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AstraZeneca and Bristol-Myers Squibb Announce Top Line Results for SAVOR-TIMI-53 Cardiovascular Outcomes Trial of Onglyza(R) (saxagliptin) PRINCETON, N.J. & WILMINGTON, Del., Jun 19, 2013 In this study of adult patients with type 2 diabetes with either a history of established cardiovascular disease or multiple risk factors, Onglyza met the primary safety objective of non-inferiority, and did not meet the primary efficacy objective of superiority, for a composite endpoint of cardiovascular death, non-fatal myocardial infarction or non-fatal ischaemic stroke, when added to a patient’s current standard of care (with or without other anti-diabetic therapies), as compared to placebo. These preliminary SAVOR-TIMI-53 data are being analyzed and the study results will be submitted to the European Society of Cardiology (ESC) for potential presentation at the ESC Congress in September.
Even when you know physical activity is good for you, it's easy to keep dragging your feet—literally. We all have reasons to stay inactive, but sometimes those reasons are based more on myth than reality. Here are some of the most common myths about physical activity and ways to replace them with a more realistic, can-do spirit. => Myth 1: "Physical activity takes too much time." Physical activity does take some time, but there are ways to make it manageable. If you don't have 30 minutes in your daily schedule for an activity break, try to find three 10-minute periods. If you're aiming for 60 minutes daily—a good goal if you're trying to avoid weight gain—perhaps you can carve out some "fitness time" early in the day, before your schedule gets too busy. Another idea is to combine physical activity with a task that's already part of your daily routine, such as walking the dog or doing yard chores. => Myth 2: "Getting in shape makes you tired." Once you begin regular physical activity, you're likely to have even more energy than before. As you progress, daily tasks will seem easier. Regular, moderate-to-brisk physical activity can also help you to reduce fatigue and manage stress. => Myth 3: "The older you are, the less physical activity you need." Most people become less physically active as they age, but keeping fit is important throughout life. Regular physical activity increases older people's ability to perform routine daily tasks and to stay independent longer. No matter what your age, you can find a physical activity program that is tailored to your particular fitness level and needs. => Myth 4: "Taking medication interferes with physical activity." In most cases, this is not true. In fact, becoming more active may lessen your need for certain medicines, such as high blood pressure drugs. However, before beginning a physical activity program, be sure to inform your doctor about both prescription and over-the-counter medications you are taking, so that your health can be properly monitored. => Myth 5: "You have to be athletic to exercise." Most physical activities don't require any special athletic skills. In fact, many people who have bad memories of difficult school sports have discovered a whole world of enjoyable, healthful activities that involve no special talent or training. A perfect example is brisk walking—a superb, heart healthy activity. Others include bicycling, gardening, or yard work, as long as they're done at a brisk pace. Just do more of the activities you already like and already know how to do. It's that simple.
But very little of medicine falls into that absolute category. Many of our treatments haven’t been rigorously studied, and even if they have, large swaths of the population are woefully underrepresented in clinical trials — the very old, the very sick, women, members of racial and ethnic minorities, children, pregnant women and those low on the socioeconomic scale. Much of the time, therefore, we function in an ambiguous zone, without clear-cut answers. My patient didn’t fit perfectly into the “high-risk” category, and he was from an ethnic minority that wasn’t well represented in the I.C.D. trials.
Background The impact of diet on specific age-related diseases has been studied extensively, but few investigations have adopted a more holistic approach to determine the association of diet with overall health at older ages. We examined whether diet, assessed in midlife, using dietary patterns and adherence to the Alternative Healthy Eating Index (AHEI), is associated with aging phenotypes, identified after a mean 16-year follow-up. Methods Data were drawn from the Whitehall II cohort study of 5350 adults (age 51.3±5.3 years, 29.4% women). Diet was assessed at baseline (1991-1993). Mortality, chronic diseases, and functioning were ascertained from hospital data, register linkage, and screenings every 5 years and were used to create 5 outcomes at follow-up: ideal aging (free of chronic conditions and high performance in physical, mental, and cognitive functioning tests; 4%), nonfatal cardiovascular event (7.3%), cardiovascular death (2.8%), noncardiovascular death (12.7%), and normal aging (73.2%). Results Low adherence to the AHEI was associated with an increased risk of cardiovascular and noncardiovascular death. In addition, participants with a “Western-type” diet (characterized by high intakes of fried and sweet food, processed food and red meat, refined grains, and high-fat dairy products) had lower odds of ideal aging (odds ratio for top vs bottom tertile: 0.58; 95% confidence interval, 0.36-0.94; P=.02), independently of other health behaviors. Conclusions By considering healthy aging as a composite of cardiovascular, metabolic, musculoskeletal, respiratory, mental, and cognitive function, the present study offers a new perspective on the impact of diet on aging phenotypes.
