Juha Hakkila

Pericarditis and myocarditis caused by toxoplasma: Report of a case and review of the literature

Abstract The writers have described a case of pericarditis and myocarditis caused by Toxoplasma in a 54-year-old man, who recovered. The diagnosis of toxoplasmosis was based upon a strongly positive dye test and complement fixation test, which showed rising titers during the disease. The cases of pericarditis and myocarditis in acquired toxoplasmosis reported in the literature are reviewed.

Absorption of I131-triolein in congestive heart failure

Abstract The absorption of I 131 -triolein into the blood and the fecal excretion of I 131 activity were studied in seventeen patients with congestive heart failure and twelve control subjects with no congestive heart failure or gastrointestinal disease. The recovery of I 131 -lipid was distinctly smaller and the peak activity occurred later in patients with heart failure than in control subjects. The fecal excretion of radioactivity by these patients after the ingestion of I 131 -triolein was several times the radioactivity excreted by the control subjects. The changes were greatest in patients with severe congestive heart failure and improved as the heart failure became compensated.

Prognostic Value of an Exercise Test One Year after Myocardial Infarction

An exercise test was performed in 306 patients who had had acute myocardial infarction one year previously. The five year cumulative coronary heart disease mortality was 40.0%, when the test had to be discontinued because of ventricular arrhythmias but only 13.0% if discontinued because of fatigue (P less than 0.05). If the maximum work load was less than 80 W the mortality was 30.7% compared with 16.6% in patients who exercised at least 80 W (P less than 0.01). If maximum systolic blood pressure was less than or equal to 150 mmHg mortality was 40.3% compared with 8.5% in patients with greater than 200 mgHg (P less than 0.001). The mortality was 38.2% in patients having single monoform ventricular ectopic beats at a rate of three or more per minute or multiform, paired or early cycle ventricular ectopic beats or ventricular tachycardias: this compared with 14.1% (P less than 0.001) in patients having no or only single monoform ventricular ectopic beats at a rate of less than three per minute. ST-segment depression in univariate testing had no prognostic value. When both exercise test and clinical variables were used in survival analysis (Coxs regression) the most important variable was heart volume and after that ventricular arrhythmias. In multivariate regression analysis ST segment depression also had additional prognostic value. Thus ventricular arrhythmias turned out to be the most important prognostic factor measured during exercise test.

Multifactorial Intervention Program After Acute Myocardial Infarction

In 1973, a project consisting of a rehabilitation and secondary prevention program was started in several European centers coordinated by the Regional Office for Europe of the WHO. The project was based on several years of preparatory work during which various approaches had been discussed. It was eventually agreed to design a study based on a comprehensive multifactorial approach including efficient application of up-to-date knowledge on secondary prevention in patients after myocardial infarction. The study aimed at evaluating the effects of a multifactorial intervention program on mortality and morbidity after myocardial infarction and at contributing to the early physical, psychosocial, and vocational rehabilitation of these patients. Due to lack of standardized methods of assessment, treatment, and evaluation the study was not planned as a tightly controlled multicenter trial but merely a prospective controlled study to be carried out at a national level but with an attempt to pool as much information as possible at the international level. It was anticipated that some of the data, such as those on serum cholesterol, results of an exercise test, etc., could be combined as standardization improved [1].