bookofjoe

BehindTheMedspeak: How To Avoid Heart Attacks

A new study, just published in The Lancet, found that six risky behaviors or medical risk factors account for 90% of all heart attacks worldwide.

The investigators looked at 15,000 heart attack victims and 15,000 controls in 52 countries, representing every inhabited continent.

The same six factors are the culprits for virtually everyone everywhere, regardless of socioeconomic factors.

They are:

•High cholesterol (3.25 x increased risk)

•Smoking (2.87)

•Stress (2.67)

•Diabetes (2.4)

•High blood pressure (1.91)

•Obesity (1.1)

Three things proved to decrease the risk of heart attacks:

•Daily consumption of fruits and vegetables (0.70)

•Regular physical activity (0.86)

•Regular alcohol consumption (0.91)

The abstract of the article is below; if you want to read the whole thing, go to the Lancet website and register (it's free).
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Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study

Salim Yusuf, Steven Hawken, Stephanie Ôunpuu, Tony Dans, Alvaro Avezum, Fernando Lanas, Matthew McQueen, Andrzej Budaj, Prem Pais, John Varigos, Liu Lisheng, on behalf of the INTERHEART Study Investigators

Summary

Background: Although more than 80% of the global burden of cardiovascular disease occurs in low-income and middle-income countries, knowledge of the importance of risk factors is largely derived from developed countries.

Therefore, the effect of such factors on risk of coronary heart disease in most regions of the world is unknown.

Methods

We established a standardised case-control study of acute myocardial infarction in 52 countries, representing every inhabited continent.

15,152 cases and 14,820 controls were enrolled.

The relation of smoking, history of hypertension or diabetes, waist/hip ratio, dietary patterns, physical activity, consumption of alcohol, blood apolipoproteins (Apo), and psychosocial factors to myocardial infarction are reported here.

Odds ratios and their 99% CIs for the association of risk factors to myocardial infarction and their population attributable risks (PAR) were calculated.

Findings

Smoking (odds ratio 2·87 for current vs never, PAR 35·7% for current and former vs never), raised ApoB/ApoA1 ratio (3·25 for top vs lowest quintile, PAR 49·2% for top four quintiles vs lowest quintile), history of hypertension (1·91, PAR 17·9%), diabetes (2·37, PAR 9·9%), abdominal obesity (1·12 for top vs lowest tertile and 1·62 for middle vs lowest tertile, PAR 20·1% for top two tertiles vs lowest tertile), psychosocial factors (2·67, PAR 32·5%), daily consumption of fruits and vegetables (0·70, PAR 13·7% for lack of daily consumption), regular alcohol consumption (0·91, PAR 6·7%), and regular physical activity (0·86, PAR 12·2%), were all significantly related to acute myocardial infarction (p<0·0001 for all risk factors and p=0·03 for alcohol).

These associations were noted in men and women, old and young, and in all regions of the world.

Collectively, these nine risk factors accounted for 90% of the PAR in men and 94% in women.

Interpretation

Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions.

This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.

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BehindTheMedspeak: Bird-Flu - the next great killer epidemic?

The avian influenza virus that spread widely among poultry and other birds in Southeast Asia has just crossed another species barrier previously thought impossible: it's jumped to domestic cats, formerly thought resistant to influenza A virus like the avian strain.

In an even more frightening development, researchers put two healthy cats in the same cage as an infected third cat, and the healthy cats became ill with the virus.

Thus, it has now been demonstrated to be transmissible within the cat population.

The avian influenza virus has proved extraordinarily virulent in humans, killing 25 of the 35 people who were infected.

Many influenza experts fear a worst-case scenario in which a person becomes infected with both an avian influenza virus - as has happened a lot in recent years - and a human one.

Under such circumstances, the two viruses might swap genes, creating a new virus variant that could cause an epidemic planet-wide, much like that of the so-called Spanish flu of 1918-19, which killed more than 675,000 people in the U.S. alone and over 20 million world-wide.

Here's Lawrence K. Altman's excellent piece from last Friday's New York Times.
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Study Finds Bird-Flu Virus Can Spread Among Cats

The avian influenza virus that has spread widely among poultry and other birds in Southeast Asia and infected some people there has also crossed another species barrier to infect cats, and can be spread among them as well, Dutch scientists have found.

The finding is "extraordinary because domestic cats are generally considered to be resistant to disease from influenza A virus infection," like that of the avian strain, the researchers are reporting in today's issue of the journal Science.

In the Dutch study, some cats with the infection died of it, while others survived. A few did not even show any symptoms that they were carrying the disease.

Whether cats can transmit the virus strain, A(H5N1), to humans is not known.

The World Health Organization has received no reports that cats played a role in afflicting the 35 people who have developed A(H5N1) infection, all in Thailand and Vietnam, said Dick Thompson, a spokesman for the agency in Geneva.

Those cases were traced chiefly to direct contact with sick birds.

Even so, the Dutch study has important implications for human and animal health, said Juan Lubroth, a senior animal health officer at another United Nations agency, the Food and Agriculture Organization.

The findings, Dr. Lubroth and the study's authors said, underscore a need to investigate the possible role of cats and an array of other animals in the spread of avian influenza among poultry farms and to humans.

An estimated 200 million birds have either died of A(H5N1) or been slaughtered to control the outbreak since last winter, when the strain simultaneously appeared in eight Asian countries.

