Las anomalías detectadas en ECG en personas asintomáticas se asocian a un mayor riesgo de enfermedades cardiovasculares

Las anomalías detectadas en ECG en personas asintomáticas se asocian a un mayor riesgo de enfermedades cardiovasculares

Publicado el 27 febrero, 2011 por Ruben Roa

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Denes P, Larson JC, Lloyd-Jones DM, Prineas RJ, Greenland P. Major and Minor ECG Abnormalities in Asymptomatic Women and Risk of Cardiovascular Events and Mortality. JAMA 2007; 297: 978-985.  R TC (s) PDF (s)

Introducción

En varios estudios llevados a cabo fundamentalmente en varones se ha encontrado una relación entre la presencia de anomalías en el ECG y la incidencia de cardiopatía isquémica y enfermedades cardiovasculares. Sin embargo, existen pocos estudios que aporten datos sobre el significado de estas anomalías en mujeres.

Objetivo

Examinar la asociación entre la presencia de anomalías ECG mayores y menores con la morbimortalidad cardiovascular.

Perfil del estudio

Tipo de estudio: Estudio de cohortes
Área del estudio: Pronóstico
Ámbito del estudio: Comunitario

Métodos

El Women´s Health Initiative (WHI) fue un ensayo clínico que se diseñó para estudiar la eficacia del tratamiento hormonal sustitutivo en el tratamiento de los síntomas asociados a la menopausia y en la prevención de la morbimortalidad asociada a la misma. En mayo de 2002 el comité de seguridad del ensayo llegó a la conclusión de que los efectos perjudiciales del tratamiento superaban a las ventajas, por lo que se decidió interrumpirlo.
Para este análisis se excluyó a las mujeres con antecedentes de enfermedades cardiovasculares: cardiopatía isquémica (infarto de miocardio, angina, by-pass coronario, angioplastia o stent), insuficiencia cardíaca, marcapasos, AVC (o TIA), trombosis venosa profunda o TEP. Se contactaba con las participantes cada 6 meses y se las visitaba cada año. Se les hizo un ECG en el momento de su incorporación al estudio y a los 3 y 6 años de seguimiento.
Las variables de resultado principales fueron la cardiopatía isquémica (muerte por cardiopatía isquémica o infarto no fatal [IM]), AVC y revascularización coronaria (by-pass o angioplastia). Los ECG fueron interpretados de forma centralizada y se clasificaron como normales/con anomalías marginales, con anomalías menores y con anomalías mayores (tabla 1).

Anomalías menores	Anomalías mayores
Bloqueo AV de I o II grado. Excitación ventricular prolongada. Repolarización ventricular prolongada. Anomalías menores aisladas de la onda Q y del ST. HVI sin anomalías del ST ni de la onda T. Crecimiento de la aurícula izquierda. Extrasístoles auriculares o ventriculares frecuentes. Bloqueos fasciculares.	Fibrilación o flutter auricular. Disociación aurículo-ventricular. BCRIHH. BCRDHH. Demora de la conducción indeterminada. Infarto de miocardio con onda Q. HVI con anomalías de la onda T o del ST. Otras arritmias.

Resultados

Se incluyeron en el análisis 14.749 mujeres, de las cuales el 51% habían sido asignadas al grupo de tratamiento activo (estrógenos y progesterona) y el 49% al grupo placebo. El 66% no tenían anomalías ECG al inicio del estudio y un 6% tenían anomalías mayores. La edad media de las participantes fue de 63 años. Las que tenían anomalías ECG tenían mayor edad e IMC, era menos probable que fuesen de raza blanca y era más probable que tuviesen diabetes, HTA o hipercolesterolemia. El seguimiento medio fue de 5,6 años. 246 mujeres desarrollaron una cardiopatía isquémica y 595 algún evento cardiovascular.
Se encontró una relación entre la presencia de anomalías ECG basales y la incidencia de cardiopatía isquémica y los eventos cardiovasculares tanto en el análisis crudo como en el ajustado. La relación más fuerte se dio con la mortalidad por enfermedades cardiovasculares.

Un 5% de las mujeres desarrollaron una anomalía nueva en el ECG del tercer año. La presencia de una anomalía de este tipo se asoció a un mayor riesgo de cardiopatía isquémica (RR 2,60; IC95% 1,08-6.27) y de enfermedades cardiovasculares (RR 2,86; IC95% 1,69-4,83). Los riesgos fueron similares para todos los subgrupos analizados. La adición de la presencia de anomalías ECG mejoró la capacidad predictiva de la ecuación de Framingham.

