PastimesHeart Attacks, Cancer and strokes. Preventative approaches

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To: LindyBill who wrote (18716)3/6/2012 6:59:43 PM
From: Ilaine
   of 33586

I recently googled calcium scan fairfax and determined that a reputable radiology health care provider offers such services a la carte.

I am planning on getting my heart and carotid artery scanned for plaque.

Can you tell me exactly what tests I am looking for?

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To: Ilaine who wrote (18720)3/6/2012 7:44:46 PM
From: LindyBill
   of 33586
You are probably looking at the FRC lab I see there on line. I recommend you get the heart scan. I see no reason to also get the ultrasound but if want, go ahead. You don't need a CTA scan unless you have symptoms and your Doc has a reason for it. Check around on pricing. If it is a CT heart scan, make sure the machine is at least a 64 slice. PM me if you need more info.

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From: Pogeu Mahone3/6/2012 10:29:22 PM
   of 33586

March 4, 2012

The Diabetes Dilemma for Statin Users By ERIC J. TOPOL
San Diego, Calif.

We’re overdosing on cholesterol-lowering statins, and the consequence could be a sharp increase in the incidence of Type 2 diabetes.

This past week, the Food and Drug Administration raised questions about the side effects of these drugs and developed new labels for these medications that will now warn of the risk of diabetes and memory loss. The announcement said the risk was “small” and should not materially affect the use of these medications. The data are somewhat ambiguous for memory loss. But the magnitude of the problem for diabetes becomes much more apparent with careful examination of the data from large clinical trials.

Statins have been available since the 1980s but their risk of inducing diabetes did not surface for nearly 20 years. When all the data available from multiple studies was pooled in 2010 for more than 91,000 patients randomly assigned to be treated with a statin or a sugar pill (placebo), the risk of developing diabetes with any statin was one in every 255 patients treated. But this figure is misleading since it includes weaker statins like Pravachol and Mevacor — which were introduced earlier and do not carry any clear-cut risk. It is only with the more potent statins — Zocor (now known as simvastatin), Lipitor (atorvastatin) and Crestor (rosuvastatin) — particularly at higher doses, that the risk of diabetes shows up. The cause and effect was unequivocal because the multiple large trials of the more potent statins had a consistent excess of diabetes.

For those statins, the higher the dose, the more diabetes, though we don’t have enough data yet to say with precision at which dose excess diabetes showed up for each drug. What we do know is that diabetes showed up. The numbers increase to one in 167 for patients taking 20 milligrams of Crestor, and up to one in 125 for intensive statin treatments involving drug strategies to markedly lower cholesterol levels. Let’s just round this off and say that one in every 200 patients treated with any of the three most potent statins will get the side effect of diabetes. That’s quite a conservative number because diabetes was not even being carefully looked for in most of the trials. And we have data for only 5 years of treatment; it might be worse with longer statin therapy.

More than 20 million Americans take statins. That would equate to 100,000 new statin-induced diabetics. Not a good thing for the public health and certainly not good for the individual affected with a new serious chronic illness.

If there were a major suppression of heart attacks or strokes or deaths, that might be justified. But in patients who have never had heart disease and are taking statins to lower their risk (so-called primary prevention), the reduction of heart attacks and other major events is only 2 per 100. And we don’t know who the 2 per 100 patients are who benefit or the one per 200 who will get diabetes! Moreover, the margin of benefit to risk is quite narrow.

What should people who are taking statins do? If they are prescribed for someone who has already had heart disease or a stroke, the benefit is overriding — no changes are suggested. But in the vast majority of people who take statins — those who have never had any heart disease — there should be a careful review of whether the statin is necessary, in light of the risk of diabetes and the relatively small benefit that can be derived. Beyond that, a dose reduction or use of a less potent statin should be considered on an individual basis.

We need to find out why statins cause diabetes and, ideally, through genomics we could determine who is at risk for this important side effect. But to date nothing has been done to sort this out — despite the fact that the market for statins is well over $20 billion per year. There are thousands of blood samples sitting in company freezers around the world that could potentially provide the answers.

The announcement, medication label change and health advisory by the F.D.A. were long overdue, and have brought this important public health issue to light. The information that we have does not support that this is a “small” problem unless one considers more than 100,000 new diabetics insignificant. The problem of statin-induced diabetes cannot be underplayed while the country is being overdosed.

