Princess Health and Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee. Princessiccia

Princess Health and Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee. Princessiccia

cardiac care cardiovascular disease heart health narcotics pain pain management prescription drug abuse research

Gusty 07:28 Add Comment

"Accidental overdoses aren't the only deadly risk from using powerful prescription painkillers," The Associated Press reports. "The drugs may also contribute to heart-related deaths and other fatalities, new research suggests."

A study of of more than 45,000 Medicaid patients in Tennessee from 1999 to 2012 found that "those using opioid painkillers had a 64 percent higher risk of dying within six months of starting treatment compared to patients taking other prescription pain medicine," AP reports. "Unintentional overdoses accounted for about 18 percent of the deaths among opioid users, versus 8 percent of the other patients."

"As bad as people think the problem of opioid use is, it's probably worse," said Vanderbilt University professor Wayne Ray, the lead author of the study report. "They should be a last resort and particular care should be exercised for patients who are at cardiovascular risk."

The report in the Journal of the American Medical Association noted that opioids can slow breathing and worsen the disrupted breathing associated with sleep apnea, which could lead to irregular heartbeats, heart attacks or sudden death.

The patients in the study "were prescribed drugs for chronic pain not caused by cancer but from other ailments including persistent backaches and arthritis," AP reports. "Half received long-acting opioids including controlled-release oxycodone, methadone and fentanyl skin patches. . . . There were 185 deaths among opioid users, versus 87 among other patients. The researchers calculated that for every 145 patients on an opioid drug, there was one excess death versus deaths among those on other painkillers. The two groups were similar in age, medical conditions, risks for heart problems and other characteristics that could have contributed to the outcomes."

Princess Health and CDC boss Tom Frieden, at SOAR, gives examples of how communities can improve health, such as smoking bans. Princessiccia

Princess Health and CDC boss Tom Frieden, at SOAR, gives examples of how communities can improve health, such as smoking bans. Princessiccia

blood pressure cardiovascular disease heart disease hypertension obesity physical activity pregnancy smoking smoking ban smoking bans teenagers teens tobacco tobacco prevention walking

Gusty 13:08 Add Comment

By Al Cross
Kentucky Health News

PIKEVILLE, Ky. -- Speaking to a region with some of the nation's poorest health, the top federal public-health official gave examples of how individual communities and states have made themselves healthier.

"Health is not just about health, it's about society," Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, told more than 1,000 people at the Shaping Our Applalachian Region Innovation Summit in Pikeville. "Healthy societies are more productive, and productive societies are more healthy."

Referring to Kentucky's high rates of disease and factors that cause them, Frieden said bringing Eastern Kentucky's health statistics up to the national average would save more than 1,000 lives a year.

Frieden cited six communities that have tackled specific health issues, such as obesity, lack of physical activity, heart health, smoking and teen pregnancy.

Obesity is one of SOAR's three main health targets, but it's not an easy one, Frieden said. He said Somerville, Mass., reduced obesity in children under 6 by 21 percent by making it a community issue, with creation of farmers' markets for local produce, construction of walking paths and the mayor leading community walks.

"Physical activity is the closest thing to a wonder drug," Frieden said, because it helps prevent heart disease, strokes, diabetes and cancer, improved mood and lengthens life.

The leading preventable cause of death is smoking, Frieden said, calling for ordinances and laws making workplaces smoke-free. "Nobody should have to risk getting cancer to come to their job," he said.

Heart disease is the most preventable major cause of death, Frieden said, explaining how Minnesota and Grace Community Health Centers in Knox, Clay, Leslie and Bell counties have improved heart health by improving treatment of high blood pressure, or hypertension. "It's the single most important thing" to do for heart health, and it's simple, Frieden said, because the medicine is inexpensive and taken once a day with few if any side effects.

Frieden said the CDC thinks a lot about teen pregnancy because "Teen pregnancy perpetuates a cycle of poverty." He said Spartanburg, S.C., reduced teen pregnancy by 61 percent from 2001 to 2014 partly because South Carolina's Medicaid program paid for long-acting, reversible contraception immediately after delivery, and was the first state to give full reimbursement for post-partum insertion of intrauterine devices for birth control. Kentucky Medicaid doesn't cover such services.

