Louis J. Sheehan, Esquire. It's been a frustrating discrepancy in health for more than a decade: Young women who suffer heart attacks and go to the hospital for treatment have been twice as likely to die as young men. Now, that gender gap is narrowing.
Louis J. Sheehan, Esquire. Women under 55 are about 30 percent more likely to die in the hospital after having a heart attack than their male peers, according to research presented yesterday at the American Heart Association conference in New Orleans.
Louis J. Sheehan, Esquire. Between 2005 and 2006, 2.4 percent of women under 55 died, a drop from the 5.1 percent who died in 1994 to 1995. Between 2004 and 2006, 1.8 percent of men younger than 55 died in the hospital after experiencing heart attacks, compared with 2.7 percent in 1994 to 1995.
"What we can see is a favorable trend," says Viola Vaccarino, a professor of medicine at Emory University School of Medicine who analyzed 916,380 heart attack patients over 12 years from the National Registry of Myocardial Infarction, a database of treatment information on some of the country's cardiac patients. "The excess mortality we noted early on is narrowing now, which is overall a good sign."
About 1.1 million people in the U.S. suffer heart attacks annually, and half of them die, according to the National Heart Lung and Blood Institute. Possible gender gaps in mortality for those who suffer heart attacks and don't go to the hospital are tougher to pin down, Vaccarino says. http://Louis-J-Sheehan.de
The reasons for the change aren't entirely clear. One possible factor may be that women's risk factors for heart attacks, such as diabetes, high cholesterol and blood pressure, aren’t worsening as much as men's are, Vaccarino says.
Still, the gap hasn’t disappeared. Studies have noted that young women whose heart attack symptoms are atypical are more likely to be misdiagnosed than are men, and that older African American women are less likely to get reperfusion therapy that restores blood flow to the heart than men are. The use of those therapies in women didn't change much between the mid-90s and 2006, Vaccarino says.
"Because there is more attention to heart disease in women, patients as well as physicians may be more aware of this and doing a better job of alerting women of their risk. Women may be willing to go to the hospital sooner," she says. "But there is still excess mortality, so it's not completely gone, but it's much better than before."
Thursday, November 13, 2008
Thursday, September 25, 2008
y
In a crucial step toward realizing medical treatments based on embryonic-like stem cells, researchers have found a safer way to revert adult mouse cells to an embryonic state. The new technique, reported online September 25 in Science, avoids using viruses that alter the cells’ DNA, a major goal among stem-cell researchers since these DNA mutations can lead to cancer। http://louis-j-sheehan.net
Such reprogrammed cells could sidestep the controversy surrounding therapies based on embryonic stem cells, many scientists believe, because the embryonic-like cells can be made from a person’s skin or blood cells without creating or destroying an embryo. Coaxing these reprogrammed cells into becoming, say, fresh heart or pancreas cells for transplantation back into the patient could offer new, personalized ways to treat ailments such as heart disease and diabetes.
Until now, reprogramming adult cells in lab dishes required infecting the cells with viruses that carry the four reprogramming genes. Although the scientists cripple the viruses so that they can’t replicate, the viruses can still insert these four genes directly into the cells’ DNA at random locations. These willy-nilly changes to the cells’ DNA could disrupt the cells’ own genes, occasionally in ways that cause the cells to grow out of control and form a tumor. In addition to this risk, any process that alters a cell’s DNA complicates government approval for medical use.
“None of the cells that we produced had any evidence of any virus left” after reprogramming, says Matthias Stadtfeld, coauthor of the study and a molecular biologist at
The safer virus carries the same four genes into adult cells — Oct4, Sox2, Klf4 and c-Myc — but instead of inserting those genes into the cells’ genetic code, the virus lets the genes free-float within the cells. Proteins encoded by these genes do the actual reprogramming, and the cells’ protein-making machinery can read the four genes even if they’re adrift in the cells. Eventually, the cells degrade the genes, and the viruses get lost as the cells repeatedly divide.
