Women, Younger Men Under-Treated Before Heart Attack: Study

WEDNESDAY, Nov. 16 (HealthDay News) -- Women and younger men account for a large number of heart attacks in the United States but are less likely than older men to receive preventive medications that lower heart attack risk, a new study indicates.

Researchers evaluated more than 3,000 heart attack patients treated at the Minneapolis Heart Institute between March 2003 and January 2010, and found that 70.3% of them had not been diagnosed with coronary heart disease (CHD) and 60% of those undiagnosed patients were men 55 and younger and women 65 and younger with premature CHD.
Even though rates of high cholesterol among the women and younger men were similar to the rate in older men, those two groups of patients were nearly half as likely (10% vs. 19%) to be taking cholesterol-lowering statins prior to their heart attack and were much less likely to be on aspirin and combination therapy.

The study was scheduled for presentation Wednesday at an American Heart Association annual meeting in Orlando, Fla.

"For those patients with known coronary disease, the evidence and guidelines are fairly clear about the benefit of aggressive medical therapy, including an aspirin and statin, regardless of your age or gender," said Dr. Michael Miedema, a cardiology fellow at the University of Minnesota working with researchers at the Minneapolis Heart Institute at Abbott Northwestern Hospital.

"However, for patients without known coronary disease, the optimal approach is much less clear," he added in an institute news release. "We currently only treat high-risk patients, but our data show that women and young males, who rarely qualify as high-risk, make up a substantial portion of the current heart attack population."

The most widely used cardiac event risk calculator is the Framingham Risk Score, which uses the patient's age, gender and factors such as cholesterol and blood pressure. But this approach is heavily weighted toward age and gender, according to Miedema.
"If you're an older male, you're much more likely to qualify for preventive therapy while females and younger males often do not meet criteria despite similar risk factors," he said.
"While older males are still the most likely group to have heart attacks, we have shown that women and patients with premature disease make up a substantial portion of the heart attacks we are seeing and very few of these patients are on the medications which research has shown to prevent heart attacks. Better methods of risk assessment could potentially allow us to target more people truly at high risk for an event and avoid excessive treatment of those who are low risk," Miedema concluded.
Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.
-- Robert Preidt

Related articles

• Traffic, Pollution and Heart Attacks | heart attack (whatontoday.com)

Read more »

Easy-to-Treat Condition Can Disrupt Breast-Feeding

 A "tongue-tie" condition in infants that hinders breast-feeding can be quickly diagnosed and treated in many cases, an expert says.
The condition, also known as ankyloglossia, occurs in 4 percent to 10 percent of newborns. The most common type is easy to identify and occurs when a tight band of tissue causes a heart-shaped tongue indentation at the front of the mouth.

Another form of the condition is harder to detect, according to Dr. Dale Tylor, an assistant professor of pediatric otolaryngology at Vanderbilt University Medical Center in Nashville, Tenn.

"For an infant to properly breast-feed, the baby needs to move his or her tongue to their lips to allow sucking to occur," Tylor said in a Vanderbilt news release. "If there's a tethering, the baby has a hard time latching on and uses his or her gums or lips. It becomes painful for the mom, and can even cause bleeding."

Other indications of tongue-tie include a baby who breast-feeds for up to an hour at a time, is frustrated during feeding, or falls asleep before becoming full.
These problems can cause mothers to supplement breast-feeding with formula or give up breastfeeding altogether.

But Tylor said more than two-thirds of mothers of babies with tongue-tie can successfully breast-feed their babies after a simple, outpatient tongue-tie-clipping procedure called a frenotomy.

Tylor also said her research shows that early treatment of tongue-tie reduces the risk of speech problems. Left untreated, tongue-tie can cause other problems.
"They may have problems taking a spoon," Tylor said. "Or they may not be able to lick an ice-cream cone or stick out their tongues with their brother, sister or peers. They could even have problems into adulthood with common social activities like brushing their teeth or even kissing."
-- Robert Preidt

Read more »

Painkiller Dependence Before Knee Surgery May Slow Recovery

Image via Wikipedia

 Recovery after knee replacement surgery can be much more difficult if patients are dependent on powerful opioid painkillers before the procedure, a new study shows.
Opioids are narcotics such as morphine, codeine and oxycodone.

