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The effect of zinc and "Health Belief Model" based education on common cold prevention in soldiers antibiotic associated colitis buy 500mg erythromycin free shipping. Improving immunization rates: initial results from a team-based bacteria beneficial to humans order generic erythromycin on-line, systems change approach antibiotic gonorrhea buy erythromycin in united states online. American Journal of Medical Quality: the Official Journal of the American College of Medical Quality infection virale purchase erythromycin 500mg with mastercard. The effect of a hand-washing intervention on preschool educator beliefs, attitudes, knowledge and self-efficacy. Design of the Jerusalem hand-washing study: meeting the challenges of a preschoolbased public health intervention trial. Clinical decision support and appropriateness of antimicrobial prescribing: a randomized trial. Multi-level intervention to prevent influenza infections in older low income and minority adults. Increasing vaccination rates among health care workers using unit "champions" as a motivator. Framing flu prevention — An experimental field test of signs promoting hand hygiene during the 2009–2010 H1N1 pandemic. Reduction of illness absenteeism in elementary schools using an alcohol-free instant hand sanitizer. The impact of a health campaign on hand hygiene and upper respiratory illness among college students living in residence halls. Tailored interventions to increase influenza vaccination in neighborhood health centers serving the disadvantaged. Dissemination and utilization of an immunization curriculum for middle schools in California. Improving physician coverage of pneumococcal vaccine: a randomized trial of a telephone intervention. Abou-Saleh 2008 Abou-Saleh M, Davis P, Rice P, Checinski K, Drummond C, Maxwell D, et al. The effectiveness of behavioural interventions in the primary prevention of hepatitis C amongst injecting drug users: a randomised controlled trial and lessons learned. Developing an enhanced counselling intervention for the primary prevention of hepatitis C among injecting drug users. Facilitating outpatient treatment entry following detoxification for injection drug use: a multisite test of three interventions. Pilot trial of an intervention aimed at modifying drug preparation practices among injection drug users in Puerto Rico. Examining future adolescent human papillomavirus vaccine uptake, with and without a school mandate. Risk perceptions and behavioral intentions for Hepatitis B: how do young adults farefi. Knowledge of human papillomavirus among high school students can be increased by an educational intervention. A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C. Perceived risk, peer influences, and injection partner type predict receptive syringe sharing among young adult injection drug users in five U. Completion and subject loss within an intensive hepatitis vaccination intervention among homeless adults: the role of risk factors, demographics, and psychosocial variables. The efficacy of social role models to increase motivation to obtain vaccination against hepatitis B among men who have sex with men. Diarrhea prevention through household-level water disinfection and safe storage in Zambia. Randomized controlled trial to determine the effectiveness of an interactive multimedia food safety education program for clients of the special supplemental nutrition program for women, infants, and children. Foodservice employees benefit from interventions targeting barriers to food safety. Healthcare workers compliance with hand hygiene guidelines: findings from a quasi-experimental study in Ireland. Effect of a multifaceted intervention on adherence to hand hygiene among healthcare workers: a cluster-randomized trial. Sociocultural aspects of mass delivery of praziquantel in schistosomiasis control: the Abeokuta experience. A controlled trial of a novel primary prevention program for Lyme disease and other tick-borne illnesses. The use of theory in health behavior research from 2000 to 2005: a systematic review. Using the internet to promote health behavior change: a systematic review and metaanalysis for the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. Improved rates of compliance with hand antisepsis guidelines: a three-phase observational study. Impact of the implementation of rest days in live bird markets on the dynamics of H5N1 highly pathogenic avian influenza. Abstracts of the Interscience Conference on Antimicrobial Agents and Chemotherapy 2005: 45: 326. Changing knowledge, behavior, and practice related to universal precautions among hospital nurses in China. Are we progressing towards elimination of diphtheria, pertussis and tetanus from Nepalfi Improvement of district hospital service system to increase treatment adherence among tuberculosis patients in Pakistan. Southeast Asian Journal of Tropical Medicine and Public Health 2011:42(3): 664-673. Are compulsory immunisation and incentives to immunise effective ways to achieve herd immunity in Europefi. Tailored interventions to introduce influenza vaccination among 6to 23-month-old children at inner-city health centers. Background Behavioural or social theories and models are considered an important tool in effective behaviour change interventions and programmes [1-3]. An explanatory theory helps to describe a problem and to identify why such a problem exists. Models draw on more than one theory and are usually informed by empirical findings [4]. Thus behavioural and social theories have the potential to help identify what changes can take place, explain and support change dynamics, identify key influencers on outcomes and select participants who are the most likely to benefit. The use of behavioural and social theories in health intervention planning and management also improves the prospects for replication, modification and scaling up of effective interventions, and improves the learning that can be derived from practice, whether successful or unsuccessful. Theories and models of behaviour change have been growing in importance to the public health community and health services research, for both communicable and non-communicable diseases [5,6]. More extensive use of theory in internet-based interventions has been found to have a significant effect on health-related behaviours [7] and to improve the effectiveness of tailored print health behaviour change interventions [8]. In the area of prevention and control of communicable diseases, relevant health behaviours to change are likely to be hygiene practices. The evidence base will include only studies published as peer reviewed articles or government/health agency reports, which will meet defined relevance and quality criteria. The scope will be limited to studies in which the intervention or programme is based on a theory or model of behaviour change, and the theory must be identified by the study’s authors (not on an assessment by the reviewers). A Cochrane Library systematic review evaluated contraceptive (including condom) use studies that had a theoretical basis for behaviour change [12]. Screening these would use up much of the resource available to this project and may skew the report findings. Which populations have been targeted and has the population been segmented into sub-populationsfi Did the evaluation assess and report on the applicability of the theory of model, and if so how and what were the findingsfi To what extent was the health behaviour change goal of the intervention or programme metfi What is the evidence for effectiveness of interventions and programmes that use theories and models of behaviour change in changing behaviours to prevent relevant communicable diseasesfi What is the evidence for effectiveness of interventions and programmes that use theories and models of behaviour change in changing behaviours to control relevant communicable diseasesfi Conference abstracts published in a peer reviewed journal are likely to contain too little information to be included, however any conference abstracts found via the search strategy will be assessed using the same inclusion criteria.

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In addition antibiotics for bordetella dogs erythromycin 250mg with visa, the potentially damaging effect of a mass-medication approach on population-wide public health measures for tobacco control antibiotic 875125 order cheap erythromycin online, healthy diets and physical activity need to antibiotics to treat lyme disease cheap 500mg erythromycin free shipping be considered antibiotics for sinus infections in adults cheap erythromycin 250mg online. Commentators are generally agreed on the need for further research on the combination pill, and for continued strong engagement with public health programmes for cardiovascular disease prevention (394, 395). Marketing a polypill directly to individuals without testing, thus avoiding the costs of clinical consultation, risk factor measurement and scoring, and individualized prescription of treatments, sounds tempting, but runs the risk of overtreating people who are at low cardiovascular risk and undertreating people at substantial risk. Use of the polypill to treat people who have been classified according to their total cardiovascular risk does have attractions, as it would simplify selection of drugs and ensure predefined doses. In summary, while a combination pill has some promise as a means of targeted treatment, it raises major challenges that would have to be addressed if it is to meet the claims made for it. Hormone therapy Issue Does hormone replacement therapy reduce cardiovascular riskfi Evidence On the basis of data from observational studies (400), hormone therapy has been used for prevention of cardiovascular disease, osteoporosis and dementia. This practice has been called into question following publication of the results of several randomized clinical trials, which showed no coronary protection, and the Women’s Health Initiative (401), which indicated that long-term use of estrogen plus progestin was associated with increased risks of cancer and cardiovascular disease. A Cochrane systematic review (402) of 15 randomized double-blind trials (involving 35 089 women aged 41 to 91 years) examined the effect of long-term hormone replacement therapy on mortality, heart disease, venous thromboembolism, stroke, transient ischaemic attacks, cancer, gallbladder disease, fractures and quality of life. All were placebo-controlled trials, in which perimenopausal or postmenopausal women were given estrogens, with or without progestogens, for at least one year. The only statistically significant benefits of hormone therapy were decreased incidences of fractures and colon cancer with long-term use. In relatively healthy women, combined continuous hormone therapy significantly increased the risk of coronary events and venous thromboembolism (after one year’s use), stroke (after 3 years), breast cancer (after 5 years) and gallbladder disease. Long-term estrogen-only hormone therapy also significantly increased the risk of stroke and gallbladder disease. In relatively healthy women over 65 years taking continuous combined hormone therapy, there was an increase in the incidence of dementia. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Prevention of recurrent heart attacks and strokes in low and middle income populations. A race against time: the challenge of cardiovascular disease in developing economies. Secondary prevention of non-communicable diseases in lowand middle-income countries through community-based and health service interventions. Risk factors in early life as predictors of adult heart disease: the Bogalusa Heart Study. Combined effects of systolic blood pressure and total cholesterol on cardiovascular disease risk. Joint effects of systolic blood pressure and serum cholesterol on cardiovascular disease in the Asia Pacific Region. Effects of different blood-pressurelowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Effect of statins on risk of coronary disease: a meta-analysis of randomized controlled trials. The effects of blood pressure reduction in older patients: an overview of five randomized controlled trials in elderly hypertensives. West of Scotland Coronary Prevention Study: identification of high-risk groups and comparison with other cardiovascular intervention trials. In: Coronary heart disease: National Service Framework for Coronary Heart Disease – Modern standards and service models. Coronary and cardiovascular risk estimation for primary prevention: validation of the new Sheffield table in the 1995 Scottish health survey population. Primary prevention of heart disease and stroke: a simplified approach to estimating risk of events and making drug treatment decisions. Prevention of coronary heart disease in clinical practice: recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. An adaptation of the Framingham coronary heart disease risk function to European Mediterranean areas. Predictive accuracy of the Framingham coronary risk score in British men: prospective cohort study. Treatment with drugs to lower blood pressure and blood cholesterol based on an individual’s absolute cardiovascular risk. Definition, diagnosis and classification of diabetes mellitus and its complications. American Diabetes Association Standards of medical care for patients with diabetes mellitus. American Heart Association/ National Heart, Lung, and Blood Institute scientific statement. Metabolic syndromes and development of diabetes mellitus: applications and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Relation between the metabolic syndrome and ischemic stroke or transient ischemic attack. A prospective cohort study in patients with atherosclerotic cardiovascular disease. The independent and combined effects of weight loss and aerobic exercise on blood pressure and oral glucose tolerance in older men. Effect of weight loss on blood pressure and insulin resistance in normotensive and hypertensive obese individuals. Effects of exercise and weight loss on cardiac risk factors associated with syndrome X. Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. A calcium antagonist vs non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. Major outcome in highrisk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic. Infiuence of low highdensity lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S. Reduction of cardiovascular events by simvastatin in nondiabetic coronary heart disease patients with and without the metabolic syndrome. Effects of rouvastatin, atrovastatin, and pravastatin on atherogenic dyslipidemia in patients with characteristics of the metabolic syndrome. Nicotinic acid in the management of dyslipideamia associated with diabetes and metabolic syndrome: a position paper developed by a European Consensus Panel. The impact of gender and general risk factors on the occurrence of atherosclerotic vascular disease in non-insulin-dependent diabetes mellitus. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases. Lowering blood pressure: a systematic review of sustained effects of non-pharmacological interventions. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada. Infiuence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Effects of alcohol reduction on blood pressure: a meta-analysis of randomized controlled trials. Long-term non-pharmacological weight loss interventions for adults with prediabetes.

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Outbreaks of febrile gastroenteritis caused by food contaminated with L monocytogenes have been reported antibiotic joint pain cause generic erythromycin 500mg visa. L monocytogenes serotypes 1/2a antimicrobial waiting room chairs buy discount erythromycin 500 mg on-line, 4b fish antibiotics for human uti purchase 250mg erythromycin visa, and 1/2b cause most human cases of invasive listeriosis virus quarantine meaning buy erythromycin 500mg with amex. The saprophytic organism is distributed widely in the environment and is an important cause of zoonoses, especially in ruminants. In 2011, a large outbreak of listeriosis occurred in the United States associated with contaminated cantaloupe. Fetal infection results from transplacental transmission following maternal bacteremia, although some infections can occur through ascending spread from vaginal colonization. The prevalence of stool carriage of L monocytogenes among healthy, asymptomatic adults is estimated to be 1% to 5%. L monocytogenes can be mistaken for