“It’s very exciting because it’s the first demonstration of [reprogrammed] cells without viral integration,” comments Robb MacLellan, a stem cell expert at the David Geffen School of Medicine at the
More research is needed before the technique could be used for medical therapies. Stadtfeld and his colleagues reprogrammed skin and liver cells from adult mice. Because they used mouse cells, the scientists could perform the ultimate test for whether the resulting reprogrammed cells possessed the quintessential trait of embryonic stem cells, the ability to become any type of cell in the body. That test is to insert the reprogrammed cells into mouse embryos and allow those embryos to grow into adult mice. Just as true embryonic stem cells would, these reprogrammed cells gave rise to all types of cells in every organ of the adult mice’s bodies.
The question remains whether the reprogramming feat will work for human cells, but many scientists expect that it will. “It’s likely that it will be able to be shown in human cells,” MacLellan says.
Friday, September 19, 2008
valor
If I absolutely had to get into a school-yard fight back in junior high, I don’t know why it had to be with Ira Blitz। I should have known I wouldn’t stand a chance. http://Louissheehan.BraveDiary.com
First of all, unlike me, Ira had mastered a number of exotic skills that gave him a distinct advantage in almost any scrap. Punching, for instance. More important, Ira actually seemed to enjoy fighting. Whenever I faced the possibility of an after-school brawl, my first response was to submit the matter to binding arbitration and hope for a resolution satisfactory to all parties. If that didn’t work, I’d ask my family if we could move.
Most important, however, was the matter of Ira Blitz’s name. If you’re looking for a partner for an adolescent brawl, it’s always a good idea to avoid someone whose surname sounds like it applies less to a person than to a Panzer division. I’m not saying that Ira’s family handle was the only reason I lost this battle, but I would have been a lot more comfortable if he had been named, say, Ira Negotiated Settlement. As it was, however, Ira won our scuffle handily, deftly landing head-to-toe blows and finishing me off with a pop in the eye that caused me to see stars, several comets, and a large portion of the Crab nebula.
While my one childhood fight taught me a couple of valuable lessons (notably, to be incredibly nice to Ira Blitz until after graduation), it also raised a question: Exactly what kind of trauma had I put my body through? Why had I seen stars, for example, between the time fist hit eye and I hit asphalt? What was responsible for the singular sensation I experienced when I was hit in the stomach and had the wind knocked out of me? Why did my nose turn out to be such a sensitive—and utterly breakable—organ? What on earth is a cauliflower ear, and had I run the risk of developing such unwelcome vegetation?
Happily for us nonpugilists, we don’t have to go to Ira Blitz for the answers. Easier and less painful explanations are available from the world of science. Even if you’re a lifetime pacifist, it can be interesting to learn just what your body has been missing all these years—and why it should keep on missing it.
Among the most remarkable sources of information on the physiology of injury is Jeremy Wolfe, a professor of ophthalmology at Harvard Medical School and a senior lecturer at MIT. Nearly every year in his classes, he offers a one-hour visual-perception seminar straightforwardly entitled “Ten Things You Can Learn by Poking Yourself in the Eye.” Although such a lecture struck me as less than a natural crowd-pleaser, the students at MIT apparently think otherwise. At one of Wolfe’s presentations, he played to a crowd of 50 enthusiastic undergrads, all of whom gladly went along with his eye-poking exercises. I was not on hand to watch Wolfe’s pupils attack their pupils, but I was able to reach him on the phone, and he agreed to talk me through some of the experiments. To be perfectly candid, I was not looking forward to the experience. Spending half an hour on the phone learning how to poke yourself in the eye seemed about as appealing as hunkering down for an hour on an airline’s outsourced customer-service line, and probably more painful. Nevertheless Wolfe assured me I would be perfectly safe as long as I did the exercises very gently and attempted them only under his guidance.
Wolfe first asked me to partially close one eye and gently press a finger against the eyelid near the tear duct. What I should see, he said—apart from a good personal-injury lawyer—was a flash of light in my field of vision on the side opposite the spot where I pressed. This, Wolfe explained, illustrates the phenomenon of labeled lines.
All nerves send signals to the brain when they are stimulated, Wolfe said, but the part of the body those nerves service determines how the brain will perceive the stimulation. If you activate a tactile nerve in the skin, the brain will register the stimulation as touch. If you activate certain nerves in the ear, the brain will perceive that as sound. When you press the eyeball, you’re mechanically stimulating retinal nerves, and the brain registers that as light.
