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| Surprising death of Tim Russert under the medical prism |
| Why do the sudden heart attacks happen |
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| In the contingency of a sudden heart attack, the heart must be desfibrilado by means of the use of an automatic defibrillator (in the photo) and second, the individual must be transported immediately to a hospital. AP |
For Juan José Rivera
Special for Washington Hispanic
Last June 13, Tim Russert, moderator of the television program Meet the Press, died suddenly of a heart attack.
The testimonies presented by those persons nearby to Russert, including his internist, indicate that although the journalist and political analyst was knowing about that was suffering from cardiovascular disease, this one was not suffering from pains in the breast or from any other symptom that he was suggesting that his life was in danger.
His death, although deplorable, it has achieved that the public eye focuses again in the increasing cardiovascular epidemic.
Next what we know about the medical Russert record across different mass media: 58 years of age, record of cardiovascular disease, historic of LDL or high bad cholesterol, good cholesterol or low HDL, excess weight, hypertension and prediabetes. An effort test realized in April of this year turned out to be negative. Russert was using medicines for the hypertension and to improve his cholesterol levels.
The cardiovascular diseases represent the first cause of death in the United States and in many of other industrialized countries. Our country invests more than 400 billion dollars a year to cover the expenses of health related to this epidemic. Approximately every 45 seconds, there dies an American citizen due to a cardiovascular complication. Let's examine the terrible Russert death and let's touch several points of vital importance.
Cardiac sudden death
Regrettably, in almost a third of the occasions, the cardiac sudden death represents the first cardiovascular disease declaration. Like that it was in case of Russert, who had badges ateromatosas in the arteries of the heart. One of these badges, located in the left coronary artery, broke, causing the sharp formation of a thrombus or arterial clot. This event did that the cardiac muscle was not receiving become oxygenated blood, which is vital for the normal functioning of the heart. In this state of physiological stress, the rhythm of the heart returned in one chaotic and lethal, called ventricular fibrillation.
In this emergency situation, two things are essential to achieve that the person survives: first, the heart must be desfibrilado by means of the use of the automatic, and second defibrillator, the individual must be transported immediately to a hospital with the aptitude to realize invasive coronary interventions. In case of Russert, apparently the first intervention did not turn out to be successful.
Vulnerable badges
A lot of of the medical controversy that surrounds this case, it is the fact that Russert had been put to an effort test recently and the same one turned out to be negative.
This concept is important. An effort test turns out to be positive when the patient has a major coronary obstruction of 70 %. Namely an individual with one, two or three arterial blockades of 50 % each one, can have a negative effort test. The key is in that a badge that obstructs the arterial cavity only 40 % or 50 % can break momentarily and cause a sharp entire obstruction of the arterial cavity. In case of Russert, this was what happened, explaining the sad event in spite of the negative effort test.
We do not know exactly what causes that some badges ateromatosas break and cause an infarction and others stay stable; to this he is met like the grade of vascular vulnerability.
Scientific and clinical investigations suggest that those vulnerable badges are those who contain a major fat quantity, have a thin vascular layer and demonstrate evidence of a higher grade of inflammation. There exists technology that is used to determine the grade of vulnerability of a badge ateromatosa. At present, these methods and instruments are used almost only in the field of the investigation.
How to prepare
The cardiovascular prevention is of supreme importance, both at an individual level and to a governmental level. It is important that it knows which his cardiovascular risk factors are this way to be able to implement life styles or therapies that take as an intention modifying them.
Tim Russert apparently was fighting against his risk factors, trying to do exercise, grow thin and using the correct medicines. Talvez this change process turned out to be late in his case.
Perhaps, as many persons say, it touched him his shift. I do not know it … but my duty is to communicate to them what indicates us the science and the current statistics. We face a cardiovascular epidemic which we do not have opportunity to conquer if we do not put into practice the cardiovascular prevention.
*El author is a cardiologist of the Hospital Johns Hopkins and he writes in the blog nuevocorazonhispano.com.
| New therapy reinforces immune answer to the melanoma |
| Experimental treatment saves a leather cancer patient |
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| This is a typical melanoma injury. AP. |
For Mike Stobbe
AP
A statesman of Oregon, whom they gave less than one year of life, had a finished reference of an advanced cancer of skin later that an experimental treatment reinforced his immune system to fight the tumors.
This dramatic draft of the 52-year-old patient of age, it has been the only success in a limited study, what it takes to the doctors to be proved to be cautious. Nevertheless, the treatment spread in New England Journal of Medicine is considered to be the most recent in a small series of successes against mortal leather cancer varieties.