Princess Health and Co-workers with CPR and AED training save Lexington man from 'widow maker' heart attack; now he's fine and cheering Wildcats. Princessiccia

Princess Health and Co-workers with CPR and AED training save Lexington man from 'widow maker' heart attack; now he's fine and cheering Wildcats. Princessiccia

cardiovascular disease health education heart disease University of Kentucky

Gusty 07:41 Add Comment

Tim Hayden (UK photo)

This time last year, co-workers' quick actions saved a Kentucky man who suffered from a usually fatal type of heart attack because they knew how to do cardiopulmonary resuscitation and how to use an automatic external defibrillator (AED). They were able to keep him alive until he could get medical help, according to a University of Kentucky news release.

Tim Hayden, a big UK basketball fan who works at Lexington's Southern Wine and Spirits, was at a work meeting last March, hoping it would end before the Southeastern Conference Tournament games started that day, when he had the heart attack.

His doctor, Adrian Messerli, director of the heart catheterization laboratory at the UK Gill Heart Institute, said it was the type of heart attack that is often called the "widow-maker" because fewer than half of its victims survive.

"Dr. Messerli told us if Tim had been at home, or if the meeting had been scheduled later, or if he'd been in his car, this type of heart attack isn't something that people typically survive," said Harold Nikirk, Southern Wine and Spirits' field sales manager and Tim's boss.

Upon realizing that Hayden wasn't just goofing off and pretending to be snoring so they would wrap up the meeting, two of the co-workers trained in CPR immediately began it. One who was trained on the AED, a portable device that checks heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm, used it.

Everyone in the office pitched in, Nikirk said, calling 911, waving down the ambulance and moving cars and furniture out of the way to make room for the paramedics.

"I think Tim was fortunate for many reasons," Messerli said. "He was surrounded by co-workers who knew how to perform CPR and knew how to use an AED. Those critical first steps sustained Tim until we could get him the treatment he needed."

Paramedics took him to UK, where his wife Catherine works and where Dr. Messerli was waiting for him in the catheterization lab.

"With a heart attack, especially one like Tim's, every minute literally counts," Messerli said. "We were the first hospital in Lexington to allow paramedics to bypass the emergency room and go directly to the cath lab, which buys us precious time and hugely increases the patient's chances for survival."

Hayden's co-workers created
a Heart Walk team. (UK photo)

Messerli restored blood flow by inserting two stents with a catheter and placing him in a type of medically induced coma to cool his body temperature, which is "thought to protect the vital organs from damage and improves healing," Messerli said. Tim spent three weeks in the hospital.

"What's so gratifying about Tim's case is that the healing has really been complete and absolute," he said. "When I see him in the office, he's in wonderful spirits, minimal complaints, and he's doing really well."

Since then, about a dozen of SWS's 40 staffers have received CPR certification and AED training, says the release.

They have also been honored by the Lexington Fire Department for their bravery, quick thinking and knowledge of CPR and have participated in the American Heart Association's 2015 Heart Walk on #TimsTeam and raised $3,500 on his behalf.

Princess Health and Know the signs of a heart attack and don't ignore or dismiss them; quick action can be the difference between life and death.Princessiccia

Princess Health and Know the signs of a heart attack and don't ignore or dismiss them; quick action can be the difference between life and death.Princessiccia

cardiac care cardiovascular disease heart disease heart health

Gusty 10:00 Add Comment

Many people who have a heart attack initially ignore the symptoms or dismiss them. For the best chance of survival and preserving heart function, you should not ignore these symptoms, and should get help quickly.

Heart disease is the leading cause of death in the U.S. and Kentucky. Nationwide, it causes about one in four deaths. The age-adjusted death rate from heart disease in Kentucky is 208.2 per 100,000 per year, according to the federal Centers for Disease Control and Prevention.

Below are some questions and answers about the symptoms and treatment of heart attacks and narrowed aortic valves, as reported by Gina Kolata for the New York Times.

How do you know if you are having a heart attack? Most people feel pain, pressure or squeezing in their chest and about one-third of people have symptoms in addition to or instead of chest pain that include abdominal pain, heavy sweating, back pain, neck and jaw pain, nausea and vomiting, Kolata reports. WebMD adds pain that radiates down one arm, indigestion or a choking feeling, extreme weakness, anxiety or shortness of breath, and rapid or irregular heartbeats to the list.

