medical windows

DRIVING GUIDE IN EMERGENCY

noreply@blogger.com (saad elfallah) — Wed, 05 Oct 2011 13:49:20 PDT

DRIVING GUIDE IN EMERGENCY
BRAKE FAILURE OF WORK

* A driver pressing the brake pedal, brake pedal, but continues to touch the floor.
* Pump the brake pedal quickly, to restore the brake pressure.
* In the event failed, gradually hand brake, lower the gear change by using the engine compression to slow the vehicle.
* If the brake to fail to operate while sitting on a hill, to quickly find objects such as bushes beside Road, rail guards and road shoulders, so that the vehicle can be controlled and slow.
* Use the horn and lights to warn other drivers

Vehicle skidded

* If the back of the crashed vehicle, release the accelerator pedal quickly.
* Turn the steering wheel in the direction of the rear crash.
* Do not use the brakes in this situation.

Stuck accelerator

* If the road is safe, try accelerator pedals that are stuck with the tip of your shoe.
* If not, switch off the engine and use the brakes to try to stop the vehicle.
* Hold the steering wheel tightly, so that is not locked when the engine switches off.
* Stop in a safe place immediately and repair the damaged accelerator pedal.
* If unable to contact mechanics.

Bonet OPEN

* Brake gradually.
* Take the road shoulder.
* See through window for the user and stop driving.
* Always make sure that the bonnet is closed after the vehicle moved.

BROKEN WHEEL

* Hold the steering wheel tightly.
* If the rear wheels are broken, will not stabilize the vehicle turned left and right.
* Brake slowly and carefully.
* Brake suddenly cause the vehicle to spin and intractable.
* Take the slow road shoulders in the distribution and safe to change the tire.
* Do not change the tires on the danger area.
* Turn on the emergency lights or placing emergency equipment other that other motorists would know ahead of emergency.

FRONT LIGHT VEHICLE erased

* This incident will limit your view.
* Hold the right direction of movement of the steering wheel to straighten the vehicle and brake quickly without causing the vehicle crashed.
* Take on the shoulder away from the flow of road traffic.
* Stop the vehicle immediately.
* Turn on the emergency lights.
* Recommended for emergency equipment to warn other road users to be more careful.

VEHICLE BURNS

* Incident occurred as a result of short circuit in the electrical system.
* Stop the vehicle immediately.
* Turn off the ignition system and direct the passengers out.
* Open the bonnet and umpilkan burnt wires if possible.
* Use a fire extinguisher.
* If the fire is out of control, leave the vehicle immediately before any mishap occurs and request the assistance of the fire.

HAD TO STOP ON THE HIGHWAY

* Give the signal and exit the highway's shoulder gently.
* Lower front lights were lit during dusk, night and during rain.
* Turn on the lights in the vehicle and emergency lights.
* If the vehicle is stopped at the corner, dipuncak hill or the danger, remove the passengers away from the traffic flow.
* Ensure that emergency equipment is placed within a distance of 5 meters behind the vehicle.
* Lift the bonnet and get help.

BROKEN MIRROR FRONT

* Slow down, increase the interval of the window and stopped in a safe place.
* Expand blanket or cloth on the dashboard and place the broken glass on the blanket or cloth.
* Protect eyes by wearing glasses.
* Replace broken windshield immediately.

TO AN ACCIDENT

* Low speed limit can reduce the impact force.
* Hala Road towards the left shoulder and drive out of the road.
* Sound the horn and turn on your headlights.
* Do not try to turn right kesebelah because motorists might be surprised and hit you.
* Planning and knowledge is important in the action to avoid accidents

Women and Weight: Find a Healthy Balance

noreply@blogger.com (saad elfallah) — Wed, 12 Jan 2011 12:09:25 PST

Weight has become a big issue in this country--no pun intended. Models are super skinny and Women are dying trying to be just a little thinner. At the same time obesity is reported as epidemic and weight loss gurus grow wealthier. Both conditions are detrimental to your health and both can cause health issues specific to women.
Learn your BMI
Body Mass Index (BMI) is a measurement of body fat relative to height and weight. A Healthy BMI lies between 18.5 and 24.9. Under 18 is underweight and 25 to 30 is overweight. A BMI of over 30 is obese. There are free BMI calculators on the internet that are very easy to use. You put in your height and weight and it tells you your BMI. From there it's easy to see where you stand.
The trouble with being too thin
In spite of the old adage, you can be too skinny. If your BMI is under 18, you are too thin. Women who are underweight have less estrogen production. Sometimes their ovaries stop functioning altogether. Without ovarian function, pregnancy is impossible. If pregnancy does occur, the baby will take what it needs from you. If you are underweight to start with, it can put your pregnancy in danger as the baby tries to pull the nutrients from you that aren't there. Long-term, underweight women are at serious risk of osteoporosis and bone fracture.
Obesity has concerns specific to women

Obesity has become one of the greatest health crises in the U.S. today. A BMI of 25 or over means you're overweight and over 30 means you're obese. All overweight people, men and women, are at a greater risk of heart disease and diabetes. But women have concerns specific just to women. Heart disease is the leading cause of death in women in the U.S. That only worsens with obesity. And on top of that, being overweight leads to increased insulin resistance and eventually diabetes. In the presence of insulin resistance, the ovaries will stop ovulating and develop polycystic ovarian syndrome. The fat cells actually produce estrogen. Without ovulation, there is no progesterone to keep the estrogen from being harmful. The high estrogen levels lead to overgrowth of the uterine lining and irregular, heavy vaginal bleeding. Over time, the risk for endometrial cancer grows. Again, without ovulation, pregnancy does not occur. If pregnancy does occur, insulin resistance can result in diabetes and any complications in labor can make for a difficult cesarean section and recovery. After menopause, the continued estrogen levels produced by the fat cells also results in an increased risk of ovarian and breast cancer. Any surgery and recovery for these conditions is complicated due to increased BMI.
A healthy diet--not dieting
As women, we need to be healthy to protect ourselves. That means maintaining a BMI between 18.5 and 25. You can't "go on a diet," you have to have a diet that you can go on. In other words, you have to Find a way to eat healthy and smart all the time. Crash dieting doesn't work because you just return to previous patterns eventually; they're not livable longterm. Always drastically dieting doesn't keep you healthy either. It has to become just a way of eating every day that shows respect for your body and your health. Throw in at least 30 minutes of exercise for 4 to 5 days per week and you'll start to achieve that healthy BMI. So go calculate your BMI and see where you stand. If you're in the healthy range, then keep up the good work--it's a lifetime endeavour! If you need to gain, find a healthy way to add some calories and weight. If you need to lose, find a way that you can live healthier for the rest of your life! Visit the Nutrition.gov website for detailed information about maintaining a healthy diet for you and your family

http://health.yahoo.net

Survivorship: More Than Just a Word

noreply@blogger.com (saad elfallah) — Wed, 12 Jan 2011 11:57:10 PST

For decades, we've measured the success of cancer treatment by statistically tracking the number of people who have been diagnosed with cancer (think of it as the denominator) and the number of people who survive their disease for some period of time (the numerator).
Though More women have become survivors of breast cancer over time, especially in the last decade or so, we need to expand our thinking a bit and consider exactly what surviving this disease means.
In the literal sense (and, yes, that's how the statisticians track this information--you are either dead or alive), what the survival stats don't tell us is how well women are living after a diagnosis of breast cancer.
My point? That surviving the disease is no longer enough. We must start looking at how enjoyable and rewarding that survival time is.
All told, I get more Than 200 emails a day from women with breast cancer, or from family members on their behalf, or from the handful of men who have been diagnosed or are fearful they are about to be. About a quarter of these emails and postings to the Hopkins website, however, happen to be from people whose acute stage of treatment (surgery, chemo, and radiation) is over and done with. The emails of these women who are done with treatment usually don't focus on the diagnosis of their disease or even on treatment; they want to know how and when they are going to start living well again, emotionally and physically.
Women who are still in the throes of the acute stage of this disease are usually so focused on getting rid of it (and who wouldn't be? so was I) that they don't have the time or energy to start thinking about the long-term side effects that might keep lingering on long after treatment is over.
But even once the acute phase of their treatment is completed, about 70 percent of these patients (those who are hormone-receptor positive) will probably still have to take hormonal therapy for another 5 years, longer than the acute treatment itself took. And this long-term hormonal therapy carries a whole new set of side effects that can really blight the quality of life.
And then there are the emotional side effects of having breast cancer and its treatments. Though oftentimes we think of a side effects as being a strictly physical phenomenon (hot flashes, neuropathies, problems with cognitive functioning), an emotional cost awaits survivors as well, which can be quite unrelated to the treatment or the stage of the disease. By this I mean the blows to her self image that the disease delivers, the ways she might now see the world differently, and the challenge of finding her "new normal."
Such emotional side effects, to one degree or another, will upset the sense of psychological wellbeing of virtually every person diagnosed with breast cancer. And yet these non-physical feelings can be hard to quantify and even harder for some family members (like spouses) to grasp. A husband, for example, might be ready to celebrate the long-awaited conclusion of his wife's treatment ordeal--but all she can do is cry and tell him she doesn't feel like celebrating. (She might Just be completely exhausted, or she might fear that celebrating will somehow jinx her and make the disease recur.)
This dread of a recurrence, by the way, either a local recurrence at the original site or a distant recurrence someplace else, is one of the most terrifying parts of breast cancer's emotional fallout. (In the minds of many breast-cancer survivors, a distant recurrence amounts to a virtual death sentence.)
Faced with this array of physical and emotional side effects, breast-cancer survivors are starting to speak up, and they're asking just how wonderful their lives are going to be after breast cancer. As a result, oncology specialists are listening and are calling for more research that's focused on the long-term side effects that so many survivors are suffering through. And researchers today are no longer satisfied to just continue devising better ways to teach patients how to cope, but are starting to look for ways to reduce and even reverse the suffering.
How can we support the women who are coming along behind us? What can we do to help encourage research in this arena? First, talk with your doctors about the quality-of-life issues you and so many other breast-cancer survivors face. Consider joining an advocacy organization, too, and bringing up these concerns in that arena. Ask if they'd consider joining up with researchers to take on the breast-cancer survivor's predicament.
Begin with yourself. Did you assume that when your treatment was completed you would resume your old life and be back to normal again in no time? Which of your present problems do you attribute to your breast-cancer treatment? Did these symptoms take you by surprise or did you know that you were likely going to experience some troubles and setbacks? Of all the physical side effects you've had, which is the most troublesome? And what psychological side effect troubles you the most?
Until we start asking such questions of ourselves, the 85 percent of breast-cancer patients who do survive this disease will continue to see their quality of life decline

