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What the Cows Know…

The dairy cow knows the value of Vitamin D.

And now so do researchers.

Study participants were given Vitamin D supplements (typical infant multivitamins) from birth on and after a tracking period of 15 to 30 years it was found that they were 29% less likely to develop type 1 diabetes than those infants who did not receive the supplemental Vitamin D. (Archives of Disease in Childhood) You can read the entire story here.

Low levels of Vitamin D apparently leads to insulin resistance.

Sources of Vitamin D:

• Vitamin D is synthesized in the human skin when it is exposed to ultraviolet light
• Fortified milk
• Swiss Cheese
• Beef Liver
• Fish (mackerel, tuna, sardines)
• Eggs
• Cod liver oil

And according to this associated article from USA Today News: June 14, 2008, Vitamin D Tests Soar As Deficiency, Diseases Linked—more doctors are testing for Vitamin D deficiency related diseases than ever before as more than 35% of adult Americans are found to have low levels.

How Much Vitamin D Do We Need?

Per the Mayo Clinic:

“You’re unlikely to get too much vitamin D from the food you eat, and prolonged sun exposure doesn’t seem to cause vitamin D toxicity. Over time, however, megadoses of vitamin D supplements can cause

nausea, vomiting, poor appetite, constipation, weakness and weight loss. More seriously, excessive doses of vitamin D can raise the level of calcium in your blood — which can cause confusion and changes in heart rhythm. Generally, the upper limit for vitamin D is 2,000 IU a day.”

Read more

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Stand Up To Cancer All Star Special is Coming

Put this on your calendar!

The stars will be out Friday, September 5, at 8pm Eastern time in a joint network special. The ABC/NBC/CBS  networks will donate one hour of primetime for a history-making interactive television special, uniting the nation as we Stand Up To Cancer. This network special will feature all three evening news anchors, and will air commercial free.

Are you ready for this line up of stars?

Casey Affleck, Jennifer Aniston, Christina Applegate, Lance Armstrong, Josh Brolin, David Cook, Dana Delany, Fran Drescher, Kirsten Dunst, Elizabeth Edwards, Jon Favreau, America Ferrera, Neil Patrick Harris, Salma Hayek, Scarlett Johansson, Julia Louis-Dreyfus, Masi Oka, Danica Patrick, Christina Ricci, Robin Roberts, Commissioner Allan H. Bud Selig, Homer Simpson, Marge Simpson, Meryl Streep, Hilary Swank, Charlize Theron, Goran Visnjic, and Forest Whitaker–AND, Jessica Alba, Charles Barkley, Halle Berry, Jack Black, Abigail Breslin, Kate Bosworth, Sheryl Crow, Ellen DeGeneres, Melissa Etheridge, Jimmy Fallon, Jennifer Garner, Brad Garrett, Angie Harmon, Tony Hawk, Marg Helgenberger, Diane Keaton, Rob Lowe, Mandy Moore, Don Newcombe, Sharon Osbourne, Josh Peck, Mekhi Phifer, Keanu Reeves, Jimmy Smits, David Spade and Carrie Underwood.

It doesn’t stop there…

Check this out!

Mariah Carey, Beyoncé, Mary J. Blige, Rihanna, Fergie, Sheryl Crow, Miley Cyrus, Melissa Etheridge, Ashanti, Natasha Bedingfield, Keyshia Cole, Ciara, Leona Lewis, LeAnn Rimes, and Carrie Underwood –  have joined together for “Just Stand Up,” a charity single.

The single will be available exclusively at the iTunes Store September 2.   “Just Stand Up” produced by Kenny ‘Babyface’ Edmonds and Antonio ‘L.A.’ Reid Read more

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Diabetes News, Weekend Edition

I hope you’re having a great weekend, where ever you are in the world. Here in Denver, we are now post Democratic National Convention. There is a nice breeze in the foothills and we have a three-day holiday weekend.

Diabetes Events From Around the World and Coast to Coast:

Enter the Walk in Nick’s Shoes Sweepstakes-Nick Jonas and The Bayer Diabetes W.I.N.S Sweepstakes

Meet Nick in Los Angeles on November 1st

Winners get to meet Nick in L.A. Flights and hotel included. And the opportunity to be part of Team Jonas at the JDRF Walk to Cure Diabetes. Plus, you’ll receive your own personal diabetes coach for 1 year who will help you simplify your life with diabetes through one-to-one support.

Read more

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Cancer News, Weekend Edition

The Democratic National Convention has been the news here in Denver this week. I can tell you traffic has been impacted but more importantly; no matter what your party affiliation, we here in the Rockies tasted a piece of history.