“ The immunotherapy has turned into the most promissory approach” to face the deadly leather cancer, said Dr. Darrell Rigel, dermatologic investigator in the Oncological Institute of the University of New York, who did not take part in the study.
Anyhow, the experiments of stimulation of the immune system have not produced a consistent therapy yet. For it, the investigators who were employed at the experiment with nine patients and with only one success they hurry to put the result in perspective. “It is a question of patient only one”, said the coauthor of the study, Dr. Cassian Yee of the Institute of Oncological Investigation Fred Hutchinson in Seattle.
Promissory result?
Two years after his notable recovery, the patient cut contact with the investigators and the scientists do not know his current situation. The individual, who lives in a small people in Oregon, has refused to give interviews to the press, said Yee.
The melanoma is a cancer in the cells of the skin that produces pigments and makes to tan the skin, like part of the attempt of the organism for be protecting from the ultraviolet radiation of the solar light. The cancer begins when the radiation is overloaded and damages the cells, causing mutations.
Approximately 62 thousand new cases are diagnosed in the United States every year, and there are approximately 8 thousand deaths for melanomas.
Found on time, the melanomas can be treated easily by surgical means removing the cancerous skin. “But once it propagates, basically it is not possible to stop him”, said Rigel.
But recently the scientists began conceiving another option: to help to the immune system so that it does the work.
| New method to know if the hair is losing |
| How to know if it is remaining bald |
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| The loss of the hair is extremely common between men and women. AP |
Writing / agency
Washington Hispanic
Does he want to know if it is remaining bald?
Begin to count the hairs that stay in his ornamental comb, not in his head.
In the edition of June of Archives of Dermatology, the scientists demonstrate that the called “account of hairs of sixty seconds” is a simple and reliable knowledge way if he is remaining a bald person and more or less at what speed.
This method can give a hope light to the men, or perhaps not.
“ The loss of the hair is loaded with emotions. This method is a count of hairs that allows to a person to know what is happening to him to his hair”, pointed out Jeffrey Miller, principal author of the study and associate teacher of dermatology of the School of Medicine of the State University of Pennsylvania.
“ With something like the count of hairs of sixty seconds, it is possible to inform and to monitor in an objective way what it is spending in the head”.
“ The reality is that the loss of the hair is extremely common between men and women. Fifty per cent of both sexes will present loss of the hair for fifty years”, added the Dra. Doris Day, doctor chief of dermatology of the Hospital Lenox Hill of New York.
Both the means and the expert dermatologists like to proclaim that to lose 100 daily hairs is normal (according to Miller, this perhaps is a very high number).
Nevertheless, there is small scientific evidence that justifies this number, which is based on the assumption of which the average scalp has 100 thousand hairs.
The experts not only do not know how many hair is normal to lose, they do not also have a standardized way of calculating the quantity of hair that gets lost in an average day.
“ We keep on saying the same repeatedly, that it is normal to lose hundred hairs a day”, made sure Day. “But the question is so normal what is and what is normal as for the loss of the hair”.
Details of the study
Sixty healthy men between 20 and 60 years without baldness indications took part in the investigation. They all were of white race and they had smooth hair, except one. (The authors did not include, principally, the men of curled or long hair “for the difficulty of spending the ornamental comb to him, what he might lead to more broken hairs”).
The men washed their hair three mornings continued with shampoo Neutrogena T/Sal. To the fourth day, identical ornamental combs were delivered to them and one instructed to them that they had to comb forward on a towel or case of contrasting color. One asked them to count the hair that were falling down. The procedure of brushing and counting recured during two following days and the hairs quantity was validated with the microscope.
After six months, the participants repeated the finished procedure.
From these results, the authors concluded that to lose 10 hairs “is normal”. In the youngest men (between 20 and 40), they got lost between 0 and 78, with an average of 10,2. In the biggest men, the status was between 0 and 43 with an average of 10,3.
When is it necessary to begin to feel panic for the loss of the hair? Miller advises to the men to lose more than 50 daily hairs (counted in the period of 60 seconds) that should consult his doctor.
“ The hair is like a window to the interior of the organism”, he said. “If something is happening inside the organism that there is not well, for example, low production of thyroid gland or shortcoming of iron, the hair reacts falling down more of the used thing. Then, if it notices that it is losing very much hair with the count of sixty seconds, he would be worth while making evaluate for a doctor to discard underlying medical causes”.
The sudden changes in the quantity of lost hair also must be evaluated, he said.
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