source http://health.yahoo.net

Hypoglycemia and Diabetes: Why Low Blood Sugar Can Be Critical

noreply@blogger.com (saad elfallah) — Wed, 12 Jan 2011 11:49:00 PST

Risks for Hypoglycemia

When your Blood glucose levels drop too low, you may feel dizzy, shaky, irritable, sweaty, confused. You may even pass out or have a seizure if low blood glucose is not treated. Some causes may be skipping meals, taking too much diabetes medication, needing a change in medication, or increased activity. My patients with diabetes often say “When my blood Sugar is low I just eat something” or “I get shaky because I have diabetes.” But this may not be correct. Let's look at the proper way to treat hypoglycemia.

Follow the “Rule of 15”
This easy to remember guidance, called the "Rule of 15,"can help keep you safe:
• When you feel symptoms of low glucose, check your blood sugar
• Take 15 grams of fast acting carbohydrate
• Wait 15 minutes; check your blood sugar again
• If glucose is greater than 70 mg/dL then have a snack or the meal you may have missed
• If glucose is still less than 70 mg/dL – then repeat the treatment
• If you still have low glucose after treating a third time then call 911
When you have low glucose you need to eat 15 grams of fast acting carbohydrate such as 4 ounces of juice or 3-4 glucose tablets. Having a candy bar or chocolate is not recommended. These have a high fat content that will increase glucose much more slowly. Instead you need a treatment that will work fast.
Preventing Hypoglycemia includes not skipping meals, talking to your healthcare provider about changes in your medication, and checking your blood sugar regularly
SOURCE : YAHOO HEALTH

Can you fight allergies with local honey?

noreply@blogger.com (saad elfallah) — Tue, 04 Jan 2011 11:08:58 PST

You can barely drag yourself out of bed. Winter is gradually receding back into the closet of seasons once again, and you're painfully aware that spring is up next. You find the thought of facing another sunny, upbeat vernal equinox when nature bursts to life anew once more too depressing for words.
It's seasonal allergies. All of those beautiful, fragrant flowers and deep green grasses that allergy-free people just love to coo over and pick and prune literally make you sick. Springtime is when trees and plants spread their seeds -- at least the pollen that becomes seeds. And that pollen wreaks havoc on your body whenever you take a breath outside.
You're hardly alone. The Food and Drug Administration (FDA) estimates around 36 million people in the United States alone suffer from seasonal allergies, known also by the common name of hay fever and the more technical name allergic rhinitis [source: FDA]. It may not improve your mood to know this, but all that pollen is actually harmless. Those months of runny nose, scratchy eyes and headaches you endure each spring is actually the result of a case of mistaken identity. Your body mistakes pollen for damaging invaders like fungal spores and dust mites. This triggers the release of histamine, a natural chemical that's part of an immune system response. Histamine causes inflammation and irritation of soft tissue, which leads to your suffering [source: Bupa].

Can my vacuum help me fight mattress allergens?

noreply@blogger.com (saad elfallah) — Tue, 04 Jan 2011 11:04:37 PST

Are you one of the estimated 50 million Americans who suffer from allergies? More than half of all Americans have an allergic response to at least one substance, and more than half of American homes have six (or more) common, detectable allergens [source: American Academy of Allergy Asthma & Immunology]. Along with animal dander, dust, mildew and mold spores, dust mites are one of the most common triggers of indoor allergies and asthma. Indoor allergies are usually caused by small particles that we inhale, and because dust mites are microscopic, you’ll find them even in the cleanest of homes. They like to eat the dead skin cells that flake off of us as we go about our day — we shed about 0.05 ounce (1.5 grams) of skin every day, which will feed about one million hungry dust mites [source: Asthma and Allergy Foundation of America].
So where does this huge mite population live? They live, eat, breed and die in our sofas, chairs, carpeting, curtains, bedding and mattresses. Mites have a short life span, and in just 3 weeks, a new generation of dust mites will inhabit all your stuff.
Unlike bedbugs, dust mites don’t bite — it’s the protein in their waste products (decaying dust mites as well as dust mite fecal matter) that can trigger an allergic response in an estimated 18 to 30 percent of Americans [source: Johannes]. While keeping them at bay may seem impossible, there are ways to minimize your exposure.
Let’s look at the bedroom, since it’s where we spend most of our time. If you sleep eight hours each night, that’s about 3,000 hours a year in bed. Keeping your mattress free from dust mites is key to waking up feeling refreshed rather than sneezy and tired. Encasing your mattress and pillows in allergen-proof covers, and washing and drying all bedding on your appliances’ hottest settings — the water needs to be at least 130 degrees F to kill dust mites — every week is one of the best ways to reduce allergens in your bed.
Vacuuming your mattress, however, may not do as much to relieve a dust mite problem as you may hope. As it turns out, mites are hearty — not only can they survive a trip through the wash if the water isn’t hot enough, they can also survive your attempts at vacuuming them up. As many as 95 percent of dust mites continue to lead their lives after you’ve tried to vacuum them from your mattress [source: Asthma and Allergy Foundation of America]. How can this be? Because they don’t live on the surface; rather, they live deep within the stuffing of the mattress.
While vacuuming your mattress isn’t very effective in reducing mattress allergens, people who suffer from allergies should try using HEPA (high-efficiency particulate) filters when vacuuming carpets, curtains and other items that are mite-friendly but not stuffed.

Are we more worried about food allergies than we should be?

noreply@blogger.com (saad elfallah) — Tue, 04 Jan 2011 10:59:06 PST

Of the many things parents are encouraged to freak out about, the fear that a peanut will cross their toddler's lips is way up there. Parents are told not to let their kids have peanut products before age 3, due to the risk of the child having a serious or even fatal allergic reaction.
As if peanuts weren't getting enough bad press in the 24-hour news cycle, alongside the inflated dangers of shark attacks and cell phones, a 2009 salmonella outbreak with origins in a Georgia peanut plant killed nine and left hundreds of consumers sick, prompting a massive recall of peanuts by the U.S. Food and Drug Administration (FDA). By this time, the lethality of the common peanut became part of the American public consciousness.
In recent years, there has been growing alarm over food allergies -- especially allergic reactions to peanuts -- in children. Fatal allergic reactions in children at school have raised concern in parents and school administrators alike. Currently, around 1 in 3 schools ban some type of food for allergy reasons [source: Broussard]. Congress has gotten involved with the creation of an act -- the Food Allergy and Anaphylaxis Management Act of 2009 -- that calls for schools to act in ways that counter the risk of serious food allergy reactions. Some professional sports teams have even sponsored "no-peanut night" promotions.

Simultaneous with the increase in warnings about food allergies is an effort to develop treatments for them. Should a new drug be developed that can protect people -- especially children -- against food allergies, its use could prove literally to be a lifesaver, and the new drug would almost be guaranteed to meet a very receptive and concerned consumer population of parents.
While food allergies are certainly of great concern, there have been questions regarding the methodology and even possible manipulation of statistics in order to heighten the sense of worry, thus creating more demand for a treatment.
And if you've seen someone have a serious food allergy reaction, you wouldn't doubt the potential danger. Reactions can cause the allergic person to develop hives, have difficulty breathing and require emergency medical attention. There are about 150 deaths each year caused by various food allergies [source: Schwartz].
So what causes food allergies? Continue reading to find out.

Device Approved for Dangerous Vessel Bulge

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:58:54 PST

TUESDAY, Dec. 21 (HealthDay News) -- Medtronic's Endurant AAA Stent Graft system, designed to treat a bulge in the largest abdominal blood vessel, has been approved by the U.S. Food and Drug Administration, the company said Tuesday.
An aneurysm is a bulging portion of a blood vessel that threatens to rupture. Some 1.2 million people have an abdominal aortic aneurysm, which typically causes no symptoms, Medtronic said in a news release. About 70 percent to 90 percent of such patients die if the aneurysm ruptures, the company added.
The newly approved device is a flexible wire frame sewn into a fabric tube. It's implanted in the weakened portion of the aorta, reducing pressure on the aneurysm and diminishing the risk of rupture.
The device is delivered via catheters that are inserted in blood vessels in the groin, Medtronic said.
More information
The U.S. National Library of Medicine has more about this condition.

