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Pulmonary Embolism: If It Can Strike Serena Williams, It Can Ace Anyone

News that tennis star Serena Williams was treated for a blood clot in her lungs is shining the spotlight on a frightfully overlooked condition that can affect anyone — even a trained athlete who stays fit for a living.

Williams had a pulmonary embolism. That’s doctor speak for a blood clot that originally formed in the legs or elsewhere in the body but that eventually broke away, traveled through the bloodstream, and got stuck in a major artery feeding the lungs. (To read more about pulmonary embolism, check out this article from the Harvard Heart Letter.) Pulmonary embolism is serious trouble because it can prevent the lungs from oxygenating blood — about one in 12 people who have one die from it.

“No one is immune from pulmonary embolism, not even super athletes,” says Dr. Samuel Z. Goldhaber, professor of medicine at Harvard Medical School and one of the country’s leading experts in this clotting disorder.

Pulmonary embolism tends to happen among people who have recently had surgery, been injured, or been confined to bed rest for some time. It can also strike after long-haul flights.

Signs of a PE

How do you know if you’re experiencing a pulmonary embolism? The most common symptoms include shortness of breath when you aren’t exerting yourself, along with chest pain and coughing up blood. If you experience any of these symptoms, see a doctor immediately. Other worrisome signs include:

  • Excessive sweating
  • Clammy or bluish skin
  • Light-headedness
  • Fast or irregular heartbeat

The tennis star’s pulmonary embolism could have been the result of the perfect storm. After having a cast removed from a foot she cut at Wimbledon, Williams flew from New York to Los Angeles. It was in LA, after an appearance at the Oscars ceremony on Sunday, that she underwent emergency treatment at Cedars Sinai Hospital for a blood clot in her lungs.

A call to action by the U.S. Surgeon General says that pulmonary embolism and a related condition — deep-vein thrombosis — affect an estimated 350,000 to 600,000 Americans each year. Together, they account for somewhere between 100,000 and 180,000 deaths each year.

To learn more about pulmonary embolism, check out this information from the North American Thrombosis Forum.

– P.J. Skerrett, Editor, Harvard Heart Letter

*This blog post was originally published at Harvard Health Blog*

Does Cell Phone Use Stimulate Brain Activity?

We all know that using a cell phone can stimulate the brain to work a bit harder. “Mr. Skerrett? This is Dr. LeWine’s office. Do you have a minute to talk about your test results?” or “Dad, a bunch of kids are going to Casey’s house after the dance. Can I go?” But a new study published in JAMA is making me wonder what the energy emitted by the phone itself — not just the information it delivers — is doing to my brain.

Here’s the study in a nutshell. Dr. Nora Volkow and her colleagues recruited 47 volunteers to have their brain activity measured twice by a PET scanner. Both times the volunteer had a cell phone strapped to each ear. During one measurement, both phones were turned off. During the other, one phone was turned on but muted so the volunteer didn’t know it was on; the other was left off. Each session lasted about an hour. The scans showed a small increase in the brain’s use of glucose (blood sugar) when the phone was on, but only in parts of the brain close to the antenna.

It was an elegant study. The researchers took pains to anticipate sources of error. They used a control (both phones off) against which to compare the effect of a “live” cell phone. They used cell phones on each ear, one on and one off, to see if the effect was localized. They muted the phone that was on to eliminate the possibility that any brain activation was due to listening to the sound of a voice coming through the phone’s speaker. So the result is probably a real one, not an artifact or measurement error.

What does this brain activation mean? No one really knows. As Dr. Volkow told NPR, “I cannot say if it is bad that they [cell phones] are increasing glucose metabolism, or if it could be good.” Read more »

*This blog post was originally published at Harvard Health Blog*

Think Zinc For A Cold? Not Me

Media channels are a-twitter with the news that zinc can beat the common cold. CBS News, the LA Times, the Huffington Post, and hundreds of others are treating a quiet research report as big news that will have a life-changing effect. After reading the report and doing a little digging into the dark side of zinc, I’m not rushing out to stock up on zinc lozenges or syrup.

The latest hubbub about zinc was sparked by a report from the Cochrane Collaboration. This global network of scientists, patients, and others evaluates the evidence on hundreds of different treatments. In the latest review, on zinc for the common cold, researchers Meenu Singh and Rashmi R. Das pooled the results of 13 studies that tested zinc for treating colds. By their analysis, taking zinc within 24 hours of first noticing the signs of a cold could shorten the cold by one day. They also found that taking zinc made colds a bit less severe.