Here’s what’s new in cancer news and events around the globe.

Hope on Wheels is a women’s cycling event in Middle Tennessee offering women an opportunity to ride and fundraise in their hope for a cure. Women can ride, train and fundraise throughout the year to prepare for this landmark women’s ride.

100% of participant entry fees are directed to breast cancer research by
the event beneficiary The Minnie Pearl Cancer Foundation.

An annual one day cycling event for women wishing to find a cure for Breast Cancer, Saturday, September 6, 2008. Register today! Choose 12, 29, 62 or 100 miles!

A Women’s’ Ride to Find A Cure!

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CVD News Watch for the Weekend 29 August

CVD treatment watch

New hope for stroke patients

3 hours max. That’s how long a stroke patient has before major brain damage and death occur. If treated within 3 hours, the patient has very high chances of survival and full recovery. After 3 hours, the brain becomes irreversibly damaged.

Anti-nogo, a new experimental approach can give new hope to patients with high risk for stroke. It can potentially restore brain function weeks or even months after the stroke has occurred. The technique disables the nogo protein which inhibits the growth of nerve fibers. In doing so, Anti-nogo stimulates the growth of nerve fibers, thereby compensating for those damaged by stroke.

 

CVD test watch

Hearts a flutter as exam includes audio portion for first time

It’s something every medical student in the US has to go through – the 3-part medical test. However, this autumn brings new angle (and sound) to the test – cardiac auscultation or listening to the heart. However, the students will not listen to a real patient’s heart beats but audios specially develop for this test. According to one medical professor, many medical students lack the skills to identify heart conditions using a stethoscope and instead depend mostly on very expensive tests for diagnosis. With the audio tests, it hoped that the students get proper training to know the difference between a healthy and a diseased heart by simply listening.

CVD weight watch

Not all fat is created equal

If you are obese, chances are your fat cells are “sick. Researchers at Temple University in Philadelphia report differences in fat cells between obese and non-obese individuals.

“The fat cells we found in our obese patients were deficient in several areas…They showed significant stress on the endoplasmic reticulum, and the tissue itself was more inflamed than in our lean patients.“, according to one study author.

 

CVD treatment watch

Olive leaf extract may help reduce blood pressure

An article in Phythotherapy Research reported that olive leaf extract at a dose of 1000 mg per day can lower blood pressure in humans. However, large-scale tests are needed to confirm these results.

 

CVD diagnostics watch

FDA Clears Test to Help Doctors Manage Heart Transplant Patients

The US FDA has approved the marketing of AlloMap, an in vitro diagnostic assay that can determine potential organ rejection among heart transplant patients.

“AlloMap measures genetic information contained in the white blood cells (cells of the immune system that defend the body against invading viruses, bacteria or other foreign material) from a patient’s blood sample.”

AlloMap has been developed by the California biotech company XDx Inc.

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TOTALLY RANDOM!

I spend a lot of time reading and surfing and hanging out at my library.

I am plethora of trivial information. If only I could find a way to market all the strange and RANDOM stuff floating around my brain.

Today I’m going to share some of the RANDOM diabetes things I have found on the net with you, thus freeing up my gray matter for other things…

And because this is RANDOM, there is NO particular order.

Feel free to share any RANDOMS you have found.

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Heart-friendly events in September

In this one of the last posts of August, I am summarizing heart-related events worldwide scheduled for September.

Walks and runs

Now, these are events everybody can join in. You can walk, run, or hike – it’s your choice. September is a good month for these outdoor activities. It’s not so hot anymore but still warm enough to have a good time. Plus, there are fundraising events out there where you can help out.

The American Heart Association is sponsoring several Start! Walking movement events across America and several walks and runs are scheduled for September. The complete schedule can be found here.

The British Heart Foundation (BHF) is organizing walks and hikes as part of their Hearts First Walks and Hearts First Hikes. There are lots scheduled for September and you’ll find the schedule here. But there are lots more! BHF is organizing or sponsoring other fun heart-friendly activities from cycling, to swimming, to skipping rope. You can download the BHF events diary here.

The American Stroke Foundation is organizing the 6^th Annual Walk on the Wildside – The Stroke Walk at  Shawnee Mission Park, Shawnee, KS, USA

Website: 2008strokewalk.kintera.org/faf/home/default.asp?ievent=279516

The Heart and Stroke Foundation of Canada also has lots of things planned for autumn. Check out them out here.

Conferences and symposiums

Let’s see what our heart experts will be doing this September.

