May 2007 – CastMD

SALT USE AND CARDIOVASCULAR DISEASE AND HYPERTENSION

buy Aurogra online made in america Stroke and other cardiovascular diseases are linked closely to high blood pressure. In many studies, hypertension is a strong predictor of these severe problems, including stroke (brain attack), congestive heart failure, and even myocardial infarction (heart attack).

The purchase Lyrica cheap importance of salt intake (sodium chloride) with regard to high blood pressure is well linked. Most of these studies have been a type of case control showing high probable causal relationship. Some other studies have shown that higher salt intake predicted the higher incidence of cardiovascular diseases over time.

But a recent published and peer reviewed study, with randomized NON-hypertensive persons, about 3000 of them, has put a strong lock on this issue. In the study, persons were given about 2.6 gms or 2.0 gms of salt daily. Another group of placebo was a control also. The groups were followed out to 18 months or 36-48 months. Then all the groups (cohorts) were followed over the next 10-15 years!

There was a remarkable 30% (approximate) lower incidence of cardiovascular events during this period. This finding was controlled for age, body mass, sex, ethnic origin, and initial blood pressure – when compared to the placebo group.

We have long known this concern of salt and high blood pressure and other cardiovascular diseases. Even back in about 1985, the World Health Organization recommended the salt intake to be reduced to about 5 grams per day.

In "Westernized" countries, bread and processed foods account for the great majority of salts in the diet, with personal use being about 15-20 %. In many developing countries however, the personal use is the burden of salt. Some countries have tried to "legislate" salt reduction, however most of the time, this effort turns to "voluntary" agreement programs with good intent, rather than hard legislation. More efforts of education and the reason for limiting salt intake should be forwarded by all the main agencies such as the American Heart Association (AHA), the American Diabetes Association (ADA), and others that take the lead to limit cardiovascular disease, morbidity, and mortality.

So think about it. Should we legislate the prepared foods, soda and beer, snack, eat 'n run, cafe, restaurant, and bar industries to limit the salt in their products? Dear ol' Mom probably had it right when she said, "Not so much salt!"

So next time you pick up the product, do a salt survey. Remember less that five grams a day is highly recommended, while 2 grams a day really makes a difference in your actual risk. The debate appears to be over. Salt can take a toll. Be a wise shopper and a wiser eater.

Salty popcorn with butter anyone? Remember, more fiber, less salt, less trans-fats….Yuk!

DROWNING AND WATER SAFETY – DO IT RIGHT

JUNEAU, Alaska (May 14, 2007)–Passengers from the Cruise Ship Empress of the North being offloaded onto the Coast Guard Cutter Liberty and civilian vessels after running aground at aproximately 2:00 a.m. here today. The Liberty took on 130 of the 248 passengers before offloading them onto the Alaska State Ferry Columbia, which will transport them back to the city of Juneau. (Official Coast Guard photo by Petty Officer Chris Caskey) (from Coast Guard website)

Did you know that most drownings happen just a few feet from safety! Many data sets show that as high as 90 % of all drownings are close to safety, in one form or another.

Often, the victims of drownings are not only close to safety, but have personal safety devices close or have personal flotation devices. But…the victims are not using them or wearing them.

Each boating season, the personal flotation devices should be checked for leaks, tears, rips, cuts, and general wear and tear. They should be replaced.

Each season, your kids also change…bigger, taller, heavier, the kids need to be sized for proper fit and make sure the PFD fits each child snuggly and properly. Do this in shallow water to practice. Have the child put the PFD on, tilt his head back, and see that the water stays below the chin level. The mouth must be well above the water level if the device is used in turbulent waters or waves. Therefore proper weight and age sizing is very important.

It is a fun family event to practice throwing a type 4 (IV) flotation device. Important techniques typically come with the device. This few minutes may save a life.

Local and national groups say alcohol is the biggest common thread of up to 75-80 % of boating accidents. Always monitor the skipper of any craft if she or he has been drinking. Best rule is do not drink and captain the boating craft.