SABCS: Aromatase Inhibitors Linked to Heart Disease Risk

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:57:19 PST

Postmenopausal women who undergo breast cancer treatment with aromatase inhibitors appear to be at an elevated risk of cardiovascular disease, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.
THURSDAY, Dec. 9 (HealthDay News) -- Postmenopausal women who undergo breast cancer treatment with aromatase inhibitors appear to be at an elevated risk of cardiovascular disease, according to a study presented at the annual San Antonio Breast Cancer Symposium, held from Dec. 8 to 12.
In a meta-analysis, Eitan Amir, M.D., of the Princess Margaret Hospital in Toronto, and colleagues evaluated data from seven large randomized clinical trials that compared tamoxifen with aromatase inhibitors in postmenopausal women with early-stage breast cancer. The investigators also evaluated whether switching from treatment with tamoxifen to aromatase inhibitors had any effect on adverse events.
The investigators found a 20 percent higher probability of developing cardiovascular disease and a 48 percent higher risk of fractures associated with any duration of any aromatase inhibitor used; aromatase inhibitor use was tied to a reduced risk for venous thrombosis and endometrial carcinoma (odds ratios, 0.53 and 0.32, respectively). The investigators also found that the risk of serious adverse events was similar among those who were initially treated with aromatase inhibitors and those who switched to aromatase inhibitors after treatment with tamoxifen.
"However, it appears from the data -- and this is strictly hypothesis-generating -- that if a woman switches from one drug to another, there is a reduction in the risk from death from causes other than breast cancer," Amir said in a statement. "This potentially suggests that there may be side effects that build up the longer a woman is on a certain drug, but switching drugs may reduce the side effects."

The Radiological Society of North America, Nov. 28-Dec. 3, 2010

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:56:02 PST

The Radiological Society of North America's 96th Scientific Assembly and Annual Meeting took place Nov. 28 to Dec. 3 in Chicago and attracted over 50,000 participants, including radiologists, radiation oncologists, physicists in medicine, radiologic technologists, and allied health care professionals from around the world. The conference highlighted recent advances in radiology, with 1,769 scientific papers presented in 16 subspecialties as well as 232 refresher courses, 1,915 education exhibits, and 679 scientific posters.
In one study, Alexander P. Lin, Ph.D., of Brigham and Women's Hospital in Boston, and colleagues found that magnetic resonance spectroscopy may help diagnose chronic traumatic encephalopathy (CTE), a condition caused by repetitive head trauma that currently can only be diagnosed upon autopsy. The investigators evaluated five retired professional athletes, including football, wrestling, and boxing professionals, with a history of concussions and cognitive symptoms associated with CTE, as well as age- and size-matched controls, aged 32 to 55 years.
"Currently, CTE can only be diagnosed after death. It is therefore imperative that we develop objective, noninvasive, diagnostic tests to stratify the risks of repetitive head injury. This study is an important first step in that direction by showing chemical changes in the repetitively-injured brain using the 'virtual biopsy' technology," Lin said.

U. Joseph Schoepf, M.D., of the Medical University of South Carolina in Charleston, and colleagues found that patients with obstructive sleep apnea (OSA) appear to have an increased risk of developing a more aggressive form of atherosclerosis. The investigators evaluated 49 obese patients (mean age, 61 years) with OSA and a mean body mass index (BMI) of 33 kg/m², and 46 obese patients without the condition (mean age of 60 years and mean BMI of 30 kg/m²), using coronary computed tomography angiography (cCTA).
The data revealed that patients with OSA had a significantly higher prevalence of non-calcified and mixed plaques compared to patients without the condition.
"cCTA is an effective way to noninvasively diagnose non-calcified and mixed plaque," Schoepf said in a statement. "With technological advancements that are lowering the radiation dose required for cCTA, this exam could become a screening tool for obese individuals at increased risk for cardiovascular disease."
Schoepf disclosed financial relationships with pharmaceutical and medical device companies.

In another study, Thomas M. Link, M.D., of the University of California in San Francisco, and colleagues found that light exercise, particularly frequent walking, may protect against cartilage degeneration in individuals with risk factors for osteoarthritis. The investigators evaluated more than 130 asymptomatic participants at risk for knee osteoarthritis who were enrolled in the National Institutes of Health Osteoarthritis Initiative, as well as 33 age- and BMI-matched controls, aged 45 to 55 years. The participants were separated into three exercise levels and strength-training groups. Exercise levels included sedentary, light exercisers, and moderate to strenuous exercisers, and strength-training groups included none, minimal, and frequent.
"The key result was that light exercise was associated with healthier cartilage in middle-aged people at risk for osteoarthritis," Link said. "In addition to light exercise, we found that frequent knee bending activities -- including more than 30 minutes of deep knee squats, more than 30 minutes of kneeling, or climbing more than 10 flights of stairs every day -- were associated with more degenerative cartilage using T2 magnetic resonance imaging. We not only found this in people at risk for osteoarthritis but in healthy people as well."
Link disclosed a financial relationship with Merck and Co.

RSNA: Annual Mammogram May Reduce Mastectomy Risk
WEDNESDAY, Dec. 1 (HealthDay News) -- Women between the ages of 40 and 50 who undergo a yearly mammogram appear to have a lower risk of mastectomy following breast cancer, according to a study presented at the annual meeting of the Radiological Society of North America, held from Nov. 28 to Dec. 3 in Chicago.

RSNA: Visceral Body Fat Tied to Poor Bone Health
TUESDAY, Nov. 30 (HealthDay News) -- Increased visceral body fat appears to be negatively associated with bone health, potentially serving as a risk factor for osteoporosis among premenopausal women, according to a study presented at the annual meeting of the Radiological Society of North America, held from Nov. 28 to Dec. 3 in Chicago.

RSNA: Walking May Reduce Cognitive Decline
MONDAY, Nov. 29 (HealthDay News) -- Walking appears to slow cognitive decline in healthy individuals as well as those with mild cognitive impairment (MCI) or Alzheimer's disease, according to a study presented at the annual meeting of the Radiological Society of North America, held from Nov. 28 to Dec. 3 in Chicago.

RSNA: Computed Tomography Use in Emergency Room Up
MONDAY, Nov. 29 (HealthDay News) -- The use of computed tomography (CT) in the emergency department has increased at a higher rate than CT use in other clinical settings, according to a study published online Nov. 29 in Radiology to coincide with presentation at the annual meeting of the Radiological Society of North America, held from Nov. 28 to Dec. 3 in Chicago.

RSNA: MRI Benefits Women With Breast Cancer History
MONDAY, Nov. 29 (HealthDay News) -- Women with a personal history of breast cancer may benefit from annual magnetic resonance imaging (MRI) screening in addition to mammography, according to a study presented at the annual meeting of the Radiological Society of North America, held from Nov. 28 to Dec. 3 in Chicago.

Negative Aspects of Social Relations Tied to Angina Risk

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:53:22 PST

Negative aspects of social relations, including excessive demands and serious worries from significant others, children, or family members, appear to be risk factors for the development of angina pectoris, according to a study published online Dec. 22 in the Journal of Epidemiology and Community Health.
THURSDAY, Dec. 23 (HealthDay News) -- Negative aspects of social relations, including excessive demands and serious worries from significant others, children, or family members, appear to be risk factors for the development of angina pectoris, according to a study published online Dec. 22 in the Journal of Epidemiology and Community Health.
During a six-year follow-up, Rikke Lund, M.D., of the University of Copenhagen in Denmark, and colleagues evaluated 4,573 middle-aged Danish men and women free of heart disease at baseline to assess whether the negative aspects of social relations were associated with angina pectoris.
The investigators found that 9 percent of participants experienced onset of symptoms of angina pectoris. After adjustment for age, gender, social class, cohabitation status, and depression in a dose-response manner, the investigators found that a higher degree of excessive demands or serious worries from social relations was associated with an increased risk of angina pectoris, including from a partner (odds ratio [OR], 3.53), child (OR, 2.19), or other family member (OR, 1.91). The researchers did not find any interaction of negative aspects of social relations with age, gender, cohabitation status, social class, or depression in terms of angina pectoris.

Fetal Antiretroviral Exposure Impacts Cardiac Development

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:52:11 PST

Fetal exposure to antiretroviral therapy appears to be associated with increased left ventricular (LV) fractional shortening and contractility as well as reduced LV mass, septal thickness, and LV dimension, especially in girls, according to a study published in the Jan. 4 issue of the Journal of the American College of Cardiology.
THURSDAY, Dec. 23 (HealthDay News) -- Fetal exposure to antiretroviral therapy (ART) appears to be associated with increased left ventricular (LV) fractional shortening and contractility as well as reduced LV mass, septal thickness, and LV dimension, especially in girls, according to a study published in the Jan. 4 issue of the Journal of the American College of Cardiology.
In the National Heart, Lung, and Blood Institute Cardiovascular Status of HAART Therapy in HIV-Exposed Infants and Children Cohort Study, Steven E. Lipshultz, M.D., of the University of Miami Miller School of Medicine, and colleagues compared echocardiograms taken between birth and 24 months among 136 infants exposed to ART (ART+) and 216 not exposed to the treatment (ART−).
Compared to ART− girls, the investigators found that mean LV mass z-scores were consistently lower in ART+ girls. Differences in mean z-scores were −0.46 at birth (P = 0.005), −1.02 at six months (P < 0.001), −0.74 at 12 months (P < 0.001), and −0.79 at 24 months (P < 0.001). Among boys, the corresponding differences in z-scores were 0.13 at one month (P = 0.42), −0.44 at six months (P = 0.01), −0.15 at 12 months (P = 0.37), and −0.21 at 24 months (P = 0.21). While septal wall thickness and LV dimension were smaller than expected in ART+ infants, LV contractility was consistently about one standard deviation higher in all age groups. LV fractional shortening was higher among ART+ infants compared to ART− infants, with girls demonstrating a greater difference.

