Chronic Infection, Chlamydia and Coronary Heart Disease

Developments in Cardiovascular Medicine

Book 218
Springer Science & Business Media
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Coronary heart disease (CHD) remains a major cause of human mortality and morbidity worldwide. Classical risk factors for atherosclerosis fail to account fully for the wide variations in CHD prevalence and/or severity between differing populations. The search for hitherto unrecognised risk factors has recently focused on the potential role of chronic inflammation and common infections.
Chronic Infection, Chlamydia and Coronary Heart Disease is the first book to review the wealth of evidence linking various infective agents with CHD, focusing particularly on the proposed pathogenetic role of the main candidate microorganism, Chlamydia pneumoniae.
Written by two leading investigators in the field, the book provides a concise, clearly written and up-to-date account of the diverse lines of evidence - seroepidemiological, pathological, animal and in vitro data and clinical antibiotic trials.
The possibility of an infective basis to atherosclerosis and CHD has already attracted much scientific interest. Chronic Infection, Chlamydia and Coronary Heart Disease highlights the key published works on the topic, and concludes with information on existing, ongoing, and future lines of enquiry.
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Additional Information

Publisher
Springer Science & Business Media
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Published on
Nov 23, 2007
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Pages
146
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ISBN
9780585375984
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Language
English
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Genres
Medical / Cardiology
Medical / Clinical Medicine
Medical / Infectious Diseases
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Content Protection
This content is DRM protected.
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The publication embodied here represents the life work of a premier Russian scientist studying Sudden Cardiac Death. As one can gather from more than 35 first authored publications cited in the References, Dr. Rajskina has been involved with the investigation of mechanisms responsible for Sudden Cardiac Death for over 30 years. She has brought a classical approach to the sub ject, considering the effects of blood supply disturbances, electrophysiological changes that occur after regional ischemia, metabolic alterations, and the role of the autonomic nervous system in modulating these changes. These studies naturally lead to a consideration of interventions, based on her research, to prevent ventricular fibrillation after coronary artery occlusion. This is a wide ranging treatise indicative of a lifetime of study of the problem and filled with the richness of scientific experiments generated in its pursuit. There is so much in here that will be of interest to the arrhythmologist interested in Sudden Cardiac Death, whether this is on a single channel level, in vitro study of hearts, in vivo investigation of intact animals, or at the bedside. And throughout it all, statements are copiously documented with more than 850 references. That alone is worth hours of computer searching. I am very proud to have been asked by this outstanding scientist to write a brief Preface to her monumental contribution. All of us involved in the study of arrhythmic mechanisms responsible for Sudden Cardiac Death can hold Dr.
Accurate diagnosis of arrhythmias is the goal of this volume. Before the clinician can accurately classify the multiple permutations of cardiac rhythm encountered in daily practice, several essential preconditions must be met. At the most basic level, the clinician must know the diagnostic criteria for each rhythm. Without a clear understanding of these criteria, an accurate differential diagnosis is impossible, and without accurate diagnosis, correct intervention is a mere matter of chance.
A second precondition of accurate rhythm diagnosis is an understanding of the mechanism of arrhythmias. Not uncommonly, two or more arrhythmic mechanisms coexist, confronting the clinician with a baffling mixture of apparently unrelated complexes and intervals. Without an understanding of the various arrhythmic mechanisms, simple and complex, the tangled skein of data can never be unraveled.
Finally accurate arrhythmia diagnosis depends on skill attained through practice. The competent electrocardiographer combines the skills of precise measurement and rational application of logic with broad theoretical knowledge. The pleasure of electrocardiography is seeing through the surface appearance to the inner workings.
Interpretation of Cardiac Arrhythmias presupposes no prior knowledge of arrhythmias, and progresses from basic to the complex. The didactic sections focus extensively on the mechanism of arrhythmia, using laddergrams and other diagramatic devices to help the student visualize what is happening with the cardiac conduction system. Extensive self-assessment sections enable students to apply critical skills and test their grasp of the diagnostic criteria.
Cardiac surgery is performed on hundreds of thousands of patients a year, and can have an important beneficial impact on the outcomes of patients with coronary and valvular heart diseases. Despite the favorable recovery of most patients, some will have their post-operative period interrupted by the development of atrial fibrillation, with a host of potential complications including stroke. High risk subgroups may develop atrial fibrillation in more than half of cases, and often despite aggressive prophylactic measures. Treatment of atrial fibrillation and its aftermath can also add days to the hospital stay of the cardiac surgical patient. In an era of aggressive cost cutting and optimization of utilization of health care resources, the financial impact of this arrhythmic complication may be enormous.
Experimental studies have led to a greater understanding of the mechanism of atrial fibrillation and potential precipitating factors in the cardiac surgical patient. Prophylactic efforts with beta-blockers, antiarrhythmic drugs and atrial pacing are being used, or are being investigated in clinical trials. New methods of achieving prompt cardioversion with minimal disruption of patient care, and prevention of the thromboembolic complications of atrial fibrillation, are also important therapeutic initiatives. This text is designed to aid health care professionals in the treatment of their patients in the recovery period after cardiac surgery, and to instigate additional research efforts to limit the occurrence of, and the complications following, this tenacious postoperative arrhythmia.
One of the major biomedical triumphs of the post-World War II era was the defmitive demonstration that hypercholesterolemia is a key causative factor in atherosclerosis; that hypercholesterolemia can be effectively treated; and that treatment significantly reduces not only coronary disease mortality but also all cause mortality. Treatment to lower plasma levels of cholesterol - primarily low density lipoprotein (LDL) cholesterol - is now accepted as best medical practice and both physicians and patients are being educated to take aggressive measures to lower LDL. We can confidently look forward to important decreases in the toll of coronary artery disease over the coming decades. However, there is still uncertainty as to the exact mechanisms by which elevated plasma cholesterol and LDL levels initiate and favor the progression of lesions. There is general consensus that one of the earliest responses to hypercholesterolemia is the adhesion of monocytes to aortic endothelial cells followed by their penetration into the subendothelial space, where they differentiate into macrophages. These cells, and also medial smooth muscle cells that have migrated into the subendothelial space, then become loaded with mUltiple, large droplets of cholesterol esters . . . the hallmark of the earliest visible atherosclerotic lesion, the so-called fatty streak. This lesion is the precursor of the more advanced lesions, both in animal models and in humans. Thus the centrality of hypercholesterolemia cannot be overstated. Still, the atherogenic process is complex and evolves over a long period of time.
The publication embodied here represents the life work of a premier Russian scientist studying Sudden Cardiac Death. As one can gather from more than 35 first authored publications cited in the References, Dr. Rajskina has been involved with the investigation of mechanisms responsible for Sudden Cardiac Death for over 30 years. She has brought a classical approach to the sub ject, considering the effects of blood supply disturbances, electrophysiological changes that occur after regional ischemia, metabolic alterations, and the role of the autonomic nervous system in modulating these changes. These studies naturally lead to a consideration of interventions, based on her research, to prevent ventricular fibrillation after coronary artery occlusion. This is a wide ranging treatise indicative of a lifetime of study of the problem and filled with the richness of scientific experiments generated in its pursuit. There is so much in here that will be of interest to the arrhythmologist interested in Sudden Cardiac Death, whether this is on a single channel level, in vitro study of hearts, in vivo investigation of intact animals, or at the bedside. And throughout it all, statements are copiously documented with more than 850 references. That alone is worth hours of computer searching. I am very proud to have been asked by this outstanding scientist to write a brief Preface to her monumental contribution. All of us involved in the study of arrhythmic mechanisms responsible for Sudden Cardiac Death can hold Dr.
This Symposium is the third of a series of scientific meetings in the field of echocardiology, held at the Erasmus University Rotterdam. * The series was initiated by Klaas Born, who organized the first two meetings with great success. These followed the procedure of two days of parallel sessions with invited speakers only. This time, we decided to broaden the basis of the meeting and have a three-day program of parallel sessions, combining invited papers, free com munications and posters. We decided, however, to maintain one of the most striking features of the last meeting- having the complete proceedings available at the time of the meeting. We confronted the authors-to-be with a very tight schedule in order to make the book a true reflection of the state of the art in echocardiology. As a 'result, editing time was also very limited and neither terminology nor units have been completely standardized. This book has three main parts. The first, and largest, part consists of contributions on echocardiology in adults, and is divided into four sections. The first section is a general survey of various applications, whereas the remaining three centre round specific applications, i.e. ischemic disease, left ventricular function and cardiac valves, respectively. The second part con tains applications in pediatric cardiology; due to the wide variety of topics covered, no particular subdivision has been made. The last part of the book is devoted to instrumentation, methods and new developments.
From one of the country's foremost doctors comes a ground-breaking book about diagnosing, treating and healing Lyme, and peeling away the layers that lead to chronic disease.

