ecology, 2008. 49 p. (CDE Working Paper No. 2008-01) Abstract: Season of birth may help disentangle the effects on health of early life exposure to poor nutrition and infectious diseases from effects associated with other childhood conditions. Using data from 60 to 74 year old Puerto Ricans who lived in rural areas during childhood (n=1459), we estimated effects of exposure to poor nutrition and infectious diseases during late gestation on the probability of (a) chronic conditions (diabetes, heart disease, obesity), (b) decreased functionality (limitation in at least one ADL and IADL), and (c) poor self-reported health controlling for childhood health and SES and knee height. Findings: (1) strong associations between exposure and heart disease; (2) virtually no attenuation of effects of self-reported childhood health with controls for exposure; (3) no association between exposure and diabetes, obesity, functionality, poor health. Conclusions: timing of birth may reveal conditions experienced perinatally which affect adult heart disease, but there is little evidence of similar effects on adult diabetes and obesity. (author's) Language: English Keywords: PUERTO RICO | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | OLDER ADULTS | FETUS | SEASONAL VARIATION | CHILDBIRTH | INFANT NUTRITION | COMMUNICABLE DISEASES | CHILD HEALTH | CHRONIC DISEASES | HEALTH | HEART DISEASES | OBESITY | DIABETES | Caribbean | Americas | Developed Countries | Research Methodology | Adults | Age Factors | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Population Dynamics | Pregnancy Outcomes | Nutrition | Infections | Diseases | Body Weight | Physiology | Biology Document Number: 325667 |
| 11. Peer Reviewed Title: HIV infection is associated with a lower incidence of constriction in presumed tuberculosis pericarditis: A prospective observational study. Author: Ntsekhe M; Wiysonge CS; Gumedze F; Maartens G; Commerford PJ Source: PLoS One. 2008;3(6):e2253. Abstract: Background: Pericardial constriction is a serious complication of tuberculous pericardial effusion that occurs in up to a quarter of patients despite anti-tuberculosis chemotherapy. The impact of human immunodeficiency virus (HIV) infection on the incidence of constrictive pericarditis following tuberculous pericardial effusion is unknown. Methods and Results: We conducted a prospective observational study to determine the association between HIV infection and the incidence of constrictive pericarditis among 185 patients (median age 33 years) with suspected tuberculous pericardial effusion. These patients were recruited consecutively between March and October 2004 on commencement of anti-tuberculosis treatment, from 15 hospitals in Cameroon, Nigeria and South Africa. Surviving patients (N = 119) were assessed for clinical evidence of constrictive pericarditis at 3 and 6 months of follow-up. Clinical features of HIV infection were present in 42 (35.2%) of the 119 patients at enrolment into the study. 66 of the 119 (56.9%) patients consented to HIV testing at enrolment. During the 6 months of follow-up, a clinical diagnosis of constrictive pericarditis was made in 13 of the 119 patients (10.9%, 95% confidence interval [CI] 5.9-18%). Patients with clinical features of HIV infection appear less likely to develop constriction than those without (4.8% versus 14.3%; P = 0.08). None of the 33 HIV seropositive patients developed constriction, but 8 (24.2%, 95% CI 11.1-42.3%) of the 33 HIV seronegative patients did (P = 0.005). In a multivariate logistic regression model adjusting simultaneously for several baseline characteristics, only clinical signs of HIV infection were significantly associated with a lower risk of constriction (odd ratio 0.14, 95% CI 0.02-0.87, P = 0.035). Conclusions: These data suggest that HIV infection is associated with a lower incidence of pericardial constriction in patients with presumed tuberculous pericarditis. (author's) Language: English Keywords: SOUTH AFRICA | CAMEROON | NIGERIA | RESEARCH REPORT | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | TUBERCULOSIS | COMPLICATIONS | PREVALENCE | HEART DISEASES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Western | Studies | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Infections | Measurement Document Number: 327415 |
| 12. Peer Reviewed Title: Are social inequalities in mortality in Britain narrowing? Time trends from 1978 to 2005 in a population-based study of older men. Author: Ramsay SE; Morris RW; Lennon LT; Wannamethee SG; Whincup PH Source: Journal of Epidemiology and Community Health. 2008;62:75-80. Abstract: The objective was to examine whether social inequalities in all-cause and coronary heart disease (CHD) mortality in Britain have reduced between 1978 and 2005. The design of the study was a prospective study of a socioeconomically representative population. The setting for the study was 24 British towns. The participants used were 7735 Men, aged 40-59 years at recruitment in 1978-1980 and followed up until 2005 through the National Health Service Central Register (164 120 person-years). The main outcome measures were relative hazards and absolute risk differences for all-cause and CHD death comparing manual with non-manual social classes, calculated for different calendar periods. 