How can you decide if symptoms other than chest pain are actually from a heart attack? If your symptoms come on suddenly, or if they worsen over a period of hours or days, call 911 and get to an emergency room. "The best time to treat a heart attack is within one to two hours of the first onset of symptoms," says WebMD. "Waiting longer increases the damage to your heart and reduces your chances of survival."

Do women have different symptoms than men? "Probably not," Dr. Mary Norine Walsh, vice president of the American College of Cardiology, told Kolata. Walsh noted that women, however, are more likely to delay seeking treatment and doctors are more likely to dismiss their symptoms, especially if the woman is younger.

The American Heart Association says women often attribute signs of a heart attack to the flu, acid reflux or the normal aging process, even though it is the number one killer of women. It also noted that symptoms in women can be subtler, like shortness of breath, upper back pressure that feels like squeezing, lightheadedness or actually fainting.

What should you do if you are having heart attack symptoms? Call 911 for an ambulance to take you to the emergency room immediately. Do not drive yourself and do not have a friend or family member drive you unless you have no other choice. Kolata notes that paramedics are trained to treat heart attacks and are less likely to get stuck in traffic.

How can you find out if your local hospital is able to treat heart attacks quickly? Don't waste time fighting with your paramedic when you are having a heart attack, they will know the best place to take you, Kolata writes.

That being said, some hospitals are faster than others in treating heart attacks, but the time to research this information is before you are in the throws of a heart attack, Kolata writes. To find out this information, she suggest you ask each hospital what its "door to balloon time" is, which will tell you how long it takes the hospital to open a blocked coronary artery with a balloon after you arrive at the emergency room. If they don't have this information, ask if they take certain steps to speed up treatment. For example ask: Do paramedics transmit a patient's electrocardiogram to the hospital en route?; Does the ER doctor read the EKG and send out a single call to summon the cardiology team?; And are the team members on call required to be within 30 minutes of the hospital?

What are the symptoms of a severely narrowed aortic valve? There are three classic symptoms of this disease of aging: shortness of breath, a feeling of heaviness and pain in the chest, and fainting, according to cardiologists. They also noted that these symptoms are often mistakenly attributed to the normal process of aging.

How can a doctor know if symptoms are caused by a narrowed aortic valve? The doctor will listen  for a heart murmur in the patient�s chest and can order an echocardiogram, which will reveal the narrowed artery and the extent of the damage.

Should everyone with a severely narrowed artery have it replaced? Not everyone should undergo treatment, Kolata reports, so ask your doctor if you are a good candidate. The latest treatment is a transcatheter aortic valve replacement, or TAVR, which allows doctors to replace valves without doing open-heart surgery. High risk patients who would have been considered at too great a risk of dying from open-heart surgery have a chance to have a valve replacement, but sometimes elderly patients whose health is compromised are not good candidates.

Princess Health and Insulin Resistance Predicts a Variety of Age-related Diseases. Princessiccia

Princess Health and Insulin Resistance Predicts a Variety of Age-related Diseases. Princessiccia

cardiovascular disease diabetes metabolic syndrome

Gusty 09:57 Add Comment

In the last post, I reviewed a study by Gerald Reaven's group showing that insulin resistance strongly predicts the risk of cardiovascular disease over a 5-year period. In 2001, Reaven's group published an even more striking follow-up result from the same cohort (1). This study shows that not only does insulin resistance predict cardiovascular disease risk, it also predicts a variety of age-related diseases, including hypertension, coronary heart disease, stroke, cancer, type 2 diabetes, and even overall mortality risk.

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Princess Health and New Study Strengthens the Case that LDL Causes Heart Disease. Princessiccia

Princess Health and New Study Strengthens the Case that LDL Causes Heart Disease. Princessiccia

cardiovascular disease

Gusty 14:00 Add Comment

There is little remaining doubt in the scientific/medical community that high levels of LDL, so-called "bad cholesterol", cause heart disease. Yet in some alternative health circles, the debate continues. A new study adds substantially to the evidence that LDL plays a causal role in heart disease.

