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CVD News Watch October 31

Happy Halloween, everyone. Here is your heart news round up for this week. Plus a couple of reminders: Watch your sweets intake! And for the Americans, don’t forget to vote.

CVD heart treatment watch

Total artificial heart to be ready by 2011: research team

News of hope amidst the financial crisis. Three years from now, a fully implantable artificial heart should be ready, according to French heart transplant specialist Alain Carpentier. The prototype artificial heart has been tested successfully in animals. Although based in France, the project is actually a collaboration between several European scientists, researchers, and funding agencies. However, it’s not only the Europeans, but also Americans, Japanese and Korean scientists who are testing similar prototypes. The European prototype is “made from chemically treated animal tissues, these “biomaterials” are designed to avoid rejection by the patient’s immune system or blood clotting, a recurrent problem with existing artificial hearts.” This is really good news for those who are waiting for a heart donor.

CVD patient watch

Are you phonagnosic?

Phonagnosia is a condition wherein a person does not have the ability to recognize voices. Phonagnosia is very rare and has been reported after suffering a stroke or brain damage. “[It] has only been documented so far in people with brain lesions in the right hemisphere following a stroke or brain damage, and the mechanisms behind it are not well understood. Researchers at the University College London reports a first and only case of somebody born with phonagnosia in the journal Neuropsychologia.

CVD obesity watch

Scripps research scientists develop a new strategy to fight obesity

Is an immunotherapeutic approach the answer to the obesity epidemic? Antibodies to fight obesity? Scientists at the Scripps Research Institute tested an antibody in mice that works against the gastric hormone ghrelin. Ghrelin has been linked to weight gain and fat storage. The antibody catalyst GHR-11E11 increased the metabolic rate and suppressed feeding in treated laboratory mice.

CVD health care watch

Patients’ Perception of Hospital Care in the United States

This study evaluated the perception of Americans regarding healthcare in their country. The results show that most Americans are moderately satisfied with the care they received in clinics and hospitals.  The survey of patient perception is based on the following six components: communication with physicians, communication with nurses, communication about medications, quality of nursing services, adequacy of planning for discharge, and pain management. The best-rated hospital has 67.4% of a hospital’s of its patients declare that they definitely recommend the hospital.

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Energy drinks and their caffeine content

It is a well-known fact that large amounts of caffeine can affect your health and your heart. Therefore, beware! Many energy drinks – purported to dietary supplements are anything but nutritional. They contain lots of sweeteners – and caffeine. Lots of it.

A recent study by Johns Hopkins scientists reported that many energy drinks could actually contain 5 to 10 times more caffeine than a can of coke or a cup of coffee. However, we consumers do not know it because the actual amount is not reflected on the label.

Softdrinks, according to US FDA requirements can contain a maximum of 71 mg caffeine in a 12-ounce can. Popular sodas such as Coke and Pepsi contain about 35 mg of caffeine. A cup of brewed coffee contains a bit more – about 80 to 150 mg. Energy drinks, however, could contain up to 500 mg caffeine per can!

So you might want to ask, what wrong with caffeine?

Well caffeine is a stimulant that affects the central nervous system. It affects our moods, alter mind functioning, and makes the heart work faster. It is not well-known but there are actually many caffeine-related disorders. One is the so-called caffeine intoxication, a clinical syndrome recognized by the World Health Organization’s International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders. Symptoms of caffeine intoxication include agitation, anxiety, insomnia, and heart palpitations.

Recently, there has been lots of concern about the potential abuse of caffeine through consumption of booster energy drinks among young people. These drinks are especially popular among the young as performance enhancers as they cram for exams and rush to finish term papers. The so-called “caffeine rush” has been described as jolts of energy that makes one feel alert and energetic. However, there also comes the “crash episodes” afterwards.

 So how much caffeine is actually too much?

According to Mayo Clinic, caffeine depends on a lot of factors such as:

• Body mass
• History of caffeine use
• Stress
• Age
• Smoking habits
• Food and alcohol intake
• Use of certain drugs
• Certain medical disorders

However, generally speaking 500 to 600 mg of caffeine intake per day is considered too much and can bring about the following symptoms:

• Restlessness
• Abnormal heart rhythms
• Anxiety
• Headaches
• Irritability
• Muscle tremors
• Nausea, diarrhea or other gastrointestinal problems
• Sleeplessness

High caffeine intake is indicated against people with heart disease and mental disorders, pregnant women and young children.

Caffeine, however, does have some medical value and are often used as additives to certain medications, including over-the-counter drugs. OTC cough syrup, for example, can make a person drowsy and not fit to drive or operate a machine. However, caffeine additives in the drug can counteract the sleepiness. However, as is in all medications, the exact caffeine content of these drugs are declared in the drug labels.