3009 Deaths from all causes (1003 from CHD) occurred during follow-up. The overall hazard ratio (manual versus non-manual) was 1.56 (95% CI 1.45 to 1.69, p < 0.001) for all-cause mortality and 1.54 (95% CI 1.35 to 1.76, p < 0.001) for CHD mortality. The relative difference between these social groups tended to increase over time. The overall relative increase in hazard ratio comparing manual with non-manual groups over a 20-year calendar period was 1.22 (95% CI 0.83 to 1.80, p=0.31) for all-cause mortality and 1.75 (95% CI 0.89 to 3.45, p=0.11) for CHD mortality. The absolute difference in probability of survival to age 65 years between nonmanual and manual groups fell from 29% in 1981 to 19% in 2001 for all-cause mortality and from 17% to 7% for CHD mortality. Relative differences in all-cause and CHD mortality between manual and non-manual social class groups persisted and may have increased during this period. Absolute differences in mortality between these social groups decreased as a result of falling overall mortality rates. Greater effort is needed to reduce social inequalities in all-cause and CHD mortality in the new millennium. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | LONGITUDINAL STUDIES | PROSPECTIVE STUDIES | EPIDEMIOLOGIC METHODS | MEN | OLDER ADULTS | INEQUALITIES | TIME FACTORS | SOCIAL CLASS | MORTALITY DETERMINANTS | MORTALITY CHANGES | DIFFERENTIAL MORTALITY | CAUSES OF DEATH | HEART DISEASES | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Socioeconomic Factors | Economic Factors | Population Dynamics | Socioeconomic Status | Mortality | Diseases Document Number: 323232 |
13.  Peer Reviewed Title: Evaluation of cardiovascular morbidity in Nigerian women after 3 years of Norplant® contraception. [Evaluation de la morbidité cardiovasculaire chez les femmes nigérianes après trois ans de la contraception Norplant] Author: Sagay AS; Okeahialam BN; Imade GE; Aisien AO Source: African Journal of Reproductive Health. 2008 Apr;12(1):47-53. Abstract: This study was conducted to determine any cardiovascular morbidity with Norplant® use by electrocardiography. Thirty Nigerian women seeking long-term reversible contraception were recruited. The clients had baseline blood pressure checks and electrocardiography (ECG) tracings. These were repeated at the 12, 24 and 36 months follow-up visits and the results were analysed. The mean age of subjects was 32.4 +or- 3.98 years. The mean weight at pre-insertion and at the 12, 24 and 36 months follow-up visits showed a statistically significant rise after 2 years (p<0.01). The blood pressures did not show any significant changes throughout the period of study. There was statistically significant prolongation of the PR and QRS intervals at the 12 month visit; mean PR interval (seconds) pre-insertion 0.153 +or- 0.003, and at 12 months 0.173 +or- 0.006 (P=0.019), mean QRS interval (seconds) pre-insertion 0.056 +or- 0.003 and at 12 months 0.074 +or- 0.002 (P=0.005). After 3 years of Norplant use, prolongation of the mean QRS interval remained evident (p=0.011) while mean PR interval had returned to pre-insertion levels. There is a tendency to prolongation of PR and QRS (ECG) intervals in Norplant users; accordingly, it may be prudent for clients with cardiac conditions showing longer ECG intervals, to consider alternative methods of contraception. French Abstract: Cette étude a été menée pour déterminer toute morbidité cardiovasculaire suite à l'utilisation de Norplant par l'électrocardiographie. Trente femmes nigérianes qui recherchent une contraception réversible à long terme ont été recuitées. Les clientes ont eu des contrôles de pression sanguine de départ et les tracées de la cardiographie (ECG). Ceux-ci ont été répétés au cours des visites de surveillance de 12, 24 et 36 mois et les résultats ont été analysés. L'âge moyen des participantes était de 32.4 +or- 3.98 ans le poids moyen au moment de la pré-insertion et pendant les visites de surveillance de 12, 24 et 36 mois a indiqué une augmentation importante statistiquement après deux ans (p < 0,01). Les tensions artérielles n'ont pas changé de manière significative pendant la période de l'étude. Statistiquement, il y avait une prolongation importante des intervalles PR et QRS au cours de la visite de 12 mois. L'intervalle PR moyen (secondes) de la pré-insertion 0,153 +or- 0,003 et à 12 mois 0,074 +or- 0,002 (P = 0,005). Après 3 ans de l'utilisation de Norplant, la prolongation de l'intervalle QRS moyen est restée évidente (P = 0, 011) alors que l'intervalle PR moyen était revenu aux niveaux de la pré-insertion. Il y a une tendance vers la prolongation des intervalles PR et QRS (ECG) chez les personnes qui utilisent Norplant ; ainsi, il sera peut-être prudent de la part des clientes qui ont les maladies de cœur indiquant les intervalles ECG plus prolongés, de considérer d'autre méthodes de contraception. Language: English Keywords: NIGERIA | RESEARCH REPORT | EVALUATION | WOMEN | CONTRACEPTIVE IMPLANTS | CARDIOVASCULAR EFFECTS | MORBIDITY | HEART DISEASES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Diseases Document Number: 322426 |
| 14. Title: Migraine with and without aura and risk for cardiovascular disease. Author: Vargas BB; Dodick DW; Wingerchuk DM; Demaerschalk BM Source: Current Atherosclerosis Reports. 2008 Oct;10(5):427-33. Abstract: Migraine, cardiovascular disease, and stroke are three highly prevalent and disabling conditions that exert a significant socioeconomic impact. The association between migraine and a twofold risk of stroke and myocardial infarction has been the topic of much debate. The mechanism underlying this link is largely unknown but may be the result of an increased prevalence of other conditions such as vasculopathies, hypercoagulable states, and patent foramen ovale seen in migraine with aura. Although many prior studies have demonstrated increased risks in women with migraine with aura, an emerging body of evidence is showing similar risks in men. These risks are further compounded with increased migraine frequency, smoking, and the use of oral contraceptive pills. Because the overall risk for stroke and myocardial infarction in migraineurs remains relatively low, recommendations at this time are limited to the modification of cardiovascular risk factors, such as smoking cessation and the avoidance of oral contraceptive pills, especially in women suffering from migraine with aura. Language: English Keywords: UNITED STATES OF AMERICA | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | TARGET POPULATION | MIGRAINE | CARDIOVASCULAR EFFECTS | RISK FACTORS | HEART DISEASES | PREVALENCE | CEREBROVASCULAR EFFECTS | RISK BEHAVIOR | RISK REDUCTION BEHAVIOR | Developed Countries | North America | Americas | Research Methodology | Program Design | Programs | Organization and Administration | Vascular Diseases | Diseases | Physiology | Biology | Measurement | Behavior Document Number: 328945 |