Conclusiones

Los autores concluyen que en las mujeres postmenopáusicas, la presencia de anomalías ECG tanto basales como incidentes se asocian a un mayor riesgo de eventos y mortalidad cardiovasculares y que esta información aumenta la capacidad predictiva de los métodos habituales de estratificación del riesgo.

Conflictos de interés

Ninguno declarado. Financiado por el National Heart, Lung, and Blood Institute de los National Institutes of Health.

Comentario

En la práctica clínica habitual es frecuente encontrarse en los ECG solicitados para el control de determinados factores de riesgo o enfermedades crónicas con anomalías ECG que no precisan de ningún tratamiento y que es frecuente que se ignoren en la valoración del paciente. Sin embargo, los resultados de este estudio, concordantes con los de otros trabajos previos demuestran que su presencia se asocia a un mayor riesgo de cardiopatía isquémica y de enferemedades cardiovasculares y de morir por esta causa. Es probable que este hecho se deba a que estas anomalías son un marcador de enfermedad cardíaca subclínica.
El hecho de que se trate de un factor de riesgo independiente y de que incremente la capacidad predictiva de otros instrumentos habitualmente utilizados como la ecuación de Framingham, puede hacer que estas anomalías sean útiles para que los clínicos identifiquen a los pacientes con un mayor riesgo de enfermedades cardiovasculares y puedan intensificar las intervenciones sobre ellos.

Bibliografía

1. De Bacquer D, De Backer G, Kornitzer M, Myny K, Doyen Z, Blackburn H. Prognostic value of ischemic electrocardiographic findings for cardiovascular mortality in men and women. J Am Coll Cardiol 1998; 32: 680-685.  R TC PDF
2. Cedres BL, Liu K, Stamler J, Dyer AR, Stamler R, Berkson DM, et al. Independent contribution of electrocardiographic abnormalities to risk of death from coronary heart disease, cardiovascular diseases and all causes: findings of three Chicago epidemiologic studies. Circulation 1982; 65: 146-153.   PDF
3. De Bacquer D, De Backer G. Electrocardiographic findings and global coronary risk assessment. Eur Heart J 2002; 23: 268-270.   TC PDF

De trabajo

Quemar...

February 16, 2011 Dr. Carla Davis, Allergy & Immunology Specialist

Guidelines For The Diagnosis And Treatment Of Food Allergies

In December 2010, the National Institute of Allergy and Infectious Diseases published guidelines for the diagnosis and treatment of food allergies. This report was developed by a 25-member expert panel to help health care professionals provide better care for patients with food allergy. It is important that patients work with their physicians to accurately diagnose and treat their food allergies according to these guidelines.
The key points from these guidelines are as follows:

1. Food allergies are not the same as food intolerance. Food intolerance includes celiac disease and other diseases, like lactose intolerance and food poisoning, which are not mediated by the immune system.
2. A small number of foods cause most allergies. In the United States, the most common food allergens include egg, milk, peanuts, tree nuts, wheat, crustacean shellfish, fish and soy.
3. Food allergies are more common in patients with other allergic diseases. Asthma, eczema and eosinophilic esophagitis can coexist in food allergic patients. If your family has a history of allergy and you have eczema, then you are at greater risk for having food allergy than someone who does not have these diseases.
4. Tests alone cannot accurately diagnose food allergy. It is important that your doctor take a medical history and perform a physical exam first before diagnosing food allergy. If the diagnosis is likely, blood or skin tests can be performed to help determine the likelihood of food allergy. These tests cannot conclusively diagnose food allergy, however. The most accurate way to diagnose food allergy is by giving the food very slowly and carefully in a doctor’s office setting prepared to treat an allergic reaction. This is called an oral challenge and should only be done in an experienced health care professional’s office with the resources to perform this test.
5. Anaphylaxis, a serious allergic reaction that is rapid in onset and may result in death, is under-diagnosed and under-treated. If you experience anaphylaxis, or even suspect that you are, immediately take epinephrine and seek medical attention by calling 9-1-1. Delaying epinephrine use significantly increases the risk of a life-threatening reaction.
6. There is no cure for food allergy. Food avoidance and use of an emergency medical plan is the best treatment for food allergy. You should work with your physician to develop an emergency medical plan which includes self-injectable epinephrine in the event of an accidental exposure. Food avoidance is best achieved by careful vigilance and knowing how to read food labels.