+++
To me it seemed that the brain whose owner has just poked a finger in his eye should register something else, like a grievance with its union. Nevertheless I tried a tentative poke and indeed got the promised flash of light. The reason the flash was on the opposite side of the eye has to do with the way the brain processes an image. In ordinary vision, the lens focuses incoming light in such a way that it flips an image upside down and backward. When the eye inverts an image, the brain knows that it must automatically compensate by flipping the picture back the right way.
Though the delicate touch I gave my eye yielded just one small flash, Wolfe said that when the eye is struck by something less forgiving—like a swinging door or Ira Blitz—many parts of the retina may be stimulated simultaneously, giving rise to a whole constellation of light. Sometimes the retina is so mechanically stimulated that a large portion of the visual cortex of the brain begins firing at once. This is what happens when you rub your eyes and your field of vision is filled with that undulating checkerboard.
Neurophysiologists have discovered that particular cells in the brain are responsible for registering particular shapes (horizontal or vertical lines, for instance), Wolfe said. If you rub your eyes too much, you send random, meaningless noise to your brain, and all the cells for all the shapes begin screaming at once. At Wolfe’s instruction, I commenced a very vigorous rub and got the promised checkerboard. To me this was enough retinal recreation for one day, so before Wolfe got me too involved in his other experiments—including the wiggle-the-eyeball and misalign-the-eyes tests—I thought it best to try my own exercise, known as hang-up-the-phone.
With my eyes thus under my belt, I went off to see what I could learn about other fistfight injuries. Perhaps the most dramatic of these is the punch in the stomach—or, specifically, the punch in the solar plexus. As most people know from experience, the solar plexus is that area just below the rib cage which, if hit just right, can cause you to feel as if you’ve had the wind—as well as the rain, the snow, and at least one kidney—knocked out of you. The term solar plexus comes from the Latin solaris, for “Try not to get punched here,” and plexus, for “We’re not kidding.”
My introduction to the perils of the solar plexus came when I was 9 or 10 years old and got into a fight with my older brother after he gave me a model of the Mayflower ship and then tried to take it back. Sibling common law usually grants an older brother unilateral rights to seize possession of any toy at any time for any reason. On this occasion, however, I had made it a point to touch a black object and recite, “Touch black, no back,” an incantation that the Supreme Court had ruled binding in 33 states, the District of Columbia, and Guam. My brother was evidently not up on recent court rulings, and a scuffle ensued, resulting in my sustaining a severe blow to the solar plexus. The loss of breath was sudden and total. I’ve never been entirely certain how long it took me to get my wind back, but family members tell me I was more or less myself again by my sophomore year in high school.
Excruciating as the experience was, however, it turns out that it was a largely harmless one. Getting the wind knocked out of you is analogous to jamming your funny bone, says physician Chris Freyberg, director of the emergency department at the Southern Arizona VA Health Care System in Tucson. It’s a temporary paralysis of the diaphragm caused by trauma to the phrenic nerve. This nerve descends from the upper part of the torso and forks off to make contact with the diaphragm on both sides. When the solar plexus is struck, the diaphragm sustains a concussion, which it transmits to the phrenic nerve. The nerve shuts down temporarily and can’t make the diaphragm contract. To the surprise and considerable disappointment of the victim, he finds he can’t draw his next breath. The worse the blow, the longer the shutdown.
Almost as sensitive to injury as the solar plexus are the exquisitely delicate nose and ears. As you know if you’ve ever flipped through a professional boxing magazine, strange, almost Picasso-esque things can happen to the face that gets in the way of too many punches. The common cauliflower ear, which gives so many professional fighters that always-fashionable fresh crudité look, is caused by a blow or other trauma to the outer ear, leading to the accumulation of blood between the cartilage and its fibrous covering. This coagulated blood then blocks the flow of new blood to the cartilage, resulting in tissue death and the buildup of scar tissue. Treatment involves draining the ear, removing the scar tissue, repositioning the fibrous covering, and giving serious thought to seeing a good career counselor.
Even if you’ve never stepped into a boxing ring, you know that almost any bump or blow can do serious damage to the proboscis, causing immediate bleeding and agonizing pain and eventually turning even a modest button nose into something closer to a buttonhook. “That’s probably why, instinctually, people have been taught to punch other people in the nose,” Freyberg says. “It’s humiliating in the sense that it’s probably the most painful spot on the face, can make you look physically deformed, and is probably the spot on the face that will become most bloodied. It’s more defaming than anything else.”
