ambulance services, nhs, air ambulance, emt, paramedic, south wales, welsh ambulance ::: Paramedics and Friends Online, P.A.F.O

Login

SP Services

Medical News

The Prevalence Of Carotid Atherosclerosis, A Leading Cause Of Stroke, Increases Significantly With T

Thursday, 04 September 2008

A study in the Sept. 1 issue of the journal Sleep shows that objectively measured heavy snoring is an independent risk factor for early carotid atherosclerosis, which may progress to be associated with stroke.

In a study of 110 adults, the prevalence of carotid atherosclerosis was 20 percent with mild snoring, 32 percent with moderate snoring and 64 percent with heavy snoring. After adjustment for age, gender, smoking history and hypertension, heavy snoring was significantly associated with carotid atherosclerosis.

"Heavy snorers may be at risk for the development of carotid atherosclerosis, which is the leading cause of stroke," said lead author and study coordinator Sharon Lee, associate professor and director of the Ludwig Engel Centre for Respiratory Research at Westmead Hospital in Australia. "Heavy snorers…should have a review of all their risk factors for vascular disease."

The study is the first to objectively measure and quantify snoring, rather than using a questionnaire, to explore the association between sleep-disordered breathing and carotid atherosclerosis. According to Lee, the high prevalence of snoring in the community means that these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke.

The American Academy of Sleep Medicine reports that habitual snoring occurs in about 24 percent of adult women and 40 percent of adult men. Loud and frequent snoring also is a warning sign for obstructive sleep apnea.

One-hundred-and-ten participants with ages ranging from 45 to 80 years were examined in a sleep laboratory. Volunteers were categorized as snorers and non-snorers with only mild, nonhypoxic obstructive sleep apnea. Participants underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis and cardiovascular risk assessment. A snoring index (the number of snores per hour) and snoring sleep time (the total number of 30-second sleep periods that contained three or more snore sounds expressed in a percentage) were used to categorize participants. Based on results, participants were deemed mild snorers (0-25 percent night snoring), moderate snorers (greater than 25-50 percent night snoring) and heavy snorers (more than 50 percent night snoring).

Prevalence of atherosclerosis was related to snoring sleep time in a nonlinear fashion, with a stable prevalence of atherosclerosis below a snoring sleep time of 50 percent but increasing substantially for snoring sleep times longer than 50 percent.

According to Lee, treatments such as weight loss, decreased alcohol intake, oral appliance therapy and continuous positive airway pressure (CPAP) therapy have all been shown to successfully reduce snoring. There are no studies on whether reducing snoring will reverse damage to the carotid arteries.

Dummies May Lower Risk Of SIDS

Monday, 18 August 2008

The risk of Sudden Infant Death Syndrome (SIDS), the third leading cause of infant death, may be lowered through the use of a pacifier. According to an article in Nursing for Women's Health, neonatal health care practitioners should counsel new parents on the potential benefits of using a pacifier.

This advice follows the release of updated recommendations from the American Academy of Pediatrics (AAP) Task Force on SIDS, suggesting that pacifier use be encouraged for children less than one year of age. "It's important to note that the AAP's pacifier recommendations are not unique," says author Elizabeth Damato, Ph.D., RN. "A variety of studies have indicated that pacifier use lowers the risk of SIDS, and several other countries have made similar recommendations." She stresses, however, that parents must be counseled on how to use pacifiers safely.

"Pacifiers shouldn't be used before the age of one month in breastfed infants to avoid the disruption of regular feeding habits," says Damato. "Also, infants should not be forced to take a pacifier and parents should not reinsert it once the infant falls asleep." Parents should also avoid using homemade pacifiers, avoid strings or cords to secure the pacifier to the child, and regularly clean and replace pacifiers.

Even though evidence is mounting that pacifiers help to prevent SIDS, no one knows why. "Because SIDS happens so rarely, it is difficult to do large-scale controlled studies to determine why pacifiers might help," says Damato. "However, because the risk for serious side effects is greatly reduced if pacifiers are used properly, they are a safe and sensible option in the battle against SIDS."

Nursing for Women's Health (formerly AWHONN Lifelines) publishes the most recent and compelling health care information on women's health, newborn care and professional nursing issues. As a refereed, clinical practice journal, it provides professionals involved in providing optimum nursing care for women and their newborns with health care trends and everyday issues in a concise, practical, and easy-to-read format. For more information, please visit http://www.blackwellpublishing.com/nwh.