Experts are calling for a re-evaluation of the current requirements for energy drink labelling. After all, drugs and alcoholic drinks are required to reveal their contents in detail. With the health effects of caffeine and the potential for abuse, caffeine-energy drinks should also be subjected to such scrutiny and transparency requirements.

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Today is World Stroke Day

Today, October 29, is World Stroke Day. The proclamation for this highly relevant day in the journal Stroke states that stroke is “a preventable and treatable catastrophe“.

Current stroke statistics

Here are some stroke statistics to ponder upon:

• Worldwide, stroke claims 5.7 million lives each year; it is second to ischemic heart disease as a cause of mortality serious disability. Stroke affects everybody regardless of age, sex, ethnic origin, or country.
• By 2015, stroke mortalities can go up to 6.7 million if preventive measures are not stepped up.
• For every five people suffering from stroke, four are residents of low and middle income countries who have limited resources in dealing with the health consequences of stroke.

Why is stroke a growing epidemic?

Here is the reason why stroke is becoming a global problem:

Aging unhealthy diets tobacco use and physical inactivity, fuel a growing epidemic of high blood pressure, high cholesterol, obesity, diabetes, stroke, heart disease and vascular cognitive impairment.

Little strokes can cause big trouble

This year’s theme for World Stroke Day is “Little Strokes, Big Trouble.”

Little strokes refer to the so-called subclinical or “silent” or “mini” strokes and they are more common than previously thought. They can actually occur five times as often as clinical strokes. A recent study reported that 1 in 10 individuals who are basically healthy and “stroke-free” do suffer from silent strokes and they do not know it.

However, although they may be “little” or “silent”, these types of stroke can build up to cause big and not-so-silent troubles. For one thing, silent strokes can have subtle neuropsychological effects and may thus affect thinking, mood, personality, as well as cognitive impairment.

Prevention can work

Stroke, however, is preventable and if what is already known is applied, almost 6 million deaths can be prevented each year, according to the World Stroke Day proclamation. “Prevention is the most readily applicable and affordable part of our knowledge but [it] is neglected.”

Here are some recommended preventive measures:

• Encourage healthy environments to support healthy habits and lifestyles.
• Use effective drugs for both primary and secondary prevention. Regretfully these drugs are neither accessible nor affordable in many developing countries, nor used optimally in developed ones.
• Discourage unproven, costly, or misdirected practices, which drain resources from more cost effective approaches.
• Educate health professionals at all levels through a common vocabulary, a core curriculum, on-line materials, long distance mentoring, and opportunities for learning in clinical practice settings.

In honor of the World Stroke Day, I will be featuring more stroke articles in this site. Stay tuned!

 

Photo credit: vein by gerard79 at stock.xchng

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On exercise: are doctors practicing what they preach?

They are just like the rest of us. They have jobs, they have families, kids, and pets to take care of. And most often their jobs are much more demanding than those of ordinary folks like you and me. They might need to travel, work night shifts, or on weekends. They are our doctors and sometimes we wonder, with their full and hectic schedules, whether they have the time to practice what they preach, e.g. do they do exercise? And if yes, how do they find the time?

heartwire interviewed several cardiologists and other doctors whether they exercise and most of the answer is “yes”.

They were also asked details about their exercise routines and why they exercise.

Why exercise?

Here is what several doctors say:

• A doctor can communicate and connect better with his patients about exercise based on his or her personal experience.
• An exercising doctor can transmit his or her passion and enthusiasm for exercise to the patients.
• Exercise helps a doctor to concentrate on the job.
• Exercise keeps a doctor healthy.
• Exercise helps a doctor clear his/her mind work off some stress.
• Exercise can help perform a job effectively. For an electrophysiologist, for example, exercise helps “maintain endurance for long EP cases and the flexibility needed for wearing lead for hours.”

Which exercise?

The routines the doctors followed were kind of varied as described below.

• Dr Valentin Fuster of Mount Sinai School of Medicine is an avid cyclist and tackles the stages of Tour de France and other challenging cycling competitions.
• Dr Peter Gallagher, an electrophysiologist at the Nebraska Heart Institute, runs and does stretches.
• Dr Roger Blumenthal of the Johns Hopkins Medical Institute keeps fit through golf and keeping up with his kid’s sports activities, from lacrosse, to basketball.
• Dr Jon Resar also of the Johns Hopkins Medical Institute runs about five miles daily, six times a week outdoors. He has his dog to keep him company on his early morning runs.
• Dr Christopher Cannon of Brigham and Women’s Hospital, Boston, MA works out indoors every morning for 30 minutes with different machines, from stationary cycle to weights.
• Dr Melissa Walton-Shirley of TJ Sampson Community Hospital, Glasgow, KY goes for the treadmill, the elliptical machine, and the cycle.

As one of the experts say

“I do think it’s a little hypocritical of a cardiologist who is not taking care of himself to ask patients to stay active.”

