CAN YOU RECOGNIZE A HEART ATTACK OR STROKE?
What To Do When Every Moment Counts
From the FMS Global News Desk of Jeanne Hambleton- August 4, 2014 By Stone Hearth News NIH NEWS IN HEALTH
How would you react to a medical emergency? When it comes to life-threatening conditions like heart attack or stroke, every minute counts. Get to know the signs and symptoms of these health threats.
If you think you or someone else might be having a heart attack or stroke, get medical help right away. Acting fast could save your life or someone else’s.
Heart disease and stroke are 2 of the top killers among both women and men in the U.S. Nationwide, someone dies from a heart attack about every 90 seconds, and stroke kills someone about every 4 minutes, according to the U.S. Centers for Disease Control and Prevention. Quick medical help could prevent many of these deaths. Fast action can also limit permanent damage to the body.
Heart attack and stroke are caused by interruptions to the normal flow of blood to the heart or brain—2 organs that are essential to life. Without access to oxygen-rich blood and nutrients, heart or brain cells begin to malfunction and die. This cell death can set off a series of harmful effects throughout the body. The changes ultimately lead to the familiar symptoms of a heart or brain emergency.
You might know the most common symptoms of heart attack: sustained, crushing chest pain and difficulty breathing. A heart attack might also cause cold sweats, a racing heart, pain down the left arm, jaw stiffness, or shoulder pain.
Many do not know that women often have different heart attack symptoms than men. For instance, instead of having chest pain during a heart attack, women may feel extremely exhausted and fatigued or have indigestion and nausea.
“Many women have a vague sense of gloom and doom, a sense of ‘I just do not feel quite right and don not know why,’ ” says Dr. Patrice Desvigne-Nickens, an NIH expert in heart health.
The symptoms of stroke include sudden difficulty seeing, speaking, or walking, and feelings of weakness, numbness, dizziness, and confusion.
“Some people get a severe headache that is immediate and strong, different from any kind you have ever had,” says Dr. Salina Waddy, an NIH stroke expert.
At the first sign of any of these symptoms, fast action by you, someone you know, or a passerby can make a huge difference. NIH-funded research has helped ensure that more people survive heart attacks and strokes every year. We now have medicines, procedures, and devices that can help limit heart and brain damage following an attack, as long as medical help arrives quickly.
If the heart is starved for blood for too long—generally more than 20 minutes—heart muscle can be irreversibly damaged, Desvigne-Nickens says.
“You need to be in the hospital because there is a risk of cardiac arrest [your heart stopping],” which could be deadly. At the hospital, doctors can administer clot-busting drugs and other emergency procedures.
With stroke, Waddy says, “The longer you wait, the more brain cells are dying,” and the greater the chance for permanent damage or disability.
Emergency treatment for stroke depends on the kind of stroke. The most common type, ischemic stroke, is caused by a clot that clogs a blood vessel in the brain.
The clot-dissolving drug tPA works best when given soon after symptoms begin. NIH research shows that patients who received tPA within 3 hours of stroke onset were more likely to recover fully.
Other strokes are caused by a hemorrhage—when a blood vessel breaks and bleeds into the brain.
“The patient can have a larger hemorrhage within the first 3 hours,” Waddy says. A hospital medical team can help contain the bleeding, so every moment counts.
Even if you are unsure, do not feel embarrassed or hesitate to call 9-1-1 if you suspect a heart attack or stroke. “You should not go get your car keys. Your spouse should not be driving you to the hospital,” advises Desvigne-Nickens.
“The emergency crew is trained to treat these symptoms, and it could mean the difference between life and death.”
Heart attack or stroke can happen to anyone, but your risk increases with age. A family or personal history of heart attack or stroke also raises your risk. But some risk factors for heart attack and stroke are within your control. Treating them can dramatically reduce your risk.
“If you have high blood pressure, high cholesterol, or diabetes, work with your doctor to get these conditions under control,” Waddy says. “Know your numbers [blood pressure, blood sugar, and cholesterol] and what they mean.”