Sharing a rare moment of person-to-person time during the scientific sessions in San Francisco, Dr Seth Bilazarian asks Drs Samuel Goldhaber how he goes about bridging with dabigatran, rivaroxaban, and apixaban.
The news was less disappointing for aerobic exercise, with 51.6% of adults getting the recommended amount, than it was for muscle-strengthening activities, with only 29.3% getting the recommended amount. The overall exercise rates also varied widely by state, ranging from 13% in Tennessee and West Virginia to 27% in Colorado. The report was published in the May 3 issue of the Morbidity and Mortality Weekly Report, a CDC publication. "Exercise not only helps with weight management, it helps reduce anxiety and depression; boosts energy, immunity and brain power; and significantly lowers the risk for chronic diseases such as cancer, diabetes and cardiovascular disease," she said. According to the Physical Activity Guidelines for Americans, adults should get at least: => two and a half hours a week of moderate-intensity aerobic activity such as walkin => or an hour and 15 minutes a week of vigorous-intensity aerobic activity, such as jogging. In addition, adults should do muscle-strengthening activities, such as push-ups, sit-ups or activities using resistance bands or weights. These exercises should be done two or more days a week and work all major muscle groups, the guidelines suggested. The highest proportion of adults meeting those guidelines were in the West (24 percent) and the Northeast (21 percent). Women, Hispanics and older and obese adults were less likely to meet the guidelines "Simple steps to start moving include: enlisting a friend or family member to join you; taking a walk every evening after dinner; getting up and marching in place at every TV commercial; limiting TV and computer time; [and] scheduling your time to exercise in your daily calendar,
A stroke, sometimes called a “brain attack,” occurs when blood flow to the brain is interrupted. When a stroke occurs, brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function. What are the symptoms of a stroke?— The symptoms of stroke are distinctive because they happen quickly—thus the origin of the name "stroke." Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)Sudden confusion, trouble speaking, or understanding speechSudden trouble seeing in one or both eyesSudden trouble walking, dizziness, loss of balance or coordinationSudden severe headache with no known cause
Sharing a rare moment of person-to-person time during the scientific sessions in San Francisco, Dr Seth Bilazarian asks Dr. Samuel Goldhaber how he goes about bridging with "Novel oral anticoagulants" (NOACs) #dabigatran, #rivaroxaban, and #apixaban.
Some says social smoking can be good. This is Ontario Ministry of Health answer. A farting one! WeWantAds shows you the most funny, creative and sexy ads all...
Data provided by UpToDate, one of the most popular tools used by Physicians, shows Apple dominating the Physician market when compared to Android. Dr. Denise Basow, President of UpToDate, responded to my questions with some of the following data: There are over 700,000 clinicians using UpToDate worldwide.25% of the usage of UpToDate is on mobile devices.At the end of 2012, there were over 75,000 iOS users and over 10,000 Android users.When using the UpToDate mobile app, 90% of the access is from iOS and 10% is from Android.
Walnuts are rich in polyunsaturated fatty acids and have been shown to improve various cardiometabolic risk factors.This trial investigated association between walnut intake & type 2 diabetes in the Nurses’ Health Study which followed 58,063 women aged 52–77 years old from 1998–2008 and
79,893 women aged 35–52 y in NHS II (1999–2009) without diabetes, cardiovascular disease, or cancer at baseline.
Consumption of walnuts and other nuts was assessed every 4 years using food questionnaires. A total of 5930 new type 2 diabetes cases during 10 y of follow-up were detetected. Walnut consumption was associated with a lower risk of type 2 diabetes for participants consuming 1–3 servings/mo (1 serving = 28 g), 1 serving/wk, and >2 servings/wk of walnuts: were 0.93, 0.81 and 0.67 compared with women who never/rarely consumed walnuts. Further adjustment for updated BMI slightly attenuated the association and the HRs were 0.96, 0.87 & 0.76 , respectively. The consumption of total nuts and other tree nuts was also inversely associated with risk of type 2 diabetes, and the associations were largely explained by BMI. Our results suggest that higher walnut consumption is associated with a significantly lower risk of type 2 diabetes in women.