The above information is general in nature and not to be used as medical advice for specific cases. If you have a specific question, I recommend discussing this with your personal physician.

Illinois Appeals Court Revives $10 Billion Suit Against Philip Morris

JIM SUHR   02/26/11 07:42 PM  

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Read More: Big Tobacco, Edwardsville, Edwardsville Illinois, Illinois Supreme Court, Philip Morris, Philip Morris Lawsuit, Tobacco, Tobacco Industry, Chicago News

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Stephen Swedlow, an attorney for the people suing Philip Morris is veiwed on a video monitor outside the courtroom at the Illinois Supreme Court in Springfield, Ill., Wednesday, Nov. 10, 2004. Lawyers for cigarette giant Philip Morris argue before the state Supreme Court that a $10 billion verdict over the marketing of "light" cigarettes as a healthier alternative to regular brands should be overturned. The lawsuit was the first in the nation to accuse a tobacco company of consumer fraud over "l

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EDWARDSVILLE, Ill. — A lawsuit that led to a $10.1 billion verdict against cigarette-making Philip Morris USA before it was tossed out by the Illinois Supreme Court has been revived by a lower court, sending the case back to the county once tagged as among the nation's most lawsuit-friendly turfs.
The unanimous ruling Thursday by the three-judge panel of the Mount Vernon-based 5th District Appellate Court cleared the way for the plaintiffs to argue that a favorable 2008 U.S. Supreme Court decision in an unrelated case may be applied to reinstate the questioned Madison County one involving Philip Morris' marketing of "light" cigarettes.
In 2003, now-retired Madison County Circuit Judge Nicholas Byron found that Philip Morris misled customers about "light" and "low tar" cigarettes and broke state law by marketing them as safer, ending a trial that both sides at the time said was the nation's first over a lawsuit accusing a tobacco company of consumer fraud.
The state's Supreme Court overturned that verdict in 2005, saying the Federal Trade Commission allowed companies to characterize or label their cigarettes as "light" and "low tar," so Philip Morris could not be held liable under state law even if such terms could be found false or misleading.
The U.S. Supreme Court in late 2006 let that ruling stand, and Byron dismissed the case the next month. But in December 2008, the nation's high court, in a 5-4 decision, ruled in a lawsuit on behalf of three Maine residents that smokers may use state consumer protection laws to sue cigarette makers for the way they promote "light" and "low tar" brands.
Counting that decision as new evidence, the attorney behind the Illinois lawsuit, Stephen Tillery, again approached the Mount Vernon appellate court in hopes of reopening his firm's class-action lawsuit involving 1.1 million people who bought "light" cigarettes in Illinois.
That suit has claimed that Philip Morris knew when it introduced such cigarettes in 1971 that they were no healthier than regular cigarettes. But the company hid that information and the fact that light cigarettes actually had a more toxic form of tar, the lawsuit claimed.
Philip Morris, which can appeal Thursday's order to the state's high court, said Saturday in a statement it would continue to fight. Murray Garnick of Altria Client Services, which represents Altria Group Inc. subsidiary Philip Morris USA, said Thursday's 11-page ruling was based solely on a procedural question about whether the plaintiffs met a statute of limitations – the appeals court found they did – and not the merits of the plaintiffs' bid to reopen the case.
Since Illinois' Supreme Court reversed the damages award, Garnick said, "the plaintiffs have made multiple unsuccessful attempts to reopen the case. We believe that the plaintiffs' latest attempt is equally without merit."