Metabolic Syndrome Increases Risk of Hyperuricemia

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:50:19 PST

Patients with metabolic syndrome who have hyperuricemia are at increased risk of myocardial infarction and sudden cardiac death, according to a report published in the Dec. 15 issue of The American Journal of Cardiology.
FRIDAY, Dec. 24 (HealthDay News) -- Patients with metabolic syndrome (MetS) who have hyperuricemia are at increased risk of myocardial infarction (MI) and sudden cardiac death, according to a report published in the Dec. 15 issue of The American Journal of Cardiology.
Yafim Brodov, M.D., Ph.D., from the Rambam Health Care Campus in Haifa, Israel, and colleagues studied 2,963 patients aged 45 to 74 with coronary artery disease. Of the total number of patients, 1,410 had MetS. All the patients were followed for an average of six years to determine the incidence of the primary end point, defined as the first occurrence of an MI or sudden cardiac death.
The researchers found that 20.1 percent of MetS patients had hyperuricemia, compared to 11.4 percent of those without MetS. Additionally, MetS patients with hyperuricemia suffered higher rates of MI and sudden cardiac death (20.1 percent) compared to MetS patients without hyperuricemia (15.3 percent). The researchers determined that MetS patients with hyperuricemia had a 45 percent risk of suffering an MI or sudden cardiac death.
"The major finding of this study is that the incidence of the primary end point in patients with MetS appears to be higher than in patients without MetS, especially if the patients are hyperuricemic," the authors write.

Chronic Statin Use Reduces Post-Op Cardiovascular Events

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:48:57 PST

Preoperative statin therapy appears to reduce the risk of cardiac and vascular adverse events after major vascular surgery, as well as lowering the mortality risk in cases of major adverse events, according to research published in the January issue of Anesthesiology.
WEDNESDAY, Dec. 29 (HealthDay News) -- Preoperative statin therapy appears to reduce the risk of cardiac and vascular adverse events after major vascular surgery, as well as lowering the mortality risk in cases of major adverse events, according to research published in the January issue of Anesthesiology.
Yannick Le Manach, M.D., of the Assistance Publique-Hôpitaux de Paris, and colleagues assessed the impact of statin therapy versus no statin therapy on adverse outcomes in 1,674 patients undergoing aortic reconstruction.
The researchers found statin therapy to be associated with a near three-fold and near two-fold reduction in the risk of death and myocardial infarction, respectively, for patients undergoing major vascular surgery. Chronic statin therapy was also associated with a lesser risk for postoperative stroke and renal failure, but did not appear to significantly reduce the risk of pneumonia, multiple organ dysfunction syndrome, or surgical complications. Reduced mortality was observed in cases of surgical complications and multiple organ dysfunction syndrome.
"Chronic statin therapy was associated with a reduction in all cardiac and vascular outcomes after major vascular surgery. Furthermore, in cases of major adverse events, such as multiple organ dysfunction syndrome and surgical complications, statins were also associated with decreased mortality," the authors write.

Wolff-Parkinson-White Syndrome and the Risk of Sudden Cardiac Death

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:47:27 PST

Wolf-Parkinson-White (WPW) will turn up on occasion in the office of a family or general practitioner, and the response to this finding will vary depending upon the experience (specific to the condition) of the provider and the symptoms, if any, of the patient.

WHAT IS IT?

WPW is a specific derangement of nerve conduction tissue in the heart. First and always there is an accessory bypass tract, a redundant pathway named, when present, the bundle of Kent, that runs from the atria to the ventricles, bypassing the atrioventricular (AV) node (the normal pathway for conduction of sinus rhythm). This, in and of itself, would probably cause few or no significant problems, but it is very often accompanied by a “looped” additional reentrant pathway nervous tissue which can – and usually will – cause intermittent reentrant tachycardia (supraventricular tachycardia) and less frequently, atrial fibrillation (AF). It is these arrhythmias, and especially the latter, which are the major concern.

HOW IS IT RECOGNIZED?

WPW is a “cooperative” disorder, since it usually produces some degree of delta wave caused by a shortened P-R interval, so that the ascending R wave appears stretched back toward the P wave and is usually a very distinctively asymmetric delta shape, thus the name. This is peculiar to WPW, and is not seen in the rare Lown-Ganong-Levine (LGL) syndrome, which is in other respects similar, but with more subtle EKG abnormalities.

SYMPTOMS

When symptoms are present and recognized they are usually in the form of palpitations, rapid, pounding pulse, fluttering in the chest, vague chest discomfort, lightheadedness, fainting, and in relatively rare instances, sudden death. Very often the condition is discovered without there being any reported symptoms, in the course of a routine office exam.

SUDDEN CARDIAC DEATH

WPW is significant for decreased quality of life in the form of the above symptoms, which obviously range from the fairly trivial to the catastrophic. The problem arises first in recognizing the condition or syndrome, and second in choice of management. While many practices feel aggressive therapy is wasteful unless there are symptoms, and because dangerous manifestations tend, statistically, to diminish to zero occurrence beyond the age of 34-40 (a dubious and strictly anecdotal assumption not often referenced anymore), there is a school – which includes some of the more prestigious medical centers, that believes the risk of sudden cardiac death (SCD), at 0.6 percent, is sufficient to treat or eliminate the problem at the earliest age practical.
WPW can show up at any age but is usually discovered between adolescence and early adulthood, when the patient is inordinately at risk for SCD because of a much more active lifestyle, involvement in sports and vigorous play, all with consequent rapid sinus rates and increased oxygen debt. These two factors make young people particularly vulnerable to an unexpected episode of reentrant tachycardia or, most seriously, AF. While exercise does not seem to be a specific trigger, the random appearance of AF is always dangerous when seen in the setting of WPW, and especially so during exertion, because that accessory bypass tract allows the atrial rhythm, whatever it may be, to conduct directly to the ventricles without passing through the “braking system” provided by the AV node. AF may occur at rates of 150-300 beats per minute and be extremely chaotic. If such a rhythm is conducted directly to the ventricles, it is, in effect, arriving as ventricular fibrillation (VF) and that rhythm may, in fact, result in very short order. Even without a rapid exercising pulse and oxygen debt, then, such an occurrence may overwhelm the larger, slower ventricles and throw them into a lethal rhythm.

CONSIDERATIONS

If medicine is to be strictly statistics-driven, then a 0.6 percent chance of anyone dying from a sudden, lethal arrhythmia, becomes academic. Will a parent be willing to accept this level of risk for his/her child? Will a reasonable adult be able to understand the relevance of this statistic added to the baseline potential of a random life-threatening arrhythmia? And most importantly, will a physician not specializing in cardiology be appreciative of the concentration of this admittedly small risk in the young and vigorous? Is any such additional risk, if easily eliminated, worth being allowed to run its course till the anecdotal “safe” age cutoff? Many major medical centers in the United States feel the answer is no. This cardiology technician also says no, with experience both in the clinical and field settings to back up this contention. The Mayo Clinic says no. The University of Birmingham, Alabama, Medical Center says no. Many individual practitioners are not willing to take this chance either, especially now that the concentration of risk is understood and because of the relative ease with which the condition can be managed or obliterated.
Still, there are those practitioners who hew to the school of thought that patient and family should not “get too excited” about what is, statistically, a fairly benign condition.

REFERAL AND MANAGEMENT

It is the writer’s conviction that any patient of any age who exhibits what may be delta waves on resting EKG should be referred to cardiology for a definitive diagnosis and decision as to management or treatment. The risk of having one patient die unnecessarily is simply too great and the cost-effectiveness of risk stratification too petty to ignore this finding, especially since the problem can well run in families and is often found in siblings and first cousins once it is uncovered in a given patient.
Management of the possible adverse or terminal event is usually accomplished, at least temporarily, by use of beta blocker drugs. Properly chosen, these can effectively slow the rate of tachyarrhythmias enough to prevent sudden death, while not slowing the overall cardiovascular response to exercise, though this can sometimes be a tradeoff, in which case the life of the patient must be weighed against medical therapy.
Fortunately there is another approach which is highly successful in obliterating the problem entirely: radiofrequency (RF) ablation of the accessory bypass tract.
Just as with other atrial and some ventricular arrhythmias, RF ablation can be used to test, reproduce, and in the case of WPW usually very simply sever the bypass tract permanently so there is no longer any risk of transmission of rapid, irregular heartbeats to the ventricles. The reentry loop or loops may also be found and ablated via this method, so that the patient will be relieved of even the risk of disruption of activity by these then less-dangerous tachyarrythmias.
Cost is not prohibitive relative to the risk removed. A 0.6 percent chance of a bomb going off in a major metropolitan center would likely not be considered tolerable and vast monies and resources would be expended to prevent it. We should be no less concerned for the safety of any given individual with a known risk that can be removed with surgical precision.
The decision ought to be left to cardiology in every case.

CITE THIS ARTICLE:
John Kenyon, CNA. Wolff-Parkinson-White Syndrome and the Risk of Sudden Cardiac Death. Doctors Lounge Website. Available at: http://www.doctorslounge.com/index.php/blogs/page/14613. Accessed December 29 2010.

The Wrongly Famous in Medical History

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:45:44 PST

In medical history, there have been instances wherein, one gained “name” and “fame” for “describing” a particular condition or “performing” a procedure, when in fact, someone else had already described or performed that procedure. Some conditions have been wrongly named after individuals who neither described nor performed them first. History is also laced with instances of supreme magnanimity as well. Here are a few examples of those who were distained “to be, or not to be” ‘famous’.

Fallot’s tetralogy

Fallot’s tetralogy was first described in 1672 by a Danish anatomist, Niels Stensen (who also described the parotid duct in 1661) and in 1888 by the French physician Etienne Fallot, for whom it is named. In Stenson’s case, the consolation is that he is at least well known for the parotid duct that is named after him!

The McBurney incision

The well known lateral muscle-splitting or “gridiron” incision is generally called the McBurney incision after Dr. Charles McBurney of New York. The incision was used almost simultaneously by Dr. Lewis L. McArthur of Chicago, and was to have been presented to the Chicago Medical Society in June 1894. The program ran overtime and McArthur’s paper was postponed. McBurney’s publication was in the July 1894, issue of Annals of Surgery. McBurney conceded priority to McArthur in a letter as well as publicly, but use of the term “McBurney incision” has continued to this day [1].