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Princess Health andHeart attacks are leading cause of death while on the job in Kentucky; being struck by objects is No. 2, and falling is No. 3.Princessiccia

Princess Health andHeart attacks are leading cause of death while on the job in Kentucky; being struck by objects is No. 2, and falling is No. 3.Princessiccia

accidents cardiovascular disease heart health safety workplace health

Gusty 15:03 Add Comment

Heart attacks are the number one killer of Kentuckians who die on the job, according to a study conducted by the state Labor Cabinet.

The study found that in the last three years, 87 Kentuckians had fatal heart attacks while on the job. Their average age was 52. Ten of them were truck drivers, seven were machine operators and six were maintenance workers.

The study found that 28 of the victims were struck by an object, 19 fell, 17 had transportation crashes, 13 were being caught in or between objects, seven were electrocuted, and one each suffered hyperthermia or suffocation. Eight deaths in the workplace were from natural causes, such as stroke, brain aneurysm and failure of the pancreas.

Kentucky ranks 48th in the nation in cardiovascular deaths, with more than 12,000 per year, a state press release said. �Employers should do everything they can to raise awareness about cardiovascular health, and everyone needs to keep an eye on their blood pressure and cholesterol levels while paying close attention to diet and exercise,� Labor Secretary Larry Roberts said.

The study includes workplaces under the jurisdiction of the Kentucky Occupational Safety and Health Program, and do not include those monitored under federal agencies, such as the Mine Safety and Health Administration or the Federal Railroad Administration.

Princess Health and Is Meat Unhealthy? Part III. Princessiccia

Princess Health and Is Meat Unhealthy? Part III. Princessiccia

cardiovascular disease vegetarian

Gusty 09:57 Add Comment

When we consider the health impacts of eating meat, cardiovascular disease is the first thing that comes to mind. Popular diet advocates often hold diametrically opposed views on the role of meat in cardiovascular disease. Even among researchers and public health officials, opinions vary. In this post, I'll do my best to sort through the literature and determine what the weight of the evidence suggests.

Ancel Keys and the Seven Countries Study

Ancel Keys was one of the first researchers to contribute substantially to the study of the link between diet and cardiovascular disease. Sadly, there is a lot of low-quality information circulating about Ancel Keys and his research (1). The truth is that Keys was a pioneering researcher who conducted some of the most impressive nutritional science of his time. The military "K ration" was designed by Keys, much of what we know about the physiology of starvation comes from his detailed studies during World War II, and he was the original Mediterranean Diet researcher. Science marches on, and not all discoveries are buttressed by additional research, but Keys' work was among the best of his day and must be taken seriously.

One of Keys' earliest contributions to the study of diet and cardiovascular disease appeared in an obscure 1953 paper titled "Atherosclerosis: A Problem in Newer Public Health" (2). This paper is worth reading if you get a chance (freely available online if you poke around a bit). He presents a number of different arguments and supporting data, most of which are widely accepted today, but one graph in particular has remained controversial. This graph shows the association between total fat intake and heart disease mortality in six countries. Keys collected the data from publicly available databases on global health and diet:

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Princess Health and Princess Health andFoundation for a Healthy Kentucky reports putting 24 percent more money into grants last year than in 2012.Princessiccia

Princess Health and Princess Health andFoundation for a Healthy Kentucky reports putting 24 percent more money into grants last year than in 2012.Princessiccia

cardiovascular disease children's health foundations health policy philanthropy public health schools smoking smoking ban smoking bans smoking ordinances

Gusty 13:33 Add Comment

The Foundation for a Healthy Kentucky made grants totaling $2,355,838 in 2013, a 24 percent increase over the 2012 total of $1,903,660, according to the annual report it released yesterday.

Last year was the first in which the foundation made grants for two major initiatives: Investing in Kentucky's Future, which it calls "a $3 million commitment to seven Kentucky communities where civic leaders have come together and committed to a process and a plan for collective impact on the future health of their children," and Promoting Responsive Health Policy, which tries to see that voices of under-represented populations are part of the health-policy conversation in Kentucky.

The first initiative's seven grantees are Fitness for Life Around Grant County, the Clinton County Schools (for the Healthy Hometown Coalition), the Foundation for Appalachian Kentucky (for the Perry County Health and Wellness Coalition), the Green River Area Development District (for the Partnership for a Healthy McLean County), the Kentucky Heart Foundation (for work in Boyd and Greenup counties), Kentucky River Community Care (for the Breathitt County Health Planning Council for Children) and the Louisville Metro Department of Health and Wellness (for the Coalition for Louisville Youth).

