Wednesday, November 22, 2017
Adult Congenital Heart Disease: Arrhythmia Management
From: Mayo Clinic https://www.youtube.com/watch?v=FN0PeUNa9I8
Report: Sugar industry hid data on health risks
A new report suggests industry leaders copied the playbook of Big Tobacco and suppressed research linking sugar to serious illnesses
From: http://www.cbsnews.com/news/sugar-health-risks-industry-hid-evidence-report/
From: http://www.cbsnews.com/news/sugar-health-risks-industry-hid-evidence-report/
USDA Ethics, Post Employment for Further Restricted Employees
From: USDA https://www.youtube.com/watch?v=Pl1gwtevhKw
USDA, The Ethics Pledge – Post Employment Restrictions
From: USDA https://www.youtube.com/watch?v=LwO6lsJBQPg
USDA Ethics, Hatch Act for Further Restricted Employees
From: USDA https://www.youtube.com/watch?v=Ri_X-ULU_zs
USDA Ética, Regalos Derivados de Fuentes Externas
From: USDA https://www.youtube.com/watch?v=8SH0zQft34Q
Mayo Clinic Minute: Hope for Alzheimer's disease
From: Mayo Clinic https://www.youtube.com/watch?v=pSNPc4-_xf4
Formerly conjoined twins able to go home for the holidays
This week, after 485 days at the hospital, the girls who are now 15 months old are well enough to head home for the very first time
From: http://www.cbsnews.com/news/formerly-conjoined-twins-able-to-go-home-for-the-holidays/
From: http://www.cbsnews.com/news/formerly-conjoined-twins-able-to-go-home-for-the-holidays/
How to have a healthier Thanksgiving
Dr. David Agus offers some advice for holiday feasting you won't regret later
From: http://www.cbsnews.com/news/thanksgiving-meal-healthy-moderation-movement/
From: http://www.cbsnews.com/news/thanksgiving-meal-healthy-moderation-movement/
American seniors are sicker than global peers
A survey of 11 high-income nations also finds those 65 and older in the US can least afford appropriate health care
From: http://www.cbsnews.com/news/american-seniors-are-sicker-than-global-peers/
From: http://www.cbsnews.com/news/american-seniors-are-sicker-than-global-peers/
Nearly half of U.S. cancer deaths blamed on these "modifiable" behaviors
New research suggests that exposure to sun, not eating enough fruits and vegetables, drinking alcohol, and smoking cause nearly half of all cancer deaths in the U.S.
From: http://www.cbsnews.com/news/nearly-half-of-u-s-cancer-deaths-blamed-on-unhealthy-behavior/
From: http://www.cbsnews.com/news/nearly-half-of-u-s-cancer-deaths-blamed-on-unhealthy-behavior/
3M withheld info about cancer-causing chemicals, suit claims
Court documents also allege 3M concealed the potential harm of chemicals from government regulators
From: http://www.cbsnews.com/news/3m-withheld-info-about-toxic-chemical-contamination-suit-claims/
From: http://www.cbsnews.com/news/3m-withheld-info-about-toxic-chemical-contamination-suit-claims/
How to have a healthier Thanksgiving
By some estimates, a Thanksgiving feast could mean over 4,500 calories in one meal – more than twice the recommended amount for two whole days. Dr. David Agus joins "CBS This Morning" to discuss steps you can take to be healthier this holiday and for the entire year.
From: http://www.cbsnews.com/videos/how-to-have-a-healthier-thanksgiving/
From: http://www.cbsnews.com/videos/how-to-have-a-healthier-thanksgiving/
Smoggy Air May Spawn Weaker Sperm
Microscopic particles in the air called particulate matter (PM2.5) may affect the quality of sperm, which in turn can make it difficult to fertilize a woman's egg, the researchers said.
From: https://www.webmd.com/men/news/20171122/smoggy-air-may-spawn-weaker-sperm?src=RSS_PUBLIC
It's the Latest Diet Craze, But Is It Safe?
