Infographic: Systemic Arterial Hypertension

Systemic arterial hypertension is the most important modifiable risk factor for all-cause morbidity and mortality worldwide and is associated with an increased risk of cardiovascular disease (CVD).

Fewer than half of those with hypertension are aware of their condition, and many others are aware but not treated or inadequately treated, although successful treatment of hypertension reduces the global burden of disease and mortality. The aetiology of hypertension involves the complex interplay of environmental and pathophysiological factors that affect multiple systems, as well as genetic predisposition.

The evaluation of patients with hypertension includes accurate standardized blood pressure (BP) measurement, assessment of the patients’ predicted risk of atherosclerotic CVD and evidence of target-organ damage, and detection of secondary causes of hypertension and presence of comorbidities (such as CVD and kidney disease). Lifestyle changes, including dietary modifications and increased physical activity, are effective in lowering BP and preventing hypertension and its CVD sequelae.

Pharmacological therapy is very effective in lowering BP and in preventing CVD outcomes in most patients; first-line antihypertensive medications include angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, dihydropyridine calcium-channel blockers and thiazide diuretics.

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Technology: New Head & Neck Cancer Treatments

Mayo Clinic (May 11, 2023) – In the U.S., HPV is linked to about 70% of throat and mouth cancers. And more than 70% of those cancers are diagnosed in men, according to the Centers for Disease Control and Prevention.

Treatment for throat and mouth cancers, also referred to as oropharyngeal or head and neck cancers, will depend on location and stage of the cancer as well as other factors. Dr. Phillip Pirgousis, a Mayo Clinic head and neck surgeon, says patients have safer, less invasive surgical treatments available to them thanks to ongoing innovation.

Heart Disease: A Surgeon’s View Of Aorta Surgery

Cleveland Clinic (MAY 9, 2023): Have you ever wondered what your surgeon thinks about when they are deciding if you need an operation?

Dr. Lars Svensson and Dr. Marijan Koprivanac discuss all things aorta, such as your past medical history, current health, and how your surgeon looks to the future to provide the best options for you.

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HEALTH: HOW THE PANDEMIC RESHAPED AMERICAN LIFE

Wall Street Journal (May 5, 2023) – The alarms sounded in March 2020, and Americans cloistered at home, sheltering from a pandemic killing at times thousands a day. Many people free to work remotely left their big-city lives for suburbs and rural communities. Americans everywhere have settled into more homebound routines for meals and entertainment. Yet even with the deadly crisis fading, the U.S. has yet to recapture the level of happiness enjoyed before the virus SARS-CoV-2 transformed our world.

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Insomnia: Can Cognitive Behavioral Therapy Help?

May 4, 2023: Difficulty initiating and maintaining sleep is a common problem for many patients. Over-the-counter sleeping aids are used by many and we commonly get asked for prescription medications to help with their sleep.

Unfortunately, the ideal sleeping medication doesn’t exist and many have potentially worrisome adverse effects, some produce daytime somnolence and others may have the potential to produce dependence.

Cognitive behavioral therapy is an alternative treatment option to pharmacologic therapy and is safe, can be easily taught, and offers an alternative to the many with chronic insomnia. In this podcast, we’ll discuss this innovative treatment option with sleep expert, Michael H. Silber, M.B.Ch.B., a neurologist at the Mayo Clinic. 

Bacteria: Helicobacter Pylori Infection Review

Helicobacter pylori infection causes chronic gastritis, which can progress to severe gastroduodenal pathologies, including peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. H. pylori is usually transmitted in childhood and persists for life if untreated. The infection affects around half of the population in the world but prevalence varies according to location and sanitation standards. H. pylori has unique properties to colonize gastric epithelium in an acidic environment.

The pathophysiology of H. pylori infection is dependent on complex bacterial virulence mechanisms and their interaction with the host immune system and environmental factors, resulting in distinct gastritis phenotypes that determine possible progression to different gastroduodenal pathologies. The causative role of H. pylori infection in gastric cancer development presents the opportunity for preventive screen-and-treat strategies. Invasive, endoscopy-based and non-invasive methods, including breath, stool and serological tests, are used in the diagnosis of H. pylori infection.

Their use depends on the specific individual patient history and local availability. H. pylori treatment consists of a strong acid suppressant in various combinations with antibiotics and/or bismuth. The dramatic increase in resistance to key antibiotics used in H. pylori eradication demands antibiotic susceptibility testing, surveillance of resistance and antibiotic stewardship.

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Infographic: Why Women Have High Risks Of Stroke

Stroke in U.S. Women by the Numbers

One in 5 women will have a stroke. About 55,000 more women than men have a stroke each year.

Stroke is the No. 3 cause of death in women. Stroke kills over 90,000 women a year.

Among women, Black Women have the highest prevalence of stroke.

Talk to your health care provider about how to lower your risk and use the American Heart Association/American Stroke Association prevention guidelines:

Stroke risk increases in women who:

  • Are pregnant. Pregnant women are three times more likely to have a stroke as women of the same age.
  • Have preeclampsia. This dangerous condition of high blood pressure during pregnancy doubles stroke risk later in life.
  • Take birth control pills. These can double the risk of stroke, especially in women with high blood pressure.
  • Use hormone replacement therapy. It doesn’t lower it, like once thought.
  • Have migraines with aura and smoke. Strokes are more common in women who have migraines with aura and smoke, compared with other women.
  • Have atrial fibrillation. This quivering or irregular heartbeat can increase stroke risk fivefold. After age 75, it’s more common in women than men.

Stroke risk decreases in women who:

  • Talk to their health care provider to determine safest medication if pregnant with high blood pressure.
  • Discuss with their health care provider low-dose aspirin guidelines starting in the second trimester (week 12) to lower preeclampsia risk.
  • Get their blood pressure checked before taking birth control pills and monitor every six months.
  • Don’t use hormone replacement therapy to prevent stroke if postmenopausal.
  • Quit smoking if they have migraines with aura.
  • Get screened for atrial fibrillation if over age 75.

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Heart Health: How The Aorta Functions (Yale)

Yale Medicine (April 29, 2023) – The aorta is a complex organ responsible for carrying blood to all organs and tissues in the body. Many disease conditions with catastrophic complications are associated with aortic pathologies, including aneurysm disease, aortic dissection, aortic ulcer and hematoma.

Care of patients with aortic diseases remains highly complex and requires the combined expertise of a multidisciplinary team of cardiovascular surgeons, neurologists, cardiac anesthesiologists, vascular surgeons, and specialized advanced practice providers.

Reviews: Young-Onset Colorectal Cancer

In the past decades the incidence of colorectal cancer (CRC) in people under the age of 50 years has increased, which is referred to as early-onset CRC or young-onset CRC (YO-CRC). YO-CRC is expected to account for 11% of colon cancers and 23% of rectal cancers by 2030. This trend is observed in different parts of the world and in both men and women. In 20% of patients with YO-CRC, a hereditary cancer syndrome is found as the underlying cause; however, in the majority of patients no genetic predisposition is present.

Beginning in the 1950s, major changes in lifestyle such as antibiotic use, low physical activity and obesity have affected the gut microbiome and may be an important factor in YO-CRC development. Owing to a lack of screening, patients with YO-CRC are often diagnosed with advanced-stage disease. Long-term treatment-related complications should be taken into account in these younger patients, making the more traditional sequential approaches of drug therapy not always the most appropriate option.

To better understand the underlying mechanism and define relationships between environmental factors and YO-CRC development, long-term prospective studies are needed with lifestyle data collected from childhood.

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