Eric J. Topol is a cardiologist at the Scripps Clinic, a professor of genomics at the Scripps Research Institute and the author of “The Creative Destruction of Medicine.”

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From: Pogeu Mahone3/6/2012 10:36:23 PM
1 Recommendation   of 33586
Change your DNA with just 20 minutes of regular exercise

By Daily Mail Reporter

Last updated at 2:00 AM on 7th March 2012

Read more:

Difference: A brief session on a bike can transform a person's DNA

A few minutes of relatively strenuous exercise can dramatically change a person’s DNA, experiments have revealed.

The changes affect the chemicals which activate, silence and crank up genes and their actions.

In the case of muscle, exercise appears to crank up the genes needed to burn fat and sugar and support the body.

Just 20 minutes of pedalling flat out on an exercise bike makes a difference, the journal Cell Metabolism reports.

Researcher Juleen Zierath, of the Karolinska Institute in Stockholm, said: ‘We often say that you are what you eat. Well, muscle adapts to what you do.

‘If you don’t use it, you lose it and this is one of the mechanisms that allows this to happen.’

Professor Zierath and colleagues from Denmark and Dublin began with two experiments in which healthy men who didn’t take exercise regularly were put through their paces on an exercise bike.

After they stopped, slivers of muscle were taken from their thigh and the DNA analysed for chemical changes.

This revealed that changes occur after just minutes. However, gentle exercise won’t do.

Read more:

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To: ig who wrote (18715)3/7/2012 12:12:49 AM
From: Aloysius Q. Finnegan
   of 33586
Hello 'ig'. I live in the Portland/Vancouver area as well. The only EBT machine in the Northwest is in Seattle, at Swedish Heart Institute on Capitol Hill. (There are a few ultr-fast cat scan machines locally. But I don't know where exactly ... and I wouldn't use one if an EBT is accessible).

Cost is $200. Number is 206-320-4411. Leave a message and Akimi will get back to you the same day.

If you can't make it up and back the same day, Silver Cloud Hotel on Broadway and Madison will give you a discount If you tell them your going to Swedish.

P.S. It is worth travelling a few extra miles to use an EBT, as you will be exposed to much less radiation. Also, the scan is graded by the cardiologists at Swedish. It carries a lot more weight if your trying to communicate the results of a CAC to your average skeptical gp.

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To: Aloysius Q. Finnegan who wrote (18724)3/7/2012 6:46:47 AM
From: ig
   of 33586
The only EBT machine in the Northwest is in Seattle, at Swedish Heart Institute on Capitol Hill.

Looks like a winner. Thanks very much, Al.

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To: Pogeu Mahone who wrote (18723)3/7/2012 7:42:13 AM
From: Travis_Bickle
   of 33586
Article says you can get the same result by drinking 50 cups of coffee per day, I might take that route.

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To: ig who wrote (18725)3/7/2012 8:25:17 AM
From: LindyBill
   of 33586
I agree. Had my first one done on an EBT, my next next 3 on a GE Lightspeed. Get the EBT if you can. Especially with the knowledge about the Cardio's there. It makes the best sense, when dealing with a heart scan, to use the same machine and reader serially. Price is sure right.

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From: LindyBill3/7/2012 8:38:27 AM
   of 33586
As a former heavy smoker and drinker, I would tend to believe this. However, I suspect the people doing the study feel they are "doing God's work."

Anti-Smoking Laws – The Proof of the Pudding
from Science-Based Medicine by Steven Novella
One consistent theme of SBM is that the application of science to medicine is not easy. We are often dealing with a complex set of conflicting information about a complex system that is difficult to predict. That is precisely why we need to take a thorough and rigorous approach to information in order to make reliable decisions.

The same is true when applied to an individual patient. Often times we cannot make a single confident diagnosis based upon objective information. We have to be content with a diagnosis that is based partly on probability or on ruling out other possibilities. Sometimes we rely upon a so-called “therapeutic trial” to help confirm a diagnosis. If, for example, it is my clinical impression that a patient is probably having seizures, but I have no objective information to verify that (EEG and MRI scans are normal, which is often the case) I can help confirm the diagnosis by giving the patient an anti-seizure medication to see if that makes the episodes stop, or at least become less frequent. Placebo effects make therapeutic trials problematic, but if you have an objective outcome measure and a fairly dramatic response to treatment, that at least raises your confidence in the diagnosis.