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Tillery countered in a statement that his St. Louis firm is "eager to return to the courtroom to seek the justice our clients deserve." Tillery said there would be no additional public comment, citing the pending status of the case.
The St. Louis Post-Dispatch first reported Thursday's appellate victory for Tillery.
The protracted Illinois legal fight has proven to be a headache for even some jurists on the state's highest court. After Byron asked the Mount Vernon appellate court in May 2007 whether he had authority to reopen the lawsuit he decided against Philip Morris, the Illinois Supreme Court in 2007 ordered without explanation that Byron stop such inquiries.
"The court's action today is entirely predictable because it quickly and quietly closes the book on a case that a majority of this court, I am sure, would rather forget," Justice Charles Freeman wrote then in dissent in the 4-2 ruling.
Former Illinois Gov. James Thompson, a Chicago attorney who was representing Philip Morris, argued then that the appellate court has no authority to decide whether the case can be reopened.
The lawsuit and its massive damages award fanned the reputation of Madison County, just east of St. Louis, as a place where lawyers from across the country filed cases hoping for big payouts in matters involving everything from asbestos exposure to medical malpractice. President George W. Bush visited the county in January 2005 as a backdrop to pressure Congress to pass legislation limiting jury awards for medical malpractice. And in August of that year, then-Gov. Rod Blagojevich came to Madison County to sign a law seeking to hold down medical malpractice costs for doctors by limiting the amount of money people can collect in lawsuits against hospitals and physicians.
Some tort-reform advocates branded the county a "judicial hellhole" but have backed off in recent years, citing reforms by the county's judiciary aggressively bent on rehabbing the jurisdiction's image.

t statins? UF cardiologists recommend new use for old drug

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t statins? UF cardiologists recommend new use for old drug

Date: 29 Sep 2010
Uploader: Symposier
Lenght: 1m 6s
Specialty: Cardiovascular Surgery   Chest Surgery   General Surgery   Head and Neck Surgery   Maxillofacial Surgery   Orthopedic - Surgery   Pharmacology  

Uploaded and shared in Youtube by: UFHealthScience — Cardiologists at the University of Florida are pointing to a new use for an old therapy. Giving patients cholesterol-lowering statins before surgery and other invasive procedures can halve the risk of heart attacks, deaths and other complications, they report in the Journal of the American College of Cardiology. "The magnitude of benefit we found in terms of reducing mortality, post-procedure myocardial infarctions and reduction in atrial fibrillation after bypass surgery is really quite large," said first author David Winchester, M.D., a cardiology fellow in the College of Medicine's department of medicine. "If you look at some of the other interventions we use, such as using beta blockers before surgery, you don't get nearly the kind of benefit that we are seeing with using statins prior to procedures. That is very surprising." The results strongly support the routine use of statin therapy before invasive procedures, experts say. Statins are known for their ability to lower cholesterol. But a different mechanism is at play in reduction of postsurgery complications. Although researchers have not pinpointed the specifics, they have clues about how statins work to benefit patients after surgery. After invasive procedures such as coronary artery angioplasty, coronary bypass surgery or major vascular surgery, the risk of heart attack is raised thanks to a combination of factors. Just the act of inserting wires and catheters directly into major blood vessels can cause physical damage to those vessels or dislodge unstable plaques that then travel in the bloodstream and restrict blood flow to the very artery that cardiologists and surgeons are trying to mend.

Brouzmi – mensajería instantánea y navegación web social

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Por Cyberfrancis el 26/02/2011

Brouzmi es una aplicación que combina mensajería instantánea y navegación social a través de una misma interfaz web. Para ello no hace falta que instalemos nada ni en nuestro navegador web ni en nuestro sistema operativo en general, sólo registrarnos y añadir a nuestros amigos a este servicio, ya que todo ocurre a través de él.
Y dentro de él tenemos a un navegador web virtual, con su campo de direcciones y su campo de búsquedas por separado, y a ambos lados tenemos unas barras que podemos desplegar para ver los amigos que tenemos disponibles y establecer conversaciones de chat, y además, ver contenidos relacionados con las web que estamos viendo, pudiendo acceder igualmente a las actividades que realicemos sobre las diferentes páginas a las que accedremos.
Y las actividades que podemos realizar básicamente consisten en comentan dichos sitios, valorarlos positivamente o negativamente, añadirlas a nuestros favoritos, e incluso obtener clips de imágenes.
Sin duda una opción interesante al que se le puede sacar alguna utilidad práctica, como académica o como cualquier ámbito que podamos imaginar.