Well, what about me?

I am not a cardiologist but time and time again, I’ve emphasized the importance of exercise in my posts. Do I practice what I advocate? Well, I definitely try. I jog outside 3 to 4 times a week, 30 to 60 minutes. My family and I go for long walks or hikes in the mountains and forests. I firmly believe in the health benefits of exercise and I live it.

Watch out for a resource post on exercise here.

 

Photo credit: lovleah at stock.xpert

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Children and Diabetes

The current initiative of the International Diabetes Federation (a worldwide alliance of some 200 diabetic associations in more than 160 countries) is Children and Diabetes:

Diabetes is one of the most common chronic diseases to affect children. It can strike children of any age, even toddlers and babies. If not detected early enough in a child, the disease can be fatal or result in serious brain damage. Yet diabetes in a child is often completely overlooked: it is often misdiagnosed as the flu or it is not diagnosed at all.

Every parent, school teacher, school nurse, doctor and anyone involved in the care of children should be familiar with the warning signs and alert to the diabetes threat.

The Diabetes Warning Signs

• Frequent urination
• Excessive thirst
• Increased hunger
• Weight loss
• Tiredness
• Lack of interest and concentration
• Blurred vision
• Vomiting and stomach pain (often mistaken as the flu)

*In children with type 2 diabetes these symptoms may be mild or absent.

Read more

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Keeping fit in a sick economy

These are tough times. The economy is sick. But that doesn’t mean to say we should let our body get sick. Here are some tips to keep our heart strong and our body fit in the face of the current recession. Without extra spending, of course.

Leave the car at home

How about keeping fit, at the same time keeping your CO₂ emission down? Try cycling. You stay fit, save money on gasoline as well as on fitness club membership fees. Plus, you avoid the traffic jams and the stress that goes with them.

The call for companies to encourage cycling to work is on. Last July, the bank Credit Suisse was awarded as “Best Company that Encourages Employees to Bike to Work” by the New York City Department of Transportation and Transportation Alternatives. The bank provides secure parking spaces for bicycles in its Manhattan office. In addition, it enables employees to use lockers and shower at a nearby fitness club at reduced rates. In its headquarters in Switzerland, the bike-to-work movement was also a resounding success.

“Around 950 Credit Suisse employees opted for this environmentally friendly method of getting to work on over 12’000 work days, covering a total distance of 145’000 kilometers – more than three times the circumference of the earth.”

Take the stairs

We spend more than half of our waking hours at the workplace. How can we integrate fitness into those hours? “The challenge remains to develop successful population-based interventions, which promote physical activities that can be easily integrated into everyday life,” according to one of the researchers of the Geneva stairs study.

Well, they may have found another way to keep fit at work – forget the elevators and take the stairs. After 12 weeks of taking the stairs at work, a significant decline in the waist circumference, weight, fat mass, diastolic blood pressure, and LDL cholesterol of the participating employees was observed. And think of the energy saved!

Get back to a healthy lifestyle

Now that the expense accounts are closed, and business travels are suspended, this is your chance to cut down on those expensive 5-course dinners, cocktail parties, and long-haul flights. In tightening our belts (and budgets), we can lose a few pounds in the process. Now, why don’t you fill up your fridge with fresh fruit and vegetables? They are great for the evenings. Apples are especially handy as snacks – easily transportable in your laptop bag and they don’t spoil easily. Plus, now that jet lag is seldom a problem, get your sleep routine in order. Be aware that your sleeping habit can affect your heart. And while you are at it, why not cut back on the cigarettes as well? Better save your cigarette money for a rainy day. Who knows how long this recession will last.

Keep moving, keep the blues away

Out of job? Moping around the house? Maybe it’s time to have some downtime from corporate life and relax more. Times are hard so expensive holidays are out of the question. What about catching up with the yard work, a bit of gardening here and there? Start a vegetable patch (season and space allowing), do some of the paint job you’ve always wanted done? Why not join a walking or running club? Remember, the fitter you are, the more competitive you will be on the job market.

There is a recession going on. All the more reason why we should take care of ourselves. We don’t want additional health care costs, do we?

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Spotlight on Diabetes Products

New diabetic products are always fun to check out!

OneTouch UltraMini Meters!

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See You in Cyber Space

Today marks my last day at Battling Diabetes. I have some new adventures that are waiting for me!

First–many thanks to Hart, the DUDE, and to the other bloggers at the Hart Empire for making this journey so comfortable. Thank you to the readers for your comments and participation.

I have learned far more from this site than I could have imagined. With a family history of diabetes, I have taken to heart the education gleaned here and hope you have also.

Finally, I wish those of you battling diabetes on a daily basis the best.

Tina Radcliffe

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See You in Cyber Space

Today marks my last day at Battling Cancer. I have some new adventures that are waiting for me!