Sounds good so far. But instead of saying, “Hey, take zinc if you have a cold,” the researchers concluded like this:

“People taking zinc lozenges (not syrup or tablet form) are more likely to experience adverse events, including bad taste and nausea. As there are no studies in participants in whom common cold symptoms might be troublesome (for example, those with underlying chronic illness, immunodeficiency, asthma, etc.), the use of zinc currently cannot be recommended for them. Given the variability in the populations studied (no studies from low- or middle-income countries), dose, formulation and duration of zinc used in the included studies, more research is needed to address these variabilities and determine the optimal duration of treatment as well as the dosage and formulations of zinc that will produce clinical benefits without increasing adverse effects [bold is mine], before making a general recommendation for zinc in treatment of the common cold.”

Not exactly a ringing endorsement. Read more »

*This blog post was originally published at Harvard Health Blog*

The Forecast For Heart Disease: Gloomy With A Chance Of “Boomers”

As a youngster, I loved being part of the baby boom — it meant there were dozens of kids on my block who were ready to play hide-and-seek or join mysterious clubs. Now that I’m of an AARP age, there’s one club I don’t want to join: The one whose members have bypass scars, pacemakers, or other trappings of cardiovascular disease. The American Heart Association’s (AHA) gloomy new forecast on cardiovascular disease tells me it won’t be easy to avoid.

The AHA foresees sizeable increases in all forms of cardiovascular disease (see table) between now and 2030, the year all of the boomers are age 65 and older. Those increases will translate into an additional 27 million people with high blood pressure, eight million with coronary heart disease, four million with stroke, and three million with heart failure. That will push the number of adult Americans with some form of heart disease to 110 million.

AHA cardiovascular disease forecast

(Percentages refer to the percentage of Americans aged 18 years and older.)

If the AHA’s projections are accurate, the cost of treating cardiovascular disease would balloon from $272 billion today to $818 billion in 2030. Add in the cost of lost productivity, and it jumps to more than $1 trillion. Yikes!

Although obesity and inactivity are part of the problem, much of the increase comes from the graying of the baby boom. We can’t stop boomers from aging, but we can fight cardiovascular disease, a condition the AHA calls “largely preventable.” Read more »

*This blog post was originally published at Harvard Health Blog*

New Dietary Guidelines Give Little New Guidance

There isn’t much new in the latest iteration of the “Dietary Guidelines for Americans.” Three years in the making, the 2010 guidelines (released a tad late, on January 31, 2011) offer the usual advice about eating less of the bad stuff (salt; saturated fat, trans fats, and cholesterol; and refined grains) and more of the good stuff (fruits and vegetables; whole grains; seafood, beans, and other lean protein; and unsaturated fats). I’ve listed the 23 main recommendations below. You can also find them on the “Dietary Guidelines” website.

The guidelines do break some new ground. They state loudly and clearly that overweight and obesity are a leading nutrition problem in the United States, and that a healthy diet can help people achieve a healthy weight. They also ratchet down sodium intake to 1,500 milligrams per day (about two-thirds of a teaspoon of salt) for African Americans and people with high blood pressure or risk factors for it, such as kidney disease or diabetes. But the guidelines also leave the recommendation for sodium at 2,300 milligrams a day for everyone else, a move that the American Heart Association and others call “a step backward.”

Vague language spoils the message

One big problem with the guidelines is that they continue to use the same nebulous language that has made previous versions poor road maps for the average person wanting to adopt a healthier diet.

Here’s an example: The new guidelines urge Americans to eat less “solid fat.” What, exactly, does that mean — stop spooning up lard or Crisco? No. Solid fat is a catchphrase for red meat, butter, cheese, ice cream, and other full-fat dairy foods. But the guidelines can’t say that, since they are partly created by the U.S. Department of Agriculture USDA), the agency charged with promoting the products of American farmers and ranchers, which includes red meat and dairy products. “Added sugars” is another circumlocution, a stand-in for sugar-sweetened sodas, many breakfast cereals, and other foods that provide huge doses of sugar and few, or no, nutrients. Read more »

*This blog post was originally published at Harvard Health Blog*

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