The Emergence of the Coronary Heart Disease Pandemic in the United States, 1910-1935
William G. Rothstein in The Coronary Heart Disease Pandemic in the Twentieth Century, 2017
Coronary heart disease changed from an unimportant cause of death in the early twentieth century to become a major cause of death in the 1930s. The new pandemic coronary heart disease was strikingly different from the normal disease. It produced much higher mortality rates in all adult age, sex, and race groups. Enumerations of the increases in mortality rates from coronary heart disease for all age groups during the early twentieth century pose several problems. They include the revisions in disease categories as well as the lack of availability of federal government vital statistics for the total population and individual population groups. An analysis of the increase in coronary heart disease mortality rates in the 1930s requires the use of two disease categories: the original "angina pectoris" category plus the additional new diagnostic category introduced in 1930, "diseases of the coronary arteries".
Explanations for the emergence of the coronary heart disease pandemic
William G. Rothstein in The Coronary Heart Disease Pandemic in the Twentieth Century, 2017
The emergence of coronary heart disease as a major cause of death at midcentury in the United States led to intense speculation as to its causes. The chapter describes changes in risk factors during the emerging phase of the pandemic. Risk factors for pandemic coronary heart disease differed from those for normal coronary heart disease before the pandemic. A set of important risk factors for coronary heart disease was specified in 1990 by the United States Department of Health and Human Services for its Healthy People program, which established objectives for the health of the American population in 2000. Measuring the impact of specific risk factors on coronary heart disease during the height of the pandemic must consider the basic characteristics of all risk factors. The "diet-heart hypothesis" holds that patterns of food consumption are key risk factors for coronary heart disease, especially foods containing dietary cholesterol and saturated fats.
The Peak and Decline of the Coronary Heart Disease Pandemic in the United States, 1970-2010
William G. Rothstein in The Coronary Heart Disease Pandemic in the Twentieth Century, 2017
Coronary heart disease was the leading cause of death in the adult population of the United States at the peak of the pandemic in the 1950s and 1960s. The 1950s and 1960s were the peak years of the coronary heart disease pandemic in the United States, when all age, sex, and race groups had their highest mortality rates. Coronary heart disease mortality rates stabilized for age groups 35-44 and 45-54 about 1950 and remained at that level to 1970, with slight differences by race. Minor discontinuities in the ischemic heart disease category that occurred among revisions eight, nine, and ten of the International Classification of Diseases had only a small effect on mortality rates. Mortality rates from the disease began to decrease for all of these population groups in the 1970s and stopped decreasing about 1990 for younger age groups but continued to decrease after 2000 for older age groups.
Early Origins of Cardiovascular Disease in Pediatric Chronic Kidney Disease
Published in Renal Failure, 2010
The importance of cardiovascular disease in adults with chronic kidney disease is now well recognized. For children who develop chronic kidney disease, cardiovascular disease is also a leading cause of eventual morbidity and mortality. Although the clinical manifestations of cardiovascular disease may not be apparent until later, early subclinical findings can be observed even during childhood. This review updates the reader on the epidemiology of cardiovascular disease in pediatric chronic kidney disease, discusses risk factors and potential mechanisms of accelerated cardiovascular disease, reviews evidence of early manifestations of cardiovascular disease in pediatric chronic kidney disease, and briefly discusses prevention and treatment strategies.
Quantitative Assessment of Clinical Disease Status in Primary Sjögren's Syndrome
Published in Scandinavian Journal of Rheumatology, 1997
K. Asmussen, V. Andersen, G. Bendixen, K. Bendtzen, J. U. Prause, J. Thorn, A. Wiik, P. Oxholm
Quantitative and qualitative assessment of the clinical disease manifestations in 41 primary Sjögren's syndrome (pSS) patients was performed according to a new classification model. Frequencies of subgrouped disease manifestations were as follows: 1) surface exocrine disease: 100%, 2) internal organ exocrine disease: 63%, 3) monoclonal B lymphocyte disease: 5%, 4) inflammatory vascular disease: 71%, 5) non-inflammatory vascular disease: 59%, 6) mediator induced disease: 98%. Summary scores for severity of surface exocrine disease correlated to the summary scores of all other disease manifestations (p = 0.02), to the summary scores of internal organ exocrine disease (p = 0.003), and to the summary scores of mediator induced disease (p = 0.03). Blood leucocyte counts showed significant negative correlations to levels of plasma IgG, serum IgA-RF, IgM-RF, anti-SSA/SSB antibodies, IL-6, and IL-lRa. We conclude that the model made detailed analysis of the clinical presentation of pSS possible, and thus may assist in elucidating important pathobiological aspect of the disease.
Crohn's Disease Is Frequently Complicated by Giardiasis
Published in Scandinavian Journal of Gastroenterology, 1988
C. Scheurlen, W. Kruis, U. Spengler, M. Weinzierl, G. Paumgartner, J. Lamina
Giardiasis is a common infection, and many of its symptoms are similar to those of Crohn's disease. Despite a long discussion on the role of microbiologic agents in Crohn's disease, giardiasis has never been investigated. We studied giardiasis as assessed by the occurrence of cysts in 86 patients with Crohn's disease, in 82 patients with other gastrointestinal disease, and in 52 patients without gastrointestinal disease. In addition, in 20 patients with Crohn's disease the effects of metronidazole on giardiasis and disease activity were studied. Frequency of giardiasis was 61.6% in patients with Crohn's disease, 31.7% in patients with other gastrointestinal disease, and 5.8% in the control group (p < 0.01). Stool frequency, disease activity, and humoral signs of inflammation in patients with Crohn's disease showed no relationship o giardiasis. All but two patients treated with metronidazole became free of cysts. rohn's disease activity index decreased in 14 of 20 patients (p < 0.05). In conclusion, giardiasis is a common finding in patients with Crohn's disease. Treatment of giardiasis can, in individual cases of Crohn's disease, result in a quick recovery from symptoms of high disease activity.
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