What do more than 2.6 million Americans have in common with All-Star San Francisco 49ers running back Michael Lewis?

Answer? They all have a cardiac condition known as atrial fibrillation (Afib or AF), the most common form of cardiac arrhythmia, which involves the upper two chambers (atria) of the heart. The Afib name comes from the irregular fibrillating (quivering) of the heart muscles of the atria, as opposed to a normal, coordinated muscle contraction. With A-fib, blood frequently pools in the atria (instead of being fully pumped out), leading those with the condition to have a significantly higher risk of developing blood clots and strokes.

Each year in the United States, Afib accounts for approximately 350,000 hospitalizations, 88,000 deaths, and costs our health care system an estimated $16 billion. Adults over age 40 have a one in four chance of developing Afib in their lifetimes.

Because of the health risks of Afib, September has been designated as National Atrial Fibrillation Awareness Month. Adults who believe they may be at risk for Afib (or know someone at risk) are encouraged to consult with a medical professional for proper diagnosis and treatment (if needed). Afib can often be detected fairly easily, sometimes simply by a pulse reading. Once detected, Afib is often highly treatable.

Warning signs of having Afib may include heart palpitations, dizziness and shortness of breath. To learn more about Afib, please visit www.stopafib.org.

Question for comment: Have you or someone you know ever experienced atrial fibrillation?

Margarine fortified with Omega-3 fatty acids may not reduce heart attack risk in patients who have previously experienced a heart attack, according to researchers in the Netherlands who published their findings in the Aug. 29, 2010, issue of The New England Journal of Medicine.

Omega 3 fatty acids are considered essential for human health but they cannot be made by the body – they can only be obtained through such foods as fish, some plants and nut oils. In recent years, many makers of margarine have added Omega-3 oils to their spreads, citing their potential heart-healthy benefits.

But according to the Netherlands Heart Foundation, Omega 3 oils did not “significantly reduce the rate of major cardiovascular events among patients who had had a myocardial infarction.” A myocardial infarction is most commonly called a heart attack. A link to the published study online can be found here.

The study involved nearly 5,000 men and women, ages 60 to 80, who were being treated for heart disease with medications ranging from antihypertension drugs to cholesterol-reducing statins. Participants consumed about four teaspoons of Omega-3 enriched margarine each day over a three-year period. Those who ate the Omega-3 enriched oils did not experience any fewer heart events than those in a placebo group who ate plain margarine.

The study’s researchers pointed out that the participants were already well-treated for their heart conditions, which may have reduced the potential positive benefit of consuming Omega-3 oils.

Question for comment: How will this study potentially affect your future margarine and/or butter purchases? Or do you have another comment?

Abbott Lab’s popular diet drug Meridia (sibutramine) may soon be off the U.S. market after a clinical study of nearly 10,000 patients showed that use of the drug increased the risk of heart attack or stroke in patients with underlying heart disease, and did little to contribute to weight loss.

As reported in the Sept. 2, 2010, issue of The New England Journal of Medicine, the study involved about 10,700 overweight or obese people 55 or older who had heart disease, diabetes or both and were treated for about 3½ years. Overall, 11.4 percent of those on the diet pill had a heart attack, stroke or died of a heart-related cause, compared with 10 percent of those taking a placebo. Ironically, the study was financed by Meridia’s maker, Abbott Laboratories. To see the study article, click here.

In a strongly worded editorial, the Journal’s editors wrote that Meridia should be removed from the market, calling it “another flawed diet pill.” They continued: “It is difficult to discern a credible rationale for keeping this medication on the market.”

Meridia has already been banned in Europe. Later in September, the U.S. Food and Drug Administration will meet to determine whether it should take action on Meridia sales in the United States.

Meridia was approved in the U.S. market in 1997 – the same year the popular diet drug combo fen-phen was pulled from the market after being linked to heart valve problems. According to Abbott, Meridia’s global sales in 2009 were about $300 million.

Question for comment: Have you or someone you know ever taken a prescription diet drug such as Meridia? Or do you have another comment?

High-risk patients with weakened hearts don’t benefit significantly when a device that keeps blood pumping through the body is used during angioplasty procedures to re-open narrowed coronary arteries. That was the main finding of a study that was published August 25 in the Journal of the American Heart Association.

The device in question is an intra-aortic balloon pump (IABP), which is placed inside the aorta, the main artery supplying blood to the body. It can be used throughout the artery-clearing procedure or as a rescue device if blood pressure falls too low.

Among 301 patients treated in 17 cardiac centers in the United Kingdom between December 2005 and January 2009, no significant differences were found in death rates, heart attacks, strokes or the need for more angioplasty procedures.

The study was conducted by researchers led by Simon Redwood, MD, of St. Thomas’ Hospital in London. They concluded that results “do not support a strategy of routine IABP placement” before angioplasty in high-risk patients.

Intra-aortic balloon pumps also can be used for cardiac support immediately after open heart surgery and in critically ill patients.

Question for comment: Have you or someone you know ever relied on an IABP device during surgery?

A drug-eluting stent (DES), a mesh tube that can help prop open arteries after they are widened by balloon angioplasty, is more helpful than a bare-metal stent in preventing death and heart attacks for up to five years, according to a new study. Drug-eluting stents release medication that helps prevent arteries from re-closing.

A survival analysis of more than 6,500 patients treated between April 1, 2004 and the end of 2008 revealed that cumulative death rate for the patients who received DES was 12.85 percent, or “significantly lower” than 14.14 percent in the bare-metal stent group. A sub-analysis of those who died showed that cardiac death was the cause for nearly half of the bare-metal stent patients versus just over one-third of the DES patients.

In addition, just 5.17 percent of the DES patients had heart attacks, or myocardial infarction (MI), compared to 5.83 percent of those with bare-metal stents.

The study was conducted by researchers led by Tamir Bental, MD, of Rabin Medical Center in Israel. The article appears in the September issue of Catheterization and Cardiovascular Interventions.

Question for comment: Have you or someone you know had a drug-eluting stent for five years or more?

Remember the old kid’s song, “Dem Bones,” with verses like “foot bone connected to the leg bone”? It turns out that if the song was ever updated, it might need to mention the leg bone’s connection to heart health.

According to a study in the October 2010 issue of Anesthesiology, researchers have discovered that improving care among postoperative orthopedic patients yielded dramatic improvements in long-term heart health.