Blackwell Publishing is the world's leading society publisher, partnering with 665 medical, academic, and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. The company employs over 1,000 staff members in offices in the US, UK, Australia, China, Singapore, Denmark, Germany, and Japan and officially merged with John Wiley & Sons, Inc.'s Scientific, Technical, and Medical business in February 2007. Blackwell's mission as an expert publisher is to create long-term partnerships with our clients that enhance learning, disseminate research, and improve the quality of professional practice. For more information, please visit http://www.blackwellpublishing.com or http://www.blackwell-synergy.com

A new study sheds light on the relationship between women who smoke while pregnant - or are exposed

Monday, 18 August 2008

A new study sheds light on the relationship between women who smoke while pregnant - or are exposed to second-hand smoke - and an increased risk of SIDS to their babies.

Researchers at McMaster University have found a mechanism that explains why an infant's ability to respond to oxygen deprivation after birth - or a hypoxic episode - is dramatically compromised by exposure to nicotine in the womb, even light to moderate amounts.

The findings are published online in the journal Federation of American Societies for Experimental Biology (FASEB) and will appear in the May 2008 print issue.

"While cigarette smoke contains many different compounds, we found there is a direct impact of one component, nicotine, on the ability of certain cells to detect and respond to oxygen deprivation," says Josef Buttigieg, lead author and a PhD graduate student in the department of Biology. "When a baby is lying face down in bed, for example, it should sense a reduction in oxygen and move its head. But this arousal mechanism doesn't work as it should in babies exposed to nicotine during pregnancy."

The research, which was conducted on laboratory rats in collaboration with Dr. Alison Holloway, explains the critical role that catecholamines - a group of hormones released by the adrenal glands - play in a baby's transition to the outside world.

During birth, the baby is exposed to low oxygen, which signals the adrenal glands to release the catecholamines, which contain adrenaline, or the 'fight or flight' hormone, explains Buttigieg.

It is these catecholamines that signal the baby's lungs to reabsorb fluid, to take its first breath, and help the heart to beat more efficiently. And for some months after birth, the adrenal gland still acts as an oxygen sensor, aiding in the baby's arousal and breathing responses during periods of apnea or asphyxia. But the ability to release catecholamines during these moments - a critical event in the adaptation of life outside the womb - is impaired due to nicotine exposure.

"At birth, the nervous control of the adrenal gland is not active and so a baby relies on these direct oxygen sensing mechanisms to release catecholamines," says Colin Nurse, academic advisor on the study and a professor in the department of Biology. "But nicotine causes premature loss of these mechanisms, which would normally occur later in development after nervous control is established. Thus, the infant becomes much more vulnerable to SIDS."

Belly Size May Be Better Stroke Predictor Than BMI

Monday, 18 August 2008

A new study from Germany suggests that belly size and other markers of abdominal fat may be a better predictor of stroke than body mass index (BMI).

The study was the work of lead author Dr Yaroslav Winter from the University of Heidelberg and other colleagues based there and at other research and clinical centers in Germany, and is published online before print on August 14th in the journal Stroke.

Previous studies have already suggested that waist circumference is a better predictor of cardiovascular risk than body mass index (BMI), and Winter and colleagues wanted to see if this was the case for cerebrovascular events such as stroke and transient ischemic attack (TIA). TIA is commonly called mini stroke, where there is a temporary interruption to the blood supply to a part of the brain, and is often a precursor to a stroke, which is a permanent disruption to blood supply in a part of the brain.

For the case control study, Winter and colleagues enrolled 379 adults with stroke and/or TIA and matched them with 758 controls of the same age and sex living in the same region. 79 per cent (301 members) of the stroke/TIA group had had a stroke, 10 per cent (37) had had bleeding in the brain, and 11 per cent had had a TIA. The stroke/TIA group had an average age of 67 and comprised 141 women and 238 men.

The researchers took various measures of obesity, including BMI, waist to hip ratio, waist circumference and waist to height ratio (these last three being what they called markers of abdominal adiposity, or abdominal fat).

They then analysed the links between these measures and stroke or TIA risk using statistical tests like conditional logistic regression and adjusted for other risk factors.

The results showed that:

While there was a positive strong link between BMI and cerebrovascular risk, it became non-significant when the researchers took out risk factors like physical inactivity, smoking, blood pressure, and diabetes.

Markers of abdominal adiposity were strongly linked to risk of stroke/TIA, regardless of the other risk factors.

For instance, participants with bigger waists (more than 40 inches for men and 35 inches for women) had 4 times the risk of developing a stroke or TIA compared to those with more typical waist sizes.

Also, participants with the largest waist-to-hip ratio had nearly 8 times the risk of developing a stroke or TIA.

Winter and colleagues concluded that:

"Markers of abdominal adiposity showed a graded and significant association with risk of stroke/TIA, independent of other vascular risk factors. Waist circumference and related ratios can better predict cerebrovascular events than BMI."

