Thus, information on working hours appears to improve risk prediction for coronary heart disease in low-risk working populations. The trial was published in The trial was stopped because the event rates were reduced so much in the mg rosuvastatin group compared with the placebo group. There were patients in the placebo group. This treatment effect was consistent regardless of baseline LDL cholesterol level. The magnitude of clinical benefit was directly related to the obtained LDL cholesterol level.
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Rates for other adverse events, including muscle weakness, myopathy, neuropsychiatric events, renal dysfunction, hemorrhagic stroke, and cancer, were not higher among patients allocated to rosuvastatin than among patients allocated to placebo, regardless of attained LDL cholesterol level. A major strength of this analysis is its large sample size. This study provides further evidence that the lower the LDL cholesterol, the better.
The calorie labeling provision was part of President Barack Obama's health overhaul law.
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The rule, expected to take effect in , provides details on eateries with 20 outlets or more and on vending machines 6. Convenience stores, supermarket eateries, pastry and retail confectionary stores, coffee shops, snack bars, and ice cream bars will be required to post calorie counts. The new law requires the posting of calorie counts of foods and drinks on menu boards. Movie theaters, airplanes, bowling centers, amusement parks, hotels, and other establishments where the sale of food is not the primary business are excluded from having to post calorie labeling. Bars and restaurants will not have to post calorie labels on beer, wine, and other alcoholic beverages, which come under the Alcohol and Tobacco Tax and Trade Bureau rather than the Food and Drug Administration FDA.
The FDA estimates that the proposed regulations would apply to just under , establishments out of an estimated , restaurants nationwide. These calorie postings are done of course to decrease the average calories per transaction. Pretend-doctors flip massive burgers and charred-in-lard fries, served by naughty nurses and washed down by Jolt cola.
It consists of 4 half-pound beef patties and 8 slices of cheese served in a lard-coated bun. Also available are maximum-density butterfat shakes. Fortunately for its patrons, the grill will be relatively close to Baylor University Medical Center at Dallas. Should appendectomy for appendicitis be done in the middle of the night or should it wait until the next morning after putting these patients on antibiotics and pain medications? A report on appendicitis patients at a New Haven, Connecticut, hospital found those who had surgery within 12 hours of arriving at the emergency room fared no better than those who waited up to 24 hours for their appendectomy 8.
It also made no difference in the length of their operation or hospital stay. No matter when the appendix is removed, people seem none the worse without it. That led Charles Darwin to conclude that it is a useless evolutionary leftover. William Parker at Duke believes the appendix is there to store friendly bacteria that could get wiped out in the gut by severe diarrhea. Appendicitis was pretty much unheard of in Western countries when diarrhea was common.
It's still apparently rare where diarrhea from contaminated drinking water is common. The deadliest drugs in the USA are not heroin or cocaine. The larger problem is abuse of drugs that are perfectly legal: prescription pain medications. According to a piece in USA Today, they kill an estimated 2 people every hour and send 40 more to emergency rooms with life-threatening overdoses 9. Powerful drugs such as OxyContin, Dilaudid, and Vicodin are obviously blessings to people with severe pain. The administration's prescription monitoring programs routinely enter prescriptions for certain drugs in a database that physicians can consult when prescribing powerful painkillers.
Physicians can consult these databases before writing prescriptions for painkillers. According to the USA Today editorial, most people who abuse painkillers get them from friends and family, sometimes innocently, sometimes by theft. A pernicious problem is unscrupulous physicians who deliberately overprescribe painkillers.
Prescription-monitoring programs may sound like a good idea, but they are not supported by all individuals or all states That's why such proposals have been defeated several times in the past and why some proposals face substantial opposition. First of all, privacy advocates are concerned about creating another online database full of sensitive personal information with every doctor, pharmacist, and health care provider in the state accessing it. Cost also is a major issue, particularly in low-tax states. Federal grants are allegedly available to pay the start-up costs, but expenses are a burden in a number of states.
The costs are not equitably spread. Chain pharmacies already have the hardware needed to comply with such programs, but independent neighborhood pharmacies will need to purchase the hardware and train their staff. The entire burden of the program falls on pharmacists to input the data and maintain the system.
It's optional for physicians. Considering that one intention of the program is to prevent physician shopping, exempting physicians from checking the database before prescribing seems inappropriate. They also want to extend the time for which records are kept, from the initial days to maybe years. According to Jason Roberson 11 , one third of 4.
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In , about a fifth of deliveries were performed via C-section. Some observations: life expectancy in the US rose from Life expectancy is one of the best measures of socioeconomic progress because it captures improvements in living standards, health care, safety, nutrition, and the environment. Ten years have been added to American life spans since , and 30 years since Furthermore, Americans are living healthier and more active lives at every age. Infant mortality rates hit an all-time low of 6.
