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Thursday 31 October 2013

Heart Disease- Part-1

Heart Disease- Part-1

View the Heart Disease Slideshow

Heart Disease- Part-1

Heart disease facts

  • Heart disease refers to several conditions that affect the heart and blood vessels. Arrhythmias, heart valve disease, congenital heart defects, and inflammation of the heart or its lining (the pericardium) are all diseases that affect the heart. However, this article will focus on the most common type of heart disease, coronary artery disease (CAD), also known as atherosclerotic heart disease (ASHD).
  • Coronary artery disease is the most common cause of death in the United States. Over a million people each year will have a heart attack and 25% will die before they get to the hospital while or in the Emergency Department.
  • Prevention is the key to treatment of heart disease.
  • Diagnosis of heart disease is often made by careful history taken by a health care practitioner. Some individuals may have atypical symptoms, including almost none at all.
  • The testing strategy to confirm the diagnosis and plan appropriate treatment needs to be individualized for each patient diagnosed with heart disease.
  • Treatment of heart disease depends upon the severity of disease, and is often directed by the symptoms experienced by the affected individual.

Introduction to heart disease

The heart is like any other muscle, requiring oxygen and nutrient-rich blood for it to function. The coronary arteries that supply blood to the heart muscle spread across the surface of the heart, beginning at the base of the aorta and branching out to all areas of the heart muscle.
The coronary arteries are at risk for narrowing as cholesterol deposits, called plaques, build up inside the artery. If the arteries narrow enough, blood supply to the heart muscle may be compromised (slowed down), and this slowing of blood flow to the heart causes pain, or angina.

Can Eating Peanut Butter Cut Breast Cancer Risk in Later Life?

Can Eating Peanut Butter Cut Breast Cancer Risk in Later Life?


 

Eating peanut butter regularly as a preteen and teen girl appears to decrease the risk of developing benign breast disease as an adult, new research has found.
Benign breast disease -- noncancerous changes in the breast tissue -- is a risk factor for breast cancer, experts agree.
The researchers followed more than 9,000 females, beginning when they were aged 9 to 15 in 1996, until 2010, when they were young women. Eating peanut butter three days a week reduced the risk of developing benign breast disease by 39 percent, said Dr. Graham Colditz, senior study author.
"I think this gives us enormous hope there are strategies we could be following to help prevent breast cancer that we haven't capitalized on yet," said Colditz, the associate director for cancer prevention and control at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, in St. Louis.
The study, published online Sept. 17 in Breast Cancer Research and Treatment, was funded by the Breast Cancer Research Foundation and the U.S. National Institutes of Health.
Benign breast disease is fairly common, and a known risk factor for breast cancer, Colditz said. Before menopause, "about one in four women have a benign lesion, confirmed by biopsy," he said. "It's very clear there is a strong link between the benign lesion and the subsequent risk of invasive breast cancer."
Depending on the characteristics of the benign lesion, he said, benign breast disease could increase breast cancer risk by threefold.
News Picture: Can Eating Peanut Butter Cut Breast Cancer Risk in Later Life?The study participants were part of a long-term, ongoing study on the health effects of diet and exercise in young people. They filled out questionnaires about their diet annually from 1996 until 2001, then four more times until 2010. They also reported if they had been diagnosed with benign breast disease. In all, 112 women said they had.
The researchers looked at foods with vegetable protein and vegetable fats, then focused on individual foods, including peanut butter, peanuts or other nuts, beans and corn.
A daily serving of any of these foods was linked with a 68 percent reduced risk of benign breast disease. At age 14, a daily serving of any of those foods was linked with a 66 percent lower risk of benign breast disease, and girls who had about three servings a week of peanut butter had a 39 percent lower risk.
The researchers found a link between eating peanut butter and lower breast disease risk, not a cause-and-effect relationship, and Colditz said he can't explain yet why the peanut butter seems protective.
"It could well be the protein," he said. In previous studies, the researchers have looked at other factors of a healthy diet, such as milk consumption, and their role in breast health. The peanut butter finding, he said, is strong, even when taking into account an overall healthy diet. "It's not something we can make go away," he said.
For now, Colditz said, the take-home message is for teens and preteens to substitute peanuts and peanut butter for less-healthy snacks such as cookies.
Another expert who reviewed the findings said the study is well done.
Dr. Steven Chen, an associate clinical professor of breast and endocrine surgery at the City of Hope Comprehensive Cancer Center, in Duarte, Calif., said that while lowering benign breast disease does lower breast cancer risk, many other factors increase breast cancer risk besides benign breast disease.
"It's always good to lower any risk [of breast cancer] you can, but whether peanut butter intake will have a major impact on developing breast cancer down the line, only time will tell," Chen said.
As for how to explain the link? "It's hard to say at this point," Chen said, adding that in countries where less meat is eaten, less breast cancer risk is reported. Based on the study findings, he said, teen girls and preteens "shouldn't avoid peanut butter and nuts if they are not allergic." Getting some protein through vegetables, which was also looked at in the study, is a good idea, too, he added.