First–many thanks to Hart, the DUDE, and to the other bloggers at the Hart Empire for making this journey so comfortable. Thank you to the readers for your comments and participation.

A special shout out goes to Paul McGee with the American Cancer Society for the heads ups he gives to this site and to the Community at My Crazy, Sexy Life, especially Debbie.

Finally, thank you to those who battle every single day and have taught me so much.

Tina Radcliffe

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More Than Pink, Breast Cancer Update

The month of October is moving to a close, but there are still more pink events out there and an amazing outpouring of pink support for breast cancer!

Let’s take a quick look at what’s going on in the battle against breast cancer.

We’ve come a long way. Based on the Gail model there are now risk prediction tools for breast cancer. The Gail model takes into account five factors including your current age, age when you started menstruating (menarche), previous breast biopsies, age at first live birth, and amily history of breast cancer.

A disadvantages of the Gail model is that it doesn’t take into account age at which a family member was diagnosed and whether the disease occurred in both breasts — early onset and bilateral disease suggests a BRCA mutation carrier.

Based on the model, the National Cancer Institute is one site that now offers a Breast Cancer Risk Assessment Tool.

“The Breast Cancer Risk Assessment Tool is an interactive tool designed by scientists at the National Cancer Institute (NCI) and the National Surgical Adjuvant Breast and Bowel Project (NSABP) to estimate a woman’s risk of developing invasive breast cancer. The tool has been updated for African American women based on the Contraceptive and Reproductive Experiences (CARE) Study.”

Remember that the results are meant to be discussed with your health care provider.

In addition to the Gail model, researchers at the University of California, San Francisco have developed a way to quickly estimate a woman’s risk for invasive breast cancer. The new model, based on a measure of breast density that is already reported with the majority of mammograms today, is the first to be validated across multiple ethnic groups living in the United States.

The model could one day be used to help calculate a woman’s risk for breast cancer each time she has a mammogram, providing her with a realistic sense of her likelihood to develop breast cancer in the future.

Read more

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CVD News Watch for October 24

Autumn is here and it’s time to prepare for the winter. Here is this weekend’s heart news round up.

CVD intervention watch

Revolutionary operation performed live for heart rhythm congress

It was a live performance of a different kind. Last Monday, October 20, Dr Andre Ng, Senior Lecturer in Cardiology at the University of Leicester and a Consultant Cardiologist at the University Hospitals of Leicester performed a revolutionary heart operation which was broadcasted live to the delegates at the Heart Rhythm Congress 2008 in Birmingham. The congress ran from 19 to 22 October. Dr. Ng used “technology that allows rapid and accurate location of the origin of the heart rhythm disturbance in a 3-dimensional geometry of the heart chambers and guides successful treatment with the use of catheter ablation.”

CVD obesity watch

Speed of eating “key to obesity”

According to this news item from BBC, Japanese researchers observed that men who eat fast were 84% more likely to be overweight than normal speed eaters of the same gender; for fast-eating women were it’s just over 54%. The study findings suggest that our moms were right when they told us never to wolf down our food but instead chew everything 20 times. “If you eat quickly you basically fill your stomach before your gastric feedback has a chance to start developing – you can overfill the thing“, according to Professor Ian McDonald of the University of Nottingham. Children should therefore be encouraged to eat slowly and not be forced to eat they are feeling full.

CVD prevention watch

Panel calls for vaccine for adult smokers

No, it is not a vaccine to help you to quit. It is a shot to protect smokers from bugs that cause pneumonia, meningitis and other illnesses that smokers tend to have. This is according to the recommendation issued by the Advisory Committee on Immunization Practices (ACIP). It has been shown that smokers are about four times more likely to suffer pneumococcal disease than nonsmokers. The vaccine is recommended for adult smokers 65 years and older.

CVD innovation watch

Heart valves that grow with the patient

German surgeons and researchers  developed this award-winning innovation – heart valves than can be used in children because they grow with the patient. The valves are made from tissues the so-called “engineered biological cardiac valves” especially suitable for growing hearts. More about this next week.

CVD BP watch

BP control suppresses AF risk

This study found a link between hypertension and atrial fibrillation (AF). Thus, controlling your blood pressure can reduce your risk for AF, according to University of Washington researchers, and even more serious cardiac events.

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Hope and Help For the Holidays — Involve Your Loved One

The holidays, for Alzheimer’s caregivers, are filled with a myriad of emotions. Hope and gratitude that another year has passed and our loved one is still with us. We have Fear and anxiety regarding the future, and a strange mixture of joy and sadness for the present. We look into our loved one’s eyes and realize that mom’s body is there, but SHE is long gone. We remember the good times when dad used to climb into the attic or descend the basement stairs to get the holiday accouterments. Grandma and pops used to host the Christmas Eve dinner and now he doesn’t even know that it’s Christmas.