December 21, 2010 Dr. Steven Abrams, Neonatologist

Vitamin D Guidelines For Infants And Children

On November 30, 2010, the U.S. and Canada released new guidelines for calcium and vitamin D intake. The vitamin D guidelines have long been awaited as there is tremendous interest in health effects of vitamin D. I have been privileged to participate in the development of these new as well as the previous guidelines.
Here are some key points related to vitamin D and children:
First, and most importantly, breastfed infants should be given vitamin D drops. It is not safe to assume that they get enough vitamin D from the sun or from breast milk. These should generally be given from a dropper that provides 400 IU each day from a single dropper. Begin the drops in the first week or two of life. Then, at 4 months of age (sooner if a baby is born at less than about 5 1/2 pounds), make sure the drops have both vitamin D and iron.
Secondly, older children need their vitamin D, up to 600 IU daily. Milk is an important source of vitamin D (and calcium!) but isn’t going to be the only source as each cup of milk has about 100 IU of vitamin D. Other vitamin D sources include some types of seafood (salmon, tuna, sardines) and fortified foods (juices, yogurts, breads, margarines, cereals, mushrooms). It is very important to look at the label and see how much vitamin D is in the food or beverage. The vitamin D intake will be listed as a percentage of the “Daily Value” of 400 IU. So, “10% Daily Value” means 40 IU/day, which is some, but not a lot, of the 600 IU needed each day.
Much is being said about the possible benefits of very high doses of vitamin D, especially in adults. However, the evidence for benefits to high dose vitamin D supplementation in children is very limited. There is a risk of children becoming toxic from too much vitamin D. The new guidelines say that the maximum safe amount of vitamin D intake for infants is 1,000 IU per day going up to 4,000 IU per day in children 9 years of age or more. Do not give higher doses of vitamin D to children without the advice of a physician who is monitoring the safety of these doses.

Manipulation Under Anaesthesia of Frozen Shoulder by Dr HC Chang

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Manipulation Under Anaesthesia of Frozen Shoulder by Dr HC Chang

Date: 04 Jan 2011
Uploader: Symposier
Lenght: 1m 7s
Specialty: Orthopedic - Surgery   Physical medicine and rehabilitation   Sports Medicine  

Uploaded and shared in Youtube by: changhawchong — Manipulation under anaesthesia for frozen shoulder can be a treatment option for frozen shoulder which has not improved with physiotherapy. It can also be the initial step before arthroscopic shoulder capsular release. By Dr HC Chang, HC Chang Orthopaedic Surgery Pte Ltd, www.ortho.com.sg, SINGAPORE

The Methuselah Knee Implants

Dr.A.K.Venkatachalam and Flickr

The Methuselah Knee Implants
Biloine W. Young • Sat, Feb 26th, 2011

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After 20 years of use, total knee replacements are still trucking. John B. Meding, M.D. of the St. Francis Medical Group, Beech Grove, Indiana, evaluated 1,757 total knee replacements (TKR) that had been implanted between 1975 and 1989. He found that 128 of the patients, whose average age was 82, were still living. Despite the fact that their implants were 20 or more years old, none had experienced implant failures after 20 years of follow-up. Ninety-five of the patients were able to walk at least five blocks.
The Knee Society knee score of the 128 patients averaged 78, the walking score was 37 and the pain scores averaged 49. The function score was 70 which the researchers attributed to an average stair score of 35. The authors wrote, “Although aging may cause a gradual decline in physical activity after TKR, improved functional outcomes continue over the long term. Our results indicate that this group of patients demonstrates remarkable functional capacity over 20 years after the index arthroplasty.” Their conclusion was that patients who underwent total knee replacement had improved outcomes, even 20 years after the original surgery. The research was presented at the 2011 annual meeting of the American Academy of Orthopaedic Surgeons in San Diego.