It's a simplified approach to eating that essentially views fruits and vegetables through the same prism as candies and soda. All that matters is the total caloric tally.
From: https://www.webmd.com/diet/news/20171122/its-the-latest-diet-craze-but-is-it-safe?src=RSS_PUBLIC
Surviving your Thanksgiving road trip
Expert tips to help make the drive to your holiday gathering as safe and stress-free as possible
From: http://www.cbsnews.com/media/surviving-your-thanksgiving-road-trip/
From: http://www.cbsnews.com/media/surviving-your-thanksgiving-road-trip/
This Thanksgiving, Promise Yourself: Don't Choke
Researchers say people are more apt to get food stuck in their throats at the holidays.
From: https://www.webmd.com/food-recipes/news/20171121/this-thanksgiving-promise-yourself-dont-choke?src=RSS_PUBLIC
'Partridge Family' Star David Cassidy Dead at 67
Musician and actor struggled with substance abuse and had been hospitalized in Florida.
From: https://www.webmd.com/a-to-z-guides/news/20171121/partridge-family-star-david-cassidy-dead-at-67?src=RSS_PUBLIC
Parasite from Vietnam may be killing vets, VA study says
Test results show some men may have been infected while fighting in the jungles of Southeast Asia
From: http://www.cbsnews.com/news/parasite-from-vietnam-may-be-killing-vets/
From: http://www.cbsnews.com/news/parasite-from-vietnam-may-be-killing-vets/
Contaminated raw milk warning in 4 states
CDC is warning people who drank raw milk from the company Udder Milk in the past six months to seek medical care
From: http://www.cbsnews.com/news/udder-milk-company-raw-contamination-brucella-bacterial-cdc/
From: http://www.cbsnews.com/news/udder-milk-company-raw-contamination-brucella-bacterial-cdc/
Report: Industry Hid Study Showing Sugar's Effects
More than four decades ago, a study in rats funded by the sugar industry found evidence linking the sweetener to heart disease and bladder cancer, the paper trail investigation reports.
From: https://www.webmd.com/diet/obesity/news/20171121/report-industry-hid-study-showing-sugars-effects?src=RSS_PUBLIC
Minimally Disruptive Medicine 2017 Workshop: Setting the Stage
From: Mayo Clinic https://www.youtube.com/watch?v=dsG_ZkIe0C8
Minimally Disruptive Medicine 2017 Workshop: The Patient Revolution
From: Mayo Clinic https://www.youtube.com/watch?v=psMqxkzjYX4
Minimally Disruptive Medicine 2017 Workshop: Burden of Treatment Experience in France
From: Mayo Clinic https://www.youtube.com/watch?v=xiiyrlvdZwk
Jury Duty Lifesaver: Mayo Clinic Radio
From: Mayo Clinic https://www.youtube.com/watch?v=KIzgf-oGrmE
New high blood pressure guidelines: Think your blood pressure is fine? Think again…
The American College of Cardiology and the American Heart Association certainly grabbed the attention of us busy primary care physicians with the recent release of their updated blood pressure guidelines. These organizations had piqued interest by declaring the release date and labeling it as “highly anticipated.” I pooh-poohed all that drama, but upon reading through the 114-page executive summary PDF with 21 authors and almost a thousand references, I have to say, I am duly impressed.
The definition of the diagnosis of high blood pressure and the decision-making process surrounding treatment have traditionally been quite individualized (read: all over the place). Personally, I invite these stricter measures, because they are accompanied by solid research, logistical guidance, and useful management strategies.
However, a whole heck of a lot of people just got pulled into a significant medical diagnosis.
Let’s review what’s new.
A new definition of high blood pressure (hypertension)
(Please note that all numbers refer to mm Hg, or, millimeters of mercury.) The guidelines, in a nutshell, state that normal blood pressure is under 120/80, whereas up until Monday, normal was under 140/90.