August 30 to September 3
European Society of Cardiology (ESC) Congress
Munich, Germany
Website: www.escardio.org

September 8 to 10
Atrial Fibrillation Symposium
Murray, UT, USA
Organized by the Heart Rhythm Society
Website: www.intermountainhealthcare.org/cme/IHRS2008

September 11 to 13
Arrhythmias in the Real World, American College of Cardiology Heart House
Washington, DC, USA
Website: www.acc.org

September 12 to 13
27th Annual Echocardiography Symposium
The Doral Marriott Hotel
Miami, FL, USA
Website: www.baptisthealth.net/meded

September 14 to 16
The American College of Cardiology’s (ACC) 2008 Legislative Conference
Fairmont Hotel in Washington, D.C., USA
Website: www.acc.org/advocacy/leg_conf_08/about.htm

September 15
16th Annual State-of-the-Art Arrhythmia Symposium
Hospital of the University of Pennsylvania
Philadelphia, PA, USA
Website: www.med.upenn.edu/apps/cme_events

September 18 to 20
Annual Meeting of the ESC Working Group of Cardiac Cellular Electrophysiology
Madrid, Spain
Website: veci.eventszone.net/ewgcce2008/

September 18 to 20
Nuclear Cardiology and Integrated Cardiovascular Imaging Today – 2008
Cesena, Italy
Website: www.ausl-cesena.emr.it/Default.aspx?alias=www.ausl-cesena.emr.it/nuclearcardiologytoday

September 18 to 20
CardioMet – 3D Lausanne 2008
Lausanne, Switzerland
Website: www.cardiomet.ch/en/cmet_home/cardiomet-evenements.htm

September 20 to 23
47th National Congress of Cardiology of the Romanian Society of Cardiology
Sinaia, Romania
Website: www.cardioportal.ro/

September 22 to 24
The 9th International Dead Sea Symposium (IDSS) on Cardiac Arrhythmias and Device Therapy
Dan Panorama Convention Center
Tel Aviv, Israel
Website: www.congress.co.il/arrhythmia08/home.html

September 24 to 27
6th World Stroke Congress
Vienna, Austria
Organized by World Stroke Organization
Website: www2.kenes.com/stroke/Pages/home.aspx

September 25 to 26
Microcirculation Abnormalities in Vascular Disease: Scientific Principles and Clinical Significance
London, United Kingdom
Website: www.cardiovascular-research.co.uk/

September 25 to 27
Artery 8
Gent, Belgium
Website: www.artery.uk.net/Pages/Default.aspx

September 25 to 27
12th International Congress of the Polish Cardiac Society
Poznan, Poland
Website: www.ptkardio.pl/

September 25 to 27
5th Global Cardiovascular Clinical Trialists Forum (CVCT)
Cannes, France
Website: www.globalcvctforum.com/

September 26
Controversies in Cardiac Arrhythmias
The Cosmos Club
Washington, DC, USA

September 26 to 27

6th Advanced Symposium on Congenital Heart Disease in the Adult
Thessaloniki
Greece
Website: achd2008.com/

 

Photo credit: geri-jean at stock.xchng

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How Does Your Hospital Measure Up?

This week 18 California hospitals were fined for poor care violations, some which led to deaths.

How can you protect yourself from poor cancer care?

One way is to find out if your hospital has The Joint Commission Accreditation.

“The Joint Commission has been accrediting hospitals for more than 50 years. Its accreditation is a nationwide seal of approval that indicates a hospital meets high performance standards. JC accreditation helps hospitals improve their performance, raise the level of patient care, and demonstrate accountability in the rapidly changing health care marketplace.”

The Joint Commission sets national patient safety goals each year and along with accreditation programs has certification programs and awards.

How does your hospital measure up?

Find out how your hospital or health care organization rates per The JC. You can also see if they have won any additional awards. You can also file a complaint here. Additionally you can search for the best health care facility in your area for your particular treatment needs on this site.

Read more

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Cardiac death and heart transplant – the ethical and clinical questions

In the recent issue of the New England Journal of Medicine, several articles discuss different aspects of heart transplantation. One interesting aspect is about reversing the irreversible – donating hearts after cardiac death.

It used to be that organ donation can only occur after cardiac death, e.g. after a donor’s heart has completely stopped. Organs such as kidneys can then be transplanted from the donor to the recipient. However, this posed a challenge for heart transplant since the donor’s heart is dead and has irreversibly stopped, and is therefore not viable for transplantation anymore.

In recent years, the concept of brain death came up – irreversible loss of brain functioning. This opened new possibilities for organ donation – especially heart donation. However, the heart remains to be the main source of vital signs and cardiac death is still one of the most common way of defining clinical death. There are, however, some recent reports of hearts from “dead” donors that were successfully transplanted and restarted in recipients bodies. This sparked some ethical as well as clinical questions.

