For all HMO Patients :
As of January 1, 2000 you have a legal right to seek a second opinion for your alleged diagnosis, testing and treatment option s requested by a physician (Specialist) of your choice, outside of your HMO system, (per California State Bill AB -12 and the source of his press release) by merely writing such a request to your HMO. And requesting response in writing in return.
In case of their not heeding to the consultant's recommendations for your (new) diagnosis, testing and treatment, then the HMO remains "liable' to you in case of any injury / harm / complications that may arise by failure of your HMO by not following the second opinion of the consultant's recommendations. Community service.
FDA: Suspected Carcinogen found in variety of Foods
The Swiss researchers have found acryl amide, a carcinogen in French fries, baked and fried starchy foods. The chemical has been used to purity drinking water and produce plastics and dyes. FDA has accepted the W.H.O. that the discovery of acryl amide in many foods as major concern and needs to be aggressively researched. FDA also listed most potato chips and French fries to have acryl amide but also in some breads, cocoas, almonds, coffee and crackers!!
Some fast food French fries have significantly higher levels of acryl amide then others!
Acryl amide is produced from cooking starchy foods for longer period of time at high heat.
CARDIOLOGY-FAQS
Patients having had a heart attack-silent or expressed by pain and have a low contractile heart with Ejection Fraction of 30% or less need Defibrillator implanted without a need for EP testing to prevent sudden cardiac death.(Madit-2 study).
Defibrillators are now known to be superior to medical treatment, in prevention of sudden cardiac death syndrome.
Recently, most Defibrillators needed to be checked out by their Cardiologists, for mechanical anomalies declared by the most companies voluntarily.
Congestive Cardiac Failure patients are now selectively helped by Bi-ventricular Pacing.
End-stage Angina patients can now be helped by External Counter Pulsation device.
Most heart attacks and strokes can now be prevented by controlling the risk factors. Send your address for free info. details.Moroever, they can be even reversed. if patients reach a hospital, with invasive intervention facilities, within 3 to 6 hrs for strokes or heart attacks respectively.
RISK-FACTORS
Non-Modifiable:
Family-History or Genetics (May become modifiable by future Genetic treatment of future!)
Aging (May become modifiable by sucessful Anti-Aging Medicine)
Male Sex/Menopausal states in the Females.
Modifiable
MAJOR FACTORS
Hypertension (High Blood Pressor >120/80)
Smoking.
HLP.(High Bld.bad Chlosterol/Low Bld.Good Chlosterol/High Triglycerides)
Adult Diabetes Mellitus-Type 2.
The above are called The Big 4.
High Mental Stress (Mental Meditation-Yoga.The best answer)
5. Apo L.P.B.:A
6. L.P. PLA2/ProBNP
Minor
Personality Type A and D.
Sedantary Life Style.
Gout (High Bld.Uric Acid ).
Recent Emerging Factors/ParaLipids
High Bld.L.P.(a).
High CRP.
High Apo-L.P.(B).
High S.Homocysteine.
High S. Fibrinogen.
High S. Insulin
New Norwegian study states that Folic Acid that lowers high Homocysteine level does not lower the cardiac risk but on the contrary may hurt the heart! Therefore, it is only a cardiac risk marker,just as CRP is. However, it does help the memory.. Recent N. I. H. study report is awaited on this marker.
Peripheral Arterial Disease (PAD) affects approx. 20%of adults >55 yrs. old. It's a powerful predictor of heart attack,stroke anddeath due to cardiovascular mortality/deaths.
The goals of its traetment of PAD are to prevent all of the above plus to ameliorate the legs pain symptoms.
Supervised walking exercises of 30 mts. every day, stop smoking by Bupropion and/or Nicotine patch or gum or inhaler and medications like Pentoxyphylline, Cilastozol,Anti-platelets and Lipid lowering meds like Fibrates, Niacin and Statins help in the management of PAD. ___ JAMA, 2006; 295(5): 547-553.
BNP high levels in conjunction with Pulse-Doppler sign of reversed A:E ratio for diastolic dysfunction aids in the diagnosis of Diastolic Heart Failure, with normal systolic L.V.function by 2D Echo L.V.E.F.---- Euro.Heart Journal. 205; 26(21):2277-2284.
High Homocysteine level is now recognised as a new risk factor for the devolopement of Diabetes Mellitus Type -2 with a pre-history of gestational Diabetes melittus.--- Diabete Care.2005; 28(11):2750-55.
Left atrial volume-index predicts Cardio-vascular events of heart attack, stroke or heart failure, if it's > 32ml/m2.---EURO Heart Journal 2005; 26(23):2556-2561.
High CRP levels improved with combined therapy of Feno- Fibrate and ARB, Candesartan as a marker of improved Endothelial function.----- Diabetic Care.2006;29(2):195-201.
Combination of Hypertension and Diabetes Type 2 drastically increases the risk of Stroke, more so than the either factor alone. Therefore, its management be more aggressive than ever before. Stroke; 36(12):2538-2543.
Cardiac resynchronization bi-ventricular pacing therapy leads to reduced morbidity and mortality in Congestive Heart Failure is now proven to be Cost Effective.-----Euro Heart J. 2005; 26(24): 2681-88.
64 slice CTA is 94% accurate, 95% sensitivity, 94% specificity, 97% positive predictive and 92% negative predictive for >50% Coronary stenosis as compared with Coronary angiography!---Am.J. Cardiolgy.2006;97(2):173-174.
16-slice CTA is now consired superior to MRA scan.
Stastically significant higher mortality of 50% is repoted in Congestive Cardiac Failure N.Y.H.A. clas II and III, Mortality in L.V.systolic dysfonction withL.V.E.F.<40% with systolic B.P.of<100 mms.Hg and diastolic B.P.of < 60 mms.Hg.---Am Heart Journal 2006;151(1): 76-83.