Now, elevated blood pressure (without a diagnosis of hypertension) is systolic blood pressure (the top number) between 120 and 129. That used to be a vague category called “prehypertension.”
Stage 1 high blood pressure (a diagnosis of hypertension) is now between 130 and 139 systolic or between 80 and 89 diastolic (the bottom number).
Stage 2 high blood pressure is now over 140 systolic or 90 diastolic.
The measurements must have been obtained from at least two careful readings on at least two different occasions. What does careful mean? The guidelines provide a six-step tutorial on how, exactly, to correctly measure a blood pressure, which, admittedly, is sorely needed. My patients often have their first blood pressure taken immediately after they have rushed in through downtown traffic, as they’re sipping a large caffeinated beverage. While we always knew this could result in a falsely elevated measurement, it is now officially poor clinical technique resulting in an invalid reading.
New recommendations on monitoring blood pressure
The new guidelines also encourage additional monitoring, using a wearable digital monitor that continually takes blood pressure readings as you go about your life, or checked with your own cuff at home. This additional monitoring can help to tease out masked hypertension (when the blood pressure is normal in our office, but high the rest of the time) or white coat hypertension (when the blood pressure is high in our office, but normal the rest of the time). There are clear, helpful directions for setting patients up with a home blood pressure monitor, including a recommendation to give people specific instructions on when not to check blood pressure (within 30 minutes of smoking, drinking coffee, or exercising) and how to take a measurement correctly (seated comfortably, using the correct size cuff). The home blood pressure cuff should first be validated (checked in the office, for accuracy).
If you now have high blood pressure, you may not need meds… yet
The guidelines also outline very clearly when a diet-and-lifestyle approach is the recommended, first-line treatment, and when medications are simply just what you have to do. Thankfully, the decision is largely based on facts and statistics. For the elevated blood pressure category, medications are actually not recommended; rather, a long list of evidence-based, non-drug interventions are. What are these interventions? Things that really work: a diet high in fruits and vegetables (such as the DASH diet, which is naturally high in potassium); decreased salt and bad fats; more activity; weight loss if one is overweight or obese; and no more than two alcoholic drinks per day for men, and one for women. Simply changing what you eat can bring down systolic blood pressure by as much as 11 points, and each additional healthy habit you adopt can bring it down another four to five points.
For people with stage 1 hypertension who don’t have cardiovascular disease and are at low risk for developing it (less than 10% risk of an event within 10 years), lifestyle changes are still the way to go. (Risk is determined using a well-researched, widely used formula available here.)
However, if a patient has any kind of cardiovascular disease and stage 1 hypertension (a blood pressure over 130 systolic or 80 diastolic), or no existing cardiovascular disease but a significant risk of developing it (over 10% risk within the next 10 years), then lifestyle changes plus medications are recommended. And, even if someone has less than a 10% risk, if their blood pressure is over 140 systolic or 90 diastolic, which is now stage 2 high blood pressure, they ought to be treated with medication as well.
Optimizing treatment of high blood pressure
The authors bring several evidence-based yet progressive concepts into the guidelines, the first of which is that high blood pressure should be treated using a team approach. This makes sense, as science supports more and better patient education around self-monitoring, nutrition, and lifestyle changes, as well as stress management. Telehealth is emphasized as a cost-effective method of ongoing monitoring that is more convenient for patients than frequent office visits.
And why should this all matter to you?
Mountains of research over time have shown a very clear link between high blood pressure and cardiovascular disease. A 20-point higher systolic blood pressure or a 10-point higher diastolic blood pressure is associated with double your risk of death from a heart attack, stroke, or other cardiovascular complication (like abdominal aortic aneurysm or heart failure). What many people don’t realize is that those who survive these events find their lives permanently altered by disability and medical complications.
Much is being made of the fact that the new definitions of high blood pressure will mean roughly half of all US citizens will be considered to have high blood pressure, but when you really look at the numbers, as cardiologists already have, not that many more people will actually be advised to take medications. Although the public has good reason to be suspicious of “big pharma,” that’s not what this is about.
