Academic literature on the topic 'Heart disease frequency rates in ohio'

AbstractObjectivesDiagnostic ultrasound is widespread in obstetric practice, yet many babies with major congenital heart disease remain undiagnosed. Factors affecting prenatal diagnosis of major congenital heart disease are not well understood. This study aims to document prenatal detection rates for major congenital heart disease in the Greater Cincinnati area, and identify factors associated with lack of prenatal diagnosis.MethodsAll living infants diagnosed with major congenital heart disease by 4 months of age at our centre were prospectively identified. Prenatal care data were obtained by parent interview. Neonatal records were reviewed for postnatal data. Obstetricians were contacted for diagnostic ultrasound data.ResultsA total of 100 infants met the inclusion criteria. In all, 95 infants were analysed, of whom 94 were offered diagnostic ultrasound. In all, 41 had a prenatal diagnosis of major congenital heart disease. The rate of prenatal detection varied by cardiac lesion, with aortic arch abnormalities, semilunar valve abnormalities, and venous anomalies going undetected in this sample. Among subjects without prenatal detection, the highest proportion consisted of those having Level 1 diagnostic ultrasound only (66%). Prenatal detection was not significantly influenced by maternal race, education level, income, or insurance type.ConclusionsDespite nearly universal diagnostic ultrasound, detection rates of major congenital heart disease remain low in southwest Ohio. An educational outreach programme including outflow tract sweeps for community-level obstetrical personnel may improve detection rates.

A ventricular septal defect (VSD) is the most common congenital heart disease, which can be cured with a high probability if it is detected in an early stage. In our previous researches on heart sounds (HSs) analysis, the detection methods of heart disease using the cardiac sound characteristic waveforms in time domain or in frequency domain were proposed, and have been succeed in discriminating several heart murmurs. In this paper, we are going to apply these methods to detect VSD. Based on analysis results, a new approach by using the feature parameters both in time domain and in frequency domain is proposed to achieve higher discrimination rates.

In greater Youngstown, Ohio coronary heart disease (CHD) is the number one cause of death and disability. Moreover, mortality rates from CHD are higher in this region than in any other part of Ohio. In response to the obvious need for risk reduction programs in this area the “Heartscore” program was created. Heartscore is a hospital-based community health promotion effort designed to help decrease the incidence of death and disability resulting from CHD by increasing the public's awareness of risk factors and the ways that they can be controlled. A total of 2,135 people took part in Heartscore. Resources for a comprehensive evaluation of the Heartscore program were scarce, therefore only a limited evaluation of the screening programs was conducted. Even a limited evaluation, however, can produce useful results. This article describes Heartscore giving particular attention to how information gathered during the evaluation of the screenings is being used to fine-tune Heartscore and to plan more specific interventions.

Epilepsy and syncope are clinical conditions with high prevalence rates in the general population, and the differential diagnosis between them is difficult. Objective To assess the frequency of syncope in patients diagnosed with drug-resistant epilepsy (DRE) without apparent heart disease, to investigate the relationship between clinical and electroencephalographic (EEG) changes, and to verify the role of the inclination test (IT). Method An open, prospective study from 2004 to 2006, including 35 consecutive patients from the Epilepsy Program of Hospital Universitário Clementino Fraga Filho who were diagnosed with DRE without apparent heart disease. Results The frequency of syncope was 25.7% (n=9), with a significant prevalence in women. Vasovagal syncope (VVS) was the most frequent diagnosis. Conclusion We found a significant association between syncope and the presence of autonomic symptoms (p=0.005). The IT plays an important role in the differential diagnosis of patients with DRE presenting with autonomic symptoms, regardless of EEG results and brain magnetic resonance imaging (MRI) abnormalities.

