bookofjoe

BehindTheMedspeak: If just thinking about exercising makes your heart beat faster, you've got a problem

Long story short: Men whose heart rate increased by more than 12 beats per minute while sitting on an exercise bike before exercising were twice as likely to die of a sudden heart attack later in life than men whose heart rate increased by less than 4 beats a minute just sitting on the bike.

Here's the abstract of the study, published online April 28, 2009 in the European Heart Journal.

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Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population

Aims: The aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk.

Methods and results: Data from 7746 civil servants participating in the Paris Prospective Study I, followed-up for 23 years, allowed to compare heart rate changes between rest and mild mental stress (preparation prior to an exercise test) between subjects who suffered sudden cardiac death (n = 81), non-sudden (n = 129) coronary death, or death from any cause (n = 1306). The mean heart rate increase during mild mental stress was 8.9 ± 10.8 b.p.m. Risk of sudden cardiac death increased progressively with heart rate increase during mental stress and the relative risk of the third vs. the first tertile was 2.09 (95% confidence interval, 1.13–3.86) after adjustment for confounders. This relationship was not observed for non-sudden coronary death.

Conclusion: An important heart rate increase produced by a mild mental stress predicts long-term risk for sudden cardiac death. Heart rate changes before an exercise test may provide a simple tool for risk stratification.

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Nice overview of the study here.

Download the paper (free) as a PDF file here.

Strawberry Slicer

Perfect in case you lose all your knives.

From the website:

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Strawberry Slicer

Cut beautiful, perfect strawberry slices in an instant.

Handy kitchen helper neatly and safely creates up to 8 even slices with one quick downward motion.

Make attractive garnishes or toppings for cakes, sundaes, fruit salads or other desserts.

Works on kiwi fruit too.

Rinse-clean stainless steel blades.

3-3/4" x 2-3/4".

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$5.98 (strawberries not included — unless your name is Queeg.).

Tonto National Forest Night Vision Jeep Tour

"It’s dark, you can barely see your hand in front of your face. You bring your night vision device up to your eyes and turn it on. Suddenly, in a green-hued clarity, the entire pitch-black Sonoran Desert is like day. Join Stellar Adventures and explore the vast darkness of the hidden treasure we call the Sonoran Desert. Experience Arizona’s wondrous nocturnal wildlife as it comes alive under the veil of the dark, desert night sky."

$145.

CoolCop — Body Armor Air Conditioning

That's different.

From the website:

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On a hot day there's nothing more uncomfortable than having to wear a T-shirt soaked with sweat. Add a bulletproof vest over it and no amount of air conditioning coming from your car vent is going to keep you cool and dry.

The CoolCop dash attachment attaches easily to the air conditioning vent. The soft vinyl vest attachment fits comfortably between your vest and undershirt. Cool air is then delivered under your vest to keep you cool, dry and comfortable.

In just minutes your T-shirt is as dry as it was in briefing.

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$49.95.

[via Cliff Hatch]

'I have no hands but I work as a dentist'

Above, the headline over a first-person account by Pak Seke (above, at work) of Jakarta, Indonesia, as told to David Goodwin and published in the dead tree version of this past weekend's Financial Times.

Here's the FT piece.

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First Person: Pak Seke

It’s really very relaxed in my dental clinic: you can have a cigarette and listen to the caged birds before I start. My patients sit in the living-room armchair while I work on them. I don’t use an anaesthetic – the television is usually enough to distract them from the pain. I do fillings, extractions, braces, polishing and make sets of false teeth.

I live in North Jakarta, on the island of Java in Indonesia. I work in my front room, which doubles as the clinic. I’ve got the red-and-white teeth-and-gums sign stuck on my window that shows I’m an ahli gigi – a tooth expert. I’m 42 years old.

I learnt by helping another ahli gigi for a couple of years. One day I realised I could do it myself. So I bought some books, read them all and set up on my own. I’ve been a tooth expert for nearly 20 years. My wife, Jumani, began filling and drilling about three years ago, too, and helps me out when I need assistance.

When I started out, people were a little afraid of me; but after a while word spread and I got a lot of patients. I have a steady stream of customers now – about seven to 10 a fortnight. Most of my patients are working-class. If they’ve got more money, they’ll go to a dokter gigi: a dentist, or tooth doctor.

One of my fillings will set you back Rp50,000 (£3.10), and an extraction costs Rp75,000. A clean-and-polish is Rp200,000 and a personally designed brace comes in at around Rp3m (£190). If I take out an old tooth and replace it with a false one, I won’t charge you for the tooth-pull.

I’m missing both hands and one leg because my mother drank a soup with monkey parts in it when she was pregnant with me. It was my father’s idea – he was Chinese-Indonesian and believed in health potions. The medicine was supposed to stop my mother from being sick, but then I was born like this. Some people in Indonesia say that you’ll harm your unborn baby if you hurt or kill something while you’re pregnant. My mum said that I’m missing some of my limbs because the monkey had his hands and legs chopped off, too. I don’t blame either of my parents, though. I’m happy that I’ve got work. I’ve also got a great family. And both of my daughters are normal.

I was born a Muslim but most Chinese-Indonesians are Buddhist, Catholic, Protestant or follow Confucianism. I don’t know when my ancestors came to Jakarta – I don’t know exactly where they’re from in China. Chinese-Indonesians were forced to give up their family names during President Suharto’s New Order, from 1965 to 1998. So now we’re all called western names or Indonesian names such as Suprianto. Even the older generations were given new names halfway through their lives. That’s why a lot of our genealogy died out during the New Order; it made it much harder for us to trace our family trees.

When I’m not busy with patients, I work as a taxi driver. I bought a minivan with the proceeds from my dental business, so I take young mums shopping, drop kids at school and ferry goods around. Driving without hands isn’t very difficult: everybody goes slow in Jakarta, and I take my time like everyone else. I put my false leg on when I’m behind the wheel so that I can use the clutch: I use a manual for more control. I’m different from your normal taxi driver. People like me for that.

Apart from when I’m driving, I don’t wear my false leg much – it grates when I walk on it. I don’t need to use it in the dental clinic as I’ve got my technique down pat. I sandwich myself between the wall and the back of the armchair, and then I push down on to the patient’s face with my forearms to keep them from shaking around. No one’s complained yet.

Charlie Brown T-Shirt

Odd, isn't it, that with the proliferation of T-shirts and places to get them you never see one of these?

Put paid to that.

$18.

The Complete Review — 'A literary saloon [sic] and site of review'

"A selectively comprehensive, objectively opinionated survey of books new and old, trying to meet all your book review, preview, and information needs."

Long sentence short: Meta-review website .

[via Cynthia Crossen's May 1, 2009 "Book Lover" column in the Wall Street Journal]

Note to file: In my next confidential memo to Rupert, mention that he needs to make sure Ms. Crossen remains on the bus — in one of the cushy reclining seats — after the next round of cuts at the WSJ.

Sandal Toe Protectors

That's different.

From the website:

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Sandal Toe Protectors

Sandal protectors make walking a breeze.

Clear flexible silicone guards slip easily on to your sandals’ thong separators to keep your toes from rubbing against sandal material.

Prevents toe chafing, irritation and blister formation.

Cushions your toes for hours of walking ease.

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Set of two: $4.98 (sandals not included).