Under the policy initiative, the report says, grantees "are working to improve access to needed health care, support children's health, strengthen local public health and "increase the number of Kentuckians living in communities where workplaces are smoke-free." For a complete list of grants made by the foundation in 2013, click here. For a January press release about them, click here.

The foundation was established in 2001 to settle a lawsuit by then-Attorney General Ben Chandler against Anthem Inc. to recover the charitable assets that Anthem had gained in its merger with the old Kentucky Blue Cross/Blue Shield. The foundation's net assets grew to nearly $56.4 million last year, a 7.7 percent increase over the end of 2012.

The foundation is a non-profit philanthropy with a mission of addressing the unmet health-care needs of Kentuckians. It has invested more than $24 million in health-policy research and pilot-project grants that invests in communities and informs health policy through grant making, research and education. It says it is "committed to improving access to care, reducing health risks and disparities and promoting health equity."

The foundation also acts as a convener, through its annual Howard L. Bost Health Policy Forum, its "Health for a Change" workshops and webinars, funding of conferences held by others and meeting space at its new offices in eastern Jefferson County for more than 21 community and statewide organizations.

It also acts as a communicator, through its annual Kentucky Health Issues Poll and other research, and it funds independent health reporting by Kentucky Educational Television and the Institute for Rural Journalism and Community Issues in the School of Journalism and Telecommunications at the University of Kentucky, which publishes Kentucky Health News.

Princess Health and Princess Health andGroup overseeing effort to make state healthier hears of 'dire need,' tools for improvement.Princessiccia

Princess Health and Princess Health andGroup overseeing effort to make state healthier hears of 'dire need,' tools for improvement.Princessiccia

cancer cardiovascular disease dental care dental health diabetes drug abuse drugs health rankings mental health obesity oral health state government

Gusty 20:23 Add Comment

Kentucky's health is "in dire need of improvement," but the state has some tools to do that, including health-care reform and the insurance program for its own employees, the group of officials charged with improving the state's health heard at its first meeting Thursday.

Mayfield

Dr. Stephanie Mayfield, commissioner of the Department of Public Health, told the group overseeing "Kyhealthnow" that the state is near the bottom of national rankings on nearly every goal set for the effort, but "is poised to make strong progress through school-based programs and the fact that federal health reform has made preventive services free," a state press release said.

The goals are that by 2019, Kentucky will reduce its smoking, obesity and uninsured rates by 10 percent; cut its death rates from cancer and cardiovascular disease by 10 percent; reduce deaths from drug overdoses and the average number of poor mental health days by 25 percent; reduce the percentage of children with untreated dental decay by 25 percent, and increase adult dental visits by 10 percent.

The effort is overseen by state cabinet secretaries, other key state officials, Mayfield as co-chair and Lt. Gov. Jerry Abramson as chair, by appointment from Gov. Steve Beshear. They are to meet quarterly.

The oversight group also heard from Department of Employee Insurance Commissioner Joe Cowles, whose agency provides health insurance coverage for 266,000 members, including employees of state agencies, school boards and local government, as well as retirees under age 65 and their dependents.

Cowles talked about the two insurance plans that contain a wellness component designed to encourage plan members to lead healthier lifestyles. "These plans provide lower coinsurance, deductibles and out-of-pocket maximums," Cowles said. "But more importantly, those who choose a LivingWell plan are required to complete an online health assessment. This helps them become more aware of their current well-being and understand their health risks. And, they get a personalized plan of action so they can get or stay healthy."

The department also offers a diabetes prevention program at no cost, and it has shown encouraging results, as participants are improving their physical activity and overall health, Cowles said. And it has anti-fraud measures that track the distance members drive to fill prescriptions, what drugs they are buying, how often, and so on.