You can also prepare for a medical emergency, to some degree. A hospital may not have access to your medical records when you arrive. Keep important health information handy, such as the medicines you are taking, allergies, and emergency contacts. It would be important for the medical team to know, for example, if you have been taking anticoagulants to help prevent blood clots; these blood thinners put you at increased risk of bleeding. You might consider carrying an NIH wallet card that lists heart attack symptoms and has room for your personal medical information.
NIH researchers are studying new drugs and procedures to help the heart and brain repair themselves and improve organ function.
“But there is absolutely nothing that will save both your time and health as well as prevention,” says Dr. Jeremy Brown, director of NIH’s Office of Emergency Care Research. Studies show that making healthy lifestyle choices can help prevent these medical emergencies from happening in the first place.
Eat a healthy diet rich in protein, whole grains, and fruits and vegetables, and low in saturated fat. Get regular physical activity and don’t smoke.
“I think one of the most important things we can do is to take a basic CPR and first aid course,” recommends Brown.
“We know the majority of cardiac arrests happen outside of hospitals and of that many, many can be saved if we get people with basic training on the scene quickly. An ambulance can never get there as quickly as a citizen passing by.”
Whether or not you are trained to offer help, if you see someone having symptoms of a heart attack or stroke, call for help immediately.
“If you’re even thinking about calling 9-1-1, you should call,” Desvigne-Nickens says.
“Yes other conditions can mimic the signs and symptoms of a heart attack or stroke, but let the emergency physician figure that out in the emergency room.”
ANTIBIOTIC PRESCRIBING ‘INCREASED BY 40% IN A DECADE’
From the FMS Global News Desk of Jeanne Hambleton from Pulse Today Posted 5 August 2014 | By Caroline Price Pulse Today
Antibiotic prescriptions for coughs and colds increased by around 40% from 1999 to 2011, reversing a trend that had seen antibiotic use decline in preceding years, according to a study from public health officials.
Public Health England (PHE) experts said prescription rates were higher than they should be and the study ‘strongly suggests a need to make improvements in antibiotic prescribing’.
GP leaders called for greater efforts to inform patients and the public about the risks of inappropriate antibiotic use, and for GPs to resist pressure from patients for unnecessary antibiotic prescriptions.
The study by PHE and University College London researchers monitored trends in prescribing at 537 GP practices and whether antibiotic use agreed with current guidelines.
They found the proportion of patients prescribed an antibiotic for coughs and colds decreased from 47% in 1995 to 36% in 1999, but then rose again to 51% in 2011.
For sore throats, the proportion of patients prescribed an antibiotic fell from 77% in 1995 to 62% in 1999, and has broadly stayed the same since.
The researchers said the use of a recommended antibiotic for sore throats had increased from 64% in 1995 to 69% in 2011.
However, the team also found wide variation in prescribing rates, with some practices prescribing them for coughs and colds at twice the rate of the lowest prescribing practices.
Treatment with a short course of trimethoprim for urinary tract infections rose markedly, from 8% in 1995 to 50% of cases in 2011, but it varies considerably between practices, from 16% to 71%.
Lead author Professor Jeremy Hawker, consultant epidemiologist at PHE, said: ‘Although it would be inappropriate to say that all cases of coughs and colds or sore throats did not need antibiotics, our study strongly suggests that there is a need to make improvements in antibiotic prescribing.
‘Previous research has shown that only 10% of sore throats and 20% of acute sinusitis benefit from antibiotic treatment, but the prescription rates we found were much higher than this. The worry is that patients who receive antibiotics when they are not needed run the risk of carrying antibiotic resistant bacteria in their gut. If these bacteria go on to cause infection, antibiotics will then not work when the patients really does need them.’
The latest findings come after the RCGP suggested GPs should take ‘personable responsibility’ for educating the public about the risks of inappropriate use of antibiotics.
