Morning MEDtalks with Dr KK Aggarwal 30th October 2018
Different aspects of the weather had variable effects on risk of MI depending on whether CCU admission was for ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI). For STEMI and NSTEMI combined, lower daily air temperature, lower atmospheric air pressure, higher wind velocity, and shorter duration of sunshine appeared to be independent triggers among the 274,029 patients in the SWEDEHEART registry cohort. “The strongest association was observed for air temperature, with a higher incidence of MI on days with air temperatures less than 0°C, with rates of MI declining when temperatures rose to greater than 3°C to 4°C,” write the authors of the report published October 24 in JAMA Cardiology, with lead author Moman A. Mohammad, MD, Lund University, Sweden. A one-standard-deviation rise in air temperature that is by 7.4°C, corresponded to a 2.8% reduction in risk for MI.
The simple act of breathing is killing 7 million people a year and harming billions more , but ‘a smog of complacency pervades the planet’, says Dr Tedros Adhanom, the WHO’s director general.
Air pollution is linked to increased rates of morbidity and mortality , in particular from cardiovascular and respiratory illnesses. A fall of PM 2.5 by 10 micrograms per cubic meter is associated with an increased life expectancy of 0.77 year.
10 ways you can fight air pollution (WHO)
- I don’t drive during rush hour
- I drive an electric vehicle
- I walk to work
- I compost my waste
- I recycle my waste
- I don’t burn waste
- I use renewable energy to power my home
- I check daily air pollution levels
- I use clean energy to cook
- I turn off lights and electronics not in use
Use of angiotensin-converting enzyme (ACE) inhibitors to lower blood pressure was associated with an overall increased risk for lung cancer of 14% compared to hypertension therapy with angiotensin receptor blockers. An analysis of primary care records of almost one million patients in the United Kingdom showed that as treatment with ACE inhibitors continued, the risk for lung cancer increased. For patients who took ACE inhibitors for 5 years, the risk for lung cancer increased by 22% compared to those who took ARBs. The increased risk for lung cancer peaked at 31% for patients who took ACE inhibitors for 10 years or longer. Secondary analyses showed that the use of ACE inhibitors for less than 5 years was not associated with an increased risk for lung cancer (Laurent Azoulay, PhD, of the Department of Epidemiology, Biostatistics and Occupational Health at McGill University in Montreal, Quebec, Canada.]
A new study found that cannabis oil significantly improves Crohn’s disease symptoms . Surprisingly, the effect does not seem to be due to the anti-inflammatory properties of cannabis (Dr Timna Naftali, a gastroenterologist and a professor at Tel Aviv University)
For patients undergoing cardiac surgery that involves cardiopulmonary bypass who are at high risk for perioperative mortality, a restrictive red blood cell transfusion strategy lowers the need for transfusion without increasing the incidence of acute kidney injury (Amit Garg, MD, from the London Health Sciences Centre in Ontario, Canada, during a news briefing here at Kidney Week 2018).
Harm reduction: After analyzing more than 300 pictorial warning messages for 40 individual features, researchers from the Annenberg School for Communication at the University of Pennsylvania found that images of diseased body parts and testimonials from real people were most effective at getting smokers to quit. The study had identified 48 objective features that could be present in the ads, including factors like image color, photo type, presence of male or female characters, presence of medical equipment, and argument type (Tobacco Control, Oct. 26, 2018).
5 Top Reasons Patients Sue Doctors (Lee S. Goldsmith, Medscape)
- Patients seek answers that physicians don’t give
- Patients have billing disputes
- Patients feel that details are missing
- Patients are suing out of desperation
- Patients are reacting to your actions
Nobel Prizes that changed medicine forever: Robert Holley, Har Gobind Khorana & Marshall Nirenberg (1968) “For their interpretation of the genetic code and its function in protein synthesis”. Building on the finding that genetic information is transferred from DNA to RNA to protein, Robert Holley, Har Gobind Khorana & Marshall Nirenberg were awarded the Nobel Prize for their work in cracking this genetic code. Holley isolated and mapped the structure of tRNA, Khorana built different RNA strains using enzymes, which enabled the production of proteins. Nirenberg, alongside Heinrich Matthaei, produced a long RNA chain consisting of a single nucleotide.
Video to watch: TEDx Video: Doctor-patient relationship www.youtube(dot)com/ watch?v=i9ml1vKK2DQ
Dr KK Aggarwal