United Nations officials have described the scale of the epidemic - geographically and economically - as unprecedented for an avian flu outbreak.

The strain has also been particularly lethal for humans, killing 25 of the 35 people infected.

Many influenza experts and health officials fear a worst-case occurrence in which a person becomes infected with both an avian influenza virus and a human one.

Under such a circumstance, the viruses might swap genes, creating a new virus that could cause an epidemic all over the planet much like that of the so-called Spanish flu of 1918-19, which killed 675,000 people in the United States alone and more than 20 million around the world.

The laboratory in Rotterdam that reported the new findings has conducted research on A(H5N1) since 1997, when its scientists detected the strain in a child who had died of the disease in Hong Kong.

The Hong Kong case was a scientific bombshell, because it was the first in which a new avian influenza virus had been transmitted from birds to humans without first mixing with mammalian influenza strains in pigs.

Since then, the A(H5N1) virus has mutated to become more virulent.

Last January a clouded leopard died, apparently of avian influenza, at a zoo in Thailand after eating virus-infected chickens, Thai health officials recalled in recent interviews in Bangkok.

A month later, scientists identified the A(H5N1) virus in three dead cats, and in a white tiger that recovered after becoming ill in the same zoo where the leopard died.

The cats belonged to a Thai woman who had 15 in all, 14 of which apparently died of avian flu, although the remains of only those 3 could be found for testing.

The woman did not develop bird flu.

Tests showed that the molecular makeup of the viruses isolated from the cats and the tiger was the same as that of the virus found in chickens.

After learning about those infections, the Rotterdam team, led by Dr. Thijs Kuiken, conducted three laboratory experiments by using the A(H5N1) virus isolated from a Vietnamese patient who had died of it.

The findings confirmed what had been observed in the cats in Thailand.

First, Dr. Kuiken's team introduced the Vietnamese virus into the airways of three European shorthair cats, the breed generally used in animal experiments.

All three became sick beginning the next day, and one died on the sixth day of illness. In comparison, none of three cats infected with the most common type of human influenza virus became ill.

In the second experiment, three cats were fed infected chicken.

Examination of their tissues under a microscope showed that all three had developed severe lung damage similar to that seen among birds and humans. (People are not vulnerable to infection by eating chicken that is cooked, but the person who cooks it may be at risk from handling it, health officials say.)

In the third experiment, the researchers put two healthy cats in the same cage two days after infecting a third cat.

The healthy cats also became ill.

Dr. Kuiken said in telephone interviews that he did not know whether these two cats had caught the infection by licking, through droplets or through the air.

His study, he said, was not devised to determine how the cats spread the virus.

Additional research is needed because of the small size and scope of the Dutch study, experts said.

But the Food and Agriculture Organization "is not set up to conduct this type of research," Dr. Lubroth said, adding that scientists at universities and other research institutes would have to do much of it, though with technical advice from his agency.

One avenue of research will be to test whether cats that are susceptible to other strains of influenza virus can spread those strains as well.

In addition, Dr. Kuiken said his team planned to test whether the original A(H5N1) virus, from the 1997 Hong Kong case, could infect cats, or whether only the later, mutated form could do so.

At the same time, Dr. Lubroth said, agricultural workers need to educate farmers about good practices like not raising swine with chickens.

Another reform will be teaching farmers to keep cats away from poultry, although that step, Dr. Lubroth said, "may be as difficult as herding wild cats.''

'China Ramps Up Net-Porn War'

Headline on a breaking story about the country's ever-toughening crackdown on bad things virtual.

Now, aren't you glad I decided to become Ivory Snow-pure?

If I didn't know better, I'd say I had a premonition....

World's First Underwater Massage Treatment Room

It's at Huvafen Fushi

in the Maldives.

The small luxury spa offers glass-walled, underwater treatment rooms where you can watch the fishes swim while you get a massage.

'If things go right, I'll be there about a week; and if things don't go right, I'll be there about an hour and a half.'

Rodney Dangerfield, upon admission to UCLA Hospital last week for heart-valve replacement surgery.

Dangerfield, 82, is pretty darned tough; he looks like a walking advertisement for an imminent heart attack, all sweaty and twitchy, but so far he's survived surgery in 1992 for an abdominal aortic aneurysm repair (extraordinarily high-risk), had double coronary artery bypass surgery, undergone yet another abdominal aortic aneurysm surgery in 2000 to correct problems related to the first one, and had a heart attack in 2001.

He remains in the ICU at UCLA today, more than a week after his operation.

You GO Rodney!

Burning Man 19 is History

The nineteenth iteration of this now-well-known festival ended yesterday in Black Rock Desert, Nevada.

Over 35,000 people were present Saturday night when the ritual burning of the 40-foot-high neon-and-wooden icon of a man took place.

This year's event was relatively uneventful compared to the 2003 version, which included two deaths and four people hospitalized after accidents with aircraft and the "Mad Max"-style "mutant vehicles" that roam the desert throughout the event.

The burning of an elaborate Temple of Stars took place Sunday evening.

Created by artist David Best, the temple took thousands of hours to build.

It was created from lace-like filigrees of plywood left over after toy punch-outs were made.

Builders started construction back in May in Petaluma, California, before shipping the components into the desert aboard flatbed trucks.

This year's structure was so elaborate it opened to participants only last Friday night, barely 48 hours before it was to be burned.

Revelers left the names of departed loved ones and other remembrances to be burned in the temple.