Cómo usar Twitter en 8 pasos

Cómo usar Twitter en 8 pasos

¿Qué estás haciendo? Es la sencilla pregunta a la que tratan de responder los mensajes que se publican en Twitter, la herramienta social de moda en internet. La única condición es que, para contarlo, utilices como máximo 140 caracteres. Por eso, a este nuevo tipo de comunicación se le conoce también como microblogging o nanoblogging. Para empezar a usarlo, basta con seguir estos sencillos pasos: 1. Alta. Date de alta en la web www.twitter.com. Crea una dirección con tu nombre: www.twitter.com/tunombredeusuario. 2. Hello world. Entra y escribe tu primer mensaje o tweet con un máximo de 140 caracteres. 3. Sigue y deja que te sigan. Hazte seguidor de tus amigos, de medios de comunicación que te interesan, de museos, de blogs, de artistas... Utiliza el buscador para encontrarlos. 4. Conversa. Para enviar un mensaje público destinado a una persona en particular, usa arroba (@) seguido del nombre del usuario. 5. Retuitea. ¿Ha llegado información interesante a tu Timeline? Pulsa Retweet (RT) y compártela. 6. #etiqueta. Ten en cuenta que en ocasiones, para agrupar los microposts que tratan de un mismo tema, se utiliza una palabra clave, etiqueta o hashtag precedida del símbolo #. Algunas están ligadas a acontecimientos de actualidad (#Iranelection) y otras se mantienen a lo largo del tiempo (#yoconfieso, #palabrasquemolan). 7. Listas para dar y tomar. Las listas de Twitter son una herramienta para organizar a los usuarios que sigues por grupos (amigos, trabajo, noticias...) o por temática (ciencia, cultura, deporte, música...). También puedes seguir listas de otros. En @muyinteresante hemos creado listas de ciencia, historia, innovación... 8. Siempre contigo. Puedes escribir y leer los mensajes de otros usuarios desde la web de Twitter o usando una aplicación como TweetDeck para PC y Mac. Si quieres enviar mensajes desde el teléfono móvil, entra en tu página de Twitter, pulsa 'Settings', ve a 'Devices' y agrega tu número de teléfono. ¡Síguenos en Twitter! Y únete a nuestros más de 493.000 followers

Beber con juicio sí beneficia al corazón

Publicado 26/02/11 14:50 - Por HealthDay/HolaDoctor

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Dos nuevos estudios confirman que tomar una o dos copas al día podría reducir el riesgo de enfermedades cardíacas y aumentar el colesterol "bueno". Se trata de un consumo moderado que nada tiene que ver con embriagarse. Lo beneficioso es el contenido de alcohol y no la bebida en sí.
Crédito: Thinkstock

El consumo moderado de alcohol podría ayudar a proteger contra las enfermedades cardíacas, de acuerdo con dos nuevos trabajos de investigadores canadienses.
Un equipo de la Universidad de Calgary revisó 84 estudios que examinaron el consumo de alcohol y las enfermedades cardíacas y concluyó que las personas que consumen alcohol con moderación (una copa al día o menos) son entre 14 y 25 por ciento menos propensas a tener una enfermedad cardiaca en comparación con los que no beben.

• Los pros y los contras del alcohol

Otro equipo revisó 63 estudios y encontró que el consumo moderado de alcohol (que los investigadores definieron como una copa al día para las mujeres y entre una y dos para los hombres) mejoraba de manera significativa los niveles de colesterol "bueno", que tiene un efecto protector contra las enfermedades cardíacas.
Los hallazgos, publicados en la edición online de la British Medical Journal, se suman a la evidencia de otros estudios previos que encontraron que el consumo moderado de alcohol podría estar asociado con un menor riesgo de enfermedades cardiacas.
Un experto señaló que la investigación parece respaldar que el consumo moderado de alcohol ayuda al corazón.
"Si abordamos aspectos del estilo de vida, el consumo de alcohol con moderación se puede recomendar como parte de un estilo de vida saludable para el corazón", señaló la doctora Suzanne Steinbaum, cardióloga del Hospital Lenox Hill de la ciudad de Nueva York.

• Cómo reducir la cantidad de alcohol que consumes

"Los autores del segundo trabajo, también de la Universidad de Calgary, concluyeron que es el contenido de alcohol lo que proporciona los beneficios para la salud y no el tipo de bebida alcohólica (vino, cerveza o licores).
Steinbaum estuvo de acuerdo con esa evaluación. "Uno de los mecanismos para reducir la incidencia de las enfermedades del corazón es incrementar los niveles de HDL (colesterol "bueno"), que es independiente del tipo de alcohol, ya sea vino, cerveza o licores", apuntó.
Sin embargo, los investigadores del primer trabajo apuntaron que aunque el consumo moderado de alcohol parece mejorar la salud del corazón, ese mensaje tiene que ponerse en una balanza con la advertencia de que beber demasiado es malo para la salud.
Las discusiones sobre el impacto del alcohol sobre las enfermedades del corazón deben centrarse en "el modo de integrar esta evidencia en la práctica clínica y los mensajes de salud pública", señaló William Ghali, de la Universidad de Calgary, en un comunicado de prensa del editor de la revista.
Más información
La American Heart Association tiene más información sobre el tabaco y la enfermedad cardíaca.