U.S. researchers compared results of 49 knee replacements in opioid-dependent patients with recovery rates for a group of patients not dependent on narcotics. They found that patients who were opioid-dependent before surgery tended to have longer hospital stays, more unexplained pain or stiffness, a higher rate of complications and were more likely to require additional surgery, compared to patients who were not opioid-dependent.
The study was published Nov. 2 in the Journal of Bone and Joint Surgery.

"We expected to find that the opioid-dependent patients have worse outcomes. But the differences between the two groups of patients were even greater than we thought they would be. The chronic narcotics users did significantly worse in every category," principal investigator Dr. Michael A. Mont, director of the Center for Joint Preservation and Reconstruction at the Rubin Institute for Advanced Orthopedics at Sinai Hospital of Baltimore, said in a journal news release.

"This doesn't mean that opioid users shouldn't have the surgery," he added. "But those patients and their physicians should know that their results may not be as optimal. It might be possible that we can work with these patients to improve their surgical outcomes."
Mont and his colleagues suggested several ways to improve recovery for opioid-dependent knee surgery patients. These include: weaning them off strong opioid medications before surgery; prescribing alternate, non-opioid pain medications; and using drug-free pain management methods.

"Previous studies have found that patients who use opioids are more dissatisfied after surgery," Mont said. "But these are more powerful findings since patients require additional surgeries. This is a topic our orthopedic community and other care providers need to address together."
-- Robert Preidt

Read more »

Bed/Wake Times Affect Kids' Weight

Australian kids seem to stay slim and active if they go to bed early and get up early. Late risers, on the other hand, were 1.5 times more likely to become obese, almost twice as likely to be physically inactive, and 2.9 times more likely to sit in front of a screen - computer or TV - for more hours than the early birds. Researchers at the University of South Australia looked at the hours sleeping, bedtimes and wake times of 2,200 youngsters ages 9 to 16 as well as at their weight and how they spent their time over four days.

Earlier research suggests that not getting enough sleep puts kids at risk of becoming overweight or obese, but this study found that all the kids averaged the same number of hours of sleep. The differences in weight and amount of physical activity seen related to the timing of their sleep, and that timing was not dramatic: the night owls stayed up 70 to 90 minutes later than the early birds and woke up 60 to 80 minutes later. The study was published in the Oct. 1 issue of SLEEP.

Related articles

• amanda knox, apple press conference, apple event, ... (searchingfreegadget.blogspot.com)
• new iphone, curtis painter, new iphone 5 release, ... (searchingfreegadget.blogspot.com)

Read more »

Fish Oil for Arthritis

New research from England suggests that fish oil may help slow the progression of osteoarthritis - the "wear and tear" version of arthritis that often is an unwelcome feature of getting older. In fact, based on their study in guinea pigs, the investigators from Britain's University of Bristol say that fish oil may help to prevent arthritis from occurring in the first place. The study team fed omega-3 rich diets to guinea pigs that have a genetic pre-disposition to develop osteoarthritis and found that compared to a control group of animals eating a standard guinea pig diet, the fish oil diet reduced incidence of the disease by 50 percent. Positive effects of the diet included a reduction of the degradation of collagen in cartilage and better retention of the molecules that give cartilage its shock-absorbing properties. Evidence also indicated that omega-3 influences the biochemistry of arthritis and as a result can help prevent osteoarthritis and slow progression where it has already occurred. The study was published in the September 2011, issue of the journal Osteoarthritis and Cartilage.

My take? We've known for some time that eating oily fleshed, cold water fish such as salmon or sardines two to three times a week or taking fish oil supplements (two grams daily of a brand that contains both EPA and DHA) helps reduce the inflammation that damages tissues and makes osteoarthritis so painful. Daily fish oil has also been studied for its benefits in those with high cholesterol, diabetes, symptoms of PMS, coronary artery disease, breast cancer, memory loss, depression, insulin resistance and rheumatoid arthritis.

Read more »