The officials also heard from Dave Adkisson, president and CEO of the Kentucky Chamber of Commerce, which has made the health and wellness of Kentuckians one of its top three priorities because health-insurance costs have increased and an increasing share of companies� tax dollars go to pay for health care. He said the state's health problems have reached �epidemic proportions.�

�We commend Governor Beshear for engaging his entire administration in a comprehensive effort to improve Kentucky�s health problems,� Adkisson told Kentucky Health News. �Health costs are a major issue among Kentucky businesses. But containing those costs can be like turning an aircraft carrier around in open water. We are glad state government as a huge employer has stepped up its efforts to encourage wellness among state employees and their family members who are covered by the state�s health insurance program. By being aggressive on wellness, prevention and disease management, tens of thousands of lives will be improved and health care costs paid by taxpayers will be contained.�

Princess Health and Corrections to the New Review Paper on Dietary Fat and Cardiovascular Risk. Princessiccia

Princess Health and Corrections to the New Review Paper on Dietary Fat and Cardiovascular Risk. Princessiccia

cardiovascular disease

Gusty 11:36 Add Comment

The meta-analysis by Chowdhury et al. raised quite a furor from certain segments of researchers and the popular media. I find this reaction interesting. I usually write about obesity, which is a topic of great interest to people, but my post about the review paper received more than twice my usual traffic. People whose findings or opinions are questioned by the paper are aggressively denouncing it in the media, even calling for retraction (1). This resembles what happens every time a high-profile review paper is published that doesn't support the conventional stance on fatty acids and health (e.g., Siri-Tarino et al. [2], which despite much gnashing of teeth is still standing*). I'm not sure why this issue in particular arouses such excitement, but I find it amusing and disturbing at the same time. This kind of reaction would be totally out of place in most other fields of science, where aggressive public media outbursts by researchers are usually frowned upon.

As it turns out, the critics have a point this time. Significant errors were uncovered in the original version of the meta-analysis, which have been corrected in the current version (3). These include the following two errors, one of which alters the conclusion somewhat:

• The outcome of one observational study on omega-3 fatty acids was reported as slightly negative, when it was actually strongly positive. This changes the conclusion of the meta-analysis, making it somewhat more favorable to omega-3 consumption for cardiovascular protection.
• The authors left out two studies on omega-6 fatty acids. These didn't change the overall conclusions on omega-6.

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Princess Health and New Review Paper on Dietary Fat and Heart Disease Risk. Princessiccia

Princess Health and New Review Paper on Dietary Fat and Heart Disease Risk. Princessiccia

cardiovascular disease diet

Gusty 15:16 Add Comment

A new review paper on dietary fatty acids and heart disease risk was just published by Dr. Rajiv Chowdhury and colleagues in the Annals of Internal Medicine-- one of the top medical journals (1). The goal of the paper is to comprehensively review the studies evaluating the effect of dietary fatty acids on heart (coronary) disease. The review covers observational and intervention studies pertaining to saturated, monounsaturated, trans, omega-6 polyunsaturated, and omega-3 polyunsaturated fats. The paper is notable for its comprehensiveness (inclusion criteria were very lax).

Here is a summary of the results:

• In observational studies that measured diet, only trans fat was related to cardiovascular risk. Saturated, monounsaturated, and polyunsaturated fats were unrelated to risk.
• In observational studies that measured circulating concentrations of fatty acids, long-chain polyunsaturated fatty acids (DHA, DPA, EPA, AA) were associated with lower risk. The dairy-fat-derived margaric acid (17:0) was also associated with lower risk. No other fatty acids were related to risk, including trans fatty acids.
• In controlled trials, supplementation with omega-3 or omega-6 fatty acids did not alter risk.

The authors conclude:

In conclusion, the pattern of findings from this analysis did not yield clearly supportive evidence for current cardiovascular guidelines that encourage high consumption of polyunsaturated fatty acids and low consumption of saturated fats. Nutritional guidelines on fatty acids and cardiovascular guidelines may require reappraisal to reflect the current evidence.

My view

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Princess Health and Does "Metabolically Healthy Obesity" Exist?. Princessiccia

Princess Health and Does "Metabolically Healthy Obesity" Exist?. Princessiccia

cancer cardiovascular disease diabetes disease metabolic syndrome overweight

Gusty 05:00 Add Comment

Obesity is strongly associated with metabolic alterations and negative health outcomes including diabetes, cardiovascular disease, and some types of cancer (1, 2, 3, 4). Excess body fat is one of the primary causes of preventable health problems and mortality in the United States and many other affluent nations, ranking in importance with cigarette smoking and physical inactivity. Obesity is thought to contribute to disease via the metabolic disturbances it causes, including excess glucose and lipids in the circulation, dysregulated hormone activity including insulin and leptin, and inflammatory effects. This immediately raises two questions:

1. Does metabolically healthy obesity exist?
2. If so, are metabolically healthy obese people at an elevated risk of disease and death?

