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CARDIORESPIRATORY FITNESS AND SHORT TERM OUTCOMES WITH CORONARY ARTERY BYPASS GRAFT SURGERY

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Pre-operative risk assessment for coronary artery bypass surgery (CABG) has been evaluated with multiple predictive models; yet none incorporate low cardiorespiratory fitness as a risk factor. The present study evaluates pre-operative metabolic equivalents (METs) and short term morbidity and mortality after CABG.

Patients undergoing CABG from January 2002 to December 2010 at Beaumont Health Systems were reviewed for peak or symptom-limited stress testing < 90 days prior to surgery. METs were estimated from the achieved treadmill speed, grade, and duration, or the cycle ergometer workload corrected for body weight.

596 patients were categorized into 2 groups: those with low aerobic capacity (<5 METs); and those achieving = 5 METs. Fisher's exact tests compared pre-operative aerobic capacity and post-operative morbidity and mortality between the two groups (Table 1). After adjusting for potential confounding variables, we found an inverse relationship between cardiorespiratory fitness and complications after CABG.

Low pre-operative cardiorespiratory fitness was associated with higher operative mortality, 30 day mortality, sternal wound infections, and prolonged ventilation after CABG. These data suggest that pre-operative cardiorespiratory fitness provides an independent and additive marker of prognosis after CABG that has not been previously reported.


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Using this simple metric there was a dramatic difference in death rates in patients having coronary bypass.  If a patient could walk just 5 minutes on the treadmill then there death rate was 1% after bypass surgery in this study.  Those patients who could not get to the fifth minute had a death rate of 5%.  This absolute difference is significant and another reason to recommend efforts at fitness.

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Researchers Professor Nattavudh Powdthavee and Dr Jinhu Li analysed what affect an additional 12 months schooling had on a person's diet, exercise and health habits. 

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Do you want to stick to your 2014 fitness goals but can't bring yourself to do the ol' treadmill-elliptical-stationary-bike routine again this week? We're all for a great cardio-focused workout, but sometimes you just need a break. So, we asked Brooke Siler — celebrity Pilates guru, owner ofre:AB Pilates Studio, and author of The Women's Health Big Book of Pilates to put together a workout any girl can do anywhere, no machines required. 

While these seven hard-hitting Pilates movements will get your heart pumping, they'll also help lengthen and stretch your body and strengthen your core. Remember, with Pilates exercises, the goal is small, controlled movements. Less is more. Focus on your form and breathing. So, give the gym a rest. Ahead, seven do-anywhere moves to tighten, tone, and help you feel incredible.


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Here are some guidelines healthcare organizations should follow to generate insight that is digestible, applicable and useful to businesses:

 

1. Use your data. We’ve discovered that agency specific data is more accurate in predicting patient risk than state, nationwide or proprietary benchmarks. If we’re aiming to discover patients most at risk for hospital readmission, we must take into account a venue’s staff, geography, demography, clinical capability, and other factors beyond the clinical composition of the patient. Those factors would be overlooked using data sources other than your own. If you want to maximize data to improve care outcomes, you need to assess your data.


2. Find predictors by understanding workflow. Understanding under what context, and in what workflow your data is generated is essential to effective analysis. A mapping exercise that takes into account your clinical workflow, where data is captured, and how the latter travels throughout your process is essential in identifying risks and opportunities for improvement. Understanding your workflow in advance, an analytics expert can create tools that better accommodate your needs.


3. Generate actionable insights. In industries like health care—where minutes matter—it’s critical your data analysis can deliver insight that clinicians can immediately understand and use. Endless reports and dashboards frustrate people, as no one has time to analyze them while also caring for patients. Your analytics team must assess every application enhancement with a single question: How will having this data improve my organization’s work, and how can I provide it to clinicians and business decision makers in a meaningful way?


Focus on this area by creating a one-page summary that ranks the relevant results. The summary should be the first page presented after logging in, so clinicians can quickly incorporate the information while reviewing their care plans

 

4. Foster usability. Just as users don’t have time to delve into pages of analytical reports, they don’t have time to read your technology’s manual. The experience of presenting data must be intuitive if you want to positively affect business and care. Two clicks of the mouse or two seconds—that’s the most amount of effort technology should require of the user. Usability may be the most important feature of any business intelligence application.