Morton’s neuralgia (Morton’s metatarsalgia)

Lewis Durlacher (1845), a chiropodist to Queen Victoria, had described the classical features of this condition in his book, before Thomas George Morton who wrongly attributed the symptoms to the subluxation of the metatarso-phalangeal joint (MTPJ) and advocated excision of the MTPJ. The term “Morton’s neuroma” came into use in the 19th century and was neither first described by Morton nor is a true neuroma. Despite calls to abandon this term, it continues to be used [2].

The Charles procedure for elephantiasis of lower limbs

The Charles procedure (1912) for elephantiasis of lower limbs is an ablative procedure named after Sir Richard Henry Havelock Charles whereby, the affected subcutaneous tissue is resected down to the muscle fascia and the raw area covered with skin grafts taken from the resected specimen. This procedure is no longer performed. The “Charles procedure”, as an eponym for the surgical treatment of leg edema, is actually a longstanding misnomer. Sir Havelock had never treated a patient with leg edema, but in 1950, Sir Archibald McIndoe, an eminent British plastic surgeon wrote an article in which he mistakenly claimed that Sir Charles had treated a patient with leg edema with excision of subcutaneous tissue and skin grafts back in 1912. Since then, the error began and has been propagated throughout the years [3].

Hodgkin’s lymphoma

Thomas Hodgkin (Guy’s hospital. London) first described this condition in 1832. Hodgkin left Guy’s Hospital in 1837. In 1856, Samuel Wilks (later, Sir Samuel Wilks) entered Guy’s hospital (where he was a student of Medicine earlier) as an assistant physician. In 1865, Samuel Wilks described the same disease independently with better precision. Later, when Wilks became aware of Hodgkin’s work, he recognized its priority and named it “Hodgkin’s disease” in a subsequent article in Guy’s Hospital Reports! [4] [5].

Poland syndrome

In 1962, Patrick Clarkson, a New Zealand born, British plastic surgeon working at Guy’s Hospital and Queen Mary’s Hospital, London, noticed that three of his patients had a combination of a hand deformity and an underdeveloped breast on the same side. Clarkson later came across a reference to a similar deformity published by Alfred Poland, over a hundred years earlier (in 1841) in Guy’s Hospital archives. Clarkson was able to trace the hand specimen originally dissected by Poland, which was still held in the hospital’s pathology museum. Poland had dissected a convict called George Elt, who was said to be unable to draw his hand across his chest. Poland noted the chest wall deformity, and this was illustrated in his article; the hand was also dissected and preserved for posterity in Guy’s Hospital museum where it remains today. Although, strictly speaking, Poland’s description can’t be called a ‘syndrome’ because he had only described one isolated case, Clarkson who published his series of three cases, named the syndrome after Poland in his article! [6] [7].
It is indeed a remarkable coincidence that two such examples of supreme magnanimity had occurred at Guy’s hospital, London under very similar circumstances!

Alexis Carrel & Charles Claude Guthrie

Alexis Carrel (1873-1944) was a French surgeon, biologist and eugenicist. Carrel has been variously referred to as the ‘father of Transplantation’, ‘father of Vascular Anastamoses’, and ‘father of Experimental Vascular Surgery’.Carrel’s experiments led to advances in vascular surgery and tissue culture. Carrel perfected the anastamosis of blood vessels which revolutionized vascular surgery and made it possible to transplant organs and restore amputated limbs.
His experiments in collaboration with the famous aviator Charles Lindbergh in 1935, also led to the creation of the “perfusion pump”( a glass perfusion pump), . He was awarded the Nobel Prize in Physiology or Medicine in 1912 for his work on vascular suture and the transplantation of blood vessels and organs.
The history of Alexis Carrel is inseparably linked to that of Charles Claude Guthrie.
Charles Claude Guthrie (1880 – 1963) was an American physiologist. A major part of the work that was the basis for Carrel being awarded the Nobel Prize, was performed jointly by Carrel and Guthrie during two 3-month periods in 1904 and 1906 at the Hull Laboratory at the University of Chicago, resulting in the publication of 21 jointly written papers. As Carrel spoke and wrote very little English, he also needed Guthrie’s help in writing his papers and speeches [8].
A 2001 book by Hugh E. Stephenson, Jr. and Robert S. Kimpton, America’s First Nobel Prize in Medicine or Physiology, “The Story of Guthrie and Carrel”, argues that the primary credit for this work should have gone to Guthrie rather than Carrel. However, Guthrie’s head transplant experiments likely came in the way of his Nobel Prize candidacy status. On May 21, 1908, Charles Guthrie succeeded in grafting one dog’s head onto the side of another’s neck, creating the world’s first man-made two headed dog [9]. Charles Claude Guthrie remained an unsung hero of vascular surgery.

Daniel Elmer Salmon and Theobald Smith

In the case of Daniel Elmer Salmon (1850-1914) of “salmonella” fame, the ‘unsung hero’ is believed to be his assistant Theobald Smith who in fact discovered the bacillus - Salmonella cholerae-suis, during his studies on hog cholera. Dr. Salmon was the administrator of the United States Department of Agriculture (USDA) research program, and thus the organism got named after him [10].

Gerhard Armauer Hansen and Albert Neisser

Norwegian physician Gerhard Henrik Armauer Hansen (1841-1912) identified the bacillus Mycobacterium leprae in 1873, but did not culture it or identify it as the causative organism of Leprosy. Albert Ludwig Sigesmund Neisser, a German physician (who later discovered Neisseria gonorrhoeae) using samples provided by Hansen, was able to stain the organisms and show that they caused leprosy. In the end however, the disease was named Hansen’s disease [10].
I will be much obliged if others could add more to this seemingly small list ...

CITE THIS ARTICLE:
M. Aroon Kamath, M.D.. The Wrongly Famous in Medical History. Doctors Lounge Website. Available at: http://www.doctorslounge.com/index.php/blogs/page/14102. Accessed December 29 2010.

Chemotherapy and cardiac toxicity - the lesser of two evils

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:43:18 PST

One of the most dreaded side effects of certain chemotherapy agents is their effect on the heart. The paradox comes from the fact that these drugs, while only a handful, are among the few chemotherapy agents with a substantial survival benefit. In some cases their use is unavoidable. They form fundamental components in the upfront curative treatment of Hodgkin’s lymphoma (ABVD regimen) and Non-Hodgkin’s Lymphoma (CHOP +/- rituximab) and more importantly in the adjuvant treatment of breast cancer patients that have been already cured using surgery (various regimens - AC, FAC, FEC, AC-Taxol). They are also used in the primary treatment of leukemia.
In many cases these drugs are used in younger patients. This again strengthens the irony because these patients will be the ones that tend to have longer life expectancies and as a result risk suffering from cardiac disability at a very early stage in their lives.
Up until recently this possible tradeoff has been regarded largely as a “lesser of two evils” and not every chemotherapy patient will develop heart disease. Still, it is both ironic and tragic that what may well cure a cancer may also kill a certain number of cancer patients who otherwise might have survived to live out a relatively normal and productive life.
There are many potential forms of heart damage that can occur even in patients with no personal or family history of heart disease, and some chemo combinations are more likely than others to cause cardiac complications.
A common example of the problem agents involved in this unfortunate complication would be the anthracycline group of drugs. Anthracyclines include the following drugs: Doxorubicin, Liposomal doxorubicin, Idarubicin, Daunorubicin, Epirubicin, and Mitoxantrone. These drugs are intercalating agents that inhibit topoisomerase II. This ultimately inhibits DNA and cellular replication a fundamental process in cancer progression. Cancer cells that are unable to replicate eventually die by a process known as apoptosis. Anthracyclines also enhance the production of free radicals and since cardiac tissues have difficulty detoxifying free radicals this has been incriminated as the cause of cardiac injury that results from anthracylcine use.
Anthracyclines can cause any ECG changes from tachycardia, heart block, ectopic contractions, nonspecific ST, T wave changes or decrease the QRS voltage. More significantly however, they can lead to prolongation of QT interval which can result in sudden death. All these side effects are conducive to damage of myocardium, and in significant numbers of cases may precipitate cardiomyopathy with resultant death or disability due to congestive heart failure. Anthracylcine use can induce cardiomyopathy in two main forms: an acute fulminant, deadly type which is rare and the more commonly known long term type.
The good news is much of this injury can be avoided (or sometimes even reversed) if chemotherapy is withheld before lasting damage occurs. The NCCN breast cancer guidelines do not specify what sort of cardiac monitoring (echocardiogram versus multi-gated acquisition “MUGA” scans) should be done, only that it BE done. The guidelines call for non-specified cardiac monitoring at 3, 6 and 9 months.
The practice with which I have had some indirect contact calls specifically for MUGA scan to be performed every six (6) weeks during the course of active chemotherapy. This strikes me as a highly conservative approach. The drawbacks are one: cost. MUGA scans are not cheap, and multiple ones (every month to six weeks according to the protocol adopted by one practice with which I’m familiar) could add considerably to the burden of cost to the payee; it could conceivably be refused by an insurance company for an otherwise covered patient, but already had been deemed reasonable and acceptable by some insurers when included as a part of the treatment and monitoring protocol. Another problem is this approach is not always going to be useful (especially in certain cases of advanced cancers).
Cardiac monitoring aside, another point to make is that cardiotoxicity is related to the total dose of the anthracycline taken during the patient’s life. This is known as the total cumulative dose and below this dose the incidence of cardiac toxicity is very low. So the target is always to keep our patients below the total cumulative doses whenever possible. The approximate cumulative doses according to which type of anthracycline employed are as follows:
* Doxorubicin - 450mg/m²
* Epirubicin - 900mg/m²
* Idarubicin - 100mg/m²
* Mitoxantrone - 120mg/m²
In addition to the total cumulative doses the oncologist may employ other methods of cardiac protection:
- The use of less cardiotoxic alternatives when available, especially in patients deemed at risk of heart disease.
- Dexrazoxane is a cardioprotective drug that acts as a chelating agent thus preventing iron-mediated free radical injury that is caused by anthracyclines. They are usually given in combination with doxorubicin after a total cumulative dose of 300mg/m2 is reached.
- Modification of dose administration with the intention to decrease anthracycline plasma level (eg, doxorubicin given over longer infusion rates).
- Liposomal preparations of doxorubicin (e.g. Doxil, equally effective in some cases and associated with much less toxicity but generally more expensive).
For the sake of completing this review I am including a list of cardiotoxic agents below as well as the type of cardiac injury they are known to cause:
* Doxorubicin and Radiotherapy to the chest wall can cause cardiomyopathy, pericarditis, ischemia, and arrhythmia.
* Other agents that cause cardiomyopathy include bleomycin, cyclophosphamide, cytarabine.
* 5FU (prolonged infusion) as well as vinca alkaloids (VCR, VLB, VDS) can cause ischemia.
* Pericarditis can result from cyclophosphamide use especially higher doses.
* Methotrexate can cause arrhythmias.
* Doxorubicin-paclitaxel combo as well as the Trastuzumab-doxorubicin combo are both prohibitively cardiotoxic when given simultaneously.
Meanwhile there is the potential to prevent the most ironic and tragic loss of life where a life-threatening cancer may be cured only to have the patient die during treatment or at some point later, instead of walking away having truly beaten the original problem with the help of skilled and courageous oncologists assisted by astute cardiologists.
The biggest single risk of chemotherapy, that it might kill the patient it seeks to cure, may well be avoidable in a great many cases. It strikes this writer as quite possibly a valuable means of changing chemotherapy from a “lesser of two evils” to a far more trustworthy ally in the battle to return healthy patients to long and productive lives.