| 15. Title: Antioxidant activity and lipid peroxidation in preeclampsia. Author: Adiga U; D'souza V; Kamath A; Mangalore N Source: Journal of the Chinese Medical Association. 2007 Oct;70(10):435-438. Abstract: Epidemiologic studies demonstrate a relation between preeclampsia and an increased risk of future maternal coronary heart disease. The pathophysiology of the underlying mechanism is unknown. Disorders of lipoprotein metabolism may contribute to endothelial dysfunction. Oxidative stress and decreased antioxidant defense enhances free radical-mediated membrane lipid peroxidation and possibly vascular endothelial damage. The aim of this study was to elucidate the possible relation between lipidemic status, lipid peroxidation and albumin with total antioxidant activity (AOA) that may contribute to atherogenicity in preeclamptic women. Twenty-five women with preeclampsia and 25 normal pregnant women who were matched for maternal and gestational age were selected for the study. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), atherogenic index (AI), malondialdehyde (MDA), a marker of lipid peroxidation, AOA and albumin levels were measured. MDA, TC and AI were significantly elevated(p less than 0.001), and HDL-C, AOA and albumin levels were significantly decreased (p less than 0.001) in preeclamptic patients compared to the control group. We conclude that hypercholesterolemia leads to excessive lipid peroxidation. Coexistent diminution in antioxidant activity leads to an imbalance between prooxidants and antioxidants, resulting in oxidative stress. Oxidative stress and elevated AI may contribute to atherogenicity in preeclampsia. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CASE CONTROL STUDIES | PREGNANT WOMEN | PREECLAMPSIA | HEART DISEASES | CHOLESTEROL | LIPID METABOLIC EFFECTS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Lipids | Physiology | Biology Document Number: 326190 |
| 16. Title: Severity of coronary artery disease and symptoms of erectile dysfunction in males with a positive exercise treadmill test. Author: Akilli H; Gok H; Soylu A; Kayrak M Source: International Journal of Urology. 2007 Aug;14(8):733-737. Abstract: The objective of this study is to investigate the significance of erectile dysfunction in males with a positive exercise treadmill test (ETT) to predict the severity of coronary artery disease (CAD). With no previous marked CAD, and applying to our clinic with chest pain, 105 male patients (mean age: 56 +or- 8 years) underwent coronary angiography after the ETT. These patients met our criteria and were included in our study. All patients were requested to complete a brief, 5-item form by the International Index of Erectile Function, and the Sexual Health Inventory for Men (SHIM), and were classified into four groups according to coronary angiography results as follows: normal coronary artery (NCA), single-vessel CAD (1 V), two-vessel CAD (2 V) and three-vessel CAD (3 V). The relation between SHIM scores and the number of arteries with significant lesions was evaluated. The median SHIM score was found to be significantly lower in both the 2 V, 15 (IQR: 12-20) and 3 V, 13 (IQR: 11-16) groups compared to the NCA, 22 (IQR: 17-23) and the 1 V, 22 (IQR: 17-23) groups (P < 0.05). Grouped as group I (NCA + 1 V) and group II (2 V + 3 V), the patients were recompared. The SHIM score is an independent parameter to define the presence of significant lesions in two or more coronary arteries (odds ratio, 0.84; 95% CI, 0.73-0.97; P = 0.019). The fact that the SHIM score is <18 in ETT positive males may suggest that the probability of multivessel CAD should be high. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | EVALUATION INDEXES | MEN | HEART DISEASES | IMPOTENCE | SIGNS AND SYMPTOMS | HEALTH STATUS INDEXES | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Quantitative Evaluation | Evaluation | Demographic Factors | Population | Diseases | Genital Effects, Male | Genitalia, Male | Genitalia | Urogenital System | Physiology | Biology | Health Document Number: 319085 |