French researchers studied 378 orthopedic surgery patients to assess their post-surgical levels of troponin, a naturally occurring complex of three proteins necessary for muscle contraction in skeletal and heart muscle. Among these patients, they found above-average levels of troponin due to physiological stress associated with surgery.

Elevated troponin levels, as revealed through a troponin test, are associated with a variety of heart disorders, including angina, myocardial infarction (heart attack), tachycardia (rapid heart beat) and congestive heart failure.

The researchers then enhanced post-surgical standards of patient care to reduce events thought to lead to elevated troponin levels. These methods included tighter control of oxygen and glucose levels in the blood, and better continuity and consistency of care among hospital staff.

Improving postoperative care led to a two-fold decrease of postoperative myocardial ischemia (which can significantly damage heart muscle) among the patients, and a four-fold decrease in major cardiac events later on.

Researchers believe this study may prompt improved care standards for patients undergoing non-cardiac surgery.

Question for comment: Do you know of someone who experienced a heart disorder following orthopedic surgery?

This week’s ruling by a U.S. judge to temporarily block federal funding of stem cell research potentially impairs several cardiac-related research projects. What’s unclear is how – or when – funding will again be made available to put these projects back on track.

On Aug. 23, Royce C. Lambert, chief judge of the U.S. Circuit Court in Washington, D.C., ruled that regulations designed to expand federal funding for embryonic stem cell research violated a law prohibiting destruction of embryos for research purposes. The ruling “stunned” many National Institutes of Health (NIH) researchers, and prompted the NIH to immediately freeze funding for more than 150 research projects up for renewal. Funding for more than 130 projects already awarded by the NIH in 2010, such as for a new study of cardiac stem cells at the University of Miami, is not immediately affected.

The U.S. Justice Department, at the behest of the Obama Administration, announced that it would immediately appeal the ruling.

Scientists have discovered that stem cells, so-called because they are the foundation for all human cells, can be coaxed into becoming new cardiac, brain and pancreas cells to replace damaged or infected cells. The potential for cardiac stem cell technology is particularly important for patients who’ve experienced a heart attack or have congestive heart failure, since these conditions typically permanently destroy healthy heart cells.

Question for comment: What do you believe will be the eventual outcome of the federal judge’s ruling regarding stem cell research?

Cardiac patients who fail to take their medication as prescribed potentially jeopardize their health and longevity, according to Grayson H. Wheatley III, M.D.

Wheatley, a cardiovascular surgeon in Phoenix, was reacting to a new study by Consumer Reports that found more than a quarter of patients failed to take a drug as prescribed, such as by not getting a prescription filled, taking an expired medication, skipping a dose or sharing a prescription with someone else.

“Cardiac patients, because of their often-fragile condition, are particularly at-risk from drug non-compliance,” Wheatley said. “With many heart disease patients, the margin for error is very thin if you fail to take your meds correctly. For instance, a patient with a mechanical valve who skips his blood thinner faces a significantly higher risk of developing a killer clot.”

The consequences of failing to properly take prescribed drugs are so severe that some health care providers have developed protocols to aid patient compliance. For example, the Pediatric Heart Transplant Program at Morgan Stanley Children’s Hospital has developed a two-way text messaging program with teenage heart transplant patients and their families to ensure patients take their medications on-time and as prescribed.

The program’s director cited a significant issue with drug non-compliance among adolescent heart transplant patients, and noted a survival rate for noncompliant patients as low as 30 percent, versus a 90 percent survival rate for compliant heart patients.

Question for comment: How might cardiac patients improve their prescription medication compliance?

Degenerative mitral valve disease without symptoms calls for a valve repair procedure, but too often the valve is replaced instead.  Those are the findings of a study conducted by David H. Adams, MD, and colleagues at Mount Sinai School of Medicine and published in the August 16 edition of The European Heart Journal. 

The study focused on patients with mitral valve regurgitation, in which the valve does not close tightly enough and blood flows backward in the heart. This is the most common form of heart valve disease. 

Surgical intervention often is needed when symptoms of mitral valve regurgitation appear. These include a decline in function or enlargement of the heart’s left ventricle, or the development of atrial fibrillation, characterized by a rapid, irregular heartbeat, or severe hypertension in the pulmonary arteries that can increase the workload on the right side of the heart. Patients with mitral valve regurgitation may experience fatigue and shortness of breath.

Compared with valve replacement, mitral valve repair is associated with better long-term survival rates and preservation of heart function and fewer complications such as infection and stroke. Valve repair also does not require long-term use of blood thinners.    

Cardiologists should become more familiar with treatment guidelines in order to make more appropriate surgical referrals, the Mount Sinai researchers concluded.  

Smartphone use among physicians has exploded in popularity, and many hospitals and other health care facilities are struggling to keep up, according to an article appearing in the Aug. 23 issue of American Medical News.

Depending on which 2010 survey is cited, 72% to 94% of physicians use smartphones personally and professionally, far exceeding the less than 20% of the general adult U.S. population that uses the devices. However, as MDs have increasingly integrated smartphones into their practices, they are also requesting access to electronic clinical information systems via their mobile devices. As the article notes, only some health care facilities are equipped to support physician use of mobile devices.

"Five to 10 years ago [hospitals] were saying, ‘If only my docs would be using computers,’” said C. Peter Waegemann, vice president for development of the mHealth Initiative, a Boston-based organization that promotes mobile technology in health care. Now hospital executives bemoan the fact that doctors are “using these smartphones all the time ... and I don't know how to integrate it,” he said.

The article notes that physicians have rapidly adopted smartphones because they fit in with their workflow and lifestyle needs. Very few physicians are tethered to a single desktop computer all day.

Even with the high rate of physicians’ use of mobile devices, however, the article notes that many doctors feel overwhelmed by the volume of communication they receive. The article does not cite how smartphone use is potentially benefitting the quality of health care delivered.

Question for comment: How do you believe physicians’ use of mobile devices can benefit the quality of patient care?

How many apparently healthy American men and women are not receiving potentially life-saving treatment because of hidden cardiac risks?

The controversial, 2006 guidelines published in the American Journal of Cardiology for screening a wide population of men and women for heart disease using noninvasive imaging are undergoing revisions. Because of advances in preventative cardiology, the Society for Heart Attack Prevention and Eradication (SHAPE) Task Force is evaluating the guidelines that not only established standards for atherosclerosis tests to detect subclinical disease in the coronary and carotid arteries, but also recommended screening for apparently healthy individuals as they age.

