recurrent respiratory papillomatosis uptodate By comparison, the American questionnaire was answered by a little over cardiologists, such total being most probably inferior to the percentage of Romanian respondents if taking into account that the entire US population is 14 times grater than the one of Romania The scores of the cardiologists happiness degree concerning their quality-of-life and the health self rating one were 3.
Both scores were lower compared with the ones reported in the American questionnaire. A high percentage of cardiologists are smokers Least happy with the quality of their lives are the human papillomavirus les symptomes cardiologists, cardiologists having less than 21 paid vacation days a year, those recurrent respiratory papillomatosis uptodate previously worked abroad, those not performing in the academic environment, single ones, those not owning households, recurrent respiratory papillomatosis uptodate those not working in the emergency cardiology field or in that of interventional cardiology.
The least happy cardiologists have a lower BMI and consider themselves healthier than the ones happy or happiest with the quality of their lives.
Data revealed by our analysis lay the grounds for the development of educational activities in the field of cardiovascular disease prevention con- ducted by Romanian Society of Cardiology; such concern should evidently extend more and more among recurrent respiratory papillomatosis uptodate members.
Information collected are useful for evaluating future evolution of the efforts made in the field of educating prevention and can easily be included in the set of valid arguments used by Romanian Society of Cardiology in front of sanitary policy decision makers in support of our plea for improving the quality-of-life recurrent respiratory papillomatosis uptodate the Romanian cardiologists.
Acknowledgements The authors are grateful to Daniela Petri for her skillful assistance and continued support and to Anca Recurrent respiratory papillomatosis uptodate for the English translation of this recurrent respiratory papillomatosis uptodate. Conflict of interest: none declared.
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References 1. Academia Romn. Institutul de Lingvistica Iorgu Iordan. Dictionarul explicativ al limbii romne DEX. Univers Enciclopedic Gold, Bucureti, Mrginean I.
Calitatea vieii n Romnia: prezent i perspective. Calitatea Vieii ; Physician well-being and professionalism. Minn Med. Peckham C. Profiles in happiness: which physicians enjoy life most?
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Wood S. Mar 22, WIN-Gallup International. The Global Index of Religiosity and Atheism Ivan GA.
Echilibrul dintre munc i viaa personal n Romnia. Cauze, efecte i tendine.
European Bank for Reconstruction and Development. The Life in Transition. After the crisis. Institutul Naional de Statistic.
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Romania n cifre Revista Romn de Statistic, Bucureti, Romanian Journal of Cardiology Vol. Burch1, Nathalie Dedieu2 Article received on the 25th of September Article accepted on the 29th of September Abstract: This Almanac highlights recent papers on congenital heart disease in the major cardiac journals.
Over articles are cited. Subheadings are used to recurrent respiratory papillomatosis uptodate relevant papers and allow readers to focus on their areas of interest, but are not meant to be comprehensive for all aspects of congenital cardiac disease.
Data from a central database for 29 population based registries in 16 countries showed a total prevalence of 8 per It was estimated that each year in the European Union 36 children are live born with congenital heart disease and another are diagnosed with congenital heart disease but die as a termination of pregnancy for fetal abnormality.
In a systematic review2 of papers and 24 live births the prevalence of congenital heart disease increased over time from 0. The rate stabilised in the past 15 years but equates to 1. The prevalence was higher recurrent respiratory papillomatosis uptodate Europe than in North America.
An increased risk recurrent respiratory papillomatosis uptodate congenital heart disease was seen with assisted reproductive techniques using data from the Paris Registry of Congenital Malformations3. The higher risk varied with the method of assisted reproductive technique and the type of cardiac abnormality.
The authors speculate that this may be due to the reproductive technology or to the underlying reason for infertility of the couple.
An adult population of patients with typical lesions tetralogy of Fallot and pulmonary atresia and ventricular septal defect was reviewed4.
Twenty patients were already known to have 22q The authors consider that as the syndrome has important clinical and reproductive implications, genetic testing should be considered in all adult patients with tetralogy of Fallot and pulmonary atresia with ventricular septal defect. Tetralogy of Fallot is common in individuals with hemizygous deletions of chromosome 22q TBX1 exons were sequenced in 93 patients with non-syndromic tetralogy5.
Single nucleotide polymorphism analysis was performed in patients with tetralogy, their parents and healthy controls. Three new variants not present in chromosomes from healthy ethnically matched controls were identified.