| 17. Peer Reviewed Title: Ultrasound screening for fetal major abnormalities at 11-14 weeks. Author: Dane B; Dane C; Sivri D; Kiray M; Cetin A Source: Acta Obstetrica et Gynecologica Scandinavica. 2007;86(6):666-670. Abstract: This study was planned to evaluate the efficiency of the 11-14 week scan in detecting fetuses with major fetal structural abnormalities. Some 1,290 pregnant women were submitted to a routine ultrasound scan between the 11th and 14th week after the detection of the fetal viability. The fetal anatomy was examined transabdominally, and in suspected cases transvaginally. Following the scans, the patients were examined in the second or third trimester of pregnancy. Fetal structural abnormalities classified as major and early onset were noted. Isolated choroid plexus cysts, cardiac defects not requiring treatment, mild ventriculomegaly, and mild renal pelviectasis in second trimester were not included. Twenty-four (1.86%) fetuses with various defects were identified, and 17 of these were diagnosed at the 11-14 week scan. The antenatal ultrasound detection rate of the fetuses with major anomalies was 95%, and 70% were detected in the first-trimester assessment. Four cardiac defects associated with genetic syndromes or requiring operation were included (0.31%) in this series. Two of the fetuses with cardiac defects (50%) had an increased nuchal translucency thickness. In this group, none of the fetuses with karyotype anomalies was born alive. The first-trimester scan is important in routine antenatal care for early detection of fetal defects, and determination of the fetuses at risk of cardiac anomalies and genetic syndromes. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | FETUS | ULTRASONICS | CONGENITAL ABNORMALITIES | HEART DISEASES | CHROMOSOME ABNORMALITIES | HEREDITARY DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Pregnancy | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Neonatal Diseases and Abnormalities | Diseases Document Number: 313553 |
| 18. Peer Reviewed Title: Evaluating causes of acute renal failure in newborn infants. Author: Gharehbaghi MM; Peirovifar A Source: Pakistan Journal of Medical Sciences. 2007 Oct-Dec;23(6):877-880. Abstract: Acute renal failure (ARF) is a common problem in admitted neonates in intensive care units. In most patients ARF accompanies with a predisposing factor such as sepsis, heart failure, perinatal asphyxia or prematurity. The objective of this study was to determine the causes and outcome of ARF in hospitalized newborn infants. In a descriptive cross sectional study we evaluated neonates with ARF who had been hospitalized in Tabriz Children Hospital from March 2004 to September 2005. There were 85 cases with diagnosed ARF in 3000 hospitalized neonates (2.83%).The male to female ratio in patients with ARF was 2.03:1. Most of involved patients were term (70.6%). The prevalence of renal, pre renal and post renal causes of ARF was 49.4%, 43.5% and 7.1% respectively. The most common predisposing factors for ARF in our study were surgery (43.5%), perinatal asphyxia (36.5%), sepsis (32.9%), respiratory distress syndrome (25.9%), heart failure (20%) and feeding problems (20%). All patients had more than one predisposing factor. Among admitted neonates with ARF mortality rate was 20% and it was significantly higher in patients with assisted ventilation and sepsis (P<0.05). Early recognition of risk factors such as sepsis, perinatal asphyxia or, perioperative problems and rapid effective treatment of contributing conditions will reduce ARF in neonatal period. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | EPIDEMIOLOGIC METHODS | INFANT | RENAL EFFECTS | NEONATAL DISEASES AND ABNORMALITIES | SURGERY | SEX FACTORS | PREVALENCE | RESPIRATORY INSUFFICIENCY | NUTRITION DISORDERS | HEART DISEASES | DEATH RATE | Developing Countries | Middle East | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Urogenital Effects | Urogenital System | Physiology | Biology | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Pulmonary Effects | Mortality | Population Dynamics Document Number: 323572 |
| 19. Title: Reducing infant mortality In Chile: success in two phases. Author: Jimenez J; Romero MI Source: Health Affairs. 2007 Mar-Apr;26(2):458-465. Abstract: Latin America, and especially Chile, has done well in reducing infant mortality, with rates of around twenty-five per thousand live births. There are two clear phases of declining mortality: one largely influenced by poverty reduction, primary health care, and environmental and demographic factors; and a second one more sensitive to focused health care interventions. In 2000 Chile reached 8.9 infant deaths per 1,000, using interventions that represent an increase in the provision of services related to perinatal risks, acute respiratory diseases, congenital heart conditions, and certain vaccine-preventable infections. Chile, with per capita income near U.S.$5,000 in 2000, has infant mortality that compares with that of wealthier countries. (author's) Language: English Keywords: CHILE | PROGRESS REPORT | HISTORICAL REVIEW | INFANT | INFANT MORTALITY | PREVENTION AND CONTROL | NEONATAL DISEASES AND ABNORMALITIES | RESPIRATORY INFECTIONS | HEART DISEASES | IMMUNIZATION | POVERTY | PRIMARY HEALTH CARE | HEALTH | INTERVENTIONS | Developing Countries | South America, Southern | South America | Latin America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Diseases | Infections | Health Services | Delivery of Health Care | Socioeconomic Factors | Economic Factors | Programs | Organization and Administration Document Number: 308362 |