You may not know that you have Lyme. It can mimic every disease process including Chronic Fatigue Syndrome, Fibromyalgia, autoimmune conditions like MS, psychiatric conditions like depression and anxiety, and cause significant memory and concentration problems, mimicking early dementia. It is called the "Great Imitator," and inaccurate testing-combined with a fierce, ongoing debate that questions chronic infection-makes it difficult for sufferers to find effective care.

When Dr. Richard Horowitz moved to the Hudson Valley over two decades ago to start his own medical practice, he had no idea that he was jumping into a hotbed of Lyme disease. He would soon realize that many of the chronic disease diagnoses people were receiving were also the result of Lyme-and he would discover how once-treatable infections, in the absence of timely intervention, could cause disabling conditions. In a field where the number of cases is growing exponentially around the world and answers remain elusive, Dr. Horowitz has treated over 12,000 patients and made extraordinary progress. His plan represents a crucial paradigm shift, without which the suffering will continue.

In this book, Dr. Horowitz:

- Breaks new ground with a 16 Point Differential Diagnostic Map, the basis for his revolutionary Lyme treatment plan, and an overarching approach to treating all chronic illness.

- Introduces MSIDS, or Multiple Systemic Infectious Disease Syndrome, a new lens on chronic illness that may prove to be an important missing link.

- Covers in detail Lyme's leading symptoms and co-infections, including immune dysfunction, sleep disorders, chronic pain and neurodegenerative disorders - providing a unique functional and integrative health care model, based on the most up-to-date scientific research, for physicians and health care providers to effectively treat Lyme and other chronic illnesses.

Cutting through the frustration, misinformation and endless questions, Dr. Horowitz's enlightening story of medical discovery, science and politics is an all-in-one source for patients of chronic illness to identify their own symptoms and work with their doctors for the best possible treatment outcome.

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