CITE THIS ARTICLE:
John Kenyon, CNA. Chemotherapy and cardiac toxicity - the lesser of two evils. Doctors Lounge Website. Available at: http://www.doctorslounge.com/index.php/blogs/page/14030. Accessed December 29 2010.

Scientists Spot DNA Linked With Dangerous Heart Rhythms

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:41:21 PST

The genes weren't suspected of playing role in heart's electrical activity.
MONDAY, Dec. 27 (HealthDay News) -- Scientists have identified DNA sequence variations associated with abnormal heart rhythms that can cause heart damage and sudden death.
The international team studied nearly 50,000 people worldwide and found variants in 22 locations across the human genome that can effect QRS interval -- a measure of electrical depolarization in the heart's lower chambers (ventricles).
QRS interval is easily measured on an electrocardiogram (EKG). A prolonged QRS interval has been associated with increased risk for heart problems and sudden cardiac death.
Among the significant findings were variations in two side-by-side genes that regulate electrically charged particles to produce signals that activate heart contractions. One of these genes, SCN5A, is known to play a role in controlling how signals start from specialized muscle cells and travel across the heart to cause rhythmic contractions. It had not been known that the neighboring gene, SCN10A, played any role in cardiac electrical activity at all.
"The size of this study really gave us the power to identify many genes not previously suspected to play a role in heart conduction," corresponding author Dan Arking, an assistant professor at McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, said in a Hopkins news release.
The study was published recently in Nature Genetics.
More information
The U.S. National Heart, Lung, and Blood Institute has more about heart rhythm problems.
SOURCE: Johns Hopkins Medicine, news release, December 2010

Roundup: 2010 Advances in Heart Disease and Stroke Care

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:39:45 PST

Improved therapies, research on lifestyle prevention expanded in past year.

TUESDAY, Dec. 28 (HealthDay News) -- 2010 was a year that enjoyed continued advances in the treatment of heart disease and stroke, according to the American Heart Association/American Stroke Association.
"We have come far in the past decade, reducing heart disease deaths by more than 27 percent and stroke deaths by more than 44 percent," American Heart Association president Dr. Ralph Sacco, chairman of the department of neurology for the Miller School of Medicine at University of Miami, said in a news release.
"But we know there is still much to be done in improving the lives of heart disease and stroke patients -- and more importantly, in preventing these devastating diseases in the first place. Scientific research will help us lead the way," he said.
The top 10 advances in heart disease for 2010 are:

More individually tailored treatment for people with type 2 diabetes to reduce their risk of heart disease.
Minimally invasive options -- such as transcatheter aortic valve implantation -- to replace a blocked aortic valve in high-risk patients who might not be able to withstand open-heart surgery.
Improving ways to reverse sudden cardiac arrest, such as using adult CPR with chest compressions alone.
More alternatives for reducing stroke risk in patients with atrial fibrillation, such as new anti-clotting drugs like dabigatran (Pradaxa) that are easier to manage than the standard drug warfarin (Coumadin).
Improving outcomes in heart failure patients with new types of implantable cardioverter defibrillators that can restore normal heart rhythms.
New procedures for infants with congenital heart disease, which may replace the need for a heart transplant.
Better options for anti-clotting therapy, including a new drug, ticagrelor (Brilinta), which may be a better anti-clotting medication than clopidogrel (Plavix) for patients undergoing surgery.
Experimental advances in stem cell therapy, which may help grow new heart muscle and that may eventually improve outcomes in heart failure patients.
Increasing scientific evidence for lifestyle changes -- including weight loss through exercise and an improved diet with less sodium -- which can help prevent heart disease.
Getting more hospitals to follow AHA guidelines, which reduces racial and ethnic disparities in cardiac care.

The top 10 advances in stroke for 2010 are:

Clot-busting drugs found most effective in the first 4.5 hours after stroke and perhaps harmful afterward.
Scientists identified a new way the body clears clots from brain vessels, thus restoring blood flow.
Opening narrowed neck arteries by surgery or stent has similar risks and benefits, but surgery appears better for those over 70.
New AHA hospital guidelines improve outcomes of stroke patients.
Researchers identified the 10 major risk factors for a stroke and found that reducing blood pressure and smoking, and encouraging physical activity and a healthy diet could significantly cut the number of strokes around the world.
An international study found that ultrasound can detect silent micro-clots in patients at risk for stroke and help determine which patients might benefit from surgery or stenting.
Robot-assisted therapy can improve arm function after stroke, although not more than intensive care from a physical therapist.
Patients with the genetic disorder Ehlers-Danlos syndrome are at risk for brain bleeds, but the risk can be managed with the use of beta-blockers, which lower blood pressure.
Dramatically lowering blood pressure early after a hemorrhagic stroke can prevent the bleeding from spreading, thereby improving outcomes.
Physical activity, even walking and other moderate exercise, reduces the risk of stroke in women.

More information
For more information on heart disease and stroke, visit the American Heart Association.
SOURCES: American Heart Association, news release, Dec. 21, 2010

For Cholesterol Control, Experts Urge More Than Meds

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:37:53 PST

Without lifestyle changes too, people remain susceptible to chronic health problems.
By Dennis Thompson
HealthDay Reporter
TUESDAY, Dec. 28 (HealthDay News) -- Advances in medical science have made it easier than ever to lower dangerous cholesterol levels.
A class of cholesterol-lowering drugs known as statins have proven particularly effective, reducing the risk for heart-related death by as much as 40 percent in people who have already suffered a heart attack, said Dr. Vincent Bufalino, president and chief executive of Midwest Heart Specialists and a spokesman for the American Heart Association.
"People have said we need them in the drinking water because they are just so effective in lowering cholesterol," Bufalino said.
But he and other doctors warn that when it comes to controlling cholesterol and enjoying overall health, nothing beats lifestyle changes, such as a heart-friendly diet and regular exercise.
"Once we became a fast-food generation, it's just too easy to order it at the first window, pick it up at the second window and eat it on the way to soccer," Bufalino said. "We need to get you to change now or you're going to end up as one of these statistics."
Folks with high cholesterol often are overweight, and if they deal with their cholesterol through medication only, they leave themselves open to such other chronic health problems as diabetes, high blood pressure and arthritis, said Alice Lichtenstein, director and senior scientist at the Cardiovascular Nutrition Laboratory of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Medford, Mass.
The thought of controlling cholesterol solely through medication is "an unfortunate point of view," Lichtenstein said. "There are a lot of other factors, especially when it comes to body weight, that the medications won't help. The idea that 'I'll just take medications' isn't a very healthy option, especially for the long term."
That point of view seems to be bolstered by new evidence that using cholesterol-lowering drugs won't necessarily help a person who hopes to avoid heart disease.
British researchers who pooled and re-analyzed data from 11 cardiovascular studies found that taking statins did not reduce cardiac deaths among people who had not developed heart disease.
The finding has been questioned, however, by some medical experts, who note that the research did find an overall reduction in cholesterol levels linked to statin use. "I have to tell you that belies a lot of the other science," Bufalino said of the study.
High cholesterol is strongly connected to cardiovascular disease, which is the leading cause of death in the United States, according to the American Heart Association. Nearly 2,300 Americans die of cardiovascular disease each day -- an average of one death every 38 seconds.
Cholesterol, which is a waxy substance, occurs naturally in the human body. In fact, the body produces about 75 percent of the cholesterol needed to perform important tasks, which include building cell walls, creating hormones, processing vitamin D and producing bile acids that digest fats, according to the U.S. National Institutes of Health. The other 25 percent of a person's cholesterol is ingested in foods that are eaten.
But many people's diets include the wrong type of cholesterol. They eat foods loaded with saturated fats or trans fats, which increase levels of low-density lipoprotein (LDL) cholesterol in the bloodstream.
LDL, the so-called "bad" cholesterol, forms plaques on the sides of artery walls, narrowing the arteries and forcing the heart to work harder to pump blood. Saturated fats are found in most animal products, and trans fats are found in processed foods that contain hydrogenated oils.
But other foods are rich in "good" cholesterol: high-density lipoprotein (HDL) cholesterol. It acts as the bloodstream's garbage truck by rounding up and hauling off some of the bad cholesterol.
These days, it's easier than ever to choose foods that contain lots of good cholesterol and little to no bad cholesterol, Lichtenstein said.
There are lots of healthy choices, including low-fat or nonfat dairy products, lean cuts of meat, poultry, fish, vegetables and grains, she said.
And for people who want to buy a processed food, the Nutrition Facts label on every product explicitly states the amount of fat it contains.
"From a consumer's perspective, it's easier than ever to restrict saturated fat and trans fatty acids," she said. "It's just a matter of doing it."
People also can lower their cholesterol by eating foods that contain lots of dietary fiber. Soluble fiber has been found to draw cholesterol out of the bloodstream, Bufalino said. Such foods, including oatmeal and whole-grain bread, are an important part of a cholesterol-fighting diet.
But beating cholesterol takes additional steps as well. Because high cholesterol is closely linked to being overweight or obese, losing pounds is critical -- as is keeping them off. And that means exercising as well as eating right.
Exercising as little as 30 minutes every day can reduce a person's risk for heart disease, according to the American Heart Association. Even more exercise can help achieve greater weight loss.
The important thing is to remain dedicated to your own health, Bufalino said.
"People can be good with it for a while, but it's hard to stay disciplined all the time," he said. "We don't need folks to be perfect. If you can be good 80 to 90 percent of the time, that's great. That's all we need from people."
More information
The American Heart Association has more on cholesterol.
For more on the effects of high cholesterol, read about one woman's story.
SOURCES: Vincent Bufalino, M.D., president and CEO, Midwest Heart Specialists, Oak Brook Terrace, Ill.; Alice Lichtenstein, D.Sc., director and senior scientist, Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Medford, Mass.