| 20. Title: Outcome of pregnancy among parturients complicated with heart disease in Rajavithi hospital. Author: Kovavisarach E; Nualplot P Source: Journal of the Medical Association of Thailand. 2007 Nov;90(11):2253-2259. Abstract: The objective was to compare the maternal and perinatal outcomes at Rajavithi Hospital from January 1st, 2000 to December 31st, 2004, (5 years), (3rd period) with those occurring in the previous two periods: 1st and 2nd (1965-1970,(6 years) and 1985-1990,(6 years) respectively. Retrospective analysis of various medical records of 196 cases diagnosed pregnancy with heart disease. The prevalence of parturients complicated with heart disease was 0.41%, an increase of 2 and 5 times compared with the first and second period, respectively. Congenital heart disease was the most common type of disorder in the second and third period (64.28% and, 49.49%, respectively) while rheumatic heart disease was the most common disorder in the first period (54.86%). Most of the cases in the 2nd and 3rd periods were delivered by operative vaginal delivery (46.43% and 44.90%, respectively), while spontaneous vaginal delivery was the most common mode of delivery in the first period (78.99%). All of the postpartum and perinatal complications except postpartum hemorrhage were significantly higher in the worse class of NYHA (class III/ IV) than those in the better class of NYHA (class I/II). The maternal death rate in the third period increased 1.81 times and 13.66 times compared with those in the first and second periods, respectively. Congenital heart disease was the most common heart disease in pregnancy from 1985 to 1990 and 2000 to 2004. Patients in the NYHA class III/IV had worse maternal and fetal outcomes than those in the NYHA class I/II except for postpartum hemorrhage. Maternal mortality rate was highest from 2000 to 2004 (12.57 per 100,000 live births). (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | INFANT | PREGNANCY COMPLICATIONS | HEART DISEASES | PREGNANCY OUTCOMES | Asia, Southeastern | Asia | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Diseases | Pregnancy | Reproduction Document Number: 323861 |
| 21. Title: [Ultrasound examination, fetal echocardiography and prenatal outcome in HIV-positive pregnant women under antiretroviral therapy] Avaliação ultra-sonográfica, ecocardiográfica fetal e resultados perinatais em gestantes portadoras do HIV em uso de terapia anti-retroviral. Author: Lopes MA; Bunduki V; Ruocco RM; Lopes LM; Tavarez G Source: Revista Brasileira de Ginecologia e Obstetricia. 2007 Oct;29(10):497-505. Abstract: Purpose: to evaluate fetal structural and/or functional abnormalities by ultrasound examination and fetal echocardiography, in pregnant women positive for human immunodeficiency virus (HIV). Methods: we analyzed prospectively 109 HIV positive pregnant women under antiretroviral therapy (Study Group) and 200 low risk pregnant patients (Control Group). All of them were submitted to ultrasound scan and fetal and neonatal echocardiography once a month. The amniotic fluid volume, fetal growth, fetal structural and functional alteration and the perinatal outcome were evaluated. Results: there were eight (7.3%) cases of fetal structural abnormality in the Study Group and two (1%) in the Control Group (p=0.616). There were four cases of congenital heart disease and four cases of hydronephrosis in the Study Group, with statistic significance (p=0.015) for the cardiac abnormalities. There were eight cases (7.3%) of oligohydramnios and 11 cases (10%) of polyhydramnios in the Study Group against two cases (1%) of oligohydramnios and none of polyhydramnios in the Control Group (p=0.004 and p<0.001). Eleven (10%) newborn babies were too small for their gestation age in the Study Group, against three (2.7%) in the Control Group (p=0,002). The incidence of preterm delivery was 8.7 and 2.5% in the Study and Control Groups respectively (p=0.041). It was observed six cases (5.5%) of fetal death in the Study Group and none in the Control Group (p=0.002). Conclusions: in the present study, we have observed higher prevalence of amniotic fluid volume and congenital heart abnormalities in the Study Group as compared to the Control Group. Statistical significance was found in both situations. The high fetal death rate found in the Study Group was probably due to fetal malformation, whereas the high prematurity rate and the prevalence of small size for the gestational age of the newborn babies were probably related to antiretroviral therapy, smoking and drug abuse. Language: Portuguese Keywords: RESEARCH REPORT | INCIDENCE | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | ANTIRETROVIRAL THERAPY | ULTRASONICS | SCREENING | CONGENITAL ABNORMALITIES | GESTATIONAL AGE | HEART DISEASES | RISK BEHAVIOR | TOBACCO USE | DRUG USE AND ABUSE | Measurement | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Neonatal Diseases and Abnormalities | Fetus | Pregnancy | Reproduction | Behavior Document Number: 325239 |
| 22. Peer Reviewed Title: A prospective study of oral contraceptive use and risk of myocardial infarction among Swedish women. Author: Margolis KL; Adami HO; Luo J; Ye W; Weiderpass E Source: Fertility and Sterility. 2007 Aug;88(2):310-316. Abstract: The objective was to determine the risk for incident myocardial infarction (MI) in women exposed to modern formulations of oral contraceptives (OCs). The design was a population-based, prospective cohort study begun in 1991 with follow-up through 2002 for an average of 11 years. A total of 48,321 Swedish women aged 30-49 were randomly selected from the population residing in the Uppsala Health Care Region of Sweden in 1990-91. Fatal and nonfatal MI ascertained through linkages with nationwide health registries for death, hospitalization, and emigration. There were 214 incident cases of MI. Compared with never users, neither former (relative risk, 1.0; 95% confidence interval, 0.7-1.4) nor current (relative risk, 0.7; 95% confidence interval, 0.4-1.4) OC users at study enrollment had an elevated risk of future MI in models adjusted for coronary heart disease risk factors. Risk of MI was not elevated by prolonged use or in subgroups defined by characteristics of the women or types of OC. Use of OC was not associated with an increased risk of MI in this prospective study, in which most current users of OC were taking low-dose estrogen and second- or third-generation progestins. (author's) Language: English Keywords: SWEDEN | RESEARCH REPORT | PROSPECTIVE STUDIES | INCIDENCE | WOMEN | MYOCARDIAL INFARCTION | HEART DISEASES | EXPOSURE | ORAL CONTRACEPTIVES | Europe, Northern | Europe | Developed Countries | Studies | Research Methodology | Measurement | Demographic Factors | Population | Diseases | Risk Factors | Biology | Contraceptive Methods | Contraception | Family Planning Document Number: 319373 |