According to Robert M. Veatch, professor of medical ethics at the Kennedy Institute of Ethics, Georgetown University

“…when can death be pronounced on the basis of loss of heart function? Death must be permanent. Clinicians sometimes carelessly speak about patients who experience “clinical death” only to be “brought back to life” by means of cardiopulmonary resuscitation.

The fact that a transplanted heart could be restarted in another body does not indicate permanency. Was the heart donor really dead?”

Where do we actually draw the line between life and death, be it cardiac death or brain death?

A 1993 protocol for the procurement of organs from adults by the University of Pittsburgh Medical Center defines cardiac death when the heart has stopped for 120 seconds, on the basis of the claim that autoresuscitation had never occurred after that period.

There are, however, varying opinions as to how long should one wait before cardiac death is declared. It is possible to restart a heart physiologically by means of external stimulation even beyond the period of 120 seconds. Some experts believe in waiting for 10 minutes or longer. Others would go for 5 minutes.

To put things into perspective, let’s look at some statistics on heart transplant from the American Heart Association:

• 2,192 heart transplants were performed in the US in 2006; 2,125 in 2005.
• In the US, 74.2% of heart transplant patients are male; 68.4% are white; 20.0% are aged 35 to 49 and 55.3% are aged 5 to 64.
• As of June 15, 2007, the five-year survival rate was 72.3% for male heart transplant recipients and 67.6% for females. 

Clearly, heart transplant have saved thousands of lives since the first successful procedure was performed in 1968. However,  if more lives were to be saved, the definition of life and death have to be resolved.

Next in this series: pediatric heart transplants

Photo credit: bizior

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Tomato, Tomatoe

In praise of the tomato.

You already know it’s high in lycopene which helps the fight against, stomach, colon and prostate cancer.

But how else do tomatoes affect your cancer battle?

Per the American Dietetic Association: “Antioxidants are dietary substances including some nutrients such as beta carotene, vitamins C and E and selenium, that can prevent damage to your body cells or repair damage that has been done.”

Basically an antioxidant is capable of counteracting the normal damaging effects of oxidation by neutralizing free radicals in the body. The balance of antioxidants to oxidants is disturbed by poor diet, smoking, disease, normal aging, x-rays and many other things. When an antioxidant neutralizes a free radical, the antioxidant becomes oxidized and the body needs to be resupplied with antioxidants.

From the U.S. Department of Agriculture: “Antioxidants such as vitamins A, C and E, help protect healthy cells from damage by free radicals. Normal body functions such as breathing or physical activity, and other lifestyle habits, such as smoking, produce substances called free radicals that weaken healthy cells. Weakened cells are more susceptible to cardiovascular disease and certain types of cancer.”

But from the Florida Tomato Growers here are some basic tomato facts:

• One medium tomato (148 g) contains only 25 calories
• And supplies 40 percent of the U.S. recommended daily allowance (U.S. RDA) of vitamin C, 20 percent of vitamin A, some of which is in the form of beta-carotene.
• Tomatoes also contain 1g of dietary fiber, about as much fiber as a slice of whole wheat bread.
• Tomatoes provide potassium, iron, phosphorous and some B vitamins.
• They are low in sodium and contain no cholesterol.

Read more

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Legumes for Diabetes Health

The results of the Shanghai Women’s Health Study conducted by Vanderbilt University Medical Center and published in the January 2008 American Journal of Clinical Nutrition, were that consumption of legumes ( peanuts, soybeans, and other legumes) reduced the risk of diabetes by over 40 percent.

Those who consumed more soy beans had the greatest reduction in risk–up to 47 percent.

What is a legume?

High in protein, iron and B vitamins legumes or Leguminosae, have seed pods that, when ripe, split along both sides.

Types of legumes:

• lentils
• peas
• soybeans
• peanuts
• beans

And oh those wonderful beans, pinto, lima, kidney, butter, garbanzo, string beans, snap beans, green and yellow wax beans!

While high in starch beans can be incorporated into your diabetic meal plan.

Try tossing some into your salad or an omelet. Need inspiration? Here are a few legume recipes to get you started.

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Lifestyle changes in many populations may be changing cardiovascular health – for the worse

When I was growing up in an Asian country in the Pacific, the daily fare was rice, fresh fish, vegetables, and fruit. That was before the fast food invasion. Several decades, the daily diet has drastically changed – burgers, pizza, fries galore.

This is happening all over as globalization proceeds in a very fast pace. With lifestyle changes come changes in diet and physical exercise with consequences on our health. Below are some examples of how lifestyle changes are adversely affecting the cardiovascular health of once primarily healthy populations.