Subway's menu fared best in a new evaluation of nutrition in kids' meals Nine restaurants, including McDonald’s (MCD), Carl’s Jr., and Popeyes Louisiana Kitchen (AFCE), had zero options that met standards. “Restaurants just aren’t making significant changes to the kids menu yet.” Many meals come with soda or deep fried foods. Subway, which already markets itself as a diet-friendly chain, emerged as the winner: All of its kids’ meals met both CSPI and NRA standards. Other chains that fared above average: IHOP (DIN), Red Lobster (DRI),Burger King (BKW), Arby’s, Chick-fil-A, Denny’s (DENN), Bob Evans (BOBE), and LongHorn Steakhouse (DRI). Of the 50 chains, Olive Garden (DRI) had the greatest number of possible kids’ meal combinations, with a whopping 780, including different variations of pastas, sauces, toppings, and sides. About 1 percent of these, or 10 different meal combos met CSPI standards.
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People who upped their red meat intake saw their risk of Type 2 diabetes rise by nearly 50 percent.
Americans spend over $20 billion annually on dietary supplements.1 Although supplements are regulated by the US Food and Drug Administration (FDA) under the Dietary Supplement Health and Education Act, there is no requirement for supplement manufacturers to demonstrate efficacy or safety of their products prior to marketing them. However, companies may not include unapproved ingredients. It turns out that even this minimal requirement is not fulfilled. Harel et al identified 237 dietary supplements that were recalled by the FDA owing to inclusion of unapproved drug ingredients. Given the limited regulation of these products, it is likely that the number of recalls grossly underestimates the number of products on sale with unapproved ingredients. Dietary supplements should be treated with the same rigor as pharmaceutical drugs and with the same goal: to protect consumer health.
NerdWallet sifted through the fifty largest metro areas to find the ones with the best indicators of health, including health scores for the residents, health insurance coverage and a high prevalence of doctors and clean air. NerdWallet assessed the health score according to the following factors: How fit are the residents? We assessed fitness of residents through the American Fitness Index, a composite index that includes the CDC’s Selected Metropolitan/Micropolitan Area Risk Trends Behavioral Risk Factor Surveillance System, environmental factors from the Trust for Public Lands, rates of disease and other government data.Is healthcare accessible? We incorporated the percentage of residents who have health insurance as well as the number of physicians per 100,000 residents.Is the air quality good? Research shows that cleaner air adds an average of 4 months to a resident’s life expectancy. We included the number of high particle pollution days per year for each metro area.
Famous people with Atrial Fibrillation
People who own dogs or cats may have a reduced risk of cardiovascular disease,. Top Ten Things To Know Pet Ownership and Cardiovascular Risk
1. This AHA Scientific Statement critically assesses studies regarding the influence of pet ownership on the presence and reduction of CVD risk factors as a novel strategy in reducing the risk of CVD.
2. Pet ownership, particularly of dogs, is probably associated with decreased CVD risk (LOE B), and may have a causal role in reducing CVD risk (LOE B). Further investigation is needed to establish a causal relationship.
3. While pet ownership may be reasonable for the reduction in CVD risk (Class IIb, LOE B), pet adoption, rescue, or purchase should not be done for the primary purpose of reducing CVD risk (Class III, LOE C).
4. An association between pet ownership and lower blood pressure has been found in some, but not all, studies.
5. Of all pets, dogs seem most likely to positively influence physical activity, especially with owners who regularly walk their dogs.
6. Pets also play an important role in providing social support, which is one of the most significant predictors of adherence to behavior change over time.
7. Companion animals may strengthen engagement in a weight loss program.
8. A positive relationship between pet ownership and autonomic function or cardiovascular reactivity to stress has been reported in most published studies. People with pets tend to have lower baseline heart rates, lower blood pressures, and significantly reduced increases in heart rate and blood pressure in response to stress. Recovery time from a stressful event is also markedly improved.
9. Further investigation is warranted regarding the influence of pet ownership on reducing CVD risk, including those on risk factor modification, primary prevention, and use of pet acquisition as a part of a strategy for secondary prevention of cardiovascular disease.