Diet and lifestyle changes are powerful medicine. Even if your blood pressure is normal now, you can help to prevent it from becoming elevated starting today. Eat more fruits, veggies, and whole grains, and limit foods high in sodium and unhealthy fats. Be as physically active as possible.
There is a lot more in the very long, detailed executive summary, including specific guidance for various populations, myriad diseases, and special circumstances, but this is the gist of it. The document is free, and available here.
The post New high blood pressure guidelines: Think your blood pressure is fine? Think again… appeared first on Harvard Health Blog.
From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/new-high-blood-pressure-guidelines-2017111712756
WHO: Road traffic victims - World day of remembrance 2017
From: World Health Organization https://www.youtube.com/watch?v=FH_yRWgoavs
OMS : Journée mondiale du souvenir des victimes de la route 2017
From: World Health Organization https://www.youtube.com/watch?v=FPDrOZSL_Cc
WHO: Dr Tedros, Director-General, addressing WHO's Executive Board
From: World Health Organization https://www.youtube.com/watch?v=VMIog39i7ZI
Heart rate variability: A new way to track well-being
Information is knowledge, and big tech companies know how important it is to collect and track data. When it comes to your health, it is now easy to measure and track all kinds of information. In the comfort of our homes we can check our weight, blood pressure, number of steps, calories, heart rate, and blood sugar. Recently some researchers have started to use an interesting marker for resilience and behavioral flexibility. It is called heart rate variability (HRV).
Have you ever wondered what the health impact of a stressful day was? Will you perform well during your long run tomorrow morning? Is there anything you can do today that would improve your ability to have a better day moving forward? HRV may be the piece of data that could help you answer these questions.
What is HRV?
HRV is simply a measure of the variation in time between each heartbeat. This variation is controlled by a primitive part of the nervous system called the autonomic nervous system (ANS). It works regardless of our desire and regulates, among other things, our heart rate, blood pressure, breathing, and digestion. The ANS is subdivided into two large components, the sympathetic and the parasympathetic nervous system, also known as the fight-or-flight mechanism and the relaxation response.
The brain is constantly processing information in a region called the hypothalamus. The hypothalamus, through the ANS, sends signals to the rest of the body either to stimulate or to relax different functions. It responds not only to a poor night of sleep, or that sour interaction with your boss, but also to the exciting news that you got engaged, or to that delicious healthy meal you had for lunch. Our body handles all kinds of stimuli and life goes on. However, if we have persistent instigators such as stress, poor sleep, unhealthy diet, dysfunctional relationships, isolation or solitude, and lack of exercise, this balance may be disrupted, and your fight-or-flight response can shift into overdrive.
Why check heart rate variability?
HRV is an interesting and noninvasive way to identify these ANS imbalances. If a person’s system is in more of a fight-or-flight mode, the variation between subsequent heartbeats is low. If one is in a more relaxed state, the variation between beats is high. In other words, the healthier the ANS the faster you are able to switch gears, showing more resilience and flexibility. Over the past few decades, research has shown a relationship between low HRV and worsening depression or anxiety. A low HRV is even associated with an increased risk of death and cardiovascular disease.
People who have a high HRV may have greater cardiovascular fitness and be more resilient to stress. HRV may also provide personal feedback about your lifestyle and help motivate those who are considering taking steps toward a healthier life. It is fascinating to see how HRV changes as you incorporate more mindfulness, meditation, sleep, and especially physical activity into your life. For those who love data and numbers, this can be a nice way to track how your nervous system is reacting not only to the environment, but also to your emotions, thoughts, and feelings.
How do you check your heart rate variability?