On some levels it’s a bit challenging. On other levels, it feels impossible. How can we possibly balance the festivities of the holidays with the uncertainty of caring for a person with Alzheimer’s disease?

Today, I’ll give you a few suggestions as to how you and your family can enjoy the holidays, while caregiving. This post will specifically address how to include your loved one in as many activities as possible and practical.

• Think smaller instead of larger – Instead of having a huge, sell-out crowd over, consider having a smaller group
• Think participation – Allow your loved one to help and participate. From setting the table, to folding napkins, to knitting or even helping with the decorations; anything your loved one can do to feel loved, appreciated and helpful will bring more joy than the most well thought out gift. I used to ask my mom to fold laundry. Although it wasn’t a holiday-specfic task, she felt needed (and it kept her occupied and out of trouble, at least for a little while).
• Think personal – Take your loved one out for a nice dinner or prepare an intimate dinner. Enjoy a special worship service or other activity together.
• Think help – If you do plan to host a big holiday dinner. Get a family member, friend or even a paid caregiver to help out with your loved one. Having one person who is dedicated to making sure your loved one is taken care of makes a world of difference. A few years ago, my husband and I hosted the family Thanksgiving dinner. There were about 50 guests. My brother designated himself the caregiver for the day and stuck close to mom for the entire day. It took a major load off of me and helped to keep her grounded.
• Think Consistency – As much as possible, keep your loved one’s routine in tact. Major changes in schedule can cause problems in the present and for days or weeks long after the company is gone.

Finally, and maybe most importantly, breathe. Take time to enjoy your family, your loved one and this special time of year.

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Your cigarette smoke is harmful to your spouse’s health

Still smoking?

Well, I’ve got bad news for you. You are not only increasing your risk for stroke, you are putting your spouse/partner at risk as well.

The study is based on analysis of data from the Health and Retirement Study (HRS), a survey of 50-year olds and above Americans, sponsored by theNational Institute on Aging.

And figures to the support the bad news are as follows:

• For those who never smoked, being married to a current smoker was associated with a 42% increase in risk of stroke compared to being married to a never-smoker.
• For former smokers, being married to a current smoker was associated with a 72% increase in risk compared to being married to a never-smoker.

On the upside, quitting immediately lowers the risk of stroke of both the smoker and his/her non-smoking spouse. Thus, the stroke risks associated to being married to a former smoker and a never-smoker are not significantly different. This indicates that quitting really pays off, no matter when. In addition, your choice for a long-term life partner can actually determine your risk for stroke.This reminds me of Carrie Bradshaw ( of Sex and the City) trying to quit while dating a nonsmoker. However, smoking and partnership are far from just a TV adult comedy series. They are for real.

In another study, the effects of smoking cessation on your vascular system are observable soon after quitting. According to one study author:

“The harms of smoking are reversible, but for some causes of death, the reduction takes many years, so it’s never too early to quit smoking. On the other hand, for some diseases-eg, CHD-there is a rapid decline in risk, so it’s never too late to stop smoking, even if you’ve been smoking for many, many years”

The final analysis of the HRS data included 16,225 participants and their spouses who were followed up for an average of 9.1 years. Adjustments were made for age, ethnicity, Southern birthstate, parental education, and occupation, income and wealth, obesity, overweight, alcohol use, and diagnosed hypertension, diabetes or heart disease but the results were the same – smoking makes you susceptible to stroke and passive or secondhand or environmental smoke makes your spouse/partner susceptible as well.

Now, if your smoking habits adversely affect your partner’s health, how do you think does it affect your child/children’s health?

Studies have shown that children who have smoking parents tend to have health problems associated with the polluted environment they live in. These problems include heart problems, allergies and asthma attacks, sudden infant death (SIDS), gum problems and tooth caries, and sleeping disorders. Smoking before and during pregnancy has also been shown to increase the incidence of congenital heart defects.

Photo credit: stock.xchng by ilco

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A blood test to detect heart attacks

Can you recognize the signs of a heart attack? Although heart attacks can happen suddenly accompanied by the unmistakable chest pain – basically the attacks portrayed in films – most heart attacks start slowly and mildly so that they may be ignored, taken for granted, or misdiagnosed. According to the Medline Medical Encyclopedia:

A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.

Each year, more than 1 million people in the US suffer from heart attacks and about half of these die. Studies have shown that the sooner medical help is given to those who suffered from heart attack, the better are the chances of survival and recovery.

Symptoms of heart attacks can sometimes be so innocuous and misleading and can include (in the absence of chest pains) numbness and pain in the upper part of the body (arms, shoulders, neck), dizziness, vomiting, shortness of breath and sweating. Symptoms can vary between men and women and from one individual to another.