Does metabolically healthy obesity exist?

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Princess Health and UK Board of Trustees OKs $31 million plan to outfit another floor of new hospital with eye toward federal certification for heart work.Princessiccia

Princess Health and UK Board of Trustees OKs $31 million plan to outfit another floor of new hospital with eye toward federal certification for heart work.Princessiccia

cardiac care cardiovascular disease health care access health care industry health care reform Medicaid Medicare University of Kentucky

Gusty 13:55 Add Comment

The University of Kentucky Board of Trustees has given UK HealthCare the green light for its $31 million plan to outfit the eighth floor of Pavilion A at UK Chandler Hospital over the next few months to make room for a growing cardiovascular program and to clear the way for a federal "Center of Excellence" certification.

After the project is complete, the floor will hold 64 beds, including 24 intensive-care beds for the cardiovascular program that offers heart transplantation, artificial hearts and ventricular devices, reflecting UK's focus on receiving the federal certification.

In the near future, such a designation will be necessary to get enough referrals from doctors and smaller hospitals to maintain important services, including cardiovascular services, and to guarantee that Kentuckians can get the care they need inside the state, Dr. Michael Karpf, executive vice president for health affairs, said in an interview with Kentucky Health News this spring.

Karpf and other UK HealthCare officials are also recommending a $30 million cost-reduction program for their system because Medicare and Medicaid reimbursements are expected to decline as competition stiffens over the next few years, reports Linda Blackford of the Lexington Herald-Leader.

In response to these forces, UK has a goal to secure half the available business from out-of-state competitive areas over the next 10 years to remain viable in a highly competitive market. And, focusing on complex care should drive revenue for the hospital because UK makes money on the complex stuff, Karpf told KHN.

Read more here: http://www.kentucky.com/2013/06/10/2673382/uk-healthcare-using-30-million.html#storylink=cpy

The $592 million, 12-floor patient tower has remained half-empty since 2010, and when the estimated $530 million project to fully occupy the tower is added to the initial cost of constructing Pavilion A, the total price tag will top $1 billion over 20 years, reports Blackford.

The overall construction and expansion is expected to support patient care for the next 100 years, says a recent UK press release. Once it's fully occupied, the the 1.2 million-square-foot facility will include 512 private patient rooms.

Read more here: http://www.kentucky.com/2013/06/10/2673382/uk-healthcare-using-30-million.html#storylink=cp

Princess Health and Neuronal Control of Appetite, Metabolism and Weight. Princessiccia

Princess Health and Neuronal Control of Appetite, Metabolism and Weight. Princessiccia

cardiovascular disease diabetes hyperphagia overweight

Gusty 19:00 Add Comment

Last week, I attended a Keystone conference, "Neuronal Control of Appetite, Metabolism and Weight", in Banff. Keystone conferences are small, focused meetings that tend to attract high quality science. This particular conference centered around my own professional research interests, and it was incredibly informative. This post is a summary of some of the most salient points.

Rapid Pace of Scientific Progress

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Princess Health and Atherosclerosis in Ancient Mummies Revisited. Princessiccia

Princess Health and Atherosclerosis in Ancient Mummies Revisited. Princessiccia

cardiovascular disease disease diseases of civilization

Gusty 19:00 Add Comment

Many of you are already aware of the recent study that examined atherosclerosis in 137 ancient mummies from four different cultures (1). Investigators used computed tomography (CT; a form of X-ray) to examine artery calcification in mummies from ancient Egypt, Peru, Puebloans, and arctic Unangan hunter-gatherers. Artery calcification is the accumulation of calcium in the vessel wall, and it is a marker of severe atherosclerosis. Where there is calcification, the artery wall is thickened and extensively damaged. Not surprisingly, this is a risk factor for heart attack. Pockets of calcification are typical as people age.