a contaminant because of its morphologic similarity to diphtheroids and streptococci. For penicillin-allergic patients, some experts recommend skin testing and desensitization. Multistate outbreak of listeriosis associated with Jensen farms cantaloupe—United States, August–September 2011. For L monocytogenes meningitis, most experts recommend 14 to 21 days of treatment. Longer courses are needed for patients who are severely ill or who have endocarditis or rhombencephalitis. Diagnostic imaging of the brain near the end of anticipated therapy allows determination of parenchymal involvement of the brain and the need for prolonged therapy in neonates with complicated courses, immocomprised patients, and patients with rhombencepalitis. In addition, people at higher risk of listeriosis (pregnant women, older adults, and immunocompromised people) should follow the dietary recommendations in Table 3. Cases should be reported promptly to the state or local health department to facilitate early recognition and control of common-source outbreaks. Ways to reduce risk include: • Cook leftover or ready-to-eat foods (eg, hot dogs) until steaming hot before eating (165°F). Divide leftovers into shallow containers; cover with airtight lids or enclose in plastic wraps or aluminum foil; use leftovers within 3 to 4 days. Early localized disease is characterized by a distinctive rash, erythema migrans, at the site of a recent tick bite. Only a small proportion of children are diagnosed at the stage of early disseminated or late Lyme disease; most of these children do not have a history of erythema migrans. Erythema migrans begins as a red macule or papule that usually expands over days to weeks to form a large, annular, erythematous lesion that typically increases in size to 5 cm or more in diameter, sometimes with partial central clearing. Localized erythema migrans can vary greatly in size and shape and may have vesicular or necrotic areas in its center and can be confused with cellulitis. Fever, malaise, headache, mild neck stiffness, myalgia, and arthralgia often accompany the rash of early localized disease. Approximately 20% of children with Lyme disease come to medical attention with early disseminated disease, most commonly multiple erythema migrans. This rash usually occurs several weeks after an infective tick bite and consists of secondary annular, erythematous lesions similar to but usually smaller than the primary lesion. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Occasionally, people with early Lyme disease have concurrent human granulocytic anaplasmosis or babesiosis, transmitted by the same tick, which may contribute to symptomatology. Late disease is characterized most commonly by arthritis that usually is pauciarticular and affects large joints, particularly knees. Peripheral neuropathy and central nervous system manifestations also can occur rarely during late disease. Children who are treated with antimicrobial agents in the early stage of disease almost never develop late disease. Because congenital infection occurs with other spirochetal infections, there has been concern that an infected pregnant woman could transmit Borrelia burgdorferi to her fetus. No causal relationship between maternal Lyme disease and abnormalities of pregnancy or congenital disease caused by B burgdorferi has been documented. The occurrence of cases in the United States correlates with the distribution and frequency of infected tick vectors—Ixodes scapularis in the east and Midwest and Ixodes pacifcus in the west. In Southern states, Ixodes ticks feed on reptiles rather than small mammals (as in the northeast). Reptile blood is bacteriostatic for B burgdorferi, which explains why the disease is not endemic in the south. Most cases of early Lyme disease occur between April and October; more than 50% of cases occur during June and July. The incubation period from tick bite to appearance of single or multiple erythema migrans lesions ranges from 1 to 32 days with a median of 11 days. Endemic Lyme disease transmitted by ixodid ticks occurs in Canada, Europe, states of the former Soviet Union, China, and Japan. Clinical manifestations of infection vary somewhat from manifestations seen in the United States, probably because of different genomospecies of Borrelia. Diagnosis in patients with early disseminated disease who have multiple lesions of erythema migrans also is made clinically. Diagnosis of early disseminated disease without rash or late Lyme disease should be made on the basis of clinical fndings and serologic test results. Some patients who are treated with antimicrobial agents for early Lyme disease never develop antibodies against B burgdorferi; they are cured and are not at risk of late disease. Development of antibodies in patients treated for early Lyme disease do not indicate lack of cure/persistent infection. Consequently, tests for antibodies should not be repeated or used to assess the success of treatment. The results of serologic tests for Lyme disease should be interpreted with careful consideration of the clinical setting and quality of the testing laboratory. A positive test result of IgM immunoblot requires detection of antibody to at least 2 of the 23/24, 39, and 41 kDa polypeptides. However, interpretation of results of antibody tests of cerebrospinal fuid is complex, and physicians should seek the advice of a specialist experienced in management of patients with Lyme disease to assist in interpreting results. The widespread practice of ordering serologic