Artículo por HealthDay, traducido por HolaDoctor

Signs of Diabetes

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Signs of Diabetes

February 26th, 2011

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people are unaware that they have the disease.
Diabetes can cause many complications. Acute complications (hypoglycemia, ketoacidosis or nonketotic hyperosmolar coma) may occur if the disease is not adequately controlled. Serious long-term complications include cardiovascular disease (doubled risk), chronic renal failure (diabetic nephropathy is the main cause of dialysis in developed world adults), retinal damage, nerve damage (of several kinds), and microvascular damage, which may cause erectile dysfunction (impotence) and poor healing.
About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes.
Diabetes affects more than 20 million Americans. About 54 million Americans have prediabetes. Diabetes, without qualification, usually refers to diabetes mellitus, but there are several rarer conditions also named diabetes. Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The most common form of diabetes is type 2 diabetes.
About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.
In type 1 diabetes, symptoms tend to develop rapidly, over a couple of weeks, and are more severe. In type 2 diabetes, symptoms develop slowly and are usually milder. At least 65 percent of those with diabetes die from heart disease or stroke. Diabetes treatment depends on the type and severity of the diabetes. Type 1 diabetes is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise.
Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who do not exercise regularly. Metformin this is often the first medicine that is advised for type 2 diabetes. Sulphonylureas for example, glibelclamide, gliclazide, glimerpirizide, glipizide, gliquidone, increase the amount of insulin produced by your pancreas.
Juliet Cohen writes articles for health and fitness and diseases treatment. For more information visit our site at http://www.healthfitnesstips.org/.
Author: Juliet Cohen
Article Source: EzineArticles.com
White Coat Hypertension

Más de 120 recursos para bloggers

Más de 120 recursos para bloggers

Publicado el 20/06/2007 por Juanguis y guardado en la categoría: Blogosfera.

Hace unos días en Mashable hicieron una lista con más de 120 herramientas para gestionar tus feeds (lo comenté en Incubaweb), hoy crearon otra lista con más de 120 recursos para bloggers.
Todas las herramientas están organizadas por plataforma, ya sea para WordPress, Movable Type, Blogger; y muchos recursos más.
En realidad son todas herramientas conocidas, que no tienen por qué ser tan enlazadas en otros blogs, pero un consejo, creen este tipo de listas en sus blogs y el tráfico crece como espuma. Todo lo que tenga título como “lo más X de X” es muy enlazable.

El 45% de los adolescentes bebe por culpa de sus padres

Publicado 20/02/11 08:10 - Por HolaDoctor

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Una investigación realizada por una entidad federal comprobó que, en el 45 por ciento de los casos, los adolescentes de entre 12 y 14 años beben alcohol no comprándolo ilegalmente en licorerías o en fiestas sino recibiendo una copa de manos de sus propios padres, o tomando el alcohol en sus casas por falta de supervisión familiar.

Crédito: Thinkstock

Según la nueva investigación realizada por la Administración de Salud Mental y Abuso de Sustancias (SAMHSA, por sus siglas en inglés), unos 700.000 niños de entre 12 y 14 años beben alcohol con regularidad, y unos 200.000 consumieron alcohol durante enero pasado. El 7 por ciento de ellos había comprado las bebidas alcohólicas por sí mismos en licorerías o en bares.

El resto accedió al alcohol de distintas maneras, sin pagar un centavo: a través de otros menores de edad, o de adultos, parientes o no, en sus propias casas. En total, el 45 por ciento de los jóvenes había bebido en sus propias casas, inducido por uno de sus padres, por algún otro familiar, o tomando el alcohol clandestinamente, por no tener la supervisión adecuada.

• Adolescente bebedor... adulto alcohólico

SAMHSA asegura que darle alcohol a un joven aumenta dramáticamente, hasta en cinco veces, la posibilidad de que desarrolle problemas con el alcohol y hasta adicción.

"Es sorprendente que gran parte de estos niños tengan acceso a licores, cervezas y tragos en su propia casa”, expresó Peter Delany, director Centro de Estadísticas de Comportamientos de Salud del SAMHSA.

Cerca del 15 por ciento habían bebido frente a sus padres o tutores, quienes les ofrecieron alcohol.

