eMedinewS Editorial

Health Care 228 Comments

Avoid Binge Drinking at the New Year Celebrations

During New Year celebrations many of us can put ourselves including our family, and our community in danger of experiencing many harmful health and safety outcomes from binge drinking.

Binge drinking is defined as 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women. One American drink is 40 ml of whisky (13 grams) and one India drink is 30 ml (10 grams) of whisky. Drinking too much, including binge drinking, is a leading preventable cause of death. More than 15% of adults report binge drinking. It is most common in men, adults in the 18–34 age range. Most people who binge drink are not alcohol–dependent or alcoholics and often engage in this behavior without realizing the health and social problems of their drinking. Alcohols can also be mixed with date rape drugs which are colorless and odorless.

Binge drinking increases the chances of:

  • Road traffic accidents
  • Violence against others and sexual assaults.
  • Risky sexual behaviors that can lead to HIV, sexually transmitted diseases (STDs), and unintended pregnancy.
  • Alcohol poisoning.
  • Babies born with fetal alcohol spectrum disorders.
  • Over time, binge drinking can lead to liver disease, certain cancers, heart disease, and other chronic diseases.

What can one do?

  • Choose not to binge drink and help others not to do it.
  • Avoid mixing alcohol with energy drinks, which can mask the depressant effects of alcohol.
  • Avoid drinking and driving
  • A rough formula is ‘one peg can impair driving for one hour.’
  • Avoid purchasing or serving alcohol to children and teenagers.
  • Choose not to drink if you are pregnant, or may become pregnant.
  • Talk about your drinking behavior and request counseling when required.
  • Participate in community efforts to prevent binge drinking.

Dr KK Aggarwal
Editor in Chief

eMedinewS Editorial

Health Care 243 Comments

Top Ten Advances in Cardiovascular Research in 2010 (AHA) (Part II)

  1. Hopeful new procedure for infants with congenital heart disease
    The Pediatric Heart Network’s randomized trial of Norwood shunt types in infants with single–ventricle lesions showed that the type of shunt used makes a difference in outcomes. Better transplantation–free survival at 12 months is a possibility with this new understanding of the better shunt choice for these patients. This was the first large–scale randomized trial in congenital heart surgery, offering an approach that should provide answers to other questions in the future. (Pediatric Heart Network Investigators – N Engl J Med 2010 May 27;362:1980–1992)
  2. Finding the right anti–clotting (anti–platelet) therapy
    Selecting the right type of anti–clotting drug and the right dosage can be tricky, and risky. New research from the PLATO investigators has found that ticagrelor may improve outcomes and reduce adverse events better than the current standard, clopidogrel. The CURRENT–OASIS 7 Trial is exploring the optimal dosing of clopidogrel and aspirin in patient undergoing invasive surgery. These studies will help providers better understand the situations where new choices and dosages may improve results for the patient. (PLATO Investigators – Lancet 2010 Jan. 14;375:283–93; CURRENT–OASIS 7 Investigators – N Engl J Med 2010 Sept 2;363:930–42; Lancet 2010 Sept. 1;376:1233–43)
  3. Basic science findings offer insight into future progress
    Several studies this year brought the future of medicine closer to the present with new insight into emerging technologies. Findings from stem cell therapy have shown improved quality of life and survival in several early studies of patients with chronic heart failure and support the development of future cell–based therapeutics. A large animal study defined the basic mechanisms for heart muscle regeneration initiated by specific types of stem cells. The results demonstrated that these stem cells repair scarred myocardium through promotion of the generation of new heart muscle and blood vessel). A second study supported the notion that the heart has the capacity to regenerate large numbers of heart muscle cells several times during its lifetime. Being able to directly reprogram stem cells into working heart muscle is a big step toward use in therapeutic settings. The STaR–Heart Study showed that injecting the patient’s own bone marrow stem cells into the heart improved hemodynamics and long–term survival in the treatment of chronic heart failure. (Hatzistergos, et al – Circ Res 2010 July 29;107(7):913–22; Kajstura et al – Circ Res 2010 June 3;107(2):305–15; The STAR–heart study – European Journal of Heart Failure; doi:10.1093/eurjhf/hfq095).
  4. Using science to support healthy lifestyle behaviors
    New science examining lifestyle behaviors in adults and children, with particular emphasis on physical activity and consumption pattern, show that such conditions as obesity and hypertension are positively influenced by a change in diet with decreasing sodium levels. Results from the school setting suggest that the earlier one starts to adopt healthy behaviors the better the effect on health outcomes. Furthermore, physical activity is an important lifestyle factor in improving cardio–metabolic factors, especially in those trying to reduce weight. Although most people don’t associate poor diet quality and physical inactivity with heart disease, the American Heart Association has created a national goal to improve seven health factors and lifestyle behaviors in support of raising awareness and helping all Americans move closer to optimal heart health over the next decade. (Bibbins–Domingo et al – N Engl J Med 2010 Jan 20;362:590–9; The HEALTHY Study Group – N Engl J Med 2010 July 20, 10.1056; Franks et al – N Engl J Med 2010 Feb 11;362(6):485–93; Goodpaster, et al – JAMA 2010 Oct 9;304(16):1795–1802).
  5. Get with the Guidelines participation eliminates disparity gaps in care
    Racial and ethnic disparities have been found in the quality of care delivered to patients with cardiovascular disease and achieving equity and addressing disparities has implications for quality, cost, risk management, and community benefit. Eliminating these disparities is a top priority for the American Heart Association. These findings are the first to show that participating in a quality improvement program, such as Get With The Guidelines–Coronary Artery Disease, can eliminate racial and ethnic disparities of care while increasing the overall use of evidence–based care for heart attack patients. (Cohen et al – Circulation 2010 June 1;121(21):2294–301)