Wednesday 30 October 2013

apixaban, Eliquis

apixaban, Eliquis

View the Atrial Fibrillation Slideshow Pictures

GENERIC NAME: apixaban

BRAND NAME: Eliquis

DRUG CLASS AND MECHANISM: Eliquis is an oral drug used for preventing blood clots in patients with atrial fibrillation. It is an anticoagulant that works by blocking the action of factor Xa. Factor Xa is an important protein in the coagulation cascade that causes blood to clot. Reducing the action of factor Xa reduces the ability of blood to clot. In patients with atrial fibrillation there is increased risk of blood clots which can travel to the brain where it causes strokes as well as to other organs. Eliquis reduces this risk. The FDA approved Eliquis in December 2012.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 2.5 and 5 mg
STORAGE: Apixaban should be stored at room temperature between 15 C to 30 C (59 F to 86 F).
PRESCRIBED FOR: Eliquis is used for reducing the risk of strokes and blood clots in patients with atrial fibrillation who have no problems with their heart valve (nonvalvular atrial fibrillation).
DOSING: The usually recommended dose is 5 mg by mouth twice daily. The dose for individuals 80 years or older, weighing less than or equal to 60 kg, or with reduced kidney function is 2.5 mg twice daily.
DRUG INTERACTIONS: Blood levels of apixaban are increased by drugs that reduce the activity of the liver enzymes that break down apixaban. The dose of apixaban should be reduced to 2.5 mg twice daily if combined with drugs that reduce the activity of these enzymes. Examples include ketoconazole (Nizoral, Extina, Xolegel, Kuric), itraconazole (Sporanox), ritonavir (Norvir), and clarithromycin (Biaxin, Biaxin XL).
Drugs that increase the breakdown of apixaban reduce its blood levels and its effectiveness. Examples include carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol), rifampin, St. John's Wort, and phenytoin (Diantin, Dilantin-125. They should not be combined with apixaban.
Administration of other drugs that also can prevent clotting will increase the risk of bleeding during treatment with apixaban. Examples include aspirin, heparin, chronic use of NSAIDs, and drugs that breakdown blood clots (fibrinolytics).
PREGNANCY: There are no adequate studies in pregnant women. Use during pregnancy may increase the risk of bleeding during pregnancy and delivery.
NURSING MOTHERS: It is not known if apixaban is excreted in human milk. Nursing mothers should discontinue apixaban or discontinue nursing.
SIDE EFFECTS: The most common side effects of apixaban involve bleeding. These include bleeding in the stomach, intestines, brain, and eyes; the bleeding may be fatal. Major bleeding events were fewer in patients who received apixaban when compared to a similar group that received warfarin (Coumadin), another widely used drug for preventing blood clots. Rash and serious allergic reactions also may occur.

