Apart from cigarette smoking and air pollution, lower respiratory tract infections of viral origin in early childhood are considered to be one of the risk factors for chronic obstructive lung disease. Acute bronchiolitis accounts for the typical disease of the small airways in the first two years of life. 16 symptom-free former patients have been studied 16 to 22 years after an acute attack of bronchiolitis. A complete lung function test was performed with special regard to the small airways. The volume of Isoflow proved to be the most sensitive test. The changes found are considered to be mild. Follow-up will show whether they correlate with an as yet symptom-free stage of a chronic obstructive lung disease.
Introduction: Cardiac Arrest (CA) is a major public health problem associated with high mortality. We aim to assess the demographic and racial trends of mortality associated with CA between 1999 and 2020. Methods: A cross-sectional analysis of the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiological Research database (CDC-WONDER) was conducted to investigate the trends in mortality associated with CA (ICD codes -I46.0, I46, I46.9, and I49.0). Using Joinpoint regression analysis, the study calculated age-adjusted mortality rates (AAMR) per 1,000,000 individuals and corresponding annual percentage changes (APC), along with 95% confidence intervals. Demographic and racial trends were evaluated. Results: 394,021 CA-related deaths occurred from 1999 to 2020. Annual trends show that the AAMR reduced from 8.3 (95% CI 8.2-8.4) in 1999 to 4.7(95% CI 4.6-4.8) in 2020. The overall AAMR from 1999-2018 had an Annual Percentage Change (APC) decrease of -2.0 (95% CI: -2.4 to -1.6). From 2012 to 2020, the APC was 0.4(95% CI: -0.3 to 1). When stratified by sex, males had a worse AAMR at 6.4 (95% CI: 6.4-6.4), and women were found to have an AAMR of 4.5 (95% CI: 4.4-4.5). When stratified by ethnicity, AAMR was highest among African Americans at 9.3 (95% CI: 9.2-9.3), followed by White at 5.0 (95% CI 5.0-5.0), followed by Asian or Pacific Islanders at 3.6(95% CI 3.5-3.7) and American Indian or Alaska Native patients at 3.0 (95% CI2.9-3.2). When stratified by geographical area, Non-metro, rural areas had worse AAMR than urban areas. Conclusions: There has been a general decrease in CA-associated mortality from 1999 to 2012 in the United States. However, since 2012, the mortality has been stable and not improving. Our data shows that the AAMR is worse in men, African Americans, and rural populations. In the setting of no improvement of AAMR since 2012, further research is needed to identify the causes and potential strategies to improve AAMR.
Human Immunodeficiency Virus (HIV) infection is a pandemic with a huge global burden. The mortality due to HIV has been steadily decreasing with better access to highly active antiretroviral therapy and better quality of care. An increase in the life expectancy of HIV infected patients has resulted in the appearance of a different spectrum of diseases due to chronic HIV infection. Though cardiovascular disease due to HIV infection is associated with significant mortality risk, these conditions still remain grossly under diagnosed. This review article discusses the cardiovascular effects of HIV infection and the cardiovascular problems faced due to superimposed opportunistic infections and drug toxicity.
We present a case of Torsade de Pointes secondary to multiple factors including patient susceptibility and iatrogenic influences. Contributing causes are presented, and the approach to treatment is discussed.