Though such fragility would make the nose seem a shabbily designed organ, it is in fact an elegant one; its very elegance is what makes it so delicate. The entire face is highly vascularized and innervated, Freyberg says. For all the different ways it has to move and all the jobs it has to do, it needs lots of blood and nerve endings. The nose, in particular, has to detect subtle smells, and for that it needs to be rich in nerves. However, that also makes it sensitive to pain. Similarly, mucous membranes are active tissues and thus have to be rich in blood, but that means an injury is going to cause them to bleed copiously.
+++
Making matters worse for the beak, the bone that makes up the top portion of the bridge is lighter and thinner than the surrounding skull. When you look at an X-ray, you can see this extremely fragile projection of bone sticking out. It’s very delicate and very pretty, but it also can be damaged very easily.
If there is one bad rap that’s been hung on the nose, it’s the general belief that a single fracture can instantly turn the average GQ man into the average Elephant Man, complete with the ability to drink through his nostrils. In fact, Freyberg explains, the nose bone heals as undetectably as any other bone, provided that it is set properly. It’s just that when your emergency room is a corner of the canvas at Madison Square Garden and your cosmetic surgeon is Don King, you can’t expect the best results.
Nastier than a blow to the nose, a punch in the ear, a pop in the eye, and a fist in the stomach, combined, is that body trauma most feared among men: a knee in the, uh, external endocrine system. Give the average man a choice between getting hit in the groin or having a girder fall on his head, and watch him go looking for a construction site.
The most graphic case of this kind of injury I ever saw came during a game of summer camp softball when Sidney Katz (not his real name) was playing second base (not his real position) and was hit by a line drive in the antler (not his real appendage). Apart from having to spend that night sleeping with a strategically placed ice pack—something that caused the rest of us to make fun of him from the summer of 1968 until the middle of last week—Sidney displayed a level of unbridled agony I had seen before only in the closing reel of Fiend Without a Face when the monster is trying to suck Kim Parker’s brain and spinal column out through the back of her neck. Sidney’s anguish finally subsided after several days, and he spent the rest of the summer engaging in no athletic activity more strenuous than turning on the kiln in arts and crafts.
The nose has to detect subtle smells, and?for that it needs to be rich in nerves. That ?also makes it sensitive to pain, however.
How such a minor injury could cause such exquisite pain was long a mystery to me, and no doubt to Sidney. Some answers, however, were available from Irwin Leventhal, a urologist at Mount Sinai Hospital in New York City. What makes a hit in the groin so painful, Leventhal says, is the same thing that makes other sensations in that area so pleasurable: an enormously high number of sensory nerve endings. When an area of the body is innervated so generously, any sensation—whether good or bad—is going to be felt very acutely. What’s more, glands don’t have a whole lot of give, so if one is hit, it’s going to absorb the whole force of the blow. Finally, while all other glands are located deep within the body, male reproductive glands are outside, since sperm cannot be produced normally at temperatures above 96 degrees. Whatever additional protection they’d get by being tucked away is thus lost.
Making matters still worse is that pain in this particular area tends not to stay there but to radiate throughout the groin and up into the abdomen (and occasionally out to any other man standing within a 100-yard radius). This, Leventhal explains, is due to the phenomenon known as referred pain, which causes a sensation originating at one spot to travel along the nerve root to other parts of the body.
In this case, the nerves that cause the most discomfort are the perineal, which innervates the groin, and the pudendal, which runs from the spinal column to the groin and scrotal area. For anyone unlucky enough to have his pudendal and perineal nerves traumatically stimulated, Leventhal recommends ice for the first 24 hours to minimize swelling, heat for the next 24 to stimulate blood flow and hasten healing, and perhaps giving up softball for a pastime like quoits, or perhaps some online Quidditch.
