March 14th, 2011 by AnnMacDonald in Health Tips, True Stories
Tags: Ann MacDonald, Be Prepared, Bystander CPR, Cardiac Distress, Cardiology, Cardiopulmonary Resuscitation, Chest Compressions, Harvard Health Blog, Harvard Heart Letter, Harvard Medical School, Harvard University, Havard Health Publications, Health Writer, Heart Attack, Heart Health, Lifesaving Techniques, Medical Emergency, Preventive Health, Preventive Medicine, Sudden Cardiac Arrest
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While I was browsing the produce section of my grocery store the other day, the sound of a panicked voice coming over the store’s loudspeaker made me jump. “Does anyone in the store know CPR? Anyone? CPR? We need you in baked goods!”
I froze. In theory, I know how to perform CPR — cardiopulmonary resuscitation. I took a two-hour course on it nearly 25 years ago. But I hadn’t given it much thought since then and I certainly hadn’t practiced what I learned.
My mind started whirling as I tried to remember the sequence of steps. They’d changed the rules a few years back — I knew that much — so I wouldn’t have to do mouth-to-mouth resuscitation. But where exactly on the chest was I supposed to push? Should I form a fist and push down with my knuckles, or use the ball of my hand?
Suddenly, sirens wailed outside the store. The rescue squad had arrived. Too late, as I learned afterward, for this man, who was a victim of a sudden cardiac arrest. This type of heart attack strikes so fast that there usually aren’t any warning signs. You might see someone grasp his or her chest, collapse, twitch and gasp a few times, and then lie deathly still.
At that point, every minute counts. Enough oxygen remains in the person’s bloodstream to nourish the brain for several minutes — but a bystander has to circulate oxygenated blood to the brain and other organs by pushing down on the chest hard and fast, mimicking the heartbeat.
I’m a health writer. I knew this intellectually. But until those agonizing moments in the grocery store, I never really understood on a gut level just how important every minute is. Read more »
*This blog post was originally published at Harvard Health Blog*
March 13th, 2011 by Linda Burke-Galloway, M.D. in Better Health Network, Health Tips
Tags: Birth Defects, Chemical Exposure, Child Development, Developmental Disabilities, Dr. Linda Burke-Galloway, Environmental Contaminants, Environmental Exposures, Environmental Health, Fetal Exposure, Fetal Health, Healthy Pregnancy, Malformations of the Unborn, Maternal-Fetal Medicine, OB/GYN, Obstetrics And Gynecology, Organization of Teratology Information Specialists, OTIS, Paint Exposure, Pregnant Women, Risks During Pregnancy, Smart Mother, Toluene
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I came across an article the other day about paint and pregnancy. Yes, that paint — the kind that you put on a canvas or slap on your walls. Did you know that paint is made of pigment particles in a liquid base called a medium? Oil paints are thinned or cleaned with paint thinners. Latex paints are thinned or cleaned with water. Most paint that’s used in the home is latex.
Can environmental forces affected pregnancy? The short answer is “yes,” according to the Organization of Teratology Information Specialists (OTIS), whose mission is to study malformations of the unborn.
Regarding paint and pregnancy, the amount of exposure is important. A one-time household exposure causes fewer problems than ongoing exposure through a work setting. And there have been medical studies documenting babies being born with problems if their mothers abused toluene-containing paint in order to “get high.” Toluene is a paint thinner that can cause low birth weight, premature labor, small head size, and developmental delays. Again, these problems only occur if pregnant women have been exposed to very high levels of toluene — much higher levels than exposure based on a hobby or a professional painter.
According to OTIS, working as a painter doesn’t pose concrete risks to the pregnancy. However, any reduction in chemical exposure is always a good thing. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
March 12th, 2011 by Toni Brayer, M.D. in Health Tips, Research
Tags: American Heart Journal, Cardioloy, Dr. Toni Brayer, Everything Health, Gender and Heart Attacks, Healthy Aging, Heart Attack Deaths, Heart Disease, Heart Health, Higher Mortality Rate, Lifestyle Choices, Living Longer, Longevity, Women's Health, Women's Heart Attack Risk
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Several studies have shown that women have a higher mortality rate than men if they have a heart attack. A study published in the American Heart Journal helps to explain why. The researchers looked at data from 2,542 women who had a heart attack. Compared to men, the women were older, less likely to be white, and less likely to smoke. They also had more serious health conditions than the men. They had diabetes, high blood pressure (hypertension), congestive heart failure, and chronic obstructive pulmonary disease (COPD).
We’ve known for a long time that women are about 10 years older than men at the time of their first heart attack. The authors believe that the reason women are more likely to die is because of these other conditions that are present. Women in the study were also more likely to receive a blood transfusion and experience gastrointestinal bleeding, strokes, and vascular complications which lead to death.
They didn’t find any gender difference when they controlled for these other conditions. The number of diseased vessels were the same as was the severity of stenosis.