We can apply the same basic principle on the population level. If a public health intervention is addressing the actual cause of one or more diseases, then we should see some objective markers of disease frequency or severity decrease over time. Putting fluoride in the public water supply decreased the incidence of tooth decay. Adding iodine to salt decreased the incidence of goiter. Fortifying milk with calcium decreased the incidence of rickets. However, removing thimerosal from the childhood vaccine schedule did not reduce the incidence of autism (or the rate of increase in autism diagnosis). That is because calcium deficiency causes rickets, but thimerosal (or the mercury it contains) does not cause autism.

In public health there is also the equivalent of placebo effects – confounding factors in epidemiological studies. So studies need to be interpreted with caution. But if we see a consistent signal – a consistent association between a treatment and a decrease in disease incidence or severity, then our conclusion becomes more and more confident.

We are beginning to see this consistent signal with anti-smoking laws and a decrease in diseases that previous evidence suggests is increased by smoking or exposure to second-hand smoke. A recent study published in PLOS Medicine looked at the incidence of preterm birth and low birth weight in Scotland following legislation that came into effect on March 26, 2006 banning smoking in public places. Prior to the legislation preterm and low birth weight were trending up. The study found a statistically significant drop of about 10% beginning January 1, 2006, with a slight reversal two years later. They interpret these results as an anticipatory effect – smokers trying to quit in anticipation of the legislation, with some smokers failing and going back to smoking over the next two years. This conclusion is supported by the spike in nicotine patch prescriptions in January of 2006.

Further, the reduction in preterm birth and low birth weight was found among current smokers as well as never smokers. The decrease among never smokers suggests a second-hand smoke effect.

Epidemiological studies are always difficult to interpret, as I stated above, and this study is no exception. The strength of this study is that it was very thorough, looking at all pregnancies in Scotland over the study period. But there are many confounding factors, one of which pointed out by the researchers is the fact that smoking status was self-reported, and the introduction of legislation may have affected willingness to self-report smoking. Since all pregnancies were looked at, however, this would not have affected the overall decrease in these outcomes reported.

The significance of this one study is enhanced by the fact that it is part of a trend in studies showing a decrease in diseases that prior evidence suggests are worsened by smoking, following smoking bans. A study of acute myocardial infarction (AMI) in Massachusetts found a decrease of 7.4% following a statewide ban on smoking in public places. It is also significant that the decrease occurred in towns that did not have a prior local smoking ban, but not in towns that did. The effect was therefore also likely attenuated by the prior existence of local smoking bans.

A 2009 review and meta-analysis concluded:

  • Using 11 reports from 10 study locations, AMI risk decreased by 17% overall (IRR: 0.83, 95% CI: 0.75 to 0.92), with the greatest effect among younger individuals and nonsmokers. The IRR incrementally decreased 26% for each year of observation after ban implementation.
Using the same Scotland cohort following the 2006 ban, a study has also found a decrease in hospital admissions for asthma:

  • After implementation of the legislation, there was a mean reduction in the rate of admissions of 18.2% per year relative to the rate on March 26, 2006 (95% CI, 14.7 to 21.8; P<0.001). The reduction was apparent among both preschool and school-age children.
Overall the data show that smoking bans reduce second hand smoke exposure, smoking, and adverse health outcomes associated with smoking. There is a fair degree of consistency in the data, and this consistency is growing as more studies are being published. We have appeared to cross the fuzzy threshold where we can conclude with a fair degree of confidence that banning smoking in public places works. In the interest of public health, reducing health care costs, and child safety, the totality of evidence strongly suggests that we should strengthen bans on smoking in public places and apply them universally.

Meanwhile, concerns that such bans would economically harm bar and restaurant owners have not been born out in the evidence. A Minnesota study, for example, found a slight increase in revenue following smoking ban laws. It seems more people are willing to go to bars if the experience does not necessarily involve being exposed to intense levels of second-hand smoke.

Smoking ban laws have passed the test of the “therapeutic trial”. Combined with the totality of evidence for the risks of smoking and second-hand smoke, this strongly supports such bans as effective public health measures.

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From: calgal3/7/2012 11:05:57 AM
   of 33586

I think you'll find this interesting...and it's not a joke.

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