To revise the guidelines, the task force will consider including newer screening tools, proteomics and genomics, and imaging modes. Biomarkers, which are biological molecules used to diagnose disease or see how well the body responds to a treatment, have been the focus of much of the committee’s attention because the results they provide are highly individualized.

The new guidelines are also expected to address what portion of the population should be tested, which tests should be used based on the severity of the individual patient’s heart attack risk, and medications to manage the symptoms of patients based on their heart attack risk severity.

Question for comment: Are the costs of screening, both financial and emotional, worth the benefit of screening a wider population for heart disease?

Did Brian Vickers’ occupation – NASCAR Sprint Cup car driver – increase his risk for the blood clots that ultimately ended his 2010 racing season?

Vickers, 26, and driver of the #83 Red Bull Toyota Camry, revealed he had surgery on July 12 to repair a small hole, caused by a genetic abnormality, in the upper chambers of his heart, and to place a stent in a vein in his left leg. In mid-May, Vickers’ NASCAR racing season ended after blood clots were discovered in his lungs and legs.

Upon examination, Vickers was diagnosed with two issues: the hole in his heart, known as a patent foramen ovale, and May-Thurner Syndrome, which is when the left iliac vein is compressed by the right iliac artery, leading to an increased risk for deep vein thrombosis (blood clot in the leg). Based on these two issues and Vickers’ job, which keeps him sitting for long periods of time (a risk factor for blood clots), Vickers had a extremely high likelihood for developing blood clots.

Vickers, who at age 20 became the youngest-ever champion in any of NASCAR’s three top-tier series, says he is on schedule to resume racing next season.

Individuals like Vickers whose jobs require them to sit for a long time should purposely strive to get up and move around as frequently as possible, according to Grayson H. Wheatley III, a cardiovascular surgeon in Phoenix. “Individuals who sit for long periods of time are known to have a greater risk for developing deep vein thrombosis,” Wheatley said. “Motor vehicle operators, like long-haul truck drivers and bus drivers, are particularly at risk, but so are those with office jobs who sit at a computer for hours at a time.”

To help prevent deep vein thrombosis, Wheatley advises that people get up and walk around at least once every two hours – and more often if circumstances permit. Nearly 2 million American experience deep vein thrombosis annually.

Question for comment: Have you or someone you know been diagnosed with deep vein thrombosis?

“When angry, count to 10 before you speak. If very angry, a hundred,” advised Thomas Jefferson.

It’s no wonder our third U.S. president and author of the Declaration of Independence lived to the ripe old age of 83: Jefferson knew how to keep his cool.

By contrast, chronically cranky people are more likely to have vascular problems that could lead to strokes or heart attacks, according to new research just published in Hypertension: Journal of the American Heart Association.

In a study of more than 5,000 Italians, those who ranked in the lowest 10 percent of agreeableness were 40 percent more likely to have thickening in the lining of their carotid artery. Thickening of the carotid artery is a strong indicator of heightened risk for heart attack and stroke.

“People who tend to be competitive and more willing to fight for their own self-interest have thicker arterial walls, which is a risk factor for cardiovascular disease,” said Angelina Sutin, Ph.D., lead author of the study and a postdoctoral fellow with the National Institute on Aging, NIH, in Baltimore, Md. “Agreeable people tend to be trusting, straightforward and show concern for others, while people who score high on antagonism tend to be distrustful, skeptical and at the extreme cynical, manipulative, self-centered, arrogant and quick to express anger.”

The effect of personality on arterial wall thickness appeared to be greater in women than in men, researchers found.

When considering a patient’s risk factors for heart disease, physicians may also want to investigate tendencies toward antagonism, Sutin said. The study could also help target patients who might benefit the most from anger management therapy.

Question for comment: Do you know someone with an aggressive personality who has experienced heart issues?

How often do patients with congestive heart failure (CHF) and coronary artery disease (CAD) tell the whole truth to their doctors about their health history or habits? Patients sometimes find recording their daily habits cumbersome, or they may be reluctant to admit to doctors face-to-face that they didn't follow their treatment regimen.

Web sites or hand-held devices may be the answer to bridge the information gap, to encourage patients to share the requested data more easily, quickly, and honestly with their caregivers. This, in turn, provides doctors with information that is critical for managing patient care.

Patients and physicians can explore web-based programs available online. One program, theCarrot.com, has trackers for food intake, medications, weight, blood pressure, symptoms, exercise and many others that may be useful to physicians and offers the convenience of using an using an iPhone to enter information. Another site, Keas.com, includes management plans specifically for CHF and CAD. From both sites, patients can create easy-to-read graphics and charts to bring or email to their doctors.

Question for comment: How can the web and mobile devices improve cardiac patient care?

If you are an African American, on Medicaid or don’t have health insurance, you are less likely than other patients to get a drug-eluting stent (DES). Stents – which come in bare-metal and DES varieties – are mesh tubes that help prop open arteries after they are widened by balloon angioplasty. Drug-eluting stents release medication that helps control growth of scar tissue that can re-close the artery.

A study published in the July issue of JACC: Cardiovascular Interventions revealed the DES socioeconomic disparities.

In the study, researchers led by Michael A. Gaglia, Jr., MD, of the Washington, D.C.-based Washington Hospital Center, looked at more than 12,500 patients who received stents at that center from April 2003 to June 2009. Overall, three-quarters of the patients got one or more DES devices. Breaking it down by insurance coverage, 78.5 percent of patients with private insurance and 72.3 percent with Medicare were DES recipients, compared to just 60.2 percent of patients with Medicaid coverage and 60.5 percent who had no insurance. Among white patients, 76.6 percent got DES compared to just 69.8 percent of African Americans.

DES patients are required to follow what is known as dual antiplatelet therapy, taking both aspirin and dopidogrel (Plavix) for a year after receiving a stent.

Costs associated with that clot-preventing therapy may influence the decision to use DES, the researchers concluded. But they added that this factor alone doesn’t adequately explain the disparities, especially since the study spanned six years and the dual antiplatelet regimen wasn’t standard protocol during the first years of the study.

Question for comment: Do you or someone you know have a drug-eluting stent?

