Morning Medtalks with Dr KK Aggarwal

Morning Health Talk :

New Delhi, May 12, 2018 :

Clinical

• Folic acid supplementation substantially reduced primary stroke events in high-risk, enalapril-treated patients who had low platelets and elevated homocysteine compared with enalapril-treatment alone, according to Chinese researchers in Journal of the American College of Cardiology.
• Among patients in septic shock and other forms of distributive shock, the addition of the antidiuretic hormone vasopressin to standard anti-hypotensive treatment is associated with a lower risk for atrial fibrillation researchers report in JAMA.
• Middle-aged and elderly men and women who had four to seven hot, dry sauna bathing sessions a week were 60% less likely to have a stroke over a 15-year period than those who had one weekly session, reported Setor Kunutsor, PhD, of the University of Bristol, U.K., and colleagues online in Neurology. Sauna has blood pressure-lowering effect, stimulate the immune system, stabilize the autonomic nervous system, and reduce inflammation, oxidative stress, arterial stiffness, and vascular resistance and high temperatures of traditional Finnish saunas increase blood supply to the periphery of the body.
• For older people being treated aggressively for hypertension, an easing of blood pressure targets might reduce recurrent falls, new research by Kenneth Boockvar, MD, from the Icahn School of Medicine at Mount Sinai in New York City shows. A systolic pressure of 120 mm Hg or below is normally considered an agressive target.
• Patients treated with the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab (Repatha, Amgen) may experience a greater reduction in cardiovascular events if they have higher baseline levels of lipoprotein(a) [Lp(a)]. (March 2017 in the New England Journal of Medicine).
• A new study confirms the emotional harm caused by cyberbullying in adolescents, particularly the most vulnerable youth. The study showed significant increases in depression and anxiety among adolescent psychiatric inpatients and outpatients who were recent victims of cyberbullying. (Samantha Saltz, MD, from University of Miami Miller School of Medicine in Florida)
• The US FDA has received reports associated with the use of neurovascular stents for stent-assisted coiling in the treatment of unruptured brain aneurysms. The reports suggest some events of periprocedural stroke and/or death may have been related to procedural risks or patient selection related factors. These factors include patients who had serious comorbidities resulting in a reduced life expectancy, or who were intolerant to required anticoagulation or antiplatelet therapy.
• Patients with heart failure with reduced ejection fraction (HFrEF) who undergo transcatheter aortic valve replacement (TAVR) have similar rates of in-hospital mortality as those without HFrEF, but lower rates of complications, according to a study presented here at the 2018 Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions.
• Can a cancer patient adopt a child?

The prospective adoptive parents shall be physically, mentally and emotionally stable, financially capable and shall not have any life threatening medical condition.

Public health

• States should have policies that allow emergency medical services to take patients directly to PCI-capable centers. Reducing the time to PCI is strongly linked to reduced mortality in STEMI patients, and current guidelines call for first medical contact to PCI time of <90 minutes for patients presenting to PCI-performing hospitals, and <120 minutes for patients presenting to non-PCI hospitals.
• New US FDA rules for chain restaurants require calorie counts to be listed for all menu items, including cocktails. As of May 7, the FDA now requires all chain restaurants with 20 or more locations to post calorie counts on everything. A margarita has about 300 calories, a bottle of beer has about 150 and a Pina colada has more than 600 calories.
• The hepatitis B virus has been infecting people since at least the Bronze Age, according to a new study by geneticists who teased the virus from 4500-year-old human remains.

AMR

The UK’s Chief Medical Officer Professor Dame Sally Davies has warned we risk returning to a world where common infections and minor injuries are deadly if the antibiotic-resistance crisis continues.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
President HCFI