| 23. Title: Evaluation of the growth percentiles of children with congenital heart disease. Author: Martins da Silva V; de Oliveira Lopes MV; Leite de Araujo T Source: Revista Latino-Americana de Enfermagem. 2007 Mar-Apr;15(2):298-303. Abstract: The purpose of this study was to evaluate the correlation between anthropometric measures of children with congenital heart disease with percentiles that represent their growth indicators. Anthropometric evaluations of 135 hospitalized children with congenital heart disease were performed in a hospital specialized in cardiac diseases in Fortaleza, CE, Brazil. For the growth evaluation, percentiles of height by age, weight by height and weight by age were calculated. Children's average age was 4.74 months (+or- 3.78) and 66.7% of the children were male. The medians of the three percentiles presented values below percentile 10, indicating a high proportion of values considered of risk. The subscapular thickness presented positive correlation with the three percentiles. The values of percentiles studied indicated growth delay. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | EVALUATION INDEXES | CHILDREN | CONGENITAL ABNORMALITIES | HEART DISEASES | ANTHROPOMETRY | GROWTH | HEALTH STATUS INDEXES | RISK ASSESSMENT | DELIVERY OF HEALTH CARE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Quantitative Evaluation | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Measurement | Child Development | Biology | Health Document Number: 319752 |
| 24. Peer Reviewed Title: Serum electrolytes changes in malnourished children with diarrhoea. Author: Memon Y; Majeed R; Ghani MH; Shaikh S Source: Pakistan Journal of Medical Sciences. 2007 Oct-Dec;23(5):760-764. Abstract: The objective was to determine the frequency of electrolyte disturbances in malnourished children with and without diarrhea and whether these findings have therapeutic value or not. It is a descriptive study conducted at pediatric Unit-II LUH Hyderabad, from 1st August to 31st September 2004. One hundred children of protein-calorie-malnutrition between 6 months to 5 year of age of either sex who were admitted due to diarrhoea, failure to thrive, acute respiratory infection, malaria, anemia, cardiac failure and feeding problems were included in the study. On the basis of history, physical examination and anthropometrics measurement they were divided into Group A patients (n=64) who were malnourished but had diarrhoea and Group B patients (n=36) who were also malnourished and had no diarrhoea. Serum electrolytes were done in patients of both groups and the results were analyzed statistically. Analysis of serum electrolyte in both groups revealed that hypokalemia, hyponatremia and low serum bicarbonate were seen more frequently in patients of group A as compared to group B. In group A hypokalemia was seen in 40 patients (62.5%) while it was observed in 8 patients (22.22%) in group B (p<0.001), hyponatremia was seen in 17 patients (26.56%) in group A and in 5 patients (13.88%) in group B (p<0.001). In group A 41 patients (64%) had low serum bicarbonate while in group B only 15 patients (41.66%) had low serum bicarbonate value (p<0.001) Electrolyte changes were commonly seen in grade II and III malnourished patients particularly who presented with diarrhoeal episode of variable duration. If these changes are diagnosed in time and treated appropriately the morbidity and mortality could be decreased. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | CLINICAL RESEARCH | CHILDREN | MALNUTRITION | CHILD NUTRITION | DIARRHEA | ELECTROLYTE BALANCE | DEFICIENCY DISEASES | RESPIRATORY INFECTIONS | HEART DISEASES | ANEMIA | MALARIA | Developing Countries | Asia, Southern | Asia | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Disorders | Diseases | Nutrition | Health | Homeostasis | Physiology | Biology | Infections | Parasitic Diseases Document Number: 323570 |
| 25. Title: Epidural anaesthesia during labour for a patient with congenital complete heart block: A Case Report. Author: Monem A; Chohan U; Ali M Source: JPMA. Journal of the Pakistan Medical Association. 2007 Nov;57(11) Abstract: We report labour pain management in a full term pregnant patient with Congenital Complete Heart Block. She delivered uneventfully under routine monitoring with facilities for pacing at hand. She previously had an uneventful normal delivery and a D&E, both outside our hospital. Only findings were a low heart rate of 45-50 beats per minute. She never had syncopal attacks. She had a good effort tolerance on ETT. Her ejection fraction was 60% on Echocardiogram. She was given a single shot low dose spinal with fentanyl followed by epidural insertion. She successfully delivered through mid-cavity forceps in about 2.5 hours. The only problem encountered was a transient bradycardia of 40 per minute with a systolic blood pressure of 70 mmHg, which settled with ephedrine. Pace maker insertion is recommended early in case the patient is symptomatic or has a prolonged Q-T interval or left atrial enlargement on ECG. Regional anaesthesia is recommended to prevent valsalva induced bradycardia or cardiac arrest during expulsive efforts by the patient. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | PREGNANT WOMEN | CONGENITAL ABNORMALITIES | HEART DISEASES | CHILDBIRTH | PAIN | DRUGS | ADMINISTRATION AND DOSAGE | ANESTHESIA | BLOOD PRESSURE | FORCEPS | Developing Countries | Asia, Southern | Asia | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Signs and Symptoms | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hemic System | Physiology | Biology | Surgical Equipment | Equipment and Supplies Document Number: 321969 |