Tuesday 29 October 2013

WebMD Resources for Affordable Care Act Enrollment

WebMD Resources for Affordable Care Act Enrollment



 Today the online "doors" swing open on the new health insurance Marketplaces. In every state and in Washington, D.C., millions of uninsured Americans will be able to shop for and buy health insurance offered through the Affordable Care Act. Despite years of preparation, that's news to most Americans. More than 70% of people without insurance don't realize that today is opening day of a 6-month open enrollment period, according to a poll by the Kaiser Family Foundation.
Whether you know about the Marketplaces or are learning about them for the first time, WebMD has a number of resources ready to help. They include:
  • Live chat today, noon to 1 p.m.: Our experts answer questions live about Day 1 of enrollment.
  • WebMD Answers: Health care reform experts give timely answers to your questions.
  • Health Insurance Advisor: This tool will help you compare plans specific to your health needs.

Monday 28 October 2013

More Evidence That Exercise Can Help Prevent High Blood Pressure

More Evidence That Exercise Can Help Prevent High Blood Pressure


 

Exercising during your leisure time could help prevent high blood pressure, but being physically active at work doesn't seem to provide the same benefit, according to a new review.
Researchers analyzed the findings of 13 studies that examined the effects of physical activity on blood pressure. The studies included a total of nearly 137,000 people in the United States, Europe and East Asia who initially had healthy blood pressure. During follow-up periods ranging from two to 45 years, more than 15,600 of the participants developed high blood pressure.
Compared to people who exercised less than one hour a week during their leisure time, the risk of developing high blood pressure was 11 percent lower among those who exercised one to three hours per week, and 19 percent lower among those who did more than four hours of recreational exercise a week, according to the study published Sept. 30 in the journal Hypertension.
The results suggest that the more leisure-time exercise you do, the lower your risk of developing high blood pressure.
News Picture: More Evidence That Exercise Can Help Prevent High Blood PressureHowever, the researchers did not find a solid link between physical activity at work and high blood pressure risk. Physical activity on the job, such as farm or industrial work, can involve heavy lifting, prolonged standing and repetitive tasks.
Exercise guidelines don't distinguish between physical activity at work or during leisure time, but "given the new findings, perhaps they should," study co-author Dr. Bo Xi, a lecturer at the Shandong University School of Public Health in Jinan, China, said in a journal news release.
Recreational exercise may help reduce the risk of high blood pressure by preventing weight gain, improving poor insulin sensitivity or reducing the blood vessels' resistance to blood flow, the researchers suggested.
But they noted that their findings don't show that leisure-time exercise actually prevents high blood pressure. People who exercise for fun may just have healthier lifestyles, Xi explained.
About 78 million U.S. adults have high blood pressure, which is a risk factor for heart and kidney disease.

Anemia Part-1

Anemia facts*

*Anemia facts medical author: William C. Shiel Jr., MD, FACP, FACR
  • Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal.
  • For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml.
  • Anemia is caused by either a decrease in production of red blood cells or hemoglobin, or an increase in loss or destruction of red blood cells.
  • Some patients with anemia have no symptoms. Others may feel tired, easily fatigued, appear pale, a feeling of heart racing, short of breath, and/or worsening of heart problems.
  • Anemia can be detected by a simple blood test called a complete blood cell count (CBC).
  • The treatment of the anemia varies greatly and very much depends on the particular cause.

What is anemia?

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. The normal level of hemoglobin is generally different in males and females. For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml. These definitions may vary slightly depending on the source and the laboratory reference used.

What causes anemia?

Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood cell is typically around 120 days. Red blood cells are made in the bone marrow.
Anemia is caused essentially through two basic pathways. Anemia is caused by either:
  1. a decrease in production of red blood cells or hemoglobin, or
  2. an increase in loss or destruction of red blood cells.
A more common classification of anemia (low hemoglobin) is based on the Mean Corposcular Volume (MCV) which signifies the average volume of individual red blood cells.
  1. If the MCV is low (less than 80), the anemia is categorized as microcytic anemia (low cell volume).
  2. If the MCV is in the normal range (80-100), it is called a normocytic anemia (normal cell volume).
  3. If the MCV is high, then it is called a macrocytic anemia (large cell volume).
Looking at each of the components of a complete blood count (CBC), especially the MCV, a physician can gather clues as to what could be the most common reason for anemia in each patient.
Picture of Red Blood Cells
Picture of Red Blood Cells