Abstract Abstract 477 Background Heavy menstrual bleeding (HMB) is the most common presenting symptom in women with von Willebrand's disease (VWD), reported in 80–90% of patients. The American Congress of Obstetricians and Gynecologists recommends that VWD screening be performed in all adolescents presenting with severe menorrhagia; however, the frequency of VWD screening in clinical practice remains unknown. Combining administrative health claims data and electronic medical records from a large population of Ohio Medicaid-enrolled adolescents, our objectives were to determine the frequency of 1) VWD screening and 2) new patient evaluations at a hemophilia treatment center in adolescents with HMB. We also sought to determine what patient-level factors predicted VWD screening. Methods The data for this study were obtained from Partners for Kids, an accountable care organization providing health care for Medicaid patients in Central (Columbus, OH and surrounding counties) and Southeastern Ohio (rural counties). Our study population included females 10–17 years of age with two or more ICD-9-CM diagnoses of HMB (626.2, 626.3, 626.8) continuously enrolled in Partners for Kids for at least 6 months prior to and 12 months following first diagnosis of HMB. We defined severe HMB as HMB plus one of the following clinical features appearing in the 12 months following first diagnosis: 1) inpatient stay for HMB, 2) iron deficiency anemia (ICD-9 codes 280.0, 280.8, 280.9), or 3) evidence of blood transfusion (CPT code 36430). We extracted data from Partners for Kids regarding patient age, county of residence, inpatient and outpatient diagnoses and procedures, and laboratory testing. By linking patient name and date of birth to electronic medical records at Nationwide Children's Hospital (the pediatric hemophilia treatment center for Central and Southeastern Ohio), we determined which patients had a hematology visit since time of first HMB diagnosis. Results Our study included 673 patients, 16% of whom met study definition for severe HMB. VWD screening occurred in only 10% of the total study population, but was significantly higher (24%) in patients with severe HMB (p <0.001). Patients living in Central Ohio (location of the region's hemophilia treatment center) were more likely to be screened for VWD (OR 2.1, p <0.03) than patients in Southeastern Ohio. When compared to 15–17 year olds, the youngest patients (aged 10–11 years) were more likely to be screened for VWD (OR 3.6, 95% C.I.: 1.6–8.1, p =0.002), and 12–14 year olds were also more likely to be screened than the oldest patients (OR 2.7, 95% C.I.: 1.5–4.8, p =0.001). Fifty-one (7.6%) patients were seen by the regional hemophilia treatment center. Almost 10% of all patients had a diagnosis of iron deficiency anemia, although only 26% of patients were screened for this common complication of HMB. Though only 3% of the study population (11% of the severe HMB population) was diagnosed with a bleeding disorder within 1 year of diagnosis of HMB, over a third of these (36%) were VWD. The prevalence of platelet function defects was similar to VWD. Discussion Despite recommendations by the American Congress of Obstetricians and Gynecologists, VWD screening is performed in a minority of adolescents with HMB, even among those with the most severe disease. Given the low rates of screening, our population reported frequencies of inherited bleeding disorders in adolescents with HMB are likely under-estimates. The low rate of screening for iron deficiency anemia in adolescents with HMB is also of concern. Future studies are needed to identify and overcome barriers to laboratory screening for inherited bleeding disorders in young women with HMB. 1. Laboratory Evaluation and Final Diagnoses in Adolescents with Heavy Menstrual Bleeding Disclosures: O'Brien: GSK: Consultancy, topic not relevant to this paper Other.

Fruit and vegetable consumption is associated with low CHD risk in the USA and Northern Europe. There is, in contrast, little information about these associations in other regions of Europe. The goal of the present study was to assess the relationship between frequency of fruit and vegetable intake and CHD risk in two European populations with contrasting cardiovascular incidence rates; France and Northern Ireland. The present prospective study was in men aged 50–59 years, free of CHD, who were recruited in France (n 5982) and Northern Ireland (n 2105). Fruit and vegetable intake was assessed by a food-frequency questionnaire. Incident cases of acute coronary events and angina were recorded over a 5-year follow-up. During follow-up there was a total of 249 ischaemic events. After adjustment on education level, smoking, physical activity, alcohol consumption, employment status, BMI, blood pressure, serum total and HDL-cholesterol, the relative risks (RR) of acute coronary events were 0·67 (95% CI 0·44, 1·03) and 0·64 (95% CI 0·41, 0·99) in the 2nd and 3rd tertiles of citrus fruit consumption, respectively (P for trend <0·03). Similar results were observed in France and Northern Ireland. In contrast, the RR of acute coronary events for ‘other fruit’ consumption were 0·70 (95% CI 0·31, 1·56) and 0·52 (95% CI 0·24, 1·14) respectively in Northern Ireland (trend P<0·05) and 1·29 (95% CI 0·69, 2·4) and 1·15 (95% CI 0·68, 1·94) in France (trend P=0·5; interaction P<0·04). There was no evidence for any association between vegetable intake and total CHD events. In conclusion, frequency of citrus fruit, but not other fruits, intake is associated with lower rates of acute coronary events in both France and Northern Ireland, suggesting that geographical or related factors might affect the relationship between fruit consumption and CHD risk.