Anyone who has stayed overnight at a hospital knows hospitals can often be a loud and lousy place to get a decent night of shuteye.

Now, a growing body of clinical evidence indicates excessive hospital noise harms the health and wellness of patients convalescing in hospitals. The issue is particularly acute for cardiac patients, who frequently stay in the hospital longer than other types of patients and are hooked up to cardiac monitors that are required to alarm at twice the volume of background noise.

Overall, hospital noise levels are three to four times higher than they were a half-century ago, according to an Aug. 16 article, “Hushing Noisy Hospitals,” by Inside Science News Service (ISNS). A comprehensive study of noise levels at Johns Hopkins Hospital showed it averaged 72 decibels during the day, which is the volume of an alarm clock, and about 60 decibels at night, or about as loud as a dishwasher.

Not only do such noise levels impede opportunities for patient rest, they also potentially increase medical errors. The ISNS story noted an internal Kaiser Permanente study which indicated that nurses operating in a noisy, chaotic environment were more likely to make mistakes.

In January 2010, the Facility Guidelines Institute (FCI) published revised standards for new hospital and clinic construction which specify that patient rooms must be kept below 45 decibels, and hallways below 50 decibels. The FCI guidelines will be used to shape building code regulations in 46 states over the next year. The noise level guidelines do not, however, apply to current hospitals and clinics.

Question for comment: Do you know of a patient whose recovery was impaired due to excessive hospital noise?

Are some physicians potentially jeopardizing the health of patients with congestive heart failure (CHF) by insufficiently prescribing heart failure drug therapies?

A recent study published in the Aug. 9 issue of the Archives of Internal Medicine indicates that prescriptions for angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) have declined since the early 2000s, and that only one-third of patients at risk of heart failure are benefitting from these medications. The American Heart Association and American College of Cardiology guidelines support using ACE inhibitors and ARBs for managing congestive heart failure.

Stanford University researchers analyzed physician survey responses to evaluate the trends of drug prescriptions between 1994 and 2009 for managing congestive heart failure. Prescriptions for ACE-inhibitor and ARB medications increased between 1994 to 2002, from 34% to 45% of CHF patients. However, by 2009, the number of prescriptions decreased to 37% of all CHF patients. Additionally, the use of another cardiac drug therapy, beta-blockers, dramatically increased between 1998 and 2006, from 11% to 44% of all CHF patients, but then decreased to 37% of patients by 2009.

The study did not examine the mortality risk to patients not receiving post-CHF drug therapy.

Question for comment: What can be done to increase guideline compliance for post-CHF patients?

One in seven patients undergoing uncomplicated percutaneous coronary intervention (PCI) can go home just eight hours after the procedure and do well, according to a new study published in the August issue of JACC: Cardiovascular Interventions.

What are the pros and cons of same-day discharge for PCI, traditionally known as angioplasty? Shorter stays typically are preferred by patients and they can reduce health care costs. However, same-day discharge may not be favored by physicians concerned about risks such as post-operative bleeding, or hospitals that rely on income from inpatient stays.

Patients in the study had balloon-tipped catheters threaded through the femoral artery in the thigh to the coronary artery. Once in place, the balloons were inflated to compress artery-narrowing plaque deposits against the artery walls. Often, stents were placed to help keep the artery open.

The study was led by Samin K. Sharma, MD, Mount Sinai Hospital in New York City. Researchers reviewed the results of same-day discharges of 2,400 Mount Sinai patients whom Sharma described as having “diverse demographics, comorbidities and risk factors with complex coronary lesions that match the real-world setting of a tertiary referral center.”

However, the 2,400 patients also were all under age 65, did not have uncontrolled diabetes or major complications, and fit other selection protocol criteria. Same-day discharges represented 14.5 percent of 16,585 elective PCI patients over a five-year period.

Same-day discharge for PCI is more common outside the United States, where more PCI procedures are performed using the radial artery in the arm. The arm artery is smaller, so there is less risk of bleeding after the procedure.

Question for comment: Have you or someone you know undergone a PCI procedure? How long after the procedure was the discharge?

If you are a woman, your odds of having a potentially life-saving surgery are lower than if you are a man, according to a new study.The study, “Gender differences in treatment of severe carotid stenosis after transient ischemic attack,” was published July 22, 2010, in Stroke.

Some people with severely narrowed carotid arteries can have what’s commonly called a “temporary stroke,” with symptoms lasting less than 24 hours. These stroke-like events are known as transient ischemic attacks (TIAs).

To help prevent future strokes, patients in this category can have a procedure called a carotid endarterectomy. In this surgery, the main neck artery supplying blood to the brain is opened and fatty plaque deposits are removed.

However, slightly more than one-third of women in the 5,120-patient study had the procedure, compared with more than half of the men. In addition, there are longer delays for women who undergo carotid endarterectomy surgery – an average of 35 days for the women in the study versus 18 days for the men. Researchers led by Sharon N. Poisson, MD, of the University of California, San Francisco, concluded that the reasons for the disparity are unclear and that more research is needed.

For study participants who did not have a carotid endarterectomy, the documented reasons did not differ by gender. When people did have the procedure, men and women did equally well 90 days after surgery.

Two large clinical trials supported by the National Institute of Neurological Disorders and Stroke (NINDS) have shown that carotid endarterectomy can reduce the two-year risk of stroke or death for patients with severe stenosis (narrowing) who have already had a stroke or stroke symptoms.  

Question for comment: Have you or someone you know undergone carotid endarterectomy surgery?

An essay on the after-effects of open-heart surgery, which appeared in the August 7 issue of The New York Times, sparked considerable interest the following week among the paper’s readers, as reflected by the volume of letters to the editor on the subject.

Essay author Rick Hamlin states his frustration about the length of time it has taken him to recover from surgery to replace his aortic root and implant a replacement valve. More specifically, he is displeased that his physicians were not more candid about his potential recovery time and complications. The surgery, he admitted “at age 52 probably saved my life, but recovering from it was far more difficult than anyone had led me to believe. Everyone — especially those who should have known better — made it seem like a walk in the park."

Hamlin voices an important point, according to Grayson H. Wheatley III, M.D., a cardiothoracic surgeon in Phoenix. “Physicians need to be candid and realistic with their patients – about treatments, options, pre-surgery and post-recovery expectations and even potential caretaker involvement,” Wheatley said. “At the same time, physicians should also strive to balance their clinical realism with appropriate messages of encouragement.”