Researchers at the Massachusetts General Hospital have developed a method to detect a heart attack soon after it occurs. The method is a blood test that detects changes in several small molecules (metabolites) present in a patient’s blood soon after a heart attack occurs.

The researchers report:

“We identified changes in circulating levels of metabolites participating in pyrimidine metabolism, the tricarboxylic acid cycle and its upstream contributors, and the pentose phosphate pathway. Alterations in levels of multiple metabolites were detected as early as 10 minutes after PMI in an initial derivation group and were validated in a second, independent group of PMI patients. A PMI-derived metabolic signature consisting of aconitic acid, hypoxanthine, trimethylamine N-oxide, and threonine differentiated patients with SMI from those undergoing diagnostic coronary angiography with high accuracy, and coronary sinus sampling distinguished cardiac-derived from peripheral metabolic changes.”

There are changes in the metabolite profiles soon after a heart attack that are indicative of heart injury and this is what the blood test is detecting. There are many way to diagnose a heart attack but most of these take time. This new test can aid health care providers in rapid diagnosis of heart attacks, provide rapid treatment and prevent subsequent attacks.

The new blood test is a product of a new field of research called metabolomics which focuses on chemical fingerprints of cellular and physiological processes.

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Hope and Help for the Holidays — General Tips and Information

The holidays can be stressful for anyone. If you add sickness, dementia and Alzheimer’s disease to the mix, you can really have a recipe for disaster as you attempt to navigate the holidays. It’s natural to get a little down during the holidays and caring for a loved one with Alzheimer’s can really complicate what is to be a joyous occassion.

In the meantime, here are a few tips and tricks to make your holidays easier:

1) Move your furniture as little as possible. It may be your custom to change your home into a winter wonderland during the holidays, but that change can throw your loved one into a real tissy.

2) Consider the crowd factor. One year, we took my mom to Virgina to my in-laws. It was a major disaster. A combination of the different atmosphere, the noise level and the crowd really took its toll on my mother. Before the evening was over, she was literally crawling on the floor, under the piano looking for the stairs because she wanted to go to the basement. There was no basement in the house we were in, but of course, she would not hear of it. That was a l-o-n-g day and night. We didn’t get to bed until 3:00 am because we ended up taking mom for a long drive and then coming in through a different door hoping that she would then accept that we were now in a different place.

3) Be aware of safety considerations.
a. Your loved one could easily take to eating brightly colored decorations
b. Keep all extension cords tucked away
c. Secure all throw rugs
d. Keep your eye on the candy jar. I read a story once of a man who ate an entire jar of his favorite candy in one sitting. Although, we tend to splurge during the holidays, an entire jar of candy isn’t good for anyone.

4) Secure your Christmas tree or other standing decorations if you have them. The lights and decorations can be alluring to someone with Alzheimer’s disease. On the other hand, they can be scary. I heard of a man who attempted to pick up the entire Christmas tree and remove it because it was, “in the way.”

5) Check out the Mayo Clinic’s suggestions for balancing the holiday’s and caregiving for a loved one with Alzheimer’s disease.

Finally, do what you can do to jog your loved one’s positive memories. Pull out picutres, bake a favorite cake or dessert, tell favorite stories. Try to include your loved one, as appropriate, in festivities, even if it means that you have to listen to the same story over and over again.

Next time, I’ll give you some specific ideas for including your loved one as you make the most of the holidays while you battle Alzheimer’s disease.

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VADs for children waiting for heart transplant

A ventricular assist device (VAD) is a mechanical device that helps a failing heart to function. The pump-like device can be for short term use only, such as those for patients recovering from heart surgery or those waiting for a heart donor, or they can be for long term use such as those for patients suffering from congestive heart failure or cardiomyopathy. The longest record of a surviving cardiac patient on VAD is 7 years, as reported by the Texas Heart Institute last year. VADs have saved many lives of patients whose hearts are not longer capable of efficiently pumping on their own. VADs are especially used in patients waiting for heart transplantation.

Unfortunately, most VADs are adult-sized and are only suitable to assist adult-sized hearts. But what about those little baby hearts that need help?

It seems that a miniaturized VAD that can be used for children is available in Europe. And pediatricians are hoping that the device will soon be available in the US market

Dr Sanjiv K Gandhi of St Louis Children’s Hospital in Montana reported how he and his colleagues successfully implanted VAD in several children awaiting heart transplant. The implants increased the chances of survival of the children as they wait for the right heart.

In the US, about 400 pediatric heart-transplantation procedures are performed every year. Of these, about 100 recipients are under the age of 1. Heart transplants statistics show that babies are 10 times more likely to die while waiting for a heart compared to adults. As many as 50 babies which are placed on the heart transplant waiting list every year do not survive the wait (Source: Curfman et al., 2008). The use of the miniaturized VAD can lengthen the waiting time while pediatric cardiac patienst await for a heart donor.