The regularity of heart rates has a loss in cases of illness and aging. Assessing the dynamics of heart rate fluctuations can provide valuable information about cardiac system. In this paper, heart rate fluctuations and its wavelet entropy (WE) are analyzed to demonstrate its potentials for risk stratification of cardiac diseases. The regularity of heart rate fluctuations is estimated by exploiting the time-frequency localization ability of wavelet analysis and the ability of entropy. The results show that WE for patients with congestive heart failure show a very low value and can be completely separated from health subjects. In addition, the values of WE decrease with aging. The lower the values of WE, the higher the risk of heart disease is. The values of WE also reflect the distribution of the energy of heart rhythm. Significant correlations are demonstrated between WE and the power in the three frequency bands. The results have shown that WE can be used to analyze short, non-stationary data time series both in time domain and in frequency domain simultaneously and can be feasible for the discrimination of the differences of heart rate fluctuations between healthy groups and CHF groups as a diagnostic tool.

AbstractBackground:Childhood obesity has increased in the last half of the century. The aim of this study was to evaluate the frequency of obesity in the children with congenital or acquired heart disease.Methods:A total of 1410 children were assessed in this study. The study population was composed of 518 children (289 boys, 229 girls) as control group and 892 children (477 boys, 415 girls) as heart disease group. Patients were grouped into four categories: (I) “Clinic control subjects”; (II) “mild heart disease” that has not been treated with either surgical or catheter intervention; (III) congenital heart disease treated with surgical and/or catheter intervention; and (IV) “arrhythmias”. A body mass index ⩾85th percentile was defined as overweight, ⩾95th percentile as obese, and <5th percentile was defined as underweight.Results:We did not detect any association between heart disease and obesity. There was no difference in the rates of overweight, obesity, and underweight between the healthy control subjects and patients with heart disease (8.1%, 13.3%, and 5.0%; 9.0%, 10.7%, and 4.7%, respectively, p=0.145). All subgroups had a similar prevalence of underweight, overweight, and obesity as the healthy control population. Within the heart disease population, the overall prevalence rates for overweight, obesity, and underweight were similar between the boys and girls.Conclusion:Obesity is a common problem in children with heart disease, at least in general population. It is an important additional risk factor for long-term cardiovascular morbidity and mortality in children with heart disease. Precautions to prevent obesity should be a part of paediatric cardiologist’s examination.

The force-frequency relationship (FFR) is an important regulatory mechanism that increases the force-generating capacity as well as the contraction and relaxation kinetics in human cardiac muscle as the heart rate increases. In human heart failure, the normally positive FFR often becomes flat, or even negative. The rate of cross-bridge cycling, which has been reported to affect cardiac output, could be potentially dysregulated and contribute to blunted or negative FFR in heart failure. We recently developed and herein use a novel method for measuring the rate of tension redevelopment. This method allows us to obtain an index of the rate of cross-bridge cycling in intact contracting cardiac trabeculae at physiological temperature and assess physiological properties of cardiac muscles while preserving posttranslational modifications representative of those that occur in vivo. We observed that trabeculae from failing human hearts indeed exhibit an impaired FFR and a reduced speed of relaxation kinetics. However, stimulation frequencies in the lower spectrum did not majorly affect cross-bridge cycling kinetics in nonfailing and failing trabeculae when assessed at maximal activation. Trabeculae from failing human hearts had slightly slower cross-bridge kinetics at 3 Hz as well as reduced capacity to generate force upon K+ contracture at this frequency. We conclude that cross-bridge kinetics at maximal activation in the prevailing in vivo heart rates are not majorly impacted by frequency and are not majorly impacted by disease. NEW & NOTEWORTHY In this study, we confirm that cardiac relaxation kinetics are impaired in filing human myocardium and that cross-bridge cycling rate at resting heart rates does not contribute to this impaired relaxation. At high heart rates, failing myocardium cross-bridge rates are slower than in nonfailing myocardium.

