Visualization and analysis of right heart blood flow patterns by contrast echocardiography.

UNLABELLED: The clinical utility of visualization of blood flow patterns across the tricuspid valve (TV) and pulmonary valve (PV) by M-mode contrast echocardiography was studied in 38 patients with documented valvular or congenital heart disease and in 15 controls. Diastolic turbulence was observed in the TV outflow side in three patients with tricuspid stenosis. Turbulent flow was also detected during systole in patients with septal defects (atrial septal defect in four patients and ventricular septal defect in one patient) in the right ventricular outflow tract and in three atrial septal defect patients also in the inflow tract, presumably because of increased volume of flow. Tricuspid regurgitation (11 patients) was characterized by retrograde laminar jet throughout systole, while in pulmonary regurgitation (six patients) retrograde flow was initially laminar although later on it might become turbulent. In pulmonary hypertension (29 patients) antegrade flow occurred approximately to mid-systole and then was interrupted by retrograde laminar flow which contributed to the mid-systolic closure of the pulmonary valve and pulmonary regurgitation in some cases. CONCLUSIONS: contrast echocardiography is a useful technique to analyse right heart blood flow patterns and may aid the diagnosis of various right heart abnormalities.

Diabetes mellitus in an urban population in Jakarta, Indonesia.

The prevalence of diabetes in an urban population in Koja Utara subdistrict of Jakarta is 1.63%. The prevalence of diabetes increases with age. The tendency toward bimodality in the 55-64 age group of our study lends support to the usefulness of the WHO criteria 1980. There is no difference between the sexes. Male to female ratio was 1.2:1. There is a higher prevalence of diabetes among the obese, and the obese and overweight comprise 65.9% of diabetics. Obesity seems to be an important risk factor in the development of diabetes. There was a higher prevalence of diabetes in the high socio-economic level group than in the low one. The group of Chinese origin showed a higher prevalence of diabetes than the other groups. A positive family history of diabetes was found in 27% of our diabetic patients. Dietary recall analysis revealed no significant difference in the percentage of carbohydrate, protein, fat, or in the percentage of refined carbohydrate. However, total caloric intake was significantly higher in the high socio-economic-diabetic group. Total caloric intake seemed to be more important than quantitative dietary factors.