Gandhi explains that

“extracorporeal membrane oxygenation (ECMO) has remained the most common form of mechanical support available prior to ventricular assist devices, but the incidence of medium- and long-term bleeding and infectious complications is exceedingly high with ECMO, and neurological impairment is also common. ECMO also restricts patient mobility, impairing physical rehabilitation.”

A 2006 review of data from the Pediatric Heart Transplant Study (PHTS) database indicate that VAD seems to be more successful in patients with cardiomyopathy compared to congenital heart diseases. The bridging time using VAD ranged from 1 to 465 days and the age of the patients ranged from 2 days to almost 18 years old.

Currently, there is an FDA-sponsored study ongoing implanting these tiny devices in American and Canadian children. According to Gandhi, the 70% to 75% survival rate may not sound much but it is definitely better than zero. In many cases, VAD is the only thing that stands between life and death for these patients. However, the doctor laments the fact that a lot of bureaucratic problems in the US hinder fast procurement of the device. For some tiny patients, this delay can mean death.

Photo credit: stock.xchng by planetka

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Big pharma pulls the plug on development of heart and stroke drugs

Many pharmaceutical companies have made billions of dollars with blockbuster drugs used for the treatment of cardiovascular diseases. Among these drugs are statins and other cholesterol-lowering drugs. However, it seems that the profitable days are over. The therapeutic area of cardiovascular medicine seems to be less lucrative nowadays, what with many of the bestselling drugs going off-patent. The market is getting flooded with cheaper generic versions of the said drugs.

Pfizer is one of the pharma giants that feels that cardiovascular drugs are no longer profitable. According to an internal Pfizer memo obtained somehow by Forbes, the company has decided to focus the development of new drugs (and therefore R& D spending) on therapeutic areas which are considered to be potentially lucrative. These high priority areas are cancer, diabetes, pain killers, and neurological disorders, such as Alzheimer’s disease but do not include cardiovascular medicine.

Pfizer is one of the companies who are suffering from drug patents running out. Its anti-cholesterol drug Lipitor (atorvastatin), said to be the world’s bestselling drug, will lose its patent in about two years’ time (2011). The company has also lost the patent of another bestseller, Norvasc (amlodipine) in 2007. Other companies have similar problems. The blockbuster drugs whose patents are about to expire are Risperdal (Johnson & Johnson’s), Seroquel (Astra Zeneca), Lamictal (GSK), and Avandia (GSK).

The last two years witnessed a lot of safety issues in the pharmaceutical industry. It has not recovered yet from the Vioxx (rofecoxib) debacle and had to face the safety problems of Avandia (rosiglitazone) and the drug-eluting stents (DES), the disappointment over ENHANCE and ezetimibe, and the failure of the HIV vaccine.

In the field of cardiovascular medicine, the use of surrogate markers such as LDL- and HDL- cholesterol levels is being question.

So far, biomarker and stem cell research haven’t delivered any “miracle” diagnostics and treatments that everyone was hoping for. It will probably take years, even decades before biotechnology can produce something that will “rock” the medical world although several early phase clinical trials are planned or ongoing. In the current financial crisis, it is no wonder that pharma companies are becoming more cautious where they put their money.

Where does that leave cardiovascular patients? I think there is a wide range of drugs out there indicated for cardiovascular health. The main focus of the health care industry should not be pharmacological therapy but prevention and treatment through lifestyle change strategies. Practical ways where we can improve cardiovascular health without the aid of drugs and pharmaceutical companies are:

• Wellness and fitness in the workplace.
• Better nutrition and fitness in schools.
• Legislation regulating smoking.
• Better access to health care.
• Increased health awareness and education.

Photo credit: Stock.xchng by tanyah

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Think Before You Pink

With the growing popularity of pink products for the month of October, National Breast Cancer Awareness Month; have you ever wondered if everything is as pink as it appears?

I found a very thought provoking site in my travels through cyberspace seeking out cancer news: Think Before You Pink, challenges people to do just that.

Think Before You Pink is a project of Breast Cancer Action:

Our plan goes beyond the notion of “the Cure,” and tackles the most pressing issues that must be addressed for real change to happen. By “Challenging Assumptions” and “Inspiring Change”, we are shaping the future of what happens in all the important aspects of breast cancer. Nearly twenty years ago, BCA initiated the conversation to address toxic exposures and environmental links to breast cancer. Because of those early conversations, researchers and some mainstream breast cancer groups are now dedicating time and money to understand those links. More recently, BCA began questioning cause marketing for breast cancer, and more organizations are now urging people to “Think Before You Pink” as a result. Based on our experience of driving new thinking about breast cancer in the past, it is time to drive the conversation to new ground again. BCA is the organization best poised to make this happen by focusing on emerging issues in breast cancer.