"Muchos padres dicen, ‘bueno, por lo menos bebe en casa y no en la calle’ o ‘al menos no fuma marihuana’, y decenas de otros pensamientos errados”, asegura Delany.

• Adolescentes hispanos beben más

David Jernigan, profesor asociado de la Escuela Bloomberg de Salud Pública de la Johns Hopkins University, apunta a la industria de la bebida alcohólica que muestra al adolescente que beber es lo más grande y “cool” que hay.

“La exposición de los jóvenes a publicidades de productos del alcohol ha aumentado 71 por ciento entre 2001 y 2009”, indica el experto. Los niños ven al menos una publicidad de un producto alcohólico al día.

El consumo de alcohol en menores de edad está relacionado con cerca de 5.000 muertes de menores de 21 años anualmente. También es factor de riesgo de casos de abuso físico o sexual y del consumo de drogas.

Expertos de la entidad federal aseguran que el monitoreo del alcohol en las casas es clave para reducir el consumo en menores.

Study Finds Too Many Surgical Breast Biopsies Performed

Healthcare News Article

Study Finds Too Many Surgical Breast Biopsies Performed

More U.S. women with abnormal mammograms should be getting less invasive needle biopsies, experts note

SUNDAY, Feb. 20 (HealthDay News) -- Too often surgical breast biopsies, and not less invasive and safer needle biopsies, are being performed on women who have abnormal mammograms, a new study says.

The latest research, conducted in the state of Florida and reported online in the American Journal of Surgery, said that although the rate of surgical biopsies should hover around 10 percent, 30 percent of the breast biopsies studied between 2003 and 2008 entailed the more invasive procedure. That translates to more than 300,000 women a year having surgery they do not need, especially since 80 percent of breast biopsies are benign. And those Florida statistics likely mirror the rest of the country, the researchers added.

There is also cost to consider: The report estimated that $37.2 million in health care expenditures could be saved if needle biopsies were always the procedure of choice.

Senior study author Dr. Stephen R. Grobmyer told The New York Times that he and his colleagues kept seeing patients who had undergone the more invasive surgical biopsies when a needle biopsy should have been performed instead.

"After a while you keep seeing this, you say something's going on here," Grobmyer, director of the breast cancer diagnosis program at the University of Florida in Gainesville, told the newspaper.

Experts in the field noted that needle biopsies should almost always be the preferred procedure.

"This new study confirms that many breast disease lesions do not need to be removed by surgical biopsy. Needle biopsy has replaced surgical biopsy," said Dr. Richard Shapiro, director of surgical oncology operations at the NYU Cancer Institute in New York City. "The take-home message for women is that needle biopsy has surpassed surgical biopsy as the initial tool to diagnose breast cancer. The majority of women almost always have a needle biopsy before requiring the surgical removal of any lesion."

"Surgery is an essential part of the treatment for breast disease, but certainly surgical biopsy is not the first line of diagnosis or defense," Shapiro added. "This practice of using needle biopsy should have been changed many years ago. Needle biopsy should be the first option doctors turn to in order to diagnose and identify what a breast lesion is exactly before removal. Surgery is an effective tool for the removal of benign and malignant breast lesions or when a needle biopsy is inconclusive."

Dr. Deborah Axelrod, director of clinical breast surgery and community outreach at the NYU Cancer Institute, added: "This is an important study which shows overzealous excision of breast lesions where the diagnosis could be made through minimally invasive interventional methods. If they can be diagnosed without a trip to the operating room, then so much the better. You are saving a woman the anxiety of the OR experience, a larger scar, possibly anesthesia, expense and asking their family or friends to take time off to accompany them and take them home from the surgery."

"Additionally," she noted, "if you look at other countries, the rate of malignant and benign biopsies is different than in the United States, where we do many more surgeries to obtain a cancer diagnosis. Here, the rate is about two per 10 biopsies which are malignant compared to Sweden, where the rates are approximately over 50 percent."

More information

For more on breast biopsies, go to the American Cancer Society.

-- HealthDay staff

SOURCES: Richard Shapiro, M.D., associate professor, department of surgery, NYU Langone Medical Center, and director, surgical oncology operations, NYU Cancer Institute, New York City; Deborah Axelrod, M.D., associate professor, department of surgery, and director of clinical breast surgery and community outreach, NYU Cancer Institute, New York City; Feb. 8, 2011, American Journal of Surgery, online; The New York Times

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