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Music Can Help Restore Stroke Patients' Sight
Posted By Blog Detailer,
CATEGORIES:
Cardiovascular
Music may have charms to help restore sight to those recovering from a stroke, a new study finds.
Stroke survivors can suffer impaired visual awareness called visual neglect. It's caused by stroke-related damage in brain areas that integrate vision, attention and action, the researchers said.Patients with visual neglect lose awareness of objects in the opposite side of space compared to the site of the brain injury. For example, if the stroke is on the right side of the brain, patients lose awareness of visual information that's to their left. This occurs even though there's no damage to the brain area associated with sight, according to the study.
"Visual neglect can be a very distressing condition for stroke patients. It has a big effect on their day-to-day lives," lead author Dr. David Soto, of Imperial College London, said in a school news release. "For example, in extreme cases, patients with visual neglect may eat only the food on their right side of their plate, or shave only half of their face, thus failing to react to certain objects in the environment."
The study included three stroke survivors who'd lost awareness of half of their field of vision. They completed vision tasks in three settings: listening to their preferred music; listening to music they didn't like; and in silence.
All the patients were better able to identify colored shapes and red lights in their depleted side of vision when they listened to music they liked, compared with music they didn't like or silence.
According to the researchers, this suggests that positive emotions triggered by listening to pleasant music may result in more efficient signaling in the brain. In turn, this may improve the patient's awareness by giving the brain more resources to process stimuli.
The study was published March 23 in the journal Proceedings of the National Academy of Sciences.
"Our results are very promising, although we would like to look at a much larger group of patients with visual neglect and with other neuropsychological impairments," Soto said. "Our findings suggest that we should think more carefully about the individual emotional factors in patients with visual neglect and in other neurological patients following a stroke," Soto said.
"Music appears to improve awareness because of its positive emotional effect on the patient, so similar beneficial effects may also be gained by making the patient happy in other ways. This is something we are keen to investigate further," he said.
HealthDay News
Stroke survivors can suffer impaired visual awareness called visual neglect. It's caused by stroke-related damage in brain areas that integrate vision, attention and action, the researchers said.Patients with visual neglect lose awareness of objects in the opposite side of space compared to the site of the brain injury. For example, if the stroke is on the right side of the brain, patients lose awareness of visual information that's to their left. This occurs even though there's no damage to the brain area associated with sight, according to the study.
"Visual neglect can be a very distressing condition for stroke patients. It has a big effect on their day-to-day lives," lead author Dr. David Soto, of Imperial College London, said in a school news release. "For example, in extreme cases, patients with visual neglect may eat only the food on their right side of their plate, or shave only half of their face, thus failing to react to certain objects in the environment."
The study included three stroke survivors who'd lost awareness of half of their field of vision. They completed vision tasks in three settings: listening to their preferred music; listening to music they didn't like; and in silence.
All the patients were better able to identify colored shapes and red lights in their depleted side of vision when they listened to music they liked, compared with music they didn't like or silence.
According to the researchers, this suggests that positive emotions triggered by listening to pleasant music may result in more efficient signaling in the brain. In turn, this may improve the patient's awareness by giving the brain more resources to process stimuli.
The study was published March 23 in the journal Proceedings of the National Academy of Sciences.
"Our results are very promising, although we would like to look at a much larger group of patients with visual neglect and with other neuropsychological impairments," Soto said. "Our findings suggest that we should think more carefully about the individual emotional factors in patients with visual neglect and in other neurological patients following a stroke," Soto said.
"Music appears to improve awareness because of its positive emotional effect on the patient, so similar beneficial effects may also be gained by making the patient happy in other ways. This is something we are keen to investigate further," he said.
HealthDay News
New Guidelines for Treating Heart Failure
Posted By Blog Detailer,
CATEGORIES:
Cardiovascular
By Ed Edelson
New guidelines for treatment of heart failure are being issued by the American Heart Association and the American College of Cardiology, with a strong emphasis on management of people hospitalized for the condition and also on the treatment of blacks."The most important change is the addition of a new section on hospitalized patients," said Dr. Mariell Jessup, professor of medicine at the University of Pennsylvania and chairwoman of the guidelines writing group. "It's unusual to have a completely new section, but it is increasingly recognized that hospitalization for heart failure contributes substantially to morbidity and mortality and to health-care costs."
About 5.7 million Americans have heart failure, the progressive loss of ability to pump blood, and 1.1 million people are hospitalized because of it each year. Heart failure management will cost the U.S. health-care system more than $37 billion this year, the guidelines group estimated.
Guidelines are assessed periodically to determine whether results of new trials or studies require changes, Jessup said. "We found that enough has happened for the guidelines to be changed," she said. "The most important studies were on hospitalized patients, so we felt there was a gap we had to fill." The guidelines are being published in the Journal of the American College of Cardiology and in the Heart Association journal Circulation.
The new guidelines "outline what has to happen in the initial evaluation, such as measurement of ejection fraction and whether the patient has coronary disease or not," Jessup said. "They describe what should be done each day to assess the patient and the need to think carefully about which drugs should be given and why."