For pain-phobes like myself, avoiding this kind of injury has always seemed like the better part of physical valor. After Sidney Katz, I made it a point never to play baseball again without the protection of a good athletic cup—as well as a saucer, salad plate, and place setting for six. After Ira Blitz, I made it a point never to engage in another school-yard quarrel without first getting in touch with Bono. And after the Mayflower, I made it a point to turn all models directly over to my brother—including any I might one day be lucky enough to date. I admit this strategy won’t ever earn me a heavyweight belt, but it won’t earn me any other kind of belt either, and that has always seemed like a pretty good trade-off.
Tuesday, September 2, 2008
Louis J. Sheehan, Esquire
Researchers have often given Egyptians living around 4,000 years ago credit for having first domesticated wildcats and then bred the tame felines. However, discoveries on the Mediterranean island of Cyprus indicate that people domesticated felines there by about 9,500 years ago, long before the cat-worshipping Egyptians' time.
Working among the remains of Shillourokambos, a village on Cyprus that was inhabited between 10,300 and 9,000 years ago, a team led by archaeologist Jean-Denis Vigne of the CNRS-National Museum of Natural History in Paris unearthed a cat's skeleton from a small grave. The animal's remains lay near a larger grave that contained a human skeleton along with offerings such as polished stones and flint tools. An adjoining pit contained 24 seashells.
Lack of any remaining collagen in the roughly 8-month-old cat's bones obstructed efforts to estimate its age based on radiocarbon measurements. The creature's location in previously dated sediment at the site indicates that it lived between 9,500 and 9,200 years ago, Vigne says. Its size resembles that of a modern African wildcat.
HERE, KITTY. The discovery of a 9,500-year-old feline skeleton (above) suggests that some of the earliest domesticated cats resembled today's African wildcats, such as the one pictured below.K. Debue
In early agricultural villages such as Shillourokambos, wildcats were probably domesticated to kill mice attracted by grain stocks, Vigne theorizes.
Scientists have suspected for some time that people brought either wild or domesticated cats to Cyprus more than 9,000 years ago. A feline jawbone was discovered nearly 20 years ago at a site on the island dating to the ancient time.
It now appears that the first colonizers of Cyprus tamed cats, the French investigators conclude in the April 9 Science. "The association of [a human grave] with both seashells and a cat grave strengthens the idea of a special burial, indicating that a strong relationship existed between cats and people," Vigne says.
No sign of butchering appears on the cat's bones, he adds, further suggesting that the animal wasn't eaten or mutilated but was a pet or had some other special relationship with people. It's not clear how the cat died, Vigne notes.
The new feline find underscores the emerging view that colonizers of Cyprus propagated a sophisticated culture, remarks archaeologist Alan H. Simmons of the University of Nevada, Las Vegas.
A recently completed excavation of a 12,000-year-old site on Cyprus, directed by Simmons, shows that residents there hunted pygmy hippos and several other native animal species nearly to extinction within about 2 millennia. Island settlers then brought over a variety of animals from the mainland, Simmons says.
At Shillourokambos and a nearby site from the same period, animal remains include sheep, goats, pigs, wild deer, and even a few cattle.http://louisjjjsheehan.blogspot.com
Saturday, August 30, 2008
Louis J. Sheehan, Esquire
Each year, approximately 1 in 20 teenagers experiences the anguish of major depression. Schoolwork and social life suffer as these youngsters grapple with feelings of helplessness and hopelessness, often topped by suicidal thoughts or behaviors.
There's uplifting news for depressed teens, though. Many feel markedly better after completing a relatively brief course of treatment that includes both an antidepressant medication and talk therapy, according to a team led by psychiatrist John S. March of Duke University Medical Center in Durham, N.C.
In the largest-ever study of treatments for teen depression, this combination of drug and talk therapies alleviated the disorder's symptoms in a larger proportion of youngsters than either treatment did alone, March and his coworkers report in the Aug. 18 Journal of the American Medical Association. The antidepressant-psychotherapy mix also showed superiority to placebo pills, the researchers say.
Few of the 439 depressed teens in the study reported that they had contemplated suicide or tried to kill themselves after beginning any of the treatments. No one carried out a suicide during the study.http://louis-j-sheehan.info
March cautions, however, that the investigation wasn't designed to address whether antidepressant drugs foster suicide (SN: 7/24/04, p. 51: http://www.sciencenews.org/articles/20040724/fob1.asp).
