Statins for healthy people - yes or no?

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The War of the Diets

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The case against saturated fat

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Sudden death in young athletes

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"Rice" and shine

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What causes heart disease?

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How many eggs should I eat?

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Do you want to avoid burnout at work? Then start exercising!

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Just a regular afternoon like any other. You have been having a long and stressful day at work. You are trying to relax ant think about something else, but you can´t really take your mind of it. Your shoulders and neck are still aching from sitting fixed in front of the computer for many hours. Or maybe you have been running around in a store or on the factory floor and your legs are heavy and feeling like steel. You can´t wait to get home and relax or maybe go to the pub or maybe just go home and spend time with your family. But don´t. Put on your tracksuit and running shoes and go for a jog or go directly to the gym and sweat with the other people. This will make you feel better at work the new day. Strange, isn´t it. But maybe not.

Making the effort to go to the gym a few times each week can dramatically improve your mood scientists say. A team from Tel Aviv University found that employees who managed to exercise a few hours each week showed less signs of depression and burnout at work.

Burnout is defined as a physical, mental and emotional exhaustion. The researchers led by Dr. Sharon Toker say that burnout may contribute to a "spiral of loss" where the loss of one resource, such as a job, could lead to loss of other resources such as one´s home, marriage end sense of self-worth. Thus, burnout is a serious problem for those who are affected.

The research is published in a recent issue of the Journal of Applied Psychology. The article is called Job burnout and depression: Unraveling their temporal relationship and considering the role of physical activity. A total of 1.632 healthy Israeli workers, both in private and public sectors are followed for nine years. The participants were  divided into four groups: one that did not engage in physical activity, a second that did 75 - 150 minutes of physical activity a week, a third that did 150 - 240 minutes a week, and a fourth that did more than 240 minutes a week. All participants completed questionnaires and came to a medical clinic for routine check-ups.

Depression and burnout rates were clearly highest among those who did not participate in physical activity. The more physical activity that participants engaged in, the less likely they were to suffer depression or burnout. Those who engaged in at least four hours of exercise displayed almost no symptoms of mental strain. 

Dr. Toker added that employers would actually benefit by building a gym on company grounds or subsidising memberships to gyms in the community, and by allowing for flexible work hours to allow employees to make physical activity an integral part of their day. Such a strategy might pay business dividends in the long run. 

Do you prefer aisle or window?

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Did you know that it may matter for your health whether you choose an aisle or a window seat on long flights?  It can actually be more dangerous for you to sit in the window seat. This has nothing to do with the window itself, space radiation or temperature which might be the first things that pop to your mind. 

During long flights blood clots may develop in the deep veins of the limb, a phenomenon known as DVT (deep vein thrombosis). It has been proposed that the risk of DVT may be related to less space on flights and therefore this phenomenon has commonly been nicknamed "economy class syndrome". These blood clots me be hazardous as they can float to the lungs and get stuck in their arteries (pulmonary embolism).

Sitting in a window seat is a risk factor for DVT, the American College of Chest Physicians (ACCP) warn in their new advisory, regardless of whether it's in economy or first class.

Various risk factors for blood clots in deep veins during flight have been identified. Immobility seems to the biggest risk factor. If you sit in a window seat you are more unlikely to stand up and move around than if you you sit by the aisle. If you sit in the aisle seat you can stand up whenever you like without annoying anyone. If you sit by the window, the person next you you might be in the middle of meal or in deep sleep when are going to do your hourly leg exercise, so you will probably skip it. 

"DVT risk has nothing to do with economy class," said Dr. Gordon H. Guyatt, chair of the ACCP panel that drafted the new guidelines. "Really, the evidence is that actually where you sit isn't really an issue. It's how much you move around. And if you're in a window seat you are probably more willing to sit for long periods of time being uncomfortable because you are reluctant to make anybody else move to let you out." These instructions are published in the latest issue of the journal Chest, and you can view them here.