Yet responsibility for effective healthcare communications does not rest solely with physicians. “Patients have a shared responsibility, with their physicians, to be as informed as possible about their care, by asking questions, researching information, and even soliciting additional medical opinions, if needed,” Wheatley said. “Quality health care decisions and outcomes come through patient/physician dialogue and understanding.”

In his essay, Hamlin does not share any proactive efforts he undertook before surgery to understand his treatment and recovery. He admits “some of this was hard to talk about because I felt surrounded by a conspiracy of positivity.”

But according to Wheatley, patients nowadays need to break through the medical profession’s historical, patriarchal model of “top-down” information-sharing. “It’s your health, and your life,” he said. “Quality health care depends on asking the right questions – and getting high-quality answers.”

Question for comment: How do you suggest enhancing patient/physician communications and collaboration?

Young adults with coronary heart disease risk are being insufficiently screened for heart disease, according to a study published in the July/August 2010 issue of Annals of Family Medicine.

The study’s authors, from the Centers for Disease Control and Prevention in Atlanta, reviewed more than 2,500 surveys from young adults participating in the 1999-2006 National Health and Nutrition Examination Surveys. The study group included men ages 20-35, and women ages 20-45.

According to the study, about 59 percent of the young adults had coronary heart disease or at least one or more cardiac risk factors, yet the overall screening rate for this higher-risk group was less than 50 percent. The study’s authors found no difference in the screening rates between young adults with no coronary risk factors versus those who had one or more risk factors.

One of the study’s authors called these findings “worrisome,” given the potential heart health risk factors involved, as reflected in the survey data. However, medicine and/or lifestyle and diet changes can potentially significantly decrease the likelihood of acute coronary issues.

Question for comment: Why do you believe that many at-risk young adults are being insufficiently screened for heart disease? 

Are some patients – particularly younger ones – truly at risk from cardiac imaging radiation exposure, as some recent news reports have indicated?

According to a study reported in the July 2010 issue of the Journal of the American College of Cardiology, cardiac imaging procedures are exposing patients to potentially harmful cumulative doses of radiation. The study reported on cardiac imaging data from nearly 1 million adults in five parts of the United States from 2005 to 2007.

However, the same journal issue also contained an editorial noting that it has not been established that the radiation exposure from low-dose cardiac imaging techniques causes cancer. "The relationship between low-dose medical imaging and harm has never been established," the editorial noted.

Further, the study’s authors also noted that cardiac imaging – especially myocardial perfusion imaging and cardiac computed tomography – may carry immediate cardiac heath benefits that may offset any potential long-term effects from radiation exposure.

The U.S. Food and Drug Administration is studying the potential effect of radiation exposure from medical imaging procedures. In March 2010, the FDA hosted public hearings on the matter.

Question for comment: Do you believe that patients are harmed by the radiation exposure they receive from cardiac imaging? 

New research potentially debunks a theory that the neurological disease multiple sclerosis is caused or worsened by jugular vein blockage. An Aug. 2, 2010, Wall Street Journal article, “Studies Cast Doubt on New MS Theory,” reports that separate studies in Sweden and Germany report no impairment of jugular vein blood flow among MS patients studied. The studies appeared in the August 2010 issue of The Annals of Neurology.

The jugular veins carry deoxygenated blood from the head (principally the brain) back to the heart. In 2009, an Italian physician postulated a theory that many types of MS are caused by jugular vein blockages, preventing excess iron from being removed from the brain. By using a stent or balloon catheter to prop open impaired jugular veins, he believed a root cause of MS could be eliminated.

The Italian physician’s research was intriguing enough that a Stanford University vascular specialist initiated a program to insert jugular stents in 40 MS patients. However, in December 2009, the Stanford program was shut down due to patient complications: one patient died of a brain hemorrhage following the procedure, while another required life-saving emergency surgery.

Further research on the potential MS-jugular vein link is being investigated. The State University of New York at Buffalo is examining 1,000 MS patients, and the National Multiple Sclerosis Society and its sister association in Canada have invested $2.4 million in studies to investigate the vein blockage theory.

Question for comment: Is there credibility to the Italian physician’s theory of a jugular vein blockage link to MS?

Statins appear to reduce the risk of postoperative atrial fibrillation and expedite recovery following cardiac surgery, according to a new study released in the August 2010 issue of The Journal of Thoracic and Cardiovascular Surgery.

Researchers from the University of Connecticut and Hartford Hospital (Hartford, Conn.) conducted eight randomized, controlled trials of 774 patients following cardiac surgery. Some patients received statin therapy; other patients received a placebo.

The study authors found that statins reduced the risk of atrial fibrillation (AF), the most common form of cardiac arrhythmia (abnormal heart rhythm), affecting some 2.2 million Americans, according to the American Heart Association. The upper two heart chambers (atria) of patients with AF do not contract normally, potentially leading to blood pooling and forming clots in the atria. As a result patients with AF have a significantly increased risk of stroke – up to five to seven times higher than the general population.

Patients taking statins also reduced their total post-operative hospital stay, including intensive care unit stay, according to the study.

Multiple prior patient studies have shown a similar beneficial effect of statins in patients with AF. Statins are a class of drugs used to reduce blood cholesterol levels.

Question for comment: Have you taken or prescribed statins following cardiac surgergy, and what was the benefit, if any? 

Bad news for Santa Claus and his hefty-sized “helpers.”

A new study reveals that men and women with the biggest bellies have twice the risk of dying, compared with those with the smallest waistlines. As reported in the August 9 issue of Archives of Internal Medicine, big waistlines carry a significantly higher risk of death even for those whose weight is considered “normal,” as measured by their body mass index (BMI).

Researchers studied mortality rates among more than 48,000 men and 56,000 women, ages 50 and older. After adjusting for BMI and other risk factors, researchers found a higher death risk due to waist circumference in all three BMI categories: normal, overweight and obese.

Large-bellied individuals had a higher death risk from such causes as heart disease, diabetes, cancer and respiratory ailments. The study did not investigate why those with excess belly fat had greater health issues.

Excessive belly fat is a problem for the majority of Americans over age 50. It is estimated that at least 50 percent of all older men and 70 percent of all older women have excessively large waistlines.