Woman Struggles to Control Cholesterol

noreply@blogger.com (saad elfallah) — Wed, 29 Dec 2010 13:34:26 PST

Diet, exercise, medication employed to cope with extraordinarily high levelsBy Dennis Thompson
HealthDay Reporter
TUESDAY, Dec. 28 (HealthDay News) -- Sheri Foote has cholesterol problems the likes of which few will ever have.
Foote, 43 and a Denver resident, was first diagnosed with high cholesterol when she had a physical examination about age 21. "I knew I had a family history of heart disease, so I thought it would be a good thing to do," Foote recalled.
Her cholesterol "was off-the-charts high," she said. "Everyone's first instinct was, 'You're young; this seems very strange.'"
It seemed that way to Foote, too. She'd been a dancer since she was 6 and worked out regularly. "It seemed very shocking to me that this would happen to someone with such a healthy lifestyle," she said.
Why Foote has struggled with high cholesterol since such a young age remains somewhat of a mystery. "All they can figure is that all the bad genes just piled up on me," she said. "My body just does not produce the good cholesterol as much as we would like it to."
She first tried to regulate her cholesterol through diet and exercise. "I even became a vegetarian in my 20s for a brief time, hoping that would help out," Foote said. "I haven't eaten beef since then, and I've really cut back on things like eggs and cheese. I eat those things in very small doses."
Nonetheless, her cholesterol levels barely budged, she said. When she was 30, her doctor prescribed a cholesterol-lowering statin drug. "I went on it for about 6 months, and my cholesterol level did come down some," Foote said. "Still it was quite high."
So high, in fact, that Foote became seized with a sense of futility about it all. "I figured I was too young to be on a statin, so I went off it, in my infinite wisdom," she said -- a decision she later came to regret.
She had to have quadruple-bypass surgery the day after her 39th birthday.
Foote said she had "very classic Hollywood symptoms of heart disease: . . . crushing in the chest and shortness of breath and numbness down both of the arms." At first it happened when exercising, she said, but then she started having episodes even when at rest.
She had an angiogram, which is a test that checks for any narrowing or blockage in the coronary arteries. Her doctors hoped they could put in a stent, a steel mesh tube that can keep an artery open, but Foote said the angiogram showed that things were too far gone. She said her arteries were choked with plaque, and her total cholesterol was at 335, with a level of high-density lipoprotein (HDL) cholesterol, the good kind, in the mid-teens. The American Heart Association considers a total cholesterol level over 240 as high risk, and an HDL level less than 50, for women, as higher risk as well.
Foote went in for bypass surgery. And she barely survived.
"I had a heart attack on the operating table," she said. "I always tell people, if you're going to have a heart attack, plan it right so you're in front of an audience of doctors when it happens. It was at the end. They were done and getting ready to close me up and send me to recovery."
Foote said that she now takes a fairly high dose of statins, a prescription-strength niacin supplement and fish oil capsules, and that her cholesterol today is a more reasonable level, though her "good" cholesterol "is rarely in the range they would like it to be, even with all of the medication." Typically, she said, her total cholesterol is 130, with an HDL level of 30 and LDL (low-density lipoprotein) of 86.
"I feel good these days, though," Foote said. "I took stock of my life, and I eliminated a lot of stress, which probably wasn't helping me either. Things are not bad at all."
More information
A companion article offers more on controlling cholesterol.
SOURCE: Sheri Foote, 43, Denver

Abscess

noreply@blogger.com (saad elfallah) — Sat, 25 Dec 2010 11:35:31 PST

Furuncle, carbuncle, or boil

Abnormal

An Abscess is an infection of the skin or deeper tissues, usually containing pus. The infection often starts in a hair follicle.

Round or swollen area of skin that is often red

Pain and tenderness over the site

Site of the Abscess may feel hard or fluid-filled

Pus may come from the site, especially as time passes

A bacterium called Staphylococcus aureus infects an area under the skin or in a hair follicle.

The infection can occur when a cut, wound, friction, pressure, or moisture forces the bacteria deeper into the skin or hair follicle.

Petroleum products such as Vaseline may plug up a hair follicle and cause an infection.

Usually apparent to the physician on exam

Cultures of pus may be sent to make sure antibiotic choice is correct

Nasal cultures may be sent for patients who get repeated infections to make sure they are not "carriers" for staphylococcal infections. People who are carriers often need longer courses of antibiotics and specific antibiotics to prevent recurring Abscess formation.

Antibiotics commonly used are Cephalexin, Dicloxacillin, and Cefazolin.

Warm soaks and moist compresses, as directed by the attending physician

Incision and drainage of the Abscess

Sebaceous Cyst

Sporotrichosis

Blastomycosis

Acne cysts

Anthrax

Tularemia

Brown Recluse Spider Bite

Venous stasis ulcer

Decubitus ulcer

AIDS

noreply@blogger.com (saad elfallah) — Sat, 25 Dec 2010 11:23:37 PST

Acquired Immune Deficiency Syndrome or HIV infection

AIDS is caused by infection with the human immunodeficiency virus HIV-1. The HIV virus infects cells in the body that fight infection. The primary cell infected is the CD4 lymphocyte, but it infects other infection-fighting cells as well. This causes immune system impairment and difficulty fighting infection. Because the immune system has a role in cancer prevention, there is also an increase in certain cancers. To be HIV positive means that one is infected with the HIV virus. To be given the diagnosis of AIDS, one must be infected with HIV, which means that the HIV infection has compromised the immune system to the extent that an AIDS-defining illness (one of multiple illnesses) has occurred. Before current "triple therapy" was developed, nearly all those who were HIV positive went on to develop AIDS. Now it is not the case. But, not all persons respond to "triple therapy" and a proportion still goes on to develop AIDS.

HIV syndrome occurs 3 to 6 weeks after infection and includes :

Fever
Sweats
Sore throat
Enlarged lymph glands
Headaches
Weight loss
Joint aches
Muscle aches
Diarrhea
Rash
Oral ulcers

Symptoms of any opportunistic illness (i.e., bacteria, fungi, protozoa, and viruses)
Some may not develop any symptoms for years after exposure.
Candidiasis (white patches in mouth)
Pneumocystis carinii (lung infection characterized by dry cough and shortness of breath)
Atypical mycobacterium
Toxoplasmosis (infection in brain with confusion)
Progressive multifocal leukoencephalopathy (causes dementia)
Herpes simplex (causes ulcers that persist over 1 month)
Lymphoma (enlarged glands)
Kaposi's sarcoma (purple skin lesions)
Diarrheas -- cryptosporidosis and isoporiasis
Recurrent pneumonias
Tuberculosis (cough)
HIV encephalopathy (dementia)
HIV wasting syndrome
Cytomegalovirus infection /blindness
Cryptococcosis (especially meningitis)
Disseminated coccidiomycosis (fungal infection found in Southwest United States, typically affects lungs, but in HIV may go into spinal fluid and cause meningitis)
AIDS wasting (weight loss) syndrome
Depression and social/family isolation
Neuropathies
Pain

HIV can be found in many types of bodily secretions (i.e., semen, urine, tears, saliva, blood, breast milk, spinal fluid, vaginal secretions). However, the risk of transmission is highest through semen and sexual activities.
Anal sex -- highest transmission rate
Heterosexual sex, homosexuals, bisexual males who engage in unprotected sex
Intravenous drug abusers who share needles
Oral Sex -- lower, but risk still present
Blood and blood product transfusions between 1977-1985 (now rare, because blood products are carefully screened)
Contaminated needle stick as in healthcare professionals (1:300 risk)
Children born to mothers with HIV infection
Not spread through casual contact such as touching, hugging, or sharing toilet seats
Not transmitted by insect bites such as mosquitoes
No documented cases of HIV infection from saliva or tears; however, if there is an open sore on the skin or mouth, the risk increases.