Drug assessment includes "the role of cardioactive drugs including nitroglycerine," Jessup said. "The guidelines also stress the role of evidence-based medicine and also what should be considered in the discharge of a patient from the hospital."
Special consideration is given to blacks, she said, because "heart failure has a different etiology [cause] and tends to occur younger" in blacks than in others. The guidelines stress the use of two drugs, hydralazine and isosorbide dinitrate, in blacks. Both relieve pressure on the heart by relaxing blood vessels.
"A trial showed that using them in a fixed-dose combination produced a remarkable reduction in mortality in African-Americans, and we really wanted to strengthen the recommendations that they should be used in African-Americans," Jessup said.
The drugs are effective, because heart failure in blacks has been shown to be more related to high blood pressure than it is in whites, she said. "Also, African-Americans with heart failure don't seem to have as much coronary disease," or blockage of the heart arteries, Jessup said.
One revised section of the guidelines contains simplified advice on implantable cardioverter defibrillators, which can prevent sudden cardiac death by delivering a shock to restore normal heart rhythm when the heart suddenly beats irregularly. Various guidelines on the use of these devices have been issued, Jessup said, "and we are trying to simplify what we have said about them," Jessup said.
Also revised is the guideline section on treatment of people who have both heart failure and the arrhythmia called atrial fibrillation. There has been a debate about whether it is better to center treatment on relieving heart failure or on restoring normal heart rhythm, Jessup said. Several studies have shown that neither strategy is superior, and so the guidelines say a decision should be based on individual patient characteristics, she said.
New guidelines for treatment of heart failure are being issued by the American Heart Association and the American College of Cardiology, with a strong emphasis on management of people hospitalized for the condition and also on the treatment of blacks."The most important change is the addition of a new section on hospitalized patients," said Dr. Mariell Jessup, professor of medicine at the University of Pennsylvania and chairwoman of the guidelines writing group. "It's unusual to have a completely new section, but it is increasingly recognized that hospitalization for heart failure contributes substantially to morbidity and mortality and to health-care costs."
About 5.7 million Americans have heart failure, the progressive loss of ability to pump blood, and 1.1 million people are hospitalized because of it each year. Heart failure management will cost the U.S. health-care system more than $37 billion this year, the guidelines group estimated.
Guidelines are assessed periodically to determine whether results of new trials or studies require changes, Jessup said. "We found that enough has happened for the guidelines to be changed," she said. "The most important studies were on hospitalized patients, so we felt there was a gap we had to fill." The guidelines are being published in the Journal of the American College of Cardiology and in the Heart Association journal Circulation.
The new guidelines "outline what has to happen in the initial evaluation, such as measurement of ejection fraction and whether the patient has coronary disease or not," Jessup said. "They describe what should be done each day to assess the patient and the need to think carefully about which drugs should be given and why."
Drug assessment includes "the role of cardioactive drugs including nitroglycerine," Jessup said. "The guidelines also stress the role of evidence-based medicine and also what should be considered in the discharge of a patient from the hospital."
Special consideration is given to blacks, she said, because "heart failure has a different etiology [cause] and tends to occur younger" in blacks than in others. The guidelines stress the use of two drugs, hydralazine and isosorbide dinitrate, in blacks. Both relieve pressure on the heart by relaxing blood vessels.
"A trial showed that using them in a fixed-dose combination produced a remarkable reduction in mortality in African-Americans, and we really wanted to strengthen the recommendations that they should be used in African-Americans," Jessup said.
The drugs are effective, because heart failure in blacks has been shown to be more related to high blood pressure than it is in whites, she said. "Also, African-Americans with heart failure don't seem to have as much coronary disease," or blockage of the heart arteries, Jessup said.
One revised section of the guidelines contains simplified advice on implantable cardioverter defibrillators, which can prevent sudden cardiac death by delivering a shock to restore normal heart rhythm when the heart suddenly beats irregularly. Various guidelines on the use of these devices have been issued, Jessup said, "and we are trying to simplify what we have said about them," Jessup said.
Also revised is the guideline section on treatment of people who have both heart failure and the arrhythmia called atrial fibrillation. There has been a debate about whether it is better to center treatment on relieving heart failure or on restoring normal heart rhythm, Jessup said. Several studies have shown that neither strategy is superior, and so the guidelines say a decision should be based on individual patient characteristics, she said.
What Causes Mystery Heart Condition?
Posted By Blog Detailer,
CATEGORIES:
Cardiovascular
By Ed Edelson
The unusual heart syndrome called stress cardiomyopathy can be triggered by some commonly used heart medications, Johns Hopkins University researchers report.
Nine cases of the condition followed injections of adrenaline or dobutamine, according to a report in the March 25 online issue of the Journal of the American College of Cardiology.