Still, "the first thing to say is that if you are a healthy person you should not really worry about DVT because your risk -- even on a long-term flight -- is considerably less than one in a thousand," said Guyatt, who is also professor in the department of clinical epidemiology and biostatistics at McMaster University in Hamilton, Ontario, Canada. "So these guidelines are for those who have more than a normal risk. For those who have had a clot before, or an abnormality of their coagulation system, or disability that affects mobility. Or if you are obese or have active cancer." Others who are at risk are older people, pregnant women, women who take estrogen replacement therapy, such as oral contraceptives and individuals who have recently undergone surgery.

Apart from seating considerations, the guidelines also suggest that people on flights lasting six or more hours move about frequently and stretch their calf muscles.

Higher-risk individuals should also wear graduated compression stockings that stretch below the knee. Guyatt said it "would be crazy" for passengers at normal risk to wear such stockings, and the ACCP guidelines specifically argue against their use by healthy passengers.

The guidelines also generally discourage the taking of aspirin and/or anticoagulant medications for the specific intent of lowering DVT risk. That said, those at very high risk are encouraged to consult their doctors in order to weigh the pros and cons of such drugs. Obviously it is not advisable to take a sleeping pill and curl up in your seat for the whole voyage.

Women may be getting worse treatment for heart attack than men

3723779 mFeb 23/2012. Women are less likely than men to exeperience chest pain as a first symptom of heart attack. This may delay correct diagnosis. The risk of early death is higher in women compared to similarly aged men. These are the results of a recently published study that analyzed more than one million hospital admissions in the United States between 1994 - 2006 and was published yesterday in the Journal of the American Medical Association (JAMA), the original scientific paper can be found here. The study was based on data from the NRMI (National Registry for Myocardial Infarction).

About 42 percent of women didn't have chest pain when they were admitted to the hospital compared with about 31 percent of the men. Overall, about 15 percent of the women died in the hospital, compared with 10 percent of men. The researchers point out that it may be more difficult to diagnose heart attack if the patient does not have chest pain. This fact makes it more likely that diagnosis will be delayed among the women than among the men.  The study also found that women are not as likely to get immediate treatment with things like clot-busting drugs and balloons that open arteries, which can stop a heart attack in progress.

Individuals without chest pain, women and men, came into hospital for treatment on average about two hours later than those who had chest pain and EKGs to check for signs of heart attack were taken about 15 minutes later than among those with chest pain. These patients were less likely to receive acute therapies aimed at restoring coronary blood flow and were significantly less likely to receive these lifesaving therapies in a timely manner compared with patients who had chest pain on admission.

Lead author Dr John Canto (Lakeland Regional Medical Center, FL) commented: "While chest pain is still the hallmark symptom of MI (heart attack) in women, more women than men present without chest pain, and this is particularly applicable to younger women. We need to be more aware that younger women with atypical symptoms could be having a MI."

The second major finding of the study was that younger women having an MI have a higher risk of death. "Younger women are not supposed to have an MI, but when do, they are at higher risk of death than the rest of the population," Canto commented.

Canto also suggested that the higher likelihood of atypical symptoms in younger women could contribute toward their high death rate. "If a young women presents without chest pain, it is easy not to realize that she is having an MI. Triage staff are less likely to think about MI in a younger woman, especially one without chest pain, so there is a higher probability of not receiving timely treatment. This could easily explain some of the increased mortality in this group."

He added: "Our results challenge the wisdom that one size fits all in terms of men and women and presenting MI symptoms. I would argue that we need to tailor the MI message and that young women are particularly at risk for an atypical presentation." Canto noted that the atypical symptoms of MI include pain in the jaw, neck, shoulder, arm, back, or stomach and unexplained shortness of breath.

Cardiologist Cam Pattersson at North Carolina University Chapel-Hill says, "When I ask my wife what is she most afraid of, she says breast cancer. And yet she is six times more likely to die of a heart attack. We have a desperate message to share about the risk of heart disease in women of all ages"

More recently, another NRMI study showed remarkable reductions in hospital mortality after MI during the past decade for both sexes, especially women, possibly in part because of better recognition and management of cardiovascular risk factors in women.

© Axel F Sigurdsson 2012