tests for patients with nonspecifc symptoms, such as fatigue or arthralgia, who have a low probability of having Lyme disease or because of parental pressure, is discouraged. Doxycycline is the drug of choice for children 8 years of age and older and, unlike amoxicillin, also treats patients with anaplasmosis (see Tetracyclines, p 801). Treatment of erythema migrans almost always prevents development of later stages of Lyme disease. Orally administered antimicrobial agents are recommended for treating multiple erythema migrans and uncomplicated Lyme arthritis. Up to one third of patients with arthritis have persistence of synovitis and joint swelling at conclusion of antimicrobial therapy, which almost always resolves without repeating the course of antimicrobial therapy. Final report of the Lyme Disease Review Panel of the Infectious Diseases Society of America. Recommended Treatment of Lyme Disease in Children Disease Category Drug(s) and Dosea Early localized diseasea 8 y of age or older Doxycycline, 4 mg/kg per day, orally, divided into 2 doses (maximum 200 mg/day) for 14–21 daysb Younger than 8 y of age Amoxicillin, 50 mg/kg per day, orally, divided into 3 doses (maxior unable to tolerate mum 1. Central nervous system infection can be treated with parenterally administered antimicrobial therapy, although there is evidence that orally administered doxycycline may be a suitable alternative. The optimal duration of therapy for manifestations of early disseminated or late disease is not well established, but there is no evidence that children with any manifestation of Lyme disease beneft from prolonged courses of orally or parenterally administered antimicrobial agents. Accordingly, the maximum duration of a single course of therapy is 4 weeks (see Table 3. The Jarisch-Herxheimer reaction (an acute febrile reaction accompanied by headache, myalgia, and an aggravated clinical picture lasting less than 24 hours) can occur when therapy is initiated. The overall risk of infection with B burgdorferi after a recognized deer tick bite is 1% to 3% and, even in areas with high endemicity, is suffciently low that prophylactic antimicrobial treatment is not indicated routinely. On the basis of a study of doxycycline for prevention of Lyme disease after a deer tick bite, some experts recommend a single 200-mg dose (4. Patients who have been treated for Lyme disease can be considered for blood donation.

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Worse antibiotics for uti or bladder infection buy generic erythromycin 500 mg on line, the public at large is not taught what to antibiotic handbook cheap erythromycin uk do infection 2 months after surgery buy erythromycin online now, nor inspired sufficiently to bacteria joke purchase erythromycin online act on knowledge to make a difference with their long-term health. The health authorities (government, physicians, and pharmaceutical companies) have grossly misled Americans—and have no effective plan to correct the fatal path most are on. Introduction G 3 Additionally, there is no uniform education in America that fully addresses the causes of cardiovascular disease, which can be reversed with knowledge and application. It is time each family learns the principles of true health on their own, and takes their health into their own hands. You and your family deserve to know what factors contribute to cardiovascular disease (much the same factors behind most all other chronic illnesses as well). What must a person really know—and do—to prevent cardiovascular disease with reasonable certaintyfi Also, what reasonable treatment options are there, both from conventional medical wisdom as well as the natural, non-surgical, non-pharmaceutical onesfi The focus of this report is to answer these questions and get you onto your path of health, happiness, and fulfilled longevity. They bear the force of each heartbeat and therefore must be strong enough to endure approximately 100,000 heart pulsations daily—that’s more than 36 million times each year. The walls of arteries must also be flexible and adjust for varying pressures due to the heart’s variation, gravity changes from bodily positioning, body and blood fluid volume changes, and even variations in blood thickness and acid-base status. Flexible arteries are healthy, while thickened or hardened walls without elasticity are the result of atherosclerosis. The outer layer of your arteries, the adventitia, is a flexible connective tissue that surrounds the next layer—the elastic smooth muscle. The muscle provides the contractile strength to expand and contract with each heartbeat. It is here where damage can occur, leading to clot formation, calcium deposition, and finally, atherosclerotic plaque. Understanding the process of how atherosclerosis develops will give you insight into the many causes and triggers of this disease, which are important to know so you can prevent them. It begins with small areas of damage to the endothelium or as a dysfunction that then causes the endothelium to act like it has been damaged. This allows cholesterol molecules and other proteins in the blood to get inside the endothelium to the basal lamina with a scarring effect, thus setting up for further buildup of plaque. Cholesterol molecules become modified so they are sticky and get incorporated into larger molecules such as immune complexes. These modified cholesterol molecules get digested by fighter white blood cells (an immune reaction) and this leads to further inflammation inside the