Question for comment: How might older adults with excessive belly fat be effectively encouraged to reduce their waistlines?

Unfortunately, once heart muscle cells die during a heart attack, the damage is irreversible. As a result, most heart attack victims – if they live long enough – will likely eventually pass away due to congestive heart failure, the nation’s leading cause of death.

While medical science does not yet offer a practical way to re-grow or replace damaged cardiac cells, it may someday soon.

Engineers and physicians at the University of Washington have perfected a new, synthetic scaffold (shown above) able to grow functional cardiac cells in a Petri dish and promote blood vessel growth in the hearts of live rats. The news of this breakthrough comes in an August 9 article in the Proceedings of the National Academy of Sciences.

Made from a flexible, biocompatible material, the synthetic scaffold has tiny pores that enable fragile cardiac cells to gain access to blood and other nutrients to grow and thrive. Researchers believe artificially grown cardiac cells will be especially beneficial to heart attack victims.

“Today, if you have a heart attack, there’s nothing that doctors can do to repair the damage,” said the study’s lead author, Buddy Ratner. “You are, in essence, sentenced to a downhill slide, developing congestive heart failure that greatly shortens your lifespan.”

Instead, Ratner and his colleagues believe they can take artificially grown cardiac cells – created from stem cells provided by either the patient or a donor – and implant them when a patient is treated for a heart attack. Patients would then be able to potentially regenerate heart muscle cells, as opposed to having a damaged heart containing useless scar tissue.

Question for comment: How long do you believe it will be before artificially grown cardiac cells are implanted in patients?

Chicago Cubs pitcher Carlos Silva is expected to make a full recovery after undergoing a two-hour outpatient procedure to correct his excessively rapid heart rate.

After being forced out of a ball game on August 1, Silva, age 31, was diagnosed with paroxysmal supraventricular tachycardia (PSVT), an irregularly fast heartbeat (150-250 beats per minute) that disconcertingly begins and ends suddenly. More alarming than physically dangerous and most common among young adults, PSVT is caused by an issue with the natural electrophysiology of the heart.

On August 9, Silva received a nonsurgical therapy called radiofrequency ablation (RFA), a procedure in which a physician guides a catheter tipped with a small electrode. Guided by x-rays, the physician directs the catheter to the exact spot of the heart muscle emitting abnormal electrical signals (causing the rapid heart beat), and directs a mild, painless radiofrequency signal to carefully destroy the problematic muscle cells.

RFA has a success rate of more than 90 percent, and a low risk of complications. Most RFA patients, including Silva, can resume normal activity within a few days of the procedure.

Question for comment: Have you or someone you know ever experienced PSVT?

Given his long and arduous history of heart disease, Dick Cheney is lucky to still be alive.

More specifically, according to the former vice president’s cardiologist, Cheney is fortunate his lifetime of heart issues have coincided with the advent of several breakthrough heart health treatments.

So said Dr. Jonathan Reiner in an Aug. 7 Fox Television interview with Liz Cheney (Dick Cheney’s daughter). The duo discussed the latest advances in the treatment of heart disease.

Reiner noted that prior to Dick Cheney’s first heart attack in 1978, treatment for heart attacks really hadn’t changed much since President Eisenhower suffered his first heart attack, in 1955. “I liken [that era of treatment methodology] to sort of watching a car wreck – you stand by helplessly and wait for the smoke to clear and see what’s left,” he said.

Since 1978, however, Reiner noted the introduction of several new methods (and mindsets) for treating heart issues. For example, clot-busting drugs and mechanical therapies, such as balloon angioplasty therapy and stent procedures, have become far more prevalent – to the point they’re commonplace today. As a result, according to Reiner, heart attacks today are seen less as a fate and more “a dynamic process that can be interrupted.”

Reiner discussed and demonstrated the ventricular assist device (VAD) recently implanted in the former vice president, and how it restores blood flow to a normal pumping volume of up to 6 liters per minute. Patients equipped with a VAD are able to resume most normal everyday activities, such as work and recreation, he noted.

Reiner also discussed the need for universal federal standards on the public placement of automated external defibrillators (AEDs) – potentially lifesaving portable devices that automatically diagnose and defibrillate abnormal heart rhythm (arrhythmia). Due to widespread inconsistencies in state standards on AED placement, Reiner said an individual’s ability to benefit from an AED is largely due to luck – being near to an AED when it’s needed, and close to someone who will actually employ it.

For several decades, open-heart surgery has been the gold-standard technique for aortic valve replacement (AVR). Now, a new technique approved in Europe and under investigation in the United States – percutaneous heart valve (PHV) replacement – may prove at least equal to the results of open-heart AVR, according to a review published Aug. 2, 2010, in The Annals of Internal Medicine.   

According to a review of 76 distinct studies over the past 20 years involving 2,375 patients with severe aortic stenosis, the PHV procedure was successful in 94 percent of patients, with a 30-day survival rate of 89 percent. The journal review, conducted by researchers at Duke University Medical Center in Durham, N.C., did not specifically compare the efficacy of PHV with AVR. A comparative study of the two procedures is expected to be released in September 2010.

With the PHV procedure, a catheter containing a compressed synthetic valve is threaded to the heart, typically through a small incision in the groin. The replacement valve is then properly placed and the installation catheter is removed. The procedure, which eliminates the need for invasive open-heart surgery, is similar to catheter-guided stent placements or balloon angioplasty procedures.

There are more than 50,000 open-heart AVR procedures performed annually in the United States, particularly to treat aortic stenosis, a potentially life-threatening condition which results from narrowing of the aortic valve opening. However, AVR has a high mortality and morbidity rate, especially in elderly and frail patients, making it unsuitable for thousands of patients with aortic stenosis.     

There are two PHV aortic valve devices currently in clinical trials in the United States: the Medtronic CoreValve and the Edwards SAPIEN.

First Lady Michelle Obama’s opinion piece August 2 in The Washington Post expressed her support for the federal Child Nutrition Bill, currently under consideration by Congress. The bill would increase fruits, vegetables and whole grains and decrease fat and salt in school lunch and breakfast programs. It also would prohibit junk food in school vending machines. Obama argues that the legislation, in tandem with efforts like the new “Let’s Move!” family-focused health and fitness program, is needed to fight the national epidemic of childhood obesity.