Alaskan Eskimos

Traditionally, Alaskan Eskimos have very robust cardiovascular health. They ate lots of fish rich with omega 3 fatty acids and stayed active even in cold temperatures. All that is changing now as the new generations of Eskimos embrace modern lifestyles and pick up bad habits which include smoking, eating fast food rich in saturated and trans fats and doing less physical exercise in favour of television or the internet.

An article published in Stroke: Journal of the American Heart Association reports that Alaskan Eskimos have significantly higher rates of artery plaques compared to the general population.

…more than half of Alaskan Eskimo adults smoke, their level of physical activity has decreased from traditional levels, and their intake of saturated and trans fats, rather than heart-healthy omega 3 fatty acids (found in fish), has increased.

India

India has the highest incidence of acute coronary syndromes in the world, according to a report in the journal The Lancet. And it is still increasing so that in 2 years, it is predicted that India will account for 60% of heart disease cases globally.

A large proportion of the Indian population used to be vegetarian. The economic development in India has brought about changes in lifestyle which proved to be high risk factors for cardiovascular disease. These changes include higher incidence of smoking and diet rich with saturated fat.

China

Obesity used to be very rare in China. The past 20 years observed a rapid in the economy resulting in lifestyle changes in the Chinese population. These changes are especially evident among high-income urban residents and resulted in increased incidence of obesity and obesity-related chronic diseases such as hypertension, heart disease and diabetes. This was according to a report published in the International Journal of Obesity.

Another report in the Chinese Medical Journal estimates that 1 in every 5 Chinese is overweight. The causes can be traced to poor nutrition and lack of physical exercise. The once agricultural country is now highly industrialized so that more and more people sit in assembly lines or behind computers rather than working in the fields.

Unfortunately, though many countries are developing fast economically, their healthcare systems are not up to speed in meeting the health challenges that progress bring. Awareness and prevention programs, as well as and emergency treatment are inadequate.

From lessons learned in North America and Europe, it is expected that this trend in cardiovascular diseases in many fast developing countries will worsen before it gets better.

 

Photo credit

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The Role of Acupuncture in Cancer Treatment

Acupuncture is used as both an alternative and a complementary cancer therapy and is utilized for cancer and associated treatment symptoms.

Alternative therapy is a plan of care that is utilized instead of the traditionally recommended therapy. Complementary therapy works hand-in-hand with traditional therapies. For more information on complementary and alternative therapies for cancer see the Battling Cancer archives.

The American Cancer Society lists important guidelines to understanding these therapies to help the cancer patient make informed decisions.

Mayo Clinic lists acupuncture in it’s list of recommended alternative treatments saying :

“Alternative cancer treatments can’t cure your cancer, but they may provide some relief from signs and symptoms caused by cancer and cancer treatments. Common signs and symptoms such as anxiety, fatigue, nausea and vomiting, pain, difficulty sleeping, and stress may be lessened by alternative treatments.”

In fact many cancer treatment facilities offer acupuncture as part of their complementary and alternative therapy programs.

Check out MD Anderson’s CancerWise for an in depth interview with an acupuncture physician, The American Cancer Society site on acupuncture.

So how does acupuncture work? There are several theories.

The Western culture theory of acupuncture is that it stimulates nerves, muscles and connective tissues also stimulating the blood flow and stimulating the body’s endorphins to relieve pain or relieves pain via the gate theory. The gate theory is that of not removing pain but of blocking pain.

The Eastern theory of acupuncture is that energy flows through the body at meridians. When these meridians are blocked pain and illness ensue. Acupuncture restores this flow and energy harmony. This Youtube video explains this theory.

Acupuncture sessions require the placement of sterile needles which are inserted at key points and remain in place for approximately twenty minutes.

Acupuncture Facts from the American Academy of Medical Acupuncture:

• Non-physician acupuncturists are required by law in most states to use disposable one-time-use sterilized needles. Physicians because of their experience and background in infection control have the prerogative of using re-usable sterilized needles. These needles would need to be sterilized in the same way as any surgical instrument.

• While the degree of beneficial results from acupuncture treatment is dependent on various clinical factors such as presenting symptoms, clinical staging, timing of the encounter in the course of the illness, areas of involvement, the answer to the opening question “can acupuncture help me?” is, in all probability, that it can help in the care of the cancer patient.

• Acupuncture treatments vary because of the wide variations in the styles of acupuncture performed. Generally three to fifteen needles will be placed. Costs vary depending on locale and practitioners training and experience.

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Childhood stroke – yes, there is such a thing

Stroke in babies? No. that can’t be. When we think of stroke, we know the risk factors involved: excess weight, bad nutrition, excessive alcohol consumption, lack of exercise, and cigarette smoking. So how can babies suffer from stroke?

