A brief history of cardiac pacing.

The history of cardiac pacing therapy must be viewed within the broader framework of electro-diagnosis and electro-therapy. Moreover it can be observed that the development of electro-therapy usually preceded the understanding of what was actually occurring within the heart.

Electro-therapy has a simple core concept: the use of an outside source of electricity to stimulate human tissue in various ways to produce a beneficial therapeutic effect. This has shown a prolonged, halting development through the ages, sometimes being looked upon as mysterious magic produced by complex machines.

Over the last fifty years or so, electro-therapy has shown a very rapid, almost explosive, development with many innovators contributing to a whole series of "firsts". This was the consequence of a remarkable co-operation among surgeons, physicians, engineers, chemists, businessmen and patients. The field of paediatric open heart surgery gave a major impetus to the development of pacemakers since heart block often accompanied impeccably performed intra-cardiac repairs of congenital defects.

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Varicella (Chicken Pox)

Varicella, also called chicken pox, is a viral disease that rarely occurs in adults as a primary infection. Up to 95% of women in childbearing age have antibodies against varicella virus. Infection of the fetus occurs in 1 to 5 per 10,000 pregnancies and induces a risk of birth defects called varicella embryopathy, to be evaluated prenatally by ultrasound. The manifestations may include microcephaly, chorioretinitis, cataract, microphthalmia, growth retardation, and developmental delay, more scarcely a hypoplastic limb. The risk varies depending on the timing of infection during pregnancy. Congenital varicella only occurs in case of primary infection during the first half of pregnancy. Varicella is more severe during pregnancy and might even be lethal for the mother. If a patient develops varicella 5 days or less before delivery or 1-2 days after delivery, there is a risk of neonatal varicella that can be very severe, and causes infant death in 30% of cases. If the patient develops varicella between 6 and 21 days before delivery, the newborn may develop a varicella, although the infection should be milder as the maternal antibodies partly protect the fetus.

Zinc: an essential micronutrient.

Zinc is an essential micronutrient for human metabolism that catalyzes more than 100 enzymes, facilitates protein folding, and helps regulate gene expression. Patients with malnutrition, alcoholism, inflammatory bowel disease, and malabsorption syndromes are at an increased risk of zinc deficiency. Symptoms of zinc deficiency are nonspecific, including growth retardation, diarrhea, alopecia, glossitis, nail dystrophy, decreased immunity, and hypogonadism in males. In developing countries, zinc supplementation may be effective for the prevention of upper respiratory infection and diarrhea, and as an adjunct treatment for diarrhea in malnourished children. Zinc in combination with antioxidants may be modestly effective in slowing the progression of intermediate and advanced age-related macular degeneration. Zinc is an effective treatment for Wilson disease. Current data do not support zinc supplementation as effective for upper respiratory infection, wound healing, or human immunodeficiency virus. Zinc is well tolerated at recommended dosages. Adverse effects of long-term high-dose zinc use include suppressed immunity, decreased high-density lipoprotein cholesterol levels, anemia, copper deficiency, and possible genitourinary complications.