One in three U.S. children is overweight or obese. One of the most serious and least visible consequences is that these young people are more likely to have key risk factors for cardiovascular disease than their normal-weight peers. Risk factors include high cholesterol and triglyceride levels.

A new 20-year study in the Annals of Internal Medicine shows that as obese and overweight children with high lipid (fat) levels in their blood move into adulthood, calcium begins to accumulate in their coronary arteries. Calcium buildup in the arteries is a strong predictor of heart disease. Children and young adults can’t afford to shun healthy diets and good exercise habits if they want healthy hearts later in life.

New research indicates that a low-carbohydrate diet is superior to a low-fat diet for improving levels of so-called “good” cholesterol.

A study released on Aug. 2, 2010, in the Annals of Internal Medicine found that while people on a low-carb or low-fat diet lost the same amount of weight, those on the low-carb diet did better at raising their HDL (good) cholesterol levels and significantly lowering their diastolic blood pressure. Both groups also participated in a two-year behavioral program that focused on how to manage relapses, self-monitoring, and an emphasis on moderate physical activity.

Two-thirds of the study’s 307 adult participants were women. All were obese, but did not have cholesterol problems or diabetes.

Study participants eating the low-carb diet raised their HDL cholesterol levels by 23 percent, on average, compared with 12 percent among low-fat diet participants.

The study suggests that a low-carb diet may improve some risk factors for heart disease. However, the study’s authors also noted that the connection between a low-carb diet and higher HDL isn’t known, and requires further research.

Americans are the salt of the Earth – literally, according to a recent study on salt intake conducted by the Centers for Disease Control and Prevention. The study revealed that Americans consume more than double their recommended daily allowance of salt.

Newly revised U.S. Dietary Guidelines, to be officially announced later this year, recommend a maximum adult intake of 1,500 mg of sodium per day, according to a Wall Street Journal article. That’s the equivalent of about two-thirds of a teaspoon of table salt.

However, the CDC study reports that the average American consumes more than 3,400 mg of sodium a day, not including salt used in cooking or sprinkled from a shaker on top of food.

We’re all aware of obvious high-salt foods, including packaged meats like hot dogs and salami, some cheeses, and snack chips and pretzels. However, because of salt’s inexpensiveness and effectiveness as a flavor enhancer, it is used in a variety of foods we may not associate as “high sodium,” including many restaurant dishes, salad dressings and frozen pizza. Even a single slice of packaged bread can have 150-200 mgs or more of sodium.

Excess sodium has long been associated with increasing the risk of high blood pressure (hypertension), which can lead to heart disease, stroke and kidney disease. We all need a modest amount of sodium for our bodies to function properly. When the body ingests too much sodium, the kidneys cannot keep up with eliminating it, leading to an increase in blood volume and blood pressure.

On July 26-27, the Federal Communications Commission (FCC) and the Food and Drug Administration (FDA) hosted a series of public meetings to gain a better understanding of the convergence of communications technologies and medical devices, the future of wireless health technologies, and the challenges these federal agencies face as they seek to oversee growth in this area.

The meetings featured presentations and group dialogue from experts in the wireless and health care industries, medical providers, higher education and government. The FCC and FDA plan to use this input as the basis for their oversight of future devices and applications.   

Through August 16, 2010, the FCC and FDA are accepting public comments on this subject. Go to http://www.regulations.gov and reference docket #FDA-2010-N-0291.

The Federal Communications Commission (FCC) and the Food and Drug Administration (FDA) announced on July 26 a first-ever partnership to promote innovation and investment in wireless-enabled medical devices. In a joint statement, the federal agencies highlighted four primary points of this partnership:

1. Innovation in broadband and wireless-enabled medical devices will potentially enhance health and reduce health care costs for all Americans.

2. Federal agencies must ensure that wireless and broadband medical devices operate safely, reliably and securely.

3. The federal government must lead and encourage innovation and investment in new health care technologies of benefit to patients, doctors and other health care professionals.

4. Federal regulatory pathways, processes and standards for wireless and broadband medical devices should be clear, predictable and streamlined to facilitate innovation yet protect patients.

What does this mean for health care?

Eventually, all wireless communications – and in particular wireless data containing patient data such as vital signs, x-ray images and patient records – will be regulated by the FDA in order to protect patient confidentiality and mandate standard communication protocols.

Eventually, just as the FDA now regulates medical devices implanted in patients, it will also regulate medical devices on patients, like "smart Band-Aids.” These are wireless medical sensors mounted on adhesive strips that transmit vital patient data to remote monitored clinical locations.

We will soon reach a point when wireless data devices and communication systems will need to undergo the same scrutiny of data-driven, evidence-based medical standards that other medical devices are now required to uphold.

iPAD sales have exceeded three million since the device’s April 3, 2010, introduction in the United States. Now comes word of ways the iPAD is significantly changing the practice of healthcare.

According to a post on FutureMedica, a blog on “the future of healthcare and biotechnology,” the iPad is being used in many patient-physician (and nurse) interactions, as well as by individuals who work in health care. Among the examples of iPAD in healthcare use cited:

• iPAD and iPhone healthcare apps – A St. Louis-area physician has created multiple iPhone and iPAD healthcare applications, including one that estimates the risk of complications for patients considering coronary artery bypass graft surgery, another that predicts the chance of death during or shortly after open-heart surgery; and a third that estimates the risk of postoperative mechanical ventilation after open-heart surgery
• iPAD helps patient with Parkinson’s disease communicate – Because fine motor skills are not required to use an iPAD, it’s ideal for patients with diminished motor skills and other disabilities
• iPad used for patient education – Hospitals in Florida and Idaho are using iPADs to assist with patient education. For instance, Florida Hospital for Children is using iPads to explaining tests such as CT scans and MRIs to children, through videos and interactive question-and-answer features.

The future impact of iPADs in healthcare was covered in a Washington Post article on April 11, 2010: “With the iPAD, Apple may just revolutionize medicine.”

Americans are apparently visiting the doctor less – but why?

A July 29, 2010, Wall Street Journal article, “Americans Cut Back On Visits To Doctor,” reports that patient visits, prescriptions and procedures were all down in the second quarter of 2010 from year-ago levels. According to Thomson Reuters, which surveys doctors and hospitals on usage, doctor visits have declined each month this year, including a 7.6% drop in May 2010 from May 2009.