| 26. Peer Reviewed Title: Toxoplasma meningoencephalitis in HIV-seronegative patients: clinical patterns, imaging features and treatment outcome. Author: Pradhan S; Yadav R; Mishra VN Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007 Jan;101(1):25-33. Abstract: We evaluated the clinical and imaging features of cranial toxoplasmosis in patients without HIV infection. Between 1995 and 2005, 15 patients with serologically proven cranial toxoplasmosis were selected for clinical and imaging study from 233 patients with chronic meningitis and 364 patients with seizures/psychosis. All patients had poor immune status due to nutritional and metabolic causes. Neurological presentations included focal encephalitis, multifocal encephalitis and diffuse meningoencephalitis. The three groups had distinct symptoms and imaging features, with some overlap. Magnetic resonance imaging showed single or multiple nodular or ring-enhancing lesions often at the grey--white junction with subcortical white matter perifocal oedema. Within the large diffuse lesions there were discrete small haemorrhagic lesions and contrast medium administration showed fine-beaded parallel lines or small discrete nodules traversing the white matter suggesting perivenous spread. Complete clinical recovery was noted in 12 patients after several 6-week courses of pyrimethamine and sulfonamide/clindamycin. Five patients required two such courses, three patients required three courses, three patients required five courses and two patients required six courses for the final radiological healing, which was complete in nine patients. One patient was lost to follow-up and one patient died of cardiomyopathy. Knowledge of these three distinct initial presentations may help in the early diagnosis of cranial toxoplasmosis in HIV-seronegative patients. Prognosis in early cases is generally good but complete recovery may need several courses of treatment. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | TARGET POPULATION | MENINGITIS | PHYSICAL EXAMINATIONS AND DIAGNOSES | CENTRAL NERVOUS SYSTEM EFFECTS | ENCEPHALITIS | SIGNS AND SYMPTOMS | TIME FACTORS | ANTIBIOTICS | HEART DISEASES | Asia, Southern | Asia | Developing Countries | Research Methodology | Program Design | Programs | Organization and Administration | Central Nervous System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Population Dynamics | Demographic Factors | Population | Drugs | Treatment Document Number: 309569 |
| 27. Title: Mother-to-child transmission of chikungunya virus infection. Author: Ramful D; Carbonnier M; Pasquet M; Bouhmani B; Ghazouani J Source: Pediatric Infectious Disease Journal. 2007 Sep;26(9):811-815. Abstract: In 2005-2006 Reunion Island experienced a massive outbreak of chikungunya, a mosquito-borne alphavirus infection. During this epidemic, early neonatal cases were observed with a highly probable mother-to-child transmission. A retrospective descriptive study was conducted in 5 neonatal medicine departments. Chikungunya virus infection was confirmed by reverse transcription-polymerase chain reaction or specific serology in mothers and their newborns. Mothers were screened if they presented signs at delivery or if their neonates became ill on the first days of life. Thirty-eight neonates were enrolled. All mothers, except 2 asymptomatic mothers, presented signs during the perinatal period (range, day(D) -4 to D+1). All neonates were symptomatic and presented symptoms on D3 to D7 (mean, D4). The mean interval between onset of maternal illness and onset of neonatal illness was 5 days (range, 3-9). The most frequent clinical signs in neonates were fever (79%), pain (100%), rash (82%), and peripheral edema (58%). Thrombocytopenia (76%), lymphopenia (47%), decreased prothrombin value (65%), and elevation of aspartate aminotransferase (77%) were detected. Complications included seizures (6), hemorrhagic syndrome (6), and hemodynamic disorders (10). Reverse transcription-polymerase chain reaction in cerebrospinal fluid was positive in 22 of 24 cases, and abnormal findings on brain magnetic resonance imaging (14 of 25) with white matter lesions or intraparenchymal hemorrhages or both were found. Echocardiography (16) showed myocardial hypertrophy (5), ventricular dysfunction (2), pericarditis (2), and coronary artery dilatation (6). One neonate died of necrotizing enterocolitis. The chikungunya epidemic that occurred on La Reunion Island revealed for the first time the possibility of mother-to-child transmission in the perinatal period with a high rate of morbidity. (author's) Language: English Keywords: REUNION | RESEARCH REPORT | CLINICAL RESEARCH | RETROSPECTIVE STUDIES | INFANT | MOTHER-TO-CHILD TRANSMISSION | VIRAL DISEASES | INSECTS | NEONATAL DISEASES AND ABNORMALITIES | SIGNS AND SYMPTOMS | THROMBOSIS | HEART DISEASES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Transmission | Infections | Diseases | Disease Transmission Control | Prevention and Control | Thromboembolism | Embolism | Vascular Diseases Document Number: 319666 |