One of the 2008 initiatives of Think Before You Pink and BCA is

Yoplait Put a Lid on It campaign.

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DexCom STS Continuous Glucose Monitoring System

In 2006 the FDA approved the DexCom STS Continuing Glucose Monitoring System for monitoring the blood glucose levels of diabetics over the age of 18.

Per the FDA guidelines, this prescription device is used to report glucose values every 5 minutes for up to 72 hours.

The sensor is inserted in the abdomen. After a 2 hour start-up period, the STS System is calibrated with 2 fingerstick measurements taken by a traditional glucose meter. After calibration, the STS System provides a glucose reading and updated glucose trend information for viewing every 5 minutes. The STS System also contains a built-in alarm that can be programmed to alert the user when results fall below pre-set low and pre-set high levels.

Since the FDA approval of the DexCom STS the company manufacturer has upgraded the system and this new system is call the SEVEN System. “The Seven System measures glucose throughout the day and night, allowing users to see trends and patterns in glucose readings. Glucose trends, alerts and a low ALARM provided by the Seven System help users stay between the lines of their target glucose range. ”

Details on the Seven System:

Comprised of three parts

1. The Sensor

• Tiny flexible Sensor goes under the skin
• Small Sensor — so small that it fits completely inside the insertion needle
• Smallest insertion needle (26 gauge) available
• Detachable, disposable applicator for easy and reliable insertion

2. The Transmitter

• Water resistant (up to 3 feet for 30 minutes)
• Uniquely miniaturized size is comfortable and discreet
• Wirelessly sends glucose readings to Receiver
• Gentle adhesive
• New microprocessor for improved Sensor data processing

3. The Receiver

• Designed for easy viewing of 1-, 3- and 9-hr glucose trends and current glucose readings
• Next generation software is intuitive and reliable
• Wireless for convenience and transportability
• Carried or worn within 5 feet of the Transmitter
• Stores up to 30 days of data
• Data is downloadable to computer for viewing of long-term trends

Preview the product with the Seven Sensor interactive video tutorial now!

And check out marathon runner and triathlete, Tom Kingery’s blog, Running on Empty, where he shares his personal experiences with the DexCom.

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CVD News Watch October 17

It’s Friday again, time for your heart and health news round up. Happy weekend.

CVD obesity watch

Fructose sets table for weight gain without warning

We’ve always though fructose is better, healthier than sucrose – our normal table sugar.

Well, this study shows that “eating too much fructose can induce leptin resistance, a condition that can easily lead to becoming overweight when combined with a high-fat, high-calorie diet.” This study was demonstrated by University of Florida researchers in rats. Fructose has always been used as a healthier alternative to sucrose but it is also found in fruits.

CVD health care watch

Nation’s only citywide electronic health information exchange: Improving health and lowering costs

Regenstrief, Indiana has the only fully electronic medical records system in the US. The system has a database of about 9.6 million patients.

Electronic medical records offer numerous advantages over paper records which are sometimes illegible and very often not where the patient is when he or she needs treatment. Because an electronic medical record allows the doctor to instantly see the patient’s prior treatment, medication history and other details critical to care, errors decrease.

It aims to improve health care services and lower costs.

CVD treatment watch

HORIZONS AMI: Drug-eluting stent safe and effective in the setting of STEMI

After all the controversies about the safety of drug-eluting stents (DES), this is good news. Results from the HORIZONS AMI trial indicate that DES has better efficacy and similar safety profiles as bare metal stents. Some experts think that the cardiovascular benefits are modest. However, the better safety profile provides more confidence.

 CVD diagnostics watch

Exercise test termination has prognostic value in HF

You are on a treadmill or pedometer and you suddenly have to stop. In this scenario during an exercise test for heart failure patients, the reason for stopping can guide the doctor towards a prognosis. Two main reasons – fatigue (exhaustion) or dyspnea (shortness of breathing) – bring about exercise termination. Stopping due to dyspnea suggests higher heart failure severity and therefore higher risk for cardiac events than stopping due to fatigue.

CVD diabetes watch

ASH releases new guidelines for hypertension control in diabetics

How do you manage hypertension in people with diabetes? The American Society of Hypertension (ASH) has just updates its guidelines with “renewed emphasis on early aggressive treatment, the use of fixed-dose drug combinations, and an integrated approach to reducing global cardiac risk.”

CVD sanitation watch

Global Handwashing Day

“Clean hands save lives” is the motto of the first United Nations Global Handwashing Day last Wednesday, October 15. More 3 million children die of diarrhea and pneumonia globally each year, 2 diseases which are preventable by washing hands with soap. The UNICEF was one of the driving forces behind this initiative to help children in many parts of the world without clean water for sanitation. 2008 has been declared by the UN as the International Year of Sanitation.

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