vessel wall. Smooth muscle cells and the fat-laden, white blood cells make up what is called a “foam cell. This forms a cap over the site of injury, to which calcium accumulates to form a strong bone-like material (the “bricks”). This complex array of foam cells, lipid accumulation, and calcification is called atherosclerotic plaque. Plaques typically become unstable as they grow and rupture, exposing them to the contents of the blood. Clotting proteins and fat accumulate around the ruptured plaque, resulting in a larger clot to which calcium attaches and the plaque grows inside the vessel wall. Large clots and large plaques can easily block the flow of blood to the heart wall muscle causing an acute heart attack. Causes of Atherosclerosis So what kinds of things play a causative role in this process of endothelial damage and dysfunctionfi Let me list several known causes of dysfunction: Infections I Hidden bacterial infections such as Chlamydia Pneumoniae and Helicobacter Pylori. Oxidative stress Endothelium I Free radical molecules are generated by Smooth muscle cell cigarette smoke, radiation, and metal infiltration into the endothelium toxicities (such as mercury). Increased blood turbulence I Increased turbulence of blood flow from thickened blood damages the endothelium, triggering more inflammatory chemicals and clotting factors. More important than maintaining low cholesterol is to minimize the other causes of inflammation that trigger the above causes. For example, poor health habits and normal aging both appear to damage the endothelium such that the endothelium boundary is broken, inflammation begins and abnormal platelet aggregation occurs, and subsequently atherosclerotic lesions form in response to this arterial wall injury. In this report, I will be covering in detail the various health habits that cause inflammation with a focus on how to reverse this disease. Likewise, there are nutrients known to help maintain a 4 5 6 healthy inner arterial lining. It is no coincidence that nutrients which suppress chronic inflammation also protect the endothelium. An Inside Look at the Heart And the Damage from a Heart Attack Your heart is surprisingly small. Your heart’s primary purpose is to pump blood and nutrients 24 hours a day to your more than 300 trillion cells. Your heart contracts and relaxes approximately 100,000 times each day, pumping about 2,000 gallons of blood. Your entire circulatory system is comprised of your heart and the vessels that carry blood from your heart to all other organs and tissues. It also includes your lungs and the veins that carry blood from your lungs back to the heart. And finally, it includes all the other deep and superficial veins, which carry blood back to your heart. If all your blood vessels were laid end-to-end they would measure nearly 75,000 miles—twice the circumference of the earth. Anatomy and Physiology of the Heart the amazing power behind the ability of your heart to continuously beat as described above is its electrical power. It has its own generator of electricity, called the “pace-maker” or sinoatrial (S-A) node, which is located at the top of the right atrium imbedded in the muscle. And from the A-V node, the electrical pulsation spreads throughout the specialized muscle fibers of the heart and valves in a coordinated fashion so as to create a contraction. This contraction creates a perfect sequence so that each chamber of the heart keeps the blood flowing in one direction only. The two weaker chambers, called atria, and the strong muscular-walled chambers, called ventricles, each have a valve that prevents the back flow of blood. You can imagine that when either a valve or the wall of a ventricle gets weak, it wouldn’t take long to cause the symptoms of light-headedness, shortness of breath, or even pain in the chest. Thank goodness for the talented cardiovascular surgeons today that can repair Understanding Cardiovascular Disease, Heart Attack and Stroke G 7 valves, reconstruct vessels, and even transplant Inside the Heart a failing heart! Then there is the regulation and interconnection of your heart with your other Superior organs. For example, the heart is slowed during vena cava Aorta Pulmonary times of relaxation, feeding, or breeding. The artery specialized nerves called the parasympathetic nerve system control this behavior. There are different nerves called the sympathetic nerve Right Left system that cause it to speed up or beat atrium atrium stronger in times of stress, exercise, changes in blood volume, changes in body temperature, and changes in body positioning. There is also a delicate balance of the three main mineral electrolytes that keep Right muscles contracting: Sodium, potassium, and ventricle calcium. Several disease states are known to affect these minerals in the body to the point Left where the heart’s electrical activity and muscle ventricle pumping ability threatens failure. You deserve to know something about the arteries to the heart muscle itself, called coronary arteries. The three main vessels are the right coronary, the left anterior descending, and the circumflex artery. Blockage anywhere along these vessels can cause ischemia (lack of oxygenated blood) and result in damage to the muscle known as myocardial infarction. This can make it weak and vulnerable for pump failure, or can even cause wall motion abnormalities to the point that it goes into “fibrillation,” which can be lethal within minutes if not reversed.

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