Both dobutamine and adrenaline (which physicians prefer to call epinephrine) are used to increase the heart's ability to pump blood. The report that they can cause stress cardiomyopathy might provide at least a partial solution to the riddle presented by the condition, said study senior author Dr. Ilan S. Wittstein, an assistant professor of medicine at Hopkins.
The unusual heart syndrome called stress cardiomyopathy can be triggered by some commonly used heart medications, Johns Hopkins University researchers report.
Nine cases of the condition followed injections of adrenaline or dobutamine, according to a report in the March 25 online issue of the Journal of the American College of Cardiology.
Both dobutamine and adrenaline (which physicians prefer to call epinephrine) are used to increase the heart's ability to pump blood. The report that they can cause stress cardiomyopathy might provide at least a partial solution to the riddle presented by the condition, said study senior author Dr. Ilan S. Wittstein, an assistant professor of medicine at Hopkins.
Stress cardiomyopathy was first described in Japan in the early 1990s, and has been called Takotsubo cardiomyopathy. It is sometimes called "broken heart syndrome," since it can be precipitated by an intense physical or emotional event.
Its symptoms resemble those of a heart attack, including intense chest pain and shortness of breath, but the underlying physical cause is different -- not the death of heart muscle seen in a heart attack, but instead a temporary weakening of the heart. It generally is not fatal, but aggressive management usually is needed to get patients through a critical early period.
"On an echocardiogram, you can actually see the walls of the heart not squeezing, a ballooning pattern of the heart muscle," Wittstein said.
While epinephrine and dobutamine affect the heart, they can be used to treat non-cardiac conditions. One woman described in the report was given epinephrine for nausea while she underwent liposuction. Another patient was given a too-high dose of epinephrine intended to stop bleeding during a colonoscopy.
"There have been previous reports of stress cardiomyopathy after dobutamine and a few case reports of heart muscle dysfunction after epinephrine," Wittstein sad. "We are the first to report a series of such cases."
While an overdose can trigger the condition, "some of the patients received the right dose of the medicine and developed it anyway, so there may be susceptibility in some people," he said. "The issue is why some people get it and some don't."
There are several messages to physicians in the report, Wittstein said. "One is that this is happening after routine procedures, so it is probably happening more than people are picking up now," he said. "So we need to recognize the clinical features of the syndrome, because it is likely more common than people know.
"Another message is that we need to be careful about the dosage of these medications."
Yet stress cardiomyopathy was seen in some people who got normal doses of the drugs, Wittstein said. "It may even be genetic," he said. "There are people who are vulnerable, and we don't know who they are. It is important to figure out who those people are."
More light is shed by a report in the March 26 issue of the American Journal of Cardiology by physicians at The Miriam Hospital, which is associated with the Warren Alpert Medical School of Brown University in Providence, R.I.
A group led by Dr. Richard Regnante, an interventional cardiology fellow, has created a registry of 70 cases of stress cardiomyopathy, the largest to date. Two-thirds of them had experienced a physical or psychological stressful event, such as an auto accident or bad news about a family member. All eventually recovered, although two had a recurrence of the condition.
"This data will help us better understand the disease process and could play a major role in developing and tailoring more effective short- and long-term treatment strategies," Regnante said in a statement.
10 Ways to Control Your High Blood Pressure
Posted By Blog Detailer,
CATEGORIES:
Cardiovascular,
Medical Educations
1.Know your blood pressure. Have it checked regularly.
2.Know what your weight should be. Keep it at or below that level.
3.Don't use too much salt in cooking or at meals. Avoid salty foods.
4.Eat a diet rich in fruits, vegetables and whole-grain high-fiber foods according to American Heart Association recommendations.
5.Control alcohol intake. Don't have more than one drink a day if you're a woman or two a day if you're a man.
6.Take your medicine exactly as prescribed. Don't run out of pills even for a single day.
7.Keep appointments with the doctor.
8.Follow your doctor's advice about physical activity.
9.Make certain your parents, brothers, sisters and children have their blood pressure checked regularly.
10.Live a normal life in every other way.
Following the recommendations of your healthcare professionals is essential to lowering your high blood pressure. Find facts, tips and tools if you need help with making lifestyle changes or taking your medications properly.
http://www.americanheart.org/
2.Know what your weight should be. Keep it at or below that level.
3.Don't use too much salt in cooking or at meals. Avoid salty foods.
4.Eat a diet rich in fruits, vegetables and whole-grain high-fiber foods according to American Heart Association recommendations.
5.Control alcohol intake. Don't have more than one drink a day if you're a woman or two a day if you're a man.
6.Take your medicine exactly as prescribed. Don't run out of pills even for a single day.
7.Keep appointments with the doctor.
8.Follow your doctor's advice about physical activity.
9.Make certain your parents, brothers, sisters and children have their blood pressure checked regularly.
10.Live a normal life in every other way.
Following the recommendations of your healthcare professionals is essential to lowering your high blood pressure. Find facts, tips and tools if you need help with making lifestyle changes or taking your medications properly.
http://www.americanheart.org/
CATEGORIES
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