Dr K K Aggarwal

Non-cardiac Chest Pain may Not be Benign

Patients discharged with non cardiac chest pain may not always b with low risk as a new study shows a worrying one-year mortality rate of around 4% in this group, which is higher in patients with a previous psychiatric hospitalization. Around one-third of the deaths were cardiovascular, suggesting that a fairly substantial number of patients with heart disease are being missed when presenting to hospitals with chest pain. The study is published in European Heart Journal on December 1, 2011 by Dr Michelle Gillies from University of Glasgow, Scotland.

One should do a thorough review of the diagnostic parameters that lead to a diagnosis of non cardiac chest pain. In patients with negative high-sensitivity troponin and stress tests and in whom a specific non cardiac cause of the chest pain has not been identified, the use of N-terminal pro-brain natriuretic peptide (NT-pro BNP) or the measurement of unbound free fatty acids may be considered, which have shown high negative predictive abilities.

Given the known link between psychiatric and cardiovascular diseases, the best time for intensive cardiac evaluation would be at the initial psychiatric hospitalization or diagnosis of psychiatric illness, rather than at hospitalization for chest pain.

COPD patients more likely to develop lung cancer

Lung cancer may be detected at an earlier stage by screening individuals with chronic obstructive pulmonary disease (COPD) early as per a report in Nov 20011 issue of European Respiratory Journal.

COPD is the fourth leading cause of death in the world and lung cancer is the seventh, according to the World Health Organization. These two conditions are associated.

The research has shown that individuals with COPD are more likely to develop lung cancer compared to individuals who currently or previously smoked with normal lung function.

Amongst COPD patients 1% develops lung cancer each year compared to 0.2% of people with normal lung function, a five time increase in the risk of COPD patients developing lung cancer.

Practicing dietary habits for a few months makes all the difference

• You need only 500 mg of salt per day but most eat more than 3.5 grams in a day
• One can live without sugar (without any kind of carbohydrate as long as some fat and protein are available).
• Adopting diets low in salt, fat, sugar, or animal products can alter the food preferences.
• Flavor and food preferences are more malleable when we’re young (indeed, in utero), but as adults, we can still work on them.
• People who manage to follow a low-sodium diet for several months wind up preferring lower concentrations of salt in their food.
• Tastes changes to liking for sweeter things after a month of drinking a sweetened energy drink.