The American journal of medicine
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The present appraisal indicates that blood pressure patterns in adolescence differ from those in adulthood and that the design of hypertension detection programs needs to be modified for this age group. Routine blood pressure screening within the school system would appear to be the most effective means for early detection of hypertension. Links with established hypertension clinics, preferably within an adolescent unit, should be forged so that health preservation becomes a meaningful part of the educational process. Although primary hypertension has been documented in the adolescent age group, the incidence is unknown and careful diagnostic evaluation is warranted until our knowledge of its characteristics is more fully expanded.
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Proportions and absolute numbers of T and B lymphocytes were determined among 30 newborn infants and group of 77 elderly patients 60 to 95 years of age. Total lymphocytes in the cord blood of the newborn showed a distinct elevation in total numbers of T and B lymphocytes (p less than 0.005) as compared to that in blood from normal adult controls, reflecting the relative lymphocytosis of infancy. Proportions of cord blood T lymphocytes as reflected by the sheep cell rosette technic were considerable lower than those in lymphocytes from normal adult controls, however, proportions of cord blood T lymphocytes as determined by indirect immunofluorescence were not significantly different from those in controls. ⋯ In addition, there was a broad increment in the incidence of various autoantibodies (anti-nuclear, andi-IgG, antismooth muscle, antimitochondrial and antiparietal cell) among the old people studies. No direct correlation could be determined between relative B-cell percentage increase or T-cell decrease and the presence of various autoantibodies in individual patients. Diminution in total lymphocyte counts as well as absolute numbers of T cells in the elderly may provide the cellular basis for an increased susceptibility to neoplasia and infection.
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Initiation of quick prehospital cardiopulmonary resuscitation and emergency cardiac care completed the total system needed to provide emergency and convalescent coronary care for a community. Subsequently, annual community rates for coronary death during ambulance transport fell by 62 per cent and for prehospital coronary death by 26 per cent in people under 70 years of age. In cardiac arrest due to acute myocardial infarction, prompt successful prehospital correction of ventricular fibrillation and asystole yielded long-term survival in two thirds of cases. ⋯ The present frequency of coronary death during ambulance transport, 9 to 22 per cent of prehospital coronary deaths in this and other surveys, suggests that the prehospital cardiopulmonary resuscitation and emergency cardiac care component needs improvement in many communities. By reducing prehospital and ambulance coronary death rates, prehospital cardiopulmonary resuscitation and emergency cardiac care for acute myocardial infarction constitutes an essential component of the total system approach to emergency coronary care. Since prehospital cardiopulmonary resuscitation and emergency cardiac care have cheaply and effectively expedited and abbreviated hospitalization for acute myocardial infarction, and lowered community death rates from coronary artery disease, its adoption throughout the United States and the western world seems justified.
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Case Reports Historical Article
Acquired bullous disease of the skin and solitary amyloidoma of the lung.