The development of ultrasound technology to visualize cardiac structures, based on the pioneering work by Edler and Hertz at the University of Lund in Sweden, has literally created a revolution in the field of paediatric cardiology. Before the era of cardiac catheterization and echocardiography the diagnosis of congenital heart disease was mainly based on combining physical findings, cardiac auscultation, electrocardiogram (ECG), and chest X-ray. This was largely based on the work by Helen B. Taussig at John Hopkins in the 1930s who established the field of clinical paediatric cardiology by integrating pathology knowledge with clinical findings. Diagnosis at that time was based on clinical skills and was more an art than science. The introduction of paediatric cardiac surgery in the 1950s was made possible due to the simultaneous development of cardiac catheterization and angiography which allowed an accurate description of the different cardiac lesions and the associated haemodynamics prior to surgery. For a long period catheterization was the diagnostic gold standard and all surgical patients underwent an invasive cardiac evaluation. In the 1970s, echocardiography was developed as a clinical tool and due to its non-invasive nature, was introduced quickly in paediatric cardiology. As anatomical diagnosis is challenging by M-mode echocardiography, it was really the development of two-dimensional (2-D) echocardiography in the late 1970s and early 1980s that deeply influenced the field. For the first time the congenital defects could be imaged noninvasively and the 2-D images were extensively validated by comparing them with pathological and surgical findings. Adding pulsed, continuous, and colour Doppler data to the 2-D images resulted in a complete detailed description of congenital cardiac defects and their haemodynamic consequences. Further optimization of ultrasound technology specifically for paediatric imaging, such as the development of higher-frequency probes and increasing the standard grey-scale frame rates, further improved spatial and temporal resolution and overall image quality. Based on its excellent diagnostic accuracy and its non-invasive nature, echocardiography quickly became the primary non-invasive diagnostic technique for all children with heart disease. Currently every paediatric patient with suspected heart disease will undergo an echocardiographic examination as the first (and often only) diagnostic test.

Supraventricular arrhythmias encompass atrial premature beats, supraventricular tachycardias (SVTs), and atrial fibrillation. SVT is used to describe tachycardias in which the mechanism involves tissue from the His bundle or above, thus including atrial tachycardias, atrioventricular nodal reentrant tachycardia, and atrioventricular reentrant tachycardia due to accessory pathways. Atrial fibrillation is not included among the SVTs and is described elsewhere. The term tachycardia refers to atrial and/or ventricular rates greater than 100 beats per minute at rest. Atrial premature beats, the most common supraventricular arrhythmia, can be seen in Holter recordings in the majority of healthy individuals, and increase in frequency with age and presence of structural heart disease. Paroxysmal SVTs that can be terminated by vagal manoeuvres are usually reentrant tachycardias involving the atrioventricular node, such as atrioventricular nodal reentrant tachycardia or atrioventricular reentrant tachycardia. Symptoms may result in a poor quality of life. Rarely, patients with the Wolff–Parkinson–White syndrome develop atrial fibrillation that may degenerate into ventricular fibrillation in case the anterograde refractory period of the accessory pathway is very short and permanent forms of SVTs result in tachycardiomyopathy with left ventricular dysfunction. Paroxysmal SVT can be terminated by vagal manoeuvres, adenosine, overdrive pacing, and DC cardioversion. Atrial flutter, the most common atrial tachycardia, is a macro-reentrant atrial tachycardia that can be terminated by drugs, overdrive atrial pacing, and DC cardioversion. Most SVTs can be successfully treated by catheter ablation facilitated by modern electroanatomical mapping systems. Long-term antiarrhythmic drug therapy may be required for patients who are not suitable for or cured by catheter ablation.

Cancer is a common cause of morbidity and mortality in the United Kingdom (UK), affecting approximately two out of every five people during their lifetime. In 2015 there was an estimated 2.5 million people in the UK who had had a cancer diagnosis, an increase of almost half a million in the previous 5 years. The proportion of people living longer after cancer is increasing, and the number of people alive more than 5 years from initial diagnosis is predicted to more than double between 2010 and 2030 to 2.7 million. By the end of 2020, more than a thousand people would have been diagnosed with cancer every day in the UK. Cancer can affect all organs of the body with over 200 types identified. However, only a small number of cancer types account for most cases. Over half of all new diagnoses are due to four cancers (in order of frequency)— breast, pros­tate, lung, and bowel. In 2011 there were approximately 50 000 new diagnoses of breast cancer in the UK. The in­cidence of cancer diagnosis is increasing year on year, in part due to improving diagnostic skills, but also because of an increasing elderly population. Cancer of unknown primary origin accounts for about 3% of total cancers. Although UK statistics show a general improvement in the 5-year survival rates for the majority of common cancers, some have not shown any notable improvement. Survival is not only determined by the type of cancer, but also the age at diagnosis, stage, and co- morbidities such as heart, pulmonary, and renal disease, which can affect the treatment regimen. As well as this, certain cancers carry a significantly worse prognosis than others. For example, 10- year survival for pancreatic and lung cancer are 1% and 5%, respectively. In comparison, the 10- year survival for testicular cancer is over 98% and almost 90% in skin con­fined melanoma. Newer diagnostic strategies are expected to detect all cancers early, allowing prompt intervention, and improving both morbidity and mortality rates further. Cancer is a product of mutations in genes involved in controlling cell growth, differentiation, and death (apop­tosis).