10. Minimal data are available to make an association between hyperlipidemia and pet ownership, as well as survival in people without established cardiovascular disease and pet ownership. COMPLETE INFO at Levine GN, et al; on behalf of the American Heart Association Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing. Pet ownership and cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2013:
http://circ.ahajournals.org/lookup/doi/10.1161/CIR.0b013e31829201e1
Subclinical hyperthyroidism is associated with a 20% increased risk for cardiovascular mortality, primarily driven by heart-failure deaths, according to a large study in more than half a million individuals from general practice in Denmark, reported at the 2013 European Congress on Endocrinology. "The main finding is a 20% increased risk of mortality in all levels of hyperthyroidism, including overt and subclinical but also high-normal, euthyroid patients, those lying in the lower range of the normal thyroid-stimulating hormone [TSH]," "The take-home message is that if a person has a family history with any thyroid problem or has any signs of thyroid problems, they should go for a checkup. Their family doctors need to be aware that any sign of thyroid abnormality can affect cardiovascular health, and they should act accordingly." The link between overt hyperthyroidism and cardiovascular mortality is quite well established, he said, but the finding of an association with subclinical hyperthyroid disease is much more novel. Of 574,595 included individuals (mean age, 48.7 years; 39.1% male), 95.9% were euthyroid, 1603 (0.3%) had overt hypothyroidism, 11,834 (2.1%) had subclinical hypothyroidism, 3967 (0.7%) had overt hyperthyroidism, and 6264 (1.1%) had subclinical hyperthyroidism.
Eating fish, chicken, olive oil and other foods rich in omega-3 fatty acids while staying away from meats and dairy -- the so-called Mediterranean diet -- may help older adults keep their memory and thinking skills sharp, a large new U.S. study suggests. Using data from participants enrolled in a nationwide study on stroke, the researchers gleaned diet information from more than 17,000 white and black men and women whose average age was 64. The participants also took tests that measured their memory and thinking (cognitive) skills. During the four years of the study, 7 percent of the individuals developed problems with these skills, the researchers reported. "Greater adherence to Mediterranean diet was associated with lower risk of incident cognitive impairment in this large population-based study," said lead researcher Dr. Georgios Tsivgoulis, from the University of Alabama at Birmingham as well as the University of Athens, in Greece.
The FDA is creating a largely automated surveillance system to monitor safety of high-risk medical devices, and has authorized a cellphone app for doctors to simplify reporting deaths and injuries to the agency.
Many U.S. adolescents are already on their way to increased cardiovascular risk in adulthood, researchers found. Roughly half of about 5,000 study participants ages 12 to 19 (54.7% of males and 50.5% of females) met "ideal" standards for fewer than five of the seven variables developed by the American Heart Association to define cardiovascular health, according to Christina Shay, PhD, of the University of Oklahoma Health Sciences Center in Oklahoma City, and colleagues. And 0% met all seven variables including not smoking and having low total cholesterol, the researchers reported online in Circulation: Journal of the American Heart Association.
A tiny South Pacific airline is charging passengers based on their weight, at a time when other carriers have only ventured to seek payment for luggage and meals. Customers flying Samoan upstart carrier Samoa Air Ltd. on short international hops to neighboring American Samoa are set to pay US$0.92 per kilogram, or $0.42 a pound, for each flight.
Stewart Hamilton, Chief Medical Officer at Medical Travel Commission looks at the soft side of delivering services to the medical traveller. What really makes a difference in terms of patient satisfaction?
The Digital Media Project at Harvard University tracks lawsuits filed against patients and others for online comments. Its website includes seven such cases filed over the past five years or so, though it’s not a comprehensive list. In some, patients took down their negative comments. In others, judges dismissed the suit, ruling that patients’ comments were protected under the First Amendment guarantee of free speech. In one 2011 case, Dr. Aaron Filler, a neurosurgeon, sued a former patient in a Los Angeles court for posting negative comments about him on rating sites such as RateMDs.com, including that he posed an unusually high risk of death to patients. A judge dismissed Filler’s suit, deciding that the patient was exercising free speech on a public issue, and ordered the doctor to pay $50,000 in legal fees. Doctors feel they are at a disadvantage in responding to negative reviews because medical privacy laws forbid them from discussing a patient’s care in public — a limitation that hotels, restaurants, and other often-rated businesses and professionals don’t face. They also worry that their explanations could be used against them in a malpractice suit — although a new Massachusetts law protects doctors’ apologies.
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