This study demonstrated that rare TBX1 variants with functional consequences are present in a small proportion of patients with nonsyndromic tetralogy.
The thorny issue of the use and interpretation of genetic tests was reviewed by Caleshu recurrent respiratory papillomatosis uptodate al. Familial transposition of the great arteries was shown to be caused by multiple mutations in the laterality genes7 in a study of seven families. The editorial by Keavney8 considered this a useful step forward recurrent respiratory papillomatosis uptodate understanding transposition.
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Homocysteine is known to be an independent risk factor for congenital heart disease and genetic abnormalities which recurrent respiratory papillomatosis uptodate homocysteine may be expected to influence the incidence of congenital heart problems.
This was demonstrated when a functional variant in methionine synthase reductase intron-1 significantly increased the risk of congenital heart disease in the Han Chinese population9. The paper by Marek et al. There were some particular successes and in recent years antenatal diagnosis of hypoplastic left heart reached Whether the antenatal development of the cardiac chambers is dependent on flow is debated, but an elegant paper by Stressig et al from Bonn11 demonstrated that preferential flow to the right heart in the setting of a diaphragmatic hernia does impair left heart development.
Isolated fetal atrioventricular block recurrent respiratory papillomatosis uptodate reviewed in a retrospective European study of cases No significant effect of treatment with corticosteroids was seen.
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In a multicentre French recurrent respiratory papillomatosis uptodate, patients with non-immune atrioventricular block, diagnosed in utero or up to age 15 years, were followed up long term and showed surprisingly good outcomes, with no deaths or dilated cardiomyopathy at a mean follow-up of In a nonrandomised multicentre study of 20 fetuses exposed to maternal lupus antibodies15 it found recurrent respiratory papillomatosis uptodate treatment with intravenous gamma globulin and steroids potentially improved the outcome for these children, with better than expected survival.
Transplacental drug treatment for fetal tachyarrhythmias was reviewed in a multicentre study17, which hpv ricerca uomo the superiority of flecainide and digoxin; however, the study was weakened by being non-randomised.
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An Italian study on the value of preparticipationscreening of children with ECGs demonstrated that postpubertal persistence of Twave inversion was associated with an increased risk of cardiomyopathy When recurrent respiratory papillomatosis uptodate propose transplantation remains difficult in ambulatory patients. The risk of death and transplantation in paediatric dilated cardiomyopathy was reviewed in a multicentre database, and the authors showed that an increased left ventricular enddiastolic dimension was associated with increased risk of transplantation but not death Work by Giardini et al.
Transplantation recurrent respiratory papillomatosis uptodate congenital heart disease is generally considered higher risk, although encouraging results were shown in a small adult congenital transplant series from the UK An American database review of over a thousand transplants for adult congenital heart disease confirmed the high day mortality, but better late survival after transplantation. Although heart transplants remain a precious resource, at present the recurrent respiratory papillomatosis uptodate justify the continued expansion of adult congenital heart transplant programmes An international database showed that extracorporeal membrane oxygenation does not appear to be a reliable long-term circulatory support for children awaiting heart transplantation Recurrent respiratory papillomatosis uptodate, other options of support exist, and Stiller et al.
Patients with a single ventricle remain a great focus for congenital heart disease resources.
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Many controversies exist about the management of these patients. ACE inhibitors are often used in this complex circulation, recurrent respiratory papillomatosis uptodate Michael Burch, Nathalie Dedieu Almanac congenital heart disease the effects of their vasodilatation are unclear.
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Work in children with bidirectional cavopulmonary shunts demonstrated that enalaprilat did not increase total cardiac output but redistributed flow to the lower body, with a concomitant decrease in arterial oxygen saturation The authors concluded that it is difficult to increase cardiac output in these patients and ACE inhibitors should be used with caution in those with borderline aortic saturations.
This work fits rather well with the results of a randomised multicentre trial, which found administration of enalapril to infants with single-ventricle physiology in the first year of life did not improve somatic growth, recurrent respiratory papillomatosis uptodate function or heart failure severity In a further analysis of their study population, the authors have also recurrent respiratory papillomatosis uptodate that the renin aldosterone genotype influences ventricular remodelling in infants with a single ventricle The late outcomes after the Fontan operation remain a concern.
In some patients there is a progressive failure of the circulationover time, the underlying pathophysiology of which is not fully understood.
In a review of the current evidence for alterations in the pulmonary vasculature in Fontan patients, the potential of treatments approved for pulmonary arterial hypertension.