According to a report in WebMD, Dr Tobias Back, the senior author of the study, who is based at Saxon Hospital Arnsdorf in Dresden, told the press people should keep and eye on their waistline and not let it get big:

"While gaining too much weight can present health risks, it's even more dangerous to have the abdominal type of obesity."

Back urged everyone to stay physically active too; the researchers noticed there was a higher proportion of physically active people in the healthy group than in the stroke group. He also encouraged people to eat more healthily:

"A Mediterranean diet containing fish and olive oil can lower your risk of coronary heart disease and possibly also lower stroke risk."

Back said that as well as considering a patient's whole vascular risk profile, doctors should use waistline measures such as the waist to hip ratio as defined by the World Health Organization (WHO) to monitor stroke risk.

The WHO estimates that about 17 million people a year die of cardiovascular diseases, particularly heart attack and strokes. A great number of these can be attributed to tobacco smoking, which increases the risk two or three-fold, while physical inactivity and poor diet are other main risk factors.

"Contribution of Obesity and Abdominal Fat Mass to Risk of Stroke and Transient Ischemic Attacks."
Yaroslav Winter, Sabine Rohrmann, Jakob Linseisen, Oliver Lanczik, Peter A. Ringleb, Johannes Hebebrand, and Tobias Back.
Stroke Published online before print August 14, 2008.
doi:10.1161/STROKEAHA.108.523001.

Click here for Abstract.

Sources: Journal article, WebMD, WHO.

Lung Association: Going Back To School With Asthma Shouldn't Cause Anxiety

Monday, 18 August 2008

As the school bells get ready to ring, parents and other caregivers of children who have asthma should prepare for a possible peak in asthma episodes (also known as attacks or exacerbations). According to the American Lung Association of the Upper Midwest, the greatest number of asthma hospitalizations occurs in the fall, usually September.

The fall increase may be caused by respiratory infections, increased pollen, and outdoor mold counts. Children going back to school also have more contact with other children in an indoor environment, possibly increasing their exposure to viral and bacterial respiratory infections which can lead to an asthma episode.

"Parents and guardians can prepare for this possible increase in asthma episodes by scheduling a 'well-asthma' visit with the child's asthma provider," said Harold Wimmer, CEO of the American Lung Association of the Upper Midwest. "At this visit, health care providers should review or develop an Asthma Action Plan for the child."

According to the Lung Association, parents and guardians should:

-- Obtain an up-do-date Asthma Action Plan from the health care provider and forward copies to the school health office and/or childcare provider.

-- Ensure the child has rescue medications (often called albuterol) and holding chambers (also called spacers) available at home and school/childcare. Make sure rescue medication inhalers are not outdated or empty.

-- Ensure the child has access to his/her asthma medications and knows how to use them.

-- Reduce exposure to things that could trigger an asthma attack such as allergens and secondhand smoke.

-- Schedule an influenza vaccine appointment when the vaccine is available.

-- Teach children to wash their hands frequently with soap and water both at home and school.

Children whose asthma is well-controlled can participate in all activities just like anyone else, including sports, gym and other aerobic type activities by following an Asthma Action Plan and providers' instructions. Signs that a child's asthma is well-controlled include:

-- Ability to participate in all physical activities without developing asthma symptoms.

-- Sleeping through the night without episodes of coughing and wheezing.

-- No missed school days due to asthma or other respiratory illnesses.

-- No emergency room, urgent care or unscheduled provider office visits.

If your child is having symptoms or asthma episodes, the American Lung Association of the Upper Midwest advises parents and caregivers to schedule an appointment with the child's health care provider as soon as possible to resolve these issues.

American Lung Association of the Upper Midwest
http://www.lungum.org

More...

<< Start < Prev 1 2 3 4 5 Next > End >>

Results 1 - 9 of 42

Related Items

Syndicate - RSS feeds to our news articles

Latest Posts

Re:FAO All First Responders
Letsworktogether 21-11-08 13:58

Re:FAO All First Responders
arnie 21-11-08 13:21

Re:FAO All First Responders
Letsworktogether 21-11-08 11:35

Help
mintymurray 19-11-08 21:30

Re:FAO All First Responders
mintymurray 19-11-08 21:23

Re:FAO All First Responders
wibble 19-11-08 15:53

Re:FAO All First Responders
masteroftwojackofnone 19-11-08 05:38

Little Reminders

Did you know that an overdose of Amitriptyline (on its own quite nasty) is made twice as dangerous when mixed with Citalopram..... Citalopram antagonises the Amitriptyline

Toxbase

New Users

ted3028	Nezzi
Jen Taylor	Cat C is the one for me

Google Ads