I'm not going to re-hash the paper in detail because that has been done elsewhere. However, I do want to make a few key points about the study and its interpretation. First, all groups had atherosclerosis to a similar degree, and it increased with advancing age. This suggests that atherosclerosis may be part of the human condition, and not a modern disease. Although it's interesting to have this confirmed in ancient mummies, we already knew this from cardiac autopsy data in a variety of non-industrial cultures (2, 3, 4, 5).

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Princess Health and Does the Mediterranean Diet Reduce Cardiovascular Risk?. Princessiccia

Princess Health and Does the Mediterranean Diet Reduce Cardiovascular Risk?. Princessiccia

cardiovascular disease diet

Gusty 15:34 Add Comment

By now, most of you have probably heard about the recent study on the "Mediterranean diet" (1), a diet that was designed by diet-heart researchers and is based loosely on the traditional diet of Crete and certain other Mediterranean regions. The popular press has been enthusiastically reporting this trial as long-awaited proof that the Mediterranean diet reduces the risk of cardiovascular events-- by a full 30 percent over a 4.8-year period. I wish I could share their enthusiasm for the study.

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Princess Health and Body Fatness and Cardiovascular Risk Factors. Princessiccia

Princess Health and Body Fatness and Cardiovascular Risk Factors. Princessiccia

cardiovascular disease overweight

Gusty 19:00 Add Comment

I recently revisited a really cool paper published in the Lancet in 2009 on body fatness, biomarkers, health, and mortality (1). It's a meta-analysis that compiled body mass index (BMI) data from nearly 900,000 individual people, and related it to circulating lipids and various health outcomes. This is one of the most authoritative papers on the subject.

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Princess Health and Small steps can prevent Kentucky's No. 1 killer, heart disease.Princessiccia

Princess Health and Small steps can prevent Kentucky's No. 1 killer, heart disease.Princessiccia

blood pressure cardiac care cardiovascular disease exercise heart disease sleep smoking

Gusty 21:00 Add Comment

It is now February, which is American Heart Month and a perfect time to remind people that small steps can reduce their risk of heart disease, Kentucky's No. 1 killer.

You may be surprised to hear that almost 80 percent of heart disease is preventable and there are daily things that can be done to keep hearts healthy, according Dr. Martha Grogan, medical editor-in-chief of Mayo Clinic Healthy Heart for Life.

For example, try to move 10 extra minutes each day, Recent research shows a sedentary lifestyle may increase your risk of heart attack almost as much as smoking, said Grogan.

Each day, make an effort to get up from your desk to go talk to a colleague instead of sending an email, or walk around the house as you are talking on the phone, she recommends: �Moving even 10 minutes a day for someone who�s been sedentary may reduce the risk for heart disease by 50 percent.�

Hearts are also hurt when you deprive yourself of sleep, which is a necessity like food and water, said Virend Somers, a Mayo cardiologist and sleep expert. Chronic sleep deprivation can increase the risk of obesity, high blood pressure, heart attack, diabetes and depression.

Healthy habits can reduce a majority of risks for heart attack. "A 53-year-old male smoker with high blood pressure has a 20 percent chance of having a heart attack over the next 10 years. If he stops smoking, his risk drops to 10 percent; if he takes high blood pressure medicine, it falls to 5 percent," says preventive cardiologist Randal Thomas, M.D.

These healthy habits and changes like quitting smoking and taking blood pressure medicine can make a difference in life and death. For more from the Mayo Clinic, click here; for a American Heart Month information from the federal Centers for Disease Control and Prevention, go here.

Princess Health and U of L researcher gets $3.4 million to replicate studies of stem cells for heart treatment.Princessiccia

Princess Health and U of L researcher gets $3.4 million to replicate studies of stem cells for heart treatment.Princessiccia

cardiac care cardiovascular disease heart disease heart health research University of Louisville

Gusty 08:36 Add Comment

Dr. Roberto Bolli of the University of Louisville has received a $3.4 million grant from the National Institutes of Health to test the validity of several recent studies by replicating them. The studies examine whether certain types of stem cells are safe and effective in treating heart failure, heart attacks and other cardiovascular disorders.

"Replicating studies in several locations with a large number of patients is necessary for researchers to ultimately determine which ones can be submitted to the Food and Drug Administration for approval," Jill Scoggins reports in a U of L press release.

Bolli has received more than $100 million in grants for basic research for NIH. This is the first grant he has been awarded for clinical research. (Read more)