Apparently, stroke in children is not that common but not that rare, either. The risk of stroke from birth till the18th year of life is 10.7 per 100,000 children per year.

Last month, the American Heart Association issued a scientific statement on the management of stroke in infants and children.

What are the differences between adult stroke and children stroke?

Type and incidence: In adults in western countries, 80 to 85% of stroke cases are ischemic where it is about 55% in children. The rest are hemorrhagic.

Symptoms: In children, seizure is a common symptom of stroke not observed in adults. About 10% of seizures in full-term babies are due to stroke.

Treatment: It is highly recommended that adults suffering from ischemic stroke be treated with the medication tissue plasminogen activator (t-PA). t-PA is a clot-busting agent that should be administered within 3 hours of the onset of symptoms. This medication is not yet ready for pediatric use and still needs to be tested.

Risk factors: Risk factors for adult stroke are listed above. The most common risk factors for childhood stroke are sickle cell disease, congenital or acquired heart disease, and chronic anemia. Associated conditions include:

• infections including varicella (chicken pox), meningitis, tonsillitis, and otitis media (middle ear infection)
• leukocytosis, and prothrombotic disorders
• systemic conditions such as inflammatory bowel disease and autoimmune disorders
• head trauma
• dehydration.

Sickle cell disease is a risk factor common to both adults and children.

There are also maternal factors that can influence an infant’s risk for stroke and these include a history of maternal infertility, infection in the fluid surrounding the fetus (chorioamnionitis), premature rupture of membranes, and pregnancy-related hypertension (preeclampsia).

Prevention: Primary prevention is highly feasible in adults. Lifestyle change is the main preventive strategy in adult stroke, followed by medication therapy. In children, prevention is to reduce the likelihood of subsequent strokes after the first one has been correctly diagnosed. Primary prevention is only possible when the underlying condition such as sickle cell disease or congenital heart disease is already known. Children with sickle cell disease 221 times more likely to suffer stroke, according to AHA.

The AHA recommendations for the prevention of subsequent stroke in children are as follows:

Children with ischemic stroke who also have migraines may be evaluated for other stroke risks. Common migraine isn’t likely linked to stroke, but migraine with aura seems to increase risk.

It is reasonable to counsel children with stroke and their families about the benefits of a healthy diet, exercise and avoiding tobacco products.

It is reasonable to suggest an alternative to oral contraceptives after a stroke or cerebral venous sinus thrombosis (CVST).

Children with brain hemorrhage not caused by trauma should undergo a thorough risk factor evaluation, including standard cerebral angiography when noninvasive tests have failed to establish a cause to identify treatable risk factors before another hemorrhage occurs.

Parents can get more information about childhood stroke by downloading this AHA brochure Let’s Talk About Children and Stroke.

 

Photo credit

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Fun and Games for Kids With Diabetes

Learning about your diabetes doesn’t have to be scary and in fact can be a fun and educational process for kids.

And check out these products that can make compliance cool.

The Cadex Pediatric Alarm Watch with these features:

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July Resource Post: The Athlete’s Heart

The heart and physical exercise

What happens to the heart during exercise? A lot of things go faster – breathing rate, heart rate, blood flow. Now, imagine an endurance athlete such as a marathon runner, a Tour de France cyclist, an Iron Man triathelete. Their body and their heart perform faster – for hours and hours almost non-stop.

This introduction to cardiac output by the Montana State University explains what is happening to an athlete’s heart during a competition.

Cardiac output (in liters) is the total blood volume pumped by the heart’s ventricle each minute and is calculated as the heart rate (beats per minute) and stroke volume (mL of blood). Below is a table where the performance of a heart at rest and during a cross country competition is compared.

	Heart at rest	Non-athlete heart during normal exercise	Athlete heart during cross-country competition
Heart rate (beats per minute)	80	180	approx. 190
Stroke volume (mL)	60 to 80	70	210
Cardiac output (L)	4.8 to 6.4	12.6	40

Source: Montana State University; BBC

The blood pumped by the heart is distributed to different organs in the body. When resting, only 15% of cardiac output goes to the muscles. The highest proportion goes to the liver (about 27%) and the kidney (about 22%). During a cross-country skiing competition, the muscles require 60 to 70% of cardiac output, followed by the skin (about 15%) while the requirements for the kidneys and the liver drop below 10%.

The heart of a trained athlete

When the heart performs at top speed regularly such as that of an athlete, the volume of its chambers become larger, the cardiac output also increases. Thus, based on the numbers in the table above, a trained athlete’s heart during a cross-country competition performs almost 8 times more than what a normal does at rest about 3 times more than a non-athlete doing exercise.