Dr KK Aggarwal
Editor in Chief

eMedinewS Editorial

Health Care 198 Comments

AHA Top 10 Advances in Cardiovascular Research in 2010 (Part 1)

  1. Tailoring treatment for people with diabetes to reduce their risk of cardiovascular disease
    Heart disease death rates are 2 to 4 times higher for diabetics compared to people without diabetes. New research from the ACCORD Study Group offers insight into specific treatments that can reduce their risk of cardiovascular disease. The first study found that aggressive blood pressure control does not reduce CVD risk in people with type 2 diabetes at high risk for CVD. In a second study, a combination therapy with a statin plus a fibrate was no better at reducing risk than a statin alone in patients with type 2 diabetes at high risk for CVD. However, the combination lipid therapy may be successful in reducing CVD risk in those type 2 diabetes patients who had low HDL cholesterol and low triglycerides. (The ACCORD Study Group – N Engl J Med 2010 March 14;362:1575–85; N Engl J Med 2010;362:1563–74)
  2. New advances for patients who aren’t candidates for conventional valve surgery
    Many patients with severe aortic blockage have other medical conditions that make it risky for them to have conventional surgery to replace the blocked aortic valve. Transcatheter aortic valve implantation is an emerging alternative therapy to open–heart surgery in these high–risk patients. Two new studies support the evidence that TAVI can improve symptoms and outcomes – including quality of life – even over the course of several years. While there are some risks associated with TAVI, including strokes and other major cardiovascular events, the catheter-based procedure offers significant progress in this area. (PARTNER Trial Investigators – N Engl J Med 2010 Sept. 22;363(17):1597–607; Ye, et al – J Thorac Cardiovasc Surg 2010 May 1;139:1107–1113)
  3. Improving the way we reverse sudden cardiac arrest
    More than 300,000 people suffer out–of–hospital sudden cardiac arrest each year. Many die because the people around them didn’t know how to or were uncomfortable performing cardiopulmonary respiration (CPR). Significant studies now report that chest compression only, or ‘Hands Only CPR’ for adults by bystander lay rescuers improves survival outcome. Public awareness campaigns resulted in increased use of hands only CPR, as well as improved survival rates. While the new procedure appears successful in adults, it is important to note that using conventional chest compressions with rescue breathing is still important for children stricken with sudden cardiac arrest. In October, the American Heart Association issued updated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science, reflecting new advances in this field. (Bobrow, et al – JAMA Oct. 6 2010;304(13):1447–54; Rea, et al – N Engl J Med 2010 July 29;363(5):423–33; Field, et al – Circulation 2010 Oct. 18;122 (suppl 3):S640 –S656)
  4. More options for reducing stroke risk in atrial fibrillation
    For the first time in more than 20 years there are viable alternatives to the primary prevention of stroke for patients with atrial fibrillation (AF). AF is a major risk factor for stroke and affects more than 2 million people over the age of 65. Warfarin (Coumadin) has long been the standard anti–clotting drug used to reduce the risk of stroke for these patients. But it carries its own complications from bleeding, and managing the dose requires regular blood tests, making it difficult to manage for both patients and doctors. Now, several new drugs have been found to work as well as warfarin and are simpler for patients to take offering an important advance in this field. In October 2010, following further positive findings from the RE–LY trial, the U.S. FDA approved dabigatran for stroke prevention in AF patients. The ROCKET–AF trial presented at the American Heart Association’s Scientific Sessions 2010. Rivaroxiban, apixiban, edoxaban and other oral anticoagulants are being or have been studied in AF and may show future promise. (RE–LY– Lancet. 2010 Sep 18;376(9745):975–83; ROCKET–AF – American Heart Association Scientific Sessions 2010, Abstract 21839. AVERROES – European Society of Cardiology Congress 2010)
  5. Adjusting pacing therapies can improve outcomes for heart failure patients
    Many heart failure patients experience abnormal heart rhythms, known as arrhythmia. There are a number of devices available to treat arrhythmia, including implantable cardioverter difibrillators (ICDs) which can shock the heart beat back into a normal rhythm. New studies show that adding additional resynchronization pacing to ICD therapy can lead to improved outcomes in an expanded group of heart failure patients. In addition, new types of ICDs (defibrillators without leads, for example) can offer options that reduce some of the risks associated with traditional devices. (MADIT–CRT Trial Investigators – N Engl J Med 2009 Sept. 1;361(14) 1329–1338; RAFT Investigators – American Heart Association Scientific Sessions 2010, Abstract 21768; New England Journal of Medicine, Nov. 14, 2010. Bardy, et al – May 12, 2010; N Engl J Med 2010 May 12;363:36–44)

Dr KK Aggarwal
Editor in Chief

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