Examination:
May be normal
Signs & symptoms of AIDS-defining illnesses (see below)
Laboratory Findings:

HIV antibody test -- the HIV virus multiplies in the body for weeks or months before the body responds by making antibodies to it, at which time the HIV test is considered positive. Decreased CD4 lymphocyte (also known as T-helper cells) count (the lower the count the more likely to develop infections and illness)
Symptoms begin to occur with CD4 count falling below 350/ml
Anemia
Polyclonal hypergammaglobulenimia
High cholesterol
Skin antigen testing fails to react to typical antigens

The goal of treatment is to keep CD4 count above 200/ml, prevent/control opportunistic infections, and improve the quality of life.
Anti-retroviral drugs (Highly Active Anti Retroviral Therapy or HAART) -- these interfere with the HIV virus' ability to replicate. Some common ones are listed below:
Nucleoside analogs

Zidovudine (AZT)
Zalcitabine (ddC)
Lamivudine
Stavudine

Protease inhibitors

Indinavir
Ritonavir
Nelfinavir
Saquinavir

Triple therapy -- it has been found that combining two nucleoside analogue drugs with one protease inhibitor can substantially reduce the viral burden, infection rate, and death rate in HIV infection.

Post-exposure prophylaxis (e.g., after a needle stick)

AZT probably beneficial
AZT plus other antiretroviral drugs probably will be shown to be more effective.

Before the more effective "triple therapy" was developed, various regimens were recommended to prevent specific infections. For example, Trimethoprim-Sulfamethoxazole for Pneumocystitis carinii included various regimens that are now reserved for those who fail to respond or are intolerant of "triple therapy."

Abstinence
Safe sex (use of condoms and oral barriers)
HIV testing prior to a relationship
Stop intravenous drug abuse, sharing of dirty needles, and other high-risk behaviors.
Healthy lifestyle and join support groups if at risk

28 Healthy Heart Tips

noreply@blogger.com (saad elfallah) — Tue, 16 Nov 2010 15:10:06 PST

Healthline offers you 28 ways to power up, slow down, have fun, and get fit - all in the name of a healthy heart. Pick your favorites, and work them into your regular routine.

1. Stop smoking-no ifs, ands, or (cigarette) butts.

People still need to be reminded of this? Yes, they do. This nasty habit is one of the top controllable risk factors for heart disease. The AMA, the AHA, the NIH, and more than likely your MOM recommend you stub out this addiction to make a huge difference in your overall health.

2. Focus on the middle.

Your middle, that is. You don't have to be super thin to reap the benefits of a smaller waistline, but carrying too much weight around the middle raises blood pressure, affects blood lipids (and not in a good way), and does other damage to the heart. Abdominal exercises are good, but remember it's calories in (what you eat), calories out (how you exercise) that will make a difference in the tape measure.

3. Play between the sheets.

Or on top of the sheets or in the kitchen or wherever! Yep, having sex can be heart healthy. A number of studies show that sexual activity adds more than pleasure to your life. It can actually lower your blood pressure and your risk for developing heart disease.

4. Knit a scarf.

Put your hands to work and your mind will unwind. Engaging in activities like knitting, sewing, and crocheting helps relieve stress that does the ole ticker a world of good. For the "uncrafty" lot who don't do needles, a jigsaw puzzle works great too!

5. Power up your salsa.

A good salsa rich in antioxidants is a great snacking choice when paired with low-fat chips or fresh veggies. When you mix in a can of black beans (rinsed and drained) you get a two-for-one special because adding soluble fiber (such as that found in beans and other legumes) into your diet helps lower bad (LDL) cholesterol. Add a dash of lime juice and a chopped jalapeno for extra kick to jumpstart your metabolism. Munch on that!

6. Let the music move you.

Whether it's a rumba beat or a two-step tune that gets your body moving, dancing raises your heart rate, burns some calories (between 150-300 calories an hour), and makes for a great heart healthy workout.

7. Go fish.

Studies have shown that including fish with omega-3 fatty acids (i.e. salmon, herring, sardines, and to a lesser extent tuna) into your diet can reduce the risk of dying from heart disease by a third or more. To those concerned about the mercury or other contaminants, the Mayo Clinic states the heart healthy benefits outweigh the possible risks of exposure to contaminants.

8. LOL.

Not in an email, not on Twitter or Facebook, but really... laugh out loud. Whether you like watching "The Family Guy" or "Seinfeld" reruns, whatever gets you chuckling is good for your heart. Research (from the University of Maryland School of Medicine) shows that laughter helps relieve the stress that damages the endothelium (the tissue that forms the inner lining of blood vessels and helps the blood flow) and promotes the healthy function of blood vessels.

9. Stretch it out.

Practicing yoga not only makes you more limber and helps you relax (which combats stress), but according to recent research from India, it also positively affects the heart rate variability (HRV) that is an indicator for heart health.

10. Raise a glass.

Moderate consumption of alcohol can raise your HDL (good cholesterol) levels, reduce blood clot formation, and help prevent artery damage. Some studies say red wine offers more benefits than other alcoholic beverages. But other studies conflict with this. Moderation is key here, and you should talk to your doctor about potential benefits and risks.

11. Shun the salt.

Overwhelming research shows that if the entire US population reduced its salt intake (just a half teaspoon a day), it would significantly reduce the number of new cases of coronary heart disease. Studies also concluded that salt is one of the leading culprits fueling the rise in healthcare costs in America. Most of our high salt intake comes from processed food and restaurant-prepared food. Think twice before filling up on your favorite fast-food fix.

12. Move it, move it, move it.

A new study from Australia found that sitting for long periods of time can shorten your life regardless of your body weight. It appears that being a couch potato has an unhealthy influence on blood fats and blood sugar. At the office, work in "get up" breaks, and go for a short stroll around building.

13. Know your numbers.

Keeping your blood pressure, blood sugar, cholesterol, and triglycerides in check are important for good heart health. Learn the optimal levels, and don't skip your regular physical exams.

14. Eat chocolate.

No guilt required. Rich, dark chocolate tastes delicious, and according to a study published in the American Journal of Clinical Nutrition, it can help stave off heart disease because of the flavonoids it contains. Preliminary research also suggests that chocolate can positively affect blood clotting.

15. Let your housework work for you.

Vacuuming or mopping the floors may not be as invigorating as a Body Slam or Zumba class, but these activities and other household chores do burn calories. Put your favorite music on, and put some pep in your weekly chores.

16. Go nuts.

Almonds, walnuts, pecans, and other tree nuts deliver a powerful punch for lowering your risk of cardiovascular and coronary heart disease. Studies show that substituting saturated fats with fat from nuts actually helps reduce bad (LDL) cholesterol.

17. Be a kid.

Fitness doesn't have to be boring. Plan an evening out roller skating or bowling. Do both, and you can burn, on average, around 600 calories.

18. Consider pet therapy.

Our pets give us more than unconditional love; they offer numerous health benefits. Studies show that owning pets can lower the rate of dying from heart disease and possibly improve heart and lung function.

19. Start and stop.

And start again. During aerobic workouts, interval training (varying your speed and intensity in short bursts) will boost your calorie burn. Wear a heart rate monitor to make sure you are hitting your target heart rates.

20. Cut the fat.

Slicing your fat intake to no more than 30% of your daily calories will help cut your risk for heart disease. If you're not into reading labels or counting calories, think twice before you savor your next meal. Do a mental calculation of what you are eating.

21. Take the scenic route home.

Put down your cell phone, forget about the driver who cut you off, and enjoy the ride. Eliminating stress while driving will help lower your blood pressure, which your cardiovascular system will appreciate.

22. Make time for breakfast.

This is the one meal you shouldn't skip. The good-for-you benefits of eating a healthy breakfast are numerous. What is included in a healthy breakfast? Whole grains (whole grain rolls, cereals, etc.), low-fat protein (i.e. hard-boiled egg, turkey bacon), low-fat dairy (skim milk, low-fat yogurt or cheese), and fruits and vegetables.

23. Fake your fitness.

It's a no-brainer that exercise has substantial benefits to your coronary health. Why not sneak it in at every opportunity? Park on the far side of the parking lot, take the stairs, walk and talk with a friend instead of e-mailing, play with your kids at the park. It all adds up to better health.

24. Brew up a heart healthy potion.

No magic needed when you sip on green or black tea. Different studies (some focusing on black tea, others on green tea) show that drinking tea can improve arterial health.

25. Smile and say, "How does my heart look?"

Good dental hygiene does more than keep your pearly whites glistening. It may affect your overall health. Research suggests that several types of cardiovascular disease, including coronary artery disease, may be connected to your oral health.

26. Walk it off.

Next time you feel overwhelmed, get mad, or are totally exasperated, take a stroll. A five-minute walk will do wonders for clearing your head and lowering your stress levels.

27. Pump some iron.

Aerobic activities may be the star players in fitness for a healthy heart, but strength training needs to be part of the team. Its effect on weight control is awesome-more muscle mass means burning more calories. The American Heart Association gives strength training a thumbs-up for lowering the risk of heart disease.

28. Find your happy place.

A sunny outlook is good for your heart. Research from the University College London shows that those who are happy tend to have lower levels of the potentially harmful hormone cortisol and other stress-inducing chemicals.

Heart Disease and Diet

noreply@blogger.com (saad elfallah) — Tue, 16 Nov 2010 15:10:06 PST

Heart disease is a broad term for any condition that affects the heart and blood vessels. This includes:
heart attack
stroke

بالرجوع إلى:

"Heart disease is a broad term for any condition that affects the heart and blood vessels. This includes: heart attack stroke"
- Medical Blog » Diets (نظرة على ويكي Google الجانبي)