Although the numbers will vary from sport to sport and from individual athlete to individual athlete, it is clear from the figures above that a lot of physiological changes occur during physical exercise. Marathon running, cycling, and triathlon are among the most physically demanding sports. Cycling competitions like Tour de France are especially challenging because the event goes on for days with barely time for the cyclists to recover.

The benefits of exercise

We’ve always thought that athletes are the healthiest people on earth. After all, the benefits of exercise are quite well-known (see previous post) for young and old alike, as follows:

• Lowers blood pressure
• Strengthens the heart
• Strengthens the bones
• Prevents disability
• Prolongs life

Lack of exercise on the other hand, is a major risk factor for cardiovascular disorders, diabetes, and osteoporosis among others. The fact that many athletes suddenly collapse and die of cardiac events at their prime during sports events is incomprehensible to us.

Recent research on the athlete’s heart

Studies by Belgian cardiologists show that endurance sports may trigger abnormal heart rhythms (arrhythmias) among athletes, even those without cardiomyopathy. Furthermore, these arrhythmias are not necessarily benign but can lead to more serious heart conditions.

In a first study [1], 46 high-level endurance athletes, mostly cyclists, with ventricular arrhythmia (VA) were monitored for a median of 4.7 years. Over the follow up period, a large number of the athletes developed more serious heart conditions, 18 developed a major arrhythmic event that resulted in 9 deaths. The study concludes that

complex ventricular arrhythmias do not necessarily represent a benign finding in endurance athletes. ..Endurance athletes with arrhythmias have a high prevalence of right ventricular structural and/or arrhythmic involvement. Endurance sports seems to be related to the development and/or progression of the underlying arrhythmogenic substrate.

The second study [2] looked at 22 endurance athletes diagnosed with VA, 15 athletes without VA, and 10 non-athletes without VA as control. Their results show clear differences between athletic and non-athletic hearts. In addition, the condition of VA frequently start as a mild abnormality in the right ventricle that, with prolonged performance of endurance sports, can promote ventricular changes and trigger arrhythmias.

The sudden death of athlete has always been thought to be due to pre-existing conditions such as hypertrophic cardiomyopathy or right ventricular dysplasia. Many of these conditions are genetically determined, thus, the American Heart Association strongly recommends a close look at an athlete’s family history to determine his or her risk.

There is strong indication that excessive physical exercise is linked to potentially dangerous irregular heart rhythms. The studies above report about “acquired right ventricular dysplasia” among endurance athletes that may potentially lead to atrial fribrillation and sudden death. Thus, a trained athlete’s heart may actually become a health hazard rather than the fountain of youth.

Like many things in life, too much of a good thing can be bad. It seems that this also applies to exercise.

As this editorial in the European Heart Journal [3] states:

“…athlete’s heart is a well-known consequence of sport practice, and has been considered as a kind of physiological adaptation to extreme training. It was not until very recently that athlete’s heart (dilatation, hypertrophy and enhanced vagal tone) was recognized as a possible risk factor for the development of atrial fibrillation,establishing a link between excessive training and the presence of arrhythmias.”

 

References:

1. Heidbüchel et al. High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. Eur Heart J. 2003 Aug;24(16):1473-80.
2. Ector et al. Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: a quantitative angiographic assessment. Eur Heart J. 2007 Feb;28(3):345-53.
3. Lluís Mont and Josep Brugada. Endurance athletes: exploring the limits and beyond. Eur Heart J 2003 24(16):1469-1470.

Photo credit

cross-country skiing

cycling 2

marathon

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Cancer News, Weekend Edition

Here’s what’s new in cancer news around the world.

They’re back!! Harry and Louise that is.

Check out the AP article and you can see Harry and Louise circa 1993/94 on You Tube here and now

Harry and Louise have returned to promote a new multi-million dollar ad campaign that will air on national television throughout the Democratic and Republican conventions. In light of ever increasing health care costs and increasing numbers of people without health insurance coverage, Harry and Louise will urge the next President and Congress to put health care at the top of the domestic agenda.

Read more

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Diabetes News, Weekend Edition

Hope your weekend is great. Here’s what is going on in the world of diabetes.

The Diabetes Action Team is running to conquer diabetes.

By joining the Diabetes Action Team, you can participate in any event you choose and gain the satisfaction of knowing you did it not just for yourself, but to help prevent, treat, and cure diabetes.

The Diabetes Action Research and Education Foundation is committed to the prevention and treatment of diabetes and to the funding of innovative, promising research aimed at finding a cure for diabetes and diabetes related complications.