RCGP chair Dr Maureen Baker said: ‘Antibiotics are very effective drugs, as long as they are used appropriately. But we have developed a worrying reliance on them and GPs face enormous pressure to prescribe them, even for minor symptoms which will get better on their own or can be treated effectively with other forms of medication.
‘Our patients and the public need to be aware of the risks associated with inappropriate use of antibiotics and how to use them responsibly.
‘This study reinforces the message that we issued recently for frontline health professionals to resist pressure from patients for unnecessary prescriptions and explore alternatives to them.’
GPS SHOULD TAKE ‘PERSONAL RESPONSIBILITY’ FOR EDUCATING PUBLIC ON ANTIBIOTIC OVERUSE
From the FMS Global News Desk of Jeanne Hambleton from Pulse Today Posted 7 July 2014 | By Alex Matthews-King
GPs should ‘resist’ patient pressure to prescribe antibiotics, and should ‘take personal responsibility’ for educating the public about the consequences of their misuse, the RCGP has said.
Joint guidance issued today by four Royal Colleges and the Faculty of Public Health also recommends health professionals improve the monitoring of prescription rates.
It also calls on patients to give infections time to clear up and to keep themselves healthy.
This comes after warnings from the UK’s chief medical officer, Dame Sally Davies and the Prime Minister that the current attitude to prescribing could cast the world back to a ‘dark age of medicine’.
RCGP chair Dr Maureen Baker said: ‘We have developed a worrying reliance on [antibiotics] and many patients now see them as a cure-all, even for minor symptoms which will get better on their own or can be treated effectively with other forms of medication.’
‘GPs face enormous pressure to prescribe them even though we know that infections adapt to the antibiotics used to kill them and, over time, they can make treatment ineffective.’
Dr Baker added: ‘It is imperative that doctors, nurses and pharmacists start talking about the alternatives available to patients who ask for antibiotics to treat minor illnesses.’
WATCHING NEURONS FIRE FROM THE FRONT-ROW
From the FMS Global News Desk of Jeanne Hambleton Posted: 29-Jul-2014
Source Newsroom: Sandia National Laboratories
Newswise — ALBUQUERQUE, N.M. — They are with us every moment of every day, controlling every action we make, from the breath we breathe to the words we speak, and yet there is still a lot we don not know about the cells that make up our nervous systems. When things go awry and nerve cells do not communicate as they should, the consequences can be devastating. Speech can be slurred, muscles stop working on command and memories can be lost forever.
Better understanding of how neurons and brains work could lead to new prevention, diagnostic and treatment techniques, but the brain is complex and difficult to study. If you were to hold your brain, you would likely marvel at how much it feels and moves like Jell-O. This tissue is composed of neurons and other supporting cells with tiny cell bodies, which generate electrical signals that determine how the brain and the nervous system function.
Those signals can be recorded and measured if a suitably small electrode is in the vicinity, but that presents challenges. Brain tissue is always moving in response to the body’s movement and breathing patterns. In addition, the nerve tissue is incredibly sensitive. If disrupted by a foreign body, the cells trigger an immune response to encapsulate the intruder and barricade it from the electrical signal it is trying to capture and understand.
Working to develop intelligent neural interfaces
That challenge led Jit Muthuswamy, an associate professor of biomedical engineering at Arizona State University, Tempe (ASU), to pursue a robotic electrode system that would seek and maintain contact with neurons of interest autonomously in a subject going through normal behavioral routines. That led him to Sandia National Laboratories.
“We are working to develop chronic, reliable, intelligent neural interfaces that will communicate with single neurons in a variety of applications, some of which are emerging and others that are closer to market,” Muthuswamy said.
“Applications like brain prostheses are critically dependent on us being able to interface and communicate with single neurons reliably over the course of a patient’s life. Such reliable neural interfaces are also critical to help us understand the dynamic changes in the wiring diagram of the brain.”