The gold standard is to analyze a long strip of an electrocardiogram, the test we frequently do in the medical office where we attach wires to the chest. But over the past few years, several companies have launched apps and heart rate monitors that do something similar. The accuracy of these methods is still under scrutiny, but I feel the technology is improving substantially. A word of caution is that there are no agencies regulating these devices, and they may not be as accurate as they claim. The easiest and cheapest way to check HRV is to buy a chest strap heart monitor (Polar, Wahoo) and download a free app (Elite HRV is a good one) to analyze the data. The chest strap monitor tends to be more accurate than wrist or finger devices. Check your HRV in the mornings after you wake up, a few times a week, and track for changes as you incorporate healthier interventions.
The bottom line
Tracking HRV may be a great tool to motivate behavioral change for some. HRV measurements can help create more awareness of how you live and think, and how your behavior affects your nervous system and bodily functions. While it obviously can’t help you avoid stress, it could help you understand how to respond to stress in a healthier way. There are questions about measurement accuracy and reliability. However, I am hoping an independent agency eventually identifies which devices and software provide data we can trust. In the meantime, if you decide to use HRV as another piece of data, do not get too confident if you have a high HRV, or too scared if your HRV is low. Think of HRV as a preventive tool, a visual insight into the most primitive part of your brain.
Sources
Heart rate variability and myocardial infarction: systematic literature review and metanalysis. European Review for Medical and Pharmacological Sciences, July-August 2009.
Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation, August 1994.
The post Heart rate variability: A new way to track well-being appeared first on Harvard Health Blog.
From: Marcelo Campos, MD https://www.health.harvard.edu/blog/heart-rate-variability-new-way-track-well-2017112212789
Smoggy Air May Spawn Weaker Sperm
Microscopic particles in the air called particulate matter (PM2.5) may affect the quality of sperm, which in turn can make it difficult to fertilize a woman's egg, the researchers said.
From: https://www.webmd.com/men/news/20171122/smoggy-air-may-spawn-weaker-sperm?src=RSS_PUBLIC
It's the Latest Diet Craze, But Is It Safe?
It's a simplified approach to eating that essentially views fruits and vegetables through the same prism as candies and soda. All that matters is the total caloric tally.
From: https://www.webmd.com/diet/news/20171122/its-the-latest-diet-craze-but-is-it-safe?src=RSS_PUBLIC
3M withheld info about cancer-causing chemicals, suit claims
Court documents also allege 3M concealed the potential harm of chemicals from government regulators
From: http://www.cbsnews.com/news/3m-withheld-info-about-toxic-chemical-contamination-suit-claims/
From: http://www.cbsnews.com/news/3m-withheld-info-about-toxic-chemical-contamination-suit-claims/
How to have a healthier Thanksgiving
By some estimates, a Thanksgiving feast could mean over 4,500 calories in one meal – more than twice the recommended amount for two whole days. Dr. David Agus joins "CBS This Morning" to discuss steps you can take to be healthier this holiday and for the entire year.
From: http://www.cbsnews.com/videos/how-to-have-a-healthier-thanksgiving/
From: http://www.cbsnews.com/videos/how-to-have-a-healthier-thanksgiving/
This Thanksgiving, Promise Yourself: Don't Choke
Researchers say people are more apt to get food stuck in their throats at the holidays.
From: https://www.webmd.com/food-recipes/news/20171121/this-thanksgiving-promise-yourself-dont-choke?src=RSS_PUBLIC
Report: Industry Hid Study Showing Sugar's Effects
More than four decades ago, a study in rats funded by the sugar industry found evidence linking the sweetener to heart disease and bladder cancer, the paper trail investigation reports.
From: https://www.webmd.com/diet/obesity/news/20171121/report-industry-hid-study-showing-sugars-effects?src=RSS_PUBLIC
Surviving your Thanksgiving road trip
Expert tips to help make the drive to your holiday gathering as safe and stress-free as possible
From: http://www.cbsnews.com/media/surviving-your-thanksgiving-road-trip/
From: http://www.cbsnews.com/media/surviving-your-thanksgiving-road-trip/
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