1.Evaluation of electrocardiographic left ventricular hypertrophy in community
Linh Huynh Dinh ; Huong Thanh Truong
Journal of Medical Research 2008;54(2):30-33
Background: Left Ventricular Hypertrophy (LVH) has been shown to be a risk factor as well as a consequence of cardiovascular diseases. The importance of an early LVH diagnosis in the community has been desmontrated by many case studies. Objectives: (1) Find out the prevalence of electrocardiographic LVH. (2) Determine the risk factors of electrocardiographic LVH. Subjects and method: 3561 people (1410 men) over 25 years old were chosen from 3 provinces/cities (Ha Noi, Thai Binh, and Nghe An). All participants underwent electrocardiogram, and the Romhilt-Estes score on standard 12-lead electrocardiogram to measure LVH. Diagnosis of LVH was made when Romhilt-Estes score >=4. Data was analyzed by Epi-Info software version 6.04 and SPSS version 13.0. Results: According to JNC 7, there were 744 people with hypertension (352 men), accounted for 21.2%. The rate of hypertension was 24.9% in men and 18.2% in women. This difference was statistically significant (p <0.001). Overall prevalence of electrocardiographic LVH was 6.71% (95% CI: 5.94 \u2013 7.58%). Prevalence was 9.00% among men (95% CI: 7.62 \u2013 10.61%) and 5.21% in women (95% CI: 4.35 \u2013 6.23%). Risk factors of electrocardiographic LVH included male, elderly, hypertension, and obesity. Conclusion: The high prevalence of LVH in the population showed the importance of detection and early treatment for LVH patients, especially in those, who had no clinical symptoms.
Left ventricular hypertrophy
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electrocardiogram
2.Hiroshima General Hospital and Its Involvement in Community Health Care-Especially with Respect to Prevention and Control of Cardiovascular Disorders
Journal of the Japanese Association of Rural Medicine 2003;52(6):899-908
Hiroshima General Hospital dates back to 1947. Initially it was known as the Saiki Hospital affiliated with the Agricultural Association of Hiroshima Prefecture. It had 60 sickbeds and four departments-internal medicine, surgery, otolaryngology and dentistry. In those days, there were a large number of atomic bomb survivors in this medically underserved province of Saiki, so that the hospital was extremely busy treating these hibakushas. With the increase in the number of patients, the hospital kept expanding. It was not until 1979 when the number of beds increased to 270 that the hospital was reorganized and assumed the present name. Since then, it has continued to expand and its medical facilities improved. Having been accredited with the type B general hospital by Japan Council for Quality Health Care, it has now become the nucleus of the health care system in the western part of Hiroshima Prefecture, with 570 beds.By way of illustrating how our hospital has been involved in community health care, we will take a look at the trend of the number of emergency cases admitted at night or on holidays. Up until 1998, the annual number of such cases had stood at somewhere around 4,000 but in 2003 the figure exceeded 10,000. For routine physical checkups, electrocardiograms are used. In 1975, 1,800 patients underwent ECG tests and in 2000 the number leapt to 27,000. This author has taken it upon himself to interpret all these ECG records.The Department of Cardiology in our hospital had made it a rule to conduct noninvasive testing in diagnosis. In 1984, the x-ray examination system to make a diagnosis of circulatory troubles was introduced. In 1988 when the Department of Cardiovascular Surgery was set up, it started employing percutancous transluminal coronary angioplasty (PTCA) procedures and other interventional techniques. At first, coronary artery imaging was preformed on not more than 40 cases annually, but now the number of such cases surpasses 500. Interventional treatment is given to well over 130 cases, 85% of which have stents implanted. The initial success rate of intervention is 90.3% and the rate of restenosis was 35.8%. The cases of A-C bypass grafting performed at the department of cardiovascular surgery are increasing in number. Now the use of skeletonized artery bypass graft surgery with extracorporeal circulation at normal temperature has become standard procedure. By the use of the multi-detector row helical CT (MDCT), we are now studying coronary bypass patency and imaging quality. Except for some cases, it has become possible to obtain three-dimensional reconstruction images comparable to angiocardiographic images in terms of quality. We expect that MDCT will replace catheterization and become a standard noninvasive diagnostic procedure in the foreseeable future.We will adopt new thechniques and new therapeutic methods positively but not blindly placing too much confidence in state-of-the-art technology. Based on the fundamental principles of our hospital, we will devote ourselves to medical care, putting the needs of patients before everything else.
Hospitals
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Hospitals, General
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seconds
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Surgical aspects
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Electrocardiogram