5. Monitor and optimize constantly. Data and workflows change—so must your analytical models. Constantly analyze, test and if need be, alter your models so you deliver the best output, and always assess your analytics in the context of the clinical workflow in which it is created.

 

Data is indeed valuable, but it’s the insights unveiled by data that benefit patients and organizations. If your data assessment tool is not designed with your specific organization in mind, it only delivers a bunch of metrics that stifle meaningful change.

 
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Pumpkin seeds contain a wide variety of nutrients ranging from magnesium and manganese to copper, protein, and zinc.

 

If you’re in the mood for a chewy snack that doubles as a phenomenal health food, look no further than pumpkin seeds.

 

With a wide variety of nutrients ranging from magnesium and manganese to copper, protein and zinc, pumpkin seeds are nutritional powerhouses wrapped up in a very small package. They also contain plant compounds known as phytosterols and free-radical scavenging antioxidants,1 which can give your health an added boost.


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Randomized, double-blind trial comparing a sirolimus-eluting stent with a standard stent in 1058 patients at 53 centers in the United States who had a newly diagnosed lesion in a native coronary artery. The coronary disease in these patients was complex because of the frequent presence of diabetes (in 26 percent of patients), the high percentage of patients with longer lesions (mean, 14.4 mm), and small vessels (mean, 2.80 mm). The primary end point was failure of the target vessel (a composite of death from cardiac causes, myocardial infarction, and repeated percutaneous or surgical revascularization of the target vessel) within 270 days.

Results The rate of failure of the target vessel was reduced from 21.0 percent with a standard stent to 8.6 percent with a sirolimus-eluting stent (P<0.001) — a reduction that was driven largely by a decrease in the frequency of the need for revascularization of the target lesion (16.6 percent in the standard-stent group vs. 4.1 percent in the sirolimus-stent group, P<0.001). The frequency of neointimal hyperplasia within the stent was also decreased in the group that received sirolimus-eluting stents, as assessed by both angiography and intravascular ultrasonography. Subgroup analyses revealed a reduction in the rates of angiographic restenosis and target-lesion revascularization in all subgroups examined.

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In this randomized clinical trial involving patients with complex coronary lesions, the use of a sirolimus-eluting stent had a consistent treatment effect, reducing the rates of restenosis and associated clinical events in all subgroups analyzed.


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10 years ago the coronary interventional world was revolutionized with the publication and availability of the first drug eluting stent (DES) for coronary artery disease treated with angioplasty. We have several newer versions since and this first version is no longer available and the company that manufactured it ($JNJ) has exited the business.
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Before going on with the importance of mental fitness, let’s explain what it is – it’s the work you invest into your psychological well-being and your ability to find joy in each moment of life.

 

The importance of physical fitness is all over the media, and there is a good reason for that fuss. When you keep your body healthy, you will prevent many serious health conditions and preserve your well-being for longer. However, the aspect of health that’s not getting enough attention is mental fitness. Who needs a healthy, flexible and lean body without a healthy and flexible mind?

 

Read more at http://www.pickthebrain.com/blog/practice-mental-fitness/#S9lWpp08lvPmx4VV.99


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Often deemed a "perfect food", the avocado is considered one of the healthiest foods available. Here is why you should be eating this fabulous food.

Often deemed a “perfect food”, the avocado is considered one of the healthiest foods available. It’s important to understand that a body needs fats, as long as they’re healthy ones. Omega 3 fatty acids are missing in the average western diet, and this missing fatty acid is just one reason for the ‘bad health epidemic’ . It just so happens that avocados are high in omega 3 and omega 6 fats. Avocados are a rich source of wholesome unsaturated beneficial fats with lots of oleic acid, which is good for heart health.

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2 nori sheets/dried laver (“gim” in Korean)


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FDA officials did not benefit financially from their participation in the meetings, the agency said. But two later went on to work as pharmaceutical consultants and more than this, the critics said, the e-mails portray an agency that, by allowing itself to get caught up in a panel that seemed to promise influence for money, had blurred the line between the regulators and the regulated.


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