Key to the success of that robotic approach are the microscale actuators needed to reposition the electrodes. This led Muthuswamy in 2000 to seek out Sandia engineer Murat Okandan and the unique microsystems engineering capabilities available at Sandia’s Microsystems and Engineering Sciences Applications facility.
“The process flow we use to make these isn’t available anywhere else in the world, so the level of complexity and mechanical design space we had to design and fabricate these was immensely larger than what other researchers might have,” Okandan said.
He has been working with Muthuswamy’s research team since that initial contact to find a suitable method to track individual neurons as they fire.
Earlier probes were made of a sharpened metal wire inserted in the tissue. The closer the probe is to the neuron, the stronger the signal, so experimenters ideally try to get as close as possible without disrupting surrounding tissue. The problem is that even a thin wire is too big; such a probe can take measurements around the neuron, but is far too cumbersome to be reliable over time.
Equally important is capturing the signals from an awake animal. Given their size and rigidity, current probes aren’t suited to gather recordings as the animal responds to its environment. Those units aren’t self-contained, so they keep the animals from moving around freely.
Microscale key to capturing signals from awake, moving animals
Microscale actuators and microelectrodes are critical to addressing both of those issues so probes can interact with individual nerve cells while doing minimal damage to surrounding tissue.
The microscale actuators and associated packaging system developed at ASU and Sandia let a probe move autonomously in and out of the areas surrounding the cell, collecting measurements while compensating for any movement in the neuron or brain tissue.
About the size of a thumbnail, the self-contained unit has three microelectrodes and associated micro actuators. When a current runs through the thermal actuator, it expands and pushes the microelectrodes outward over the edge of the unit, which is flat to fit against the tissue.
Because the actuator is so small, it can be heated to several hundred degrees Celsius and cooled again 1,000 times per second. It takes 540 cycles to fully extend the probe, but that can be done quickly – in a second or less.
The probes were implanted in the somatosensory cortex of rodents and rigorously tested in numerous experiments, both in acute and long-term conditions, Muthuswamy said. Animal procedures were carried out with the approval of ASU’s Institute of Animal Care and Use Committee, and experiments were done in accordance with National Institute of Health guidelines.
Muthuswamy said the neural probes demonstrated significant improvement in the quality and reliability of the signals when the probes were moved with precision using the Sandia microactuators in response to loss of neural signals. Further, he said, adding autonomous closed-loop controls to compensate for microscale perturbations in brain tissue significantly improved the stability of neural recordings from the brain.
Scale of this system is unique
Thermal actuators have been used for years at Sandia and elsewhere, but the scale of this system is unique.
“The idea that we could build this system to achieve multiple millimeters of total displacement out of a micron-scaled device was a significant milestone,” said Sandia engineer Michael Baker, who designed the actuator.
“We used electrostatic actuators in the past, but the thermal actuator provides much higher force, which is needed to move the probe in tissue.”
The microelectrodes are made of highly conductive polysilicon, which the team discovered has a number of advantages. It is almost metal-like in its conductivity, but durable enough for millions of cycles. It provides a signal-to-noise ratio much greater than previous wire probes and provides high-quality measurement signals.
Muthuswamy and Okandan currently are seeking to produce richer data with resolution in the submicron range to be able to go inside cells and take measurements there. They also are working on stacking the existing neural probe chips and decreasing the spaces between probes. Muthuswamy’s Neural Microsystems lab at ASU has developed a unique stacking approach for creating three-dimensional arrays of actuated microelectrodes.
“By building a three-dimensional array, we would have access to significantly more information, rather than just a slice,” Okandan said.
“We’re very encouraged by the progress we have made, and are looking forward to building on that progress.”
Sandia National Laboratories is a multi-program laboratory operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corp., for the U.S. Department of Energy’s National Nuclear Security Administration. With main facilities in Albuquerque, N.M., and Livermore, Calif., Sandia has major R&D responsibilities in national security, energy and environmental technologies and economic competitiveness.
Here again tomorrow if the computer is working I hope. Jeanne