So what does this tell women? The guidelines for longevity and good health haven’t changed: Don’t smoke, control high blood pressure, and make sure your weight is healthy to prevent diabetes and other vascular problems. Stay active. Heart attacks can be prevented by good lifestyle choices.
*This blog post was originally published at EverythingHealth*
March 11th, 2011 by PeterWehrwein in Health Tips, Research
Tags: Dr. Barbara Yawn, Harvard Health Blog, Harvard Health Letter, Harvard Health Publications, Harvard Medical School, Harvard University, Herpes Zoster, HZ, Journal Watch, Massachusetts Medical Society, Mayo Clinic Proceedings, Melinda Beck, Merck, Olmsted Medical Center, Peter Wehrwein, Shingles Recurrence, Shingles Vaccine, Skin Rash, Varicella Zoster Virus, Wall Street Journal, Zostavax
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This month’s Harvard Health Letter has an article about getting shingles a second or even a third time. (Click here to read the full article.) The bottom line is that recurrence is a) certainly possible and b) if some recent research is correct, much more common than previously thought and about as likely as getting shingles in the first place if you’re age 60 or older.
I talked to Barbara Yawn, M.D., director of research at the Olmsted Medical Center in Rochester, Minn., for the article and mentioned results that she and her colleagues first presented at a conference several years ago.
Yawn reported a more complete version of those results in last month’s issue of the Mayo Clinic Proceedings (a favorite journal of mine). Full text of the study isn’t available unless you have a subscription to the journal, but here’s a summary (in medical publishing, such summaries are called abstracts.)
Melinda Beck, a health columnist for the Wall Street Journal, had a column about shingles last week and this how she neatly summed up Yawn’s research:
For the new study on shingles recurrence, researchers at the Olmsted Medical Center in Rochester, Minn., examined medical records of nearly 1,700 patients who had a documented case of shingles between 1996 and 2001. They found that more than 5% of them were treated for a second episode within an average of eight years—about the same rate as would typically experience a first case.
And here is a link to the Journal Watch item of the study and a short comment by the Journal Watch editor. Journal Watch is a monthly newsletter published by the Massachusetts Medical Society that summarizes and comments on recently published research.
In the Mayo Clinic Proceedings paper, Yawn and her colleagues report that 95 of the 1,669 people with an “index” case of shingles got shingles again over the course of a follow-up period that averaged 7.3 years, which works out to about 5.6 percent of the shingles sufferers. Six people had two recurrences and two had three! The timing of recurrence varied from 96 days to 10 years after the initial episode. In 45 percent of those who got shingles again, the site of the recurrence was in a different region of the body than the site of the first case. They also noted that the single biggest risk factor for having a second case of shingles was having pain that lasted 30 days or longer during the first case. Read more »
*This blog post was originally published at Harvard Health Blog*
March 10th, 2011 by Shantanu Nundy, M.D. in Health Tips, Research
Tags: Actual Causes of Death, American College of Preventive Medicine, Behavior Change, Behavioral Medicine, BeyondApples.org, Cardiology, Cause-Attributable Fraction, Disease Risk Factors, Dr. David Katz, Dr. Shantanu Nundy, Family Medicine, General Medicine, Heart Disease, Internal Medicine, Leading Causes of Death in the U.S., Lung Cancer, McGinnis and Foege, Mortality Data, Oncology, Preventive Health, Primary Care, Public Health, smoking, Stroke, Tobacco Use, U.S. Mortality Rates, U.S. Preventive Services Task Force, USPSTF
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What is the leading cause of death in the United States? Heart disease? Cancer? No, it’s smoking. Smoking? Yes, depending on how you ask the question.
In the early 90s, McGinnis and Foege turned the age-old question of what people die of on its head by asking not what diseases people die of but rather what the causes of these are. Instead of chalking up the death of an older man to say lung cancer, they sought to understand the proximate cause of death, which in the case of lung cancer is largely smoking. Using published data, the researchers performed a simple but profound calculation — they multiplied the mortality rates of leading diseases by the cause-attributable fraction, that proportion of a disease that can be attributed to a particular cause (for example, in lung cancer 90 percent of deaths in men and 80 percent of deaths in women are attributable to smoking). Published in JAMA in 1993, their landmark study became a call to action for the public health community.
When looked at the conventional way, using data from the 2004 update of the original study, heart disease, cancer, and stroke are the leading causes of death, respectively. This accounting may help us understand the nation’s burden of illness, but does little to tell us how to prevent these diseases and improve health. Through the lens of McGinnis and Foege we get the actual causes of death (e.g., the major external modifiable factors that contribute to death). This analysis shows that the number one cause of death in America is tobacco use, followed closely by poor diet and lack of physical activity, and then alcohol consumption. Read more »
*This blog post was originally published at BeyondApples.Org*