The focus of The Diabetes Action Research and Education Foundation:

• Alternative and complementary research
• Grants for nutritional research
• Promising research to find a cure for diabetes
• Innovative research to prevent and treat diabetes
• American Indian diabetes prevention and treatment programs
• International medical assistance
• Children’s camp scholarship program
• Education and prevention programs

The Diabetes Action Team will be participating in the Marine Corps Marathon October 26, 2008.

The Marine Corps Marathon, or The People’s Marathon, is the 4th largest marathon in the United States. The course moves through Washington, DC, past monuments, the Capitol, and the National Mall, and finishes in front of the Iwo Jima Memorial where a Marine will place your medal around your neck.

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CVD News Watch for the Weekend, August 22

Another weekend to look forward to. Relax, enjoy and happy reading!

CVD TV watch

Untold Stories Of The Heart

NBC and Go Red for Women join forces to bring heart disease stories on TV this coming fall. The special will feature Marie Osmond and Hoda Kotb and

“will focus on real women’s stories of struggle, success and support. Their stories will inspire conversation, compassion and greater understanding of the important journey to heart health.“

Mrs. International Laine Eden Berry also shares her heart story here.

CVD product watch

FDA and Boston Scientific recall NexStent carotid stent system

Bad news: Several stents have been recalled by the US FDA and stent manufacturer Boston Scientific. The products concerned were NexStent Monorail, NexStent Carotid Stent, and Monorail delivery system manufactured June 12, 2007 and May 2, 2008 and distributed between June 19, 2007 and May 5, 2008.

Good news: The recall does not apply to stents already implanted.

CVD healthcare watch

Seeing Red: The Growing Burden of Medical Bills and Debt Faced by U.S. Families

The price of health can be quite high and the number of working-age Americans paying off (whenever they can) medical bills has increased from 34% in 2005 to 41% in 2007. This translates to about 72 million people. Add to that 7 million senior citizens (65 and above) and you get a total of 79 million people having medical debts. These figures are based on a survey conducted by Commonwealth Fund.

CVD treatment watch

Risks of Combining Certain Cholesterol and AF Drugs

Safety alert for clinicians from the US FDA: coadministration of certain anti-cholesterol medications and medications to control atrial fibrillation might not be compatible and can result in a rare but potentially life-threatening condition of muscle injury called rhabdomyolysis. The following medications are in particular risky:

Simvastatin (marketed as Zocor and generics), ezetimibe/simvastatin (marketed as Vytorin), niacin extended-release /simvastatin (marketed as Simcor), used with amiodarone (Cordarone, Pacerone), an antiarrhythmic drug approved only for controlling life-threatening recurrent ventricular arrhythmias. (Source: Heart Rhythm Society).

Read more about the alert here.

CVD weight watch

Obesity in elderly a ticking time bomb for health services

Good news: Obesity in adults is not closely linked to early death.

Bad news: However, it can lead to increased disability as people grow older.

This is according to a study conducted by UK researchers and reported in the August 2008 issue of the Journal of the American Geriatrics Society. The increasing trend towards excess weight in the elerly can present a big burden in health services, especially in the developed world.

The research team recommends that older people should talk to their doctor or other health care professional about their weight, and take their advice regarding slimming down if they are overweight. The advice may include more exercise, a change in diet, or both.

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Diabetic Peripheral Neuropathy

Diabetic neuropathies, or nerve damage, can be a serious health issue for diabetics and in fact affects up to 50 percent of all diabetics, because it can involve nerves of any organ of the body.

Per the Mayo Clinic:

“Diabetic neuropathy has no known cure. Treatment for diabetic neuropathy focuses on:

• Slowing progression of the disease
• Relieving pain
• Managing complications
• Restoring function

Consistently keeping blood sugar within a narrow target range can help delay the progression of peripheral neuropathy and may even cause an improvement in symptoms you already have. In some people, intense glucose control may reduce the overall risk of diabetic neuropathy by more than 60 percent.”

The most common type of diabetic neuropathy is Diabetic Peripheral Neuropathy.

DPN is nerve damage that causes numbness, tingling and pain and or a burning sensation in the extremities.

The National Diabetes Information Clearinghouse defines DPN:

Peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is nerve damage in the arms and legs. Your feet and legs are likely to be affected before your hands and arms. Many people with diabetes have signs of neuropathy that a doctor could note but feel no symptoms themselves. Symptoms of peripheral neuropathy may include

• numbness or insensitivity to pain or temperature
• a tingling, burning, or prickling sensation
• sharp pains or cramps
• extreme sensitivity to touch, even light touch
• loss of balance and coordination

These symptoms are often worse at night.

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