The researchers recruited adolescents ages 12 to 17, all with a current diagnosis of major depression. About half the volunteers had received another psychiatric diagnosis as well, such as attention-deficit hyperactivity disorder. Participants were randomly assigned to receive 12 weeks of treatment with fluoxetine (Prozac), cognitive-behavioral therapy, a combination of the two, or placebo pills.
Cognitive-behavioral therapy for depression entails therapist-patient discussions about overturning negative ways of thinking, developing social skills, and setting goals to pursue pleasurable activities. In the new study, this talk treatment consisted of 15 sessions, each lasting about 50 minutes.
Cognitive-behavioral therapy exerted a complementary effect on drug treatment, the researchers say. After 12 weeks, substantial improvement had occurred for
71 percent of the youngsters given the combination treatment, compared with 61 percent of those given fluoxetine alone, 43 percent of those who received only the talk therapy, and 35 percent of those taking placebos.
Suicidal thoughts, present in nearly one-third of these depressed adolescents at the study's start, declined substantially in each treatment group. Only the combination treatment proved superior to placebos in this respect.
More participants receiving fluoxetine alone cut themselves or attempted suicide than did peers in the other groups. However, a total of only 33 such incidents occurred in the study, too few for the researchers to draw any firm conclusion.http://louis-j-sheehan.info
A 6-month follow-up of the adolescents will examine whether the benefits of cognitive-behavioral therapy alone become more apparent over time, as earlier studies of teens with less-severe depression have suggested.
"At this point, [March's] study shows that fluoxetine works as a treatment for adolescent depression and that its effectiveness is increased by adding cognitive-behavioral therapy," remarks psychiatrist Grayson S. Norquist, director of the division of services and intervention research at the National Institute of Mental Health in Rockville, Md. Norquist's division funded the new investigation. Louis J. Sheehan, Esquire
Sunday, August 24, 2008
legs
rom Milwaukee, at a joint meeting of the Paleoanthropology Society and American Association of Physical Anthropologistshttp://ljsheehan.livejournal.com
Human ancestors that lived in Africa around 3 million years ago possessed backbones like those of people today and thus walked much as we now do, says Carol V. Ward of the University of Missouri-Columbia.http://louis-j-sheehan.info
Ward and Bruce Latimer of the Cleveland Museum of Natural History analyzed the anatomy of spinal columns from the 3.2-million-year-old Australopithecus afarensis skeleton known as Lucy and a pair of roughly 2.5-million-year-old Australopithecus africanus specimens.
As in modern people, the spines of the three australopithecines bend inward at the middle of the back and curve outward at the lower back. A bony column angled in this fashion positions the torso directly over the hip joints, fostering erect posture and a two-legged gait, Ward says. The shapes of australopithecine vertebrae also correspond closely to those of modern humans, the researchers found.http://louis-j-sheehan.info
Even with an upright stance, Lucy and her kind may have spent much time in trees. A. afarensis' short legs, relative to its upper body, drained energy during walking or running but boosted climbing power, contends Karen Steudel-Numbers of the University of Wisconsin–Madison. Climbing skill must have been crucial to A. afarensis, she proposes, because the species retained short legs throughout its 1-million-year evolutionary history.
In laboratory studies, her team found that short-legged people consume substantially more oxygen while walking or running than long-legged people do. Steudel-Numbers estimates that australopithecines required an average of 30 percent more energy to walk a given distance than people do today.Louis J. Sheehan
Friday, August 15, 2008
megiddo
Archaeological excavations at a prison near Megiddo, Israel, have uncovered remains of what may have been one of the region's oldest Christian churches. The mosaic floor of the 6-meter-by-9-m structure, uncovered in the past 2 weeks, bears Greek inscriptions and a medallion decorated with drawings of fish, an ancient Christian symbol.http://Louis-j-sheehan-esquire.us
The style of letters, the wording of the inscriptions, and other features date the floor to the 3rd or 4th century A.D., says Yotam Tepper of the Israel Antiquities Authority in Jerusalem. "It's an extraordinary find if it's third century," says religion scholar Eric M. Meyers of Duke University in Durham, N.C. However, he adds that it's extremely unlikely that a major Christian church existed in the area before Roman Emperor Constantine legalized the fledgling religion in A.D. 313.
Subscribe to:
Posts (Atom)