The types of PFDs include:

Type I – the offshore, rough water type

Type II – the near shore, calmer waters type

Type III – called a flotation aid, wearable, and quick rescue most likely

Type IV – is the throwable device

HAVE A SAFE BOATING SEASON. KNOW YOUR PASSENGERS. KNOW YOUR VESSEL.

DVT – DEEP VEIN THROMBOSIS – POTENTIAL SILENT KILLER – planes, trains, and surgeries

YEARS AGO, MY FATHER RETURNED AFTER SEEING MY GRANDFATHER, FROM THE SMALL HOSPITAL IN THE LITTLE TOWN IN MIN-NEE-SOOO-TAH.

My grandfather had been in the hospital after a minor surgery. Remember years ago, even small procedures were done in the hospital by the general practitioners or early surgeons and patients were held in the hospital for days. Just shortly after my father returned from seeing his father, our telephone rang. I remember seeing his face change and his voice quiver slightly. But dad was a strong man. He said to all of us, a big family, and my mother, that grandpa had "some trouble" and that he needed to go to the hospital right away. Only, not just dad went, but mom went hurriedly along also. Grandpa died that few moments between my dad seeing him, and returning home, about 5-10 minutes. Grandpa died of a pulmonary embolism, a clot in the lungs that travelled from his leg, after that small procedure. Certainly a sudden and quick death, a reality that still exists these days.

Deep vein clot (thrombosis) is a relatively common, and a very serious potential disease. We see those patients in the emergency room, immediate care, and certainly worry about many more. The mortality and further injury (morbidity) from clots in the legs is not in the leg! The risk occurs from associated lung clots (pulmonary embolism) and a rare condition of post-clot syndrom (post-thrombotic syndrome).

There is not one specific symptom or sign that clinches the diagnosis. The elderly have rates of DVTs in the 200/100,000 range while younger people have rates of about 50 per 100K. The clots occur in the higher deep veins of the legs, or from extension of clots in the lower legs – even though this risk is lesser. When clots in the lower leg veins extend, the risk of lung clots goes up. The problem with DVTs creating the lung clot (PE) is that symptoms can range from sudden death to minimal at all symptoms.

In a doctor I knew, his clot formed during a long airplane ride and he lived. In my grandpa's case as told by my father, it was sudden death.

Risks for developing DVTs in the leg veins are:

conditions: cancer, pregnancy, blood disorders, kidney disorders, estrogens, and smoking

stagnant movement: surgery, immobility, paralysis, obesity, extended travel

other: previous DVT or PE increases risk, and trauma increases risk.

If patients have any two or more of these, they really become at risk. Symptoms that patients can feel or see are: swelling of the leg compared to the other side, calf swelling, localized tenderness of the calf or leg, new pain or numbness in the leg. There are other causes of these same symptoms, therefore you should see a doctor without hesitation.

Your doctor will most likely go through the above lists with you. But your doctor will be concerned. Lab tests will be drawn most likely and an ultrasound of your leg will be ordered stat. Usually if both of these are negative, the cause is not a clot. If the ultrasound is positive, you will begin treatment. If the blood test is positive and the ultrasound is negative, you will probably have a repeat ultrasound in about a week.

Treatment consists of starting the pill, warfarin, for "thinning the blood." But this takes days for the body to change. Therefore, almost all patients will need to use injections of a heparin substance that "thins" the blood quickly. Usually, patients will need to be on heparin medicine for 5 days or so, or at least until the pill warfarin reaches a therapeutic level in your bloodstream.

Patients will need to use compression stockings during this time and after the event to minimize risk of recurrence of DVT. These stockings also help prevent the post-thrombotic syndrome of pain, swelling, inflammation that can become a chronic condition.

Risk of recurrence never goes away. That is why proper treatment and post-event planning is so important. Expect to be on medicine for 3-12 months after a DVT or PE. Risk reduction knowledge goes a long way.

TALK WITH YOUR DOCTOR ABOUT CONCERNS AND PREVENTION.