| 28. Title: Advances in our understanding of the biology of human milk and its effects on the offspring. Author: Schack-Nielsen L; Michaelsen KF Source: Journal of Nutrition. 2007 Feb;137(2):503S-510S. Abstract: There is an intense interest in the effects of breast-feeding on the offspring and in understanding the mechanisms behind these effects. More than 50 papers are published monthly on topics such as the influence of breast-feeding on aspects of growth, immune-related effects, mental development, and noncommunicable diseases. Most breast-feeding data are observational; confounding can be difficult to rule out because some maternal factors are associated with both breastfeeding and infant outcomes (e.g., obesity and mental development). The most important short-term immunological benefit of breast-feeding is the protection against infectious diseases. There is also some evidence of lower prevalence of inflammatory bowel diseases, childhood cancers, and type I diabetes in breast-fed infants, suggesting that breast-feeding influences the development of the infant's own immune system. One of the most consistent findings of breast-feeding is a positive effect on later intelligence tests with a few test points advantage for breast-fed infants. In the last few years, several systematic reviews and meta-analyses have examined the effect of breast-feeding on noncommunicable diseases. There seems to be a small protective effect against later overweight and obesity. Blood pressure and blood cholesterol seem to be slightly lower in breast-fed infants; however, the few studies examining breast-feeding and the risk of coronary heart disease in later life did not find an association. Recent data have suggested that breast-feeding can program the insulin-like growth factor-I axis, as 3 studies found that breast-fed infants are taller as adults. (author's) Language: English Keywords: DEVELOPING COUNTRIES | LITERATURE REVIEW | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | INFANT | HUMAN MILK | INFANT NUTRITION | BREASTFEEDING | IMMUNOLOGICAL EFFECTS | PREVALENCE | INTELLIGENCE | DISEASE PREVENTION | OBESITY | HEART DISEASES | BODY HEIGHT | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Lactation | Maternal Physiology | Physiology | Biology | Nutrition | Health | Immunity | Immune System | Measurement | Personality | Psychological Factors | Behavior | Prevention and Control | Diseases | Body Weight Document Number: 312506 |
| 29. Title: Side-effects of long-term prostaglandin E 1 treatment in neonates. Author: Talosi G; Katona M; Turi S Source: Pediatrics International. 2007 Jun;49(3):335-340. Abstract: In some neonates suffering from ductus arteriosus dependent congenital heart defect, a Prostaglandin E 1 (PGE1) therapy longer than 2 weeks may be needed. However, PGE1 analogue compounds may produce several adverse effects. The authors retrospectively analyzed the data of nine patients who underwent a PGE1 treatment lasting longer than 14 days. The leukocyte count of the patients remained high throughout the treatment period, and the proportion of neutrophils was over 50%. Transient feeding difficulty and abdominal distension, and possible signs of gastric-outlet obstruction, were observed in two cases. In the case of three patients, cortical hyperostosis developed after different cumulative doses (1584, 3384 and 4320 µg/kg). Significant correlations were found between the doses of PGE1 and serum K + levels ( r = -0.770, P < 0.05) and between the blood standard bicarbonate levels and PGE1 doses ( r = 0.889, P < 0.01). Bartter syndrome-like condition developed in those three patients who received the largest cumulative doses. Fluid-electrolyte parameters must be controlled frequently in the case of each patient treated with PGE1 for longer than 2 weeks. Although the dose, the length of the therapy and individual susceptibility may be equally important, fluid-electrolyte disturbances and the development of pseudo-Bartter syndrome seem to be more dose-dependent than cortical hyperostosis. (author's) Language: English Keywords: HUNGARY | RESEARCH REPORT | RETROSPECTIVE STUDIES | INFANT | BIRTH DEFECTS | HEART DISEASES | PROSTAGLANDINS, SYNTHETIC | ADMINISTRATION AND DOSAGE | TREATMENT | SIDE EFFECTS | LONGTERM EFFECTS | Europe, Central | Europe | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Neonatal Diseases and Abnormalities | Diseases | Prostaglandins | Endocrine System | Physiology | Biology | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Time Factors | Population Dynamics Document Number: 317167 |
| 30. Peer Reviewed Title: Pregnancy outcomes in women with heart disease. Author: Borna S; Borna H; Hantooshzadeh S Source: International Journal of Gynecology and Obstetrics. 2006 Feb;92(2):122-123. Abstract: Heart disease in pregnant women is most commonly due to rheumatic heart disease or congenital abnormalities, and less commonly to ischemic heart disease or cardiomyopathy. In developing countries, rheumatic heart disease is still predominant and continues to be a major cause of maternal mortality. The likelihood of adverse maternal and fetal outcomes is related to the type and severity of maternal cardiac disease and the resulting decrease in functional capacity. New York Heart Association classification (NYHA) class III or IV patients, those with severe symptoms or tight mitral stenosis, carry a significant risk (5--15%) of maternal mortality. This study analyses the pregnancy outcomes of 186 women with heart disease who were admitted to Vali-e-Asr hospital of the Medical University of Tehran. Only women with a pregnancy duration of more than 28 weeks were included in the study. (excerpt) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | HEART DISEASES | PREGNANCY COMPLICATIONS | PREGNANCY OUTCOMES | GESTATIONAL AGE | Developing Countries | Middle East | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Pregnancy | Reproduction | Fetus Document Number: 296657 |
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