There is less chance of losing a child to early death now than at any time in history. In , the death rate fell 4. In , a child was nearly 4 times more likely to die before the age of 5 than he or she is today. The overall age-adjusted death rate the probability of dying at any particular age fell to from per , in , the 10th consecutive year the death rate has fallen.
All of this progress took place over a decade when lack of health insurance was supposedly dooming many Americans to inadequate care. Advances in medical treatments matter far more to overall health progress than do insurance coverage rates. The age-adjusted death rate also decreased significantly for 10 of the 15 leading causes of death: heart disease, cancer, various chronic diseases of the liver or respiratory system, influenza, and pneumonia. Death rates from accidents and homicide also fell significantly.
The death rate from heart attacks and strokes is now one half to one third the age-adjusted rate of 50 years ago. There also is some bad news: the incidence of obesity and diabetes mellitus has increased. These, of course, are less the result of medical care inadequacies than of lifestyle decisions, particularly quantity of consumed calories and caloric choices. The major health gains in were achieved by every race except blacks.
These numbers show that average Americans have not seen their living standards fall over the last 30 years, as is often claimed by those who focus only on wage data. Medical breakthroughs are available to the rich, the middle class, and the poor alike. A poor person in America today has access to much better health care than did a billionaire or a prince in the s! Yes, American health care is expensive, but the CDC report shows that its benefits include longer and better lives.
About babies die from SIDS each year, down from about per year in , in part due to campaigns urging parents to put infants to sleep on their backs Infant fatalities attributed to accidental suffocation and strangulation in bed quadrupled between and , according to the CDC. The use of bumpers, which line the inside of the crib, is controversial The Consumer Products Safety Commission and the American Academy of Pediatrics have urged parents not to use the puffy bumpers—the kind that a baby's face could sink into—but both have stopped short of advising against any bumpers at all, as some consumer groups urge.
Other concerns focus on the cribs themselves. Starting in June , it will be illegal to make, sell, or resell any crib in the US that doesn't meet tough new federal standards. Drop-down sides, linked to 32 infant deaths since , will be prohibited.
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The new rules also require stronger slates, mattress supports, and hardware that can withstand vigorous shaking by toddlers. Most cribs on the market now do meet these new standards, according to the Juvenile Products Manufacturers Association. Tags with the code 16 CFR for full-sized cribs and 16 CFR for compact-sized cribs indicate that cribs meet the standards. Yet millions of old cribs will remain in circulation, many of which are handed down through families or passed along to friends.
Loose fabric and soft cushions can block a baby's nose and mouth, and sleeping babies may not wake up sufficiently to fight for air, leading to SIDS. Positioning pillows designed to keep babies from rolling onto their sides or stomachs have been involved in at least 13 infant deaths since Experts have long warned against having babies sleeping in parents' beds, given the risk of suffocating in bedding or being crushed by a sleeping adult. The safest sleeping arrangement is to have the baby sleep in the parents' room for the first 6 months but in a separate bassinet or crib.
Fifty years ago in April , Dr. Jesse E. At the time, Dr. Edwards was the world's foremost student of the aortic valve. Edwards preceded his answer to the question by describing how the normal three-cuspid aortic valve opens and closes. He demonstrated that the latter does so because the distance between any two commissures lateral attachments of each independent cusp along their free margins is greater than a straight line.
The greater-than-a-straight-line distance allows each cusp to move to the center of the aortic lumen during ventricular diastole, thus closing the orifice, and move near the wall of the aorta during ventricular systole, thus opening the orifice maximally or nearly so. So how does a congenitally bicuspid aortic valve open if theoretically the distance between the two commissures across the aortic orifice is a straight line?
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Edwards demonstrated that the length of at least one of the two cusps along its free margin is not a straight line but indeed is greater than a straight line. This fact is both its savior and its defeater. If the cusps do not calcify, pure regurgitation is the usual hemodynamic consequence. Rarely does a congenitally bicuspid valve function normally or near normally during an entire lifetime.
chronorado.com/images/2019-06-22/163.php Edwards also pointed out that a congenitally bicuspid aortic valve was rarely if ever stenotic from birth. The aortic valves that are stenotic from birth are nearly always unicuspid, mainly unicommissural.
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His publication 50 years ago was a great step forward in our understanding of the congenitally bicuspid aortic valve. One in 10 white girls begin developing breasts by that age—twice the rate seen in a study. During the last 30 years, the childhood of girls has been shortened by about 18 months. According to one investigator, girls are being catapulted into adolescence long before their brains are ready for the change, a phenomenon that may pose risk to their health.