Among the reasons cited for the drop in usage:

Continuation of the weak economy – consumers are less willing to pay out-of-pocket for elective health care

Loss of individual health insurance – more American are now uninsured, due to cutbacks in jobs offering employer-provided health coverage

Growth of high-deductible health plans – a record 18 million Americans bought high-deductible plans in 2010 (compared with 13 million in 2009), which required the insured to bear more up-front costs for health services

An unusually mild flu season – in early 2010

The article does not cite the specific types of care experiencing declines.

Will some of your doctor’s appointments in the future occur at home – without your M.D. physically present?

Based on the success to-date of home health monitoring, also referred to as “telehealth,” many patient visits which previously occurred in a clinic or hospital can now happen from the convenience of home. Using a variety of wireless testing and transmission technologies, medical providers can now equip patients to self-monitor their health, with results automatically transmitted back to specially trained medical professionals.

For example, a July 27, 2010, Wall Street Journal article reports on a variety of remote health monitoring programs used to beneficially impact patient health. In California, for instance, Anthem is piloting a wireless scale and blood pressure cuff that transmits results in real time to nurses, who are alert for changes signifying potentially impaired health.

The United State Department of Veterans Affairs was one of the pioneers of telehealth, seeing it as a much-needed way to provide home health care services to veterans whose age, location or transportation requirements prevent travel to fixed clinical locations. Instead, many U.S. veterans are routinely monitored at home for a variety of concerns, including diabetes, hypertension, pulmonary disease and congestive heart failure.

Longtime Milwaukee Brewers radio announcer Bob Uecker has returned to the broadcast booth following surgery in late April to replace his aortic valve, aortic root and part of his ascending aorta, as well as perform a coronary bypass. “I’m ready to rock and roll,” proclaimed the 75-year-old Hall of Fame announcer, who returned to work despite his physicians’ requests to the contrary.

At the time of Uecker’s surgery, physicians credited Uecker’s overall fitness with enabling him to fare better than many other patients with similar heart issues. In Uecker’s case, regular exercise not only enabled him to bounce back faster than other patients, it also helped him detect his original heart problems. Because of his regular exercise regimen, Uecker was able to self-report chest discomfort and uncharacteristic fatigue several months before his heart surgery became a necessity.

Is a unique clot-dissolving drug underutilized in some stroke victims, and if so, why?

According to a July 25, 2010, article in the Milwaukee Journal-Sentinel, “Drug that could stop stroke isn’t always used,” some stroke patients do not receive tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food & Drug Administration (FDA) for treating ischemic stroke (blood clots that block blood flow to the brain). Some physicians indicated they do not use tPA due to concerns about its safety.

The FDA’s criteria for using tPA, which was approved in 1996, is strict and specific. For example, tPA cannot be used with hemorrhagic stroke (a blood vessel that has burst in the brain) or for head trauma, since the drug may prompt uncontrolled bleeding. In addition, tPA is approved for use only within the first three hours of the onset of stroke symptoms.

Because of such strict criteria for tPA, it’s important to seek medical attention immediately if you or someone you know experience any of the following stroke warning signs: sudden numbness or weakness of the face, arm or leg; sudden confusion, trouble speaking or understanding; sudden vision trouble; sudden trouble walking; or sudden, severe headache.   

In mid-July, Former Vice President Dick Cheney was equipped with a ventricular assist device (VAD), a mechanical device that partially or completely replaces the pumping function of a failing heart. In Cheney’s case, the VAD replaces the function of his left ventricle, delivering a continuous flow of blood through his body. A VAD is implanted as a last resort or as a stopgap before a full heart transplant. Cheney, who has survived five heart attacks, has not indicated his future health plans.

What lessons can we learn from Cheney’s heart health?

The incredible resilience of the human heart. Even a heart as badly damaged as Cheney’s continues to function, albeit with external assistance. Your heart beats an average of 100,000 times in a day; 35 million times in a year; and more than 2.5 billion times in an average lifetime.

Heart disease is progressive. As Cheney’s example demonstrates, once heart disease has begun, it can be difficult to reverse. For instance, a single heart attack puts you at much greater risk for a subsequent attack. A heart bypass (as Cheney had in 1988) typically last about a decade before the arterial grafts begin to narrow.

Heart care – promising, but not a panacea. There have many significant advances in heart care in recent years, including left ventricular reconstruction, drug-eluting stents and pulmonary vein isolation. Still, no technological advances to-date compare with the parts you were provided at birth – for instance, that’s why physicians still greatly prefer to repair faulty heart valves, as opposed to replacing them with non-native valves.

Take care of your heart – or suffer the consequences. Among the contributors to poor heart health: smoking, a high-fat and/or high-cholesterol diet, obesity, high blood pressure, diabetes, stress, lack of physical activity and a family history of heart issues.

When iMobileWellness started, it was related to something very specific: cardiac surgeons and cardiologists need quick access to reliable, comprehensive information to do their jobs – especially with the quick advances and changes that happen in the cardiac space. We thought of an application that was not only online, but also mobile, where doctors could quickly – and in the palm of their hand – gain access to complete information about heart valves, connections to other doctors in the field, and a database of resources to help them administer care. 

Then, we thought – what about the patients? Patients, their families and other professionals should have the same quick and easy access to the information doctors have, so that together they can make the best health care decisions possible.  Remove the barrier. Let the information flow.

Then, we thought – we can’t stop at heart valves.

A simple idea about changing the way information is made available, and how it is used by all health care stakeholders, has turned into the “big idea” that will ultimately lead to numerous applications. This first one is designed specifically for aortic valve patients, families, and doctors, but in the future, the sky is the limit.

In today’s society time is limited.  We work longer hours and value precious family time even more than the previous generation.  A recent study indicated a busier schedule than our parents and more electronics to keep us awake longer, routinely leading to 6 hours or less of sleep per night.  This “time crunch” commands a need to maximize our time while searching the Internet by looking for the most efficient and effective way to gather information.  Apple’s iphone, and the over 100 Million apps we can put on it, has answered this call.

Apples’ apps have revolutionized the technology of the 21^st century and integrated the concepts of efficiency and cumulative information in one source.    These apps provide a direct source of information and answer the question, “How can it help me now?”, in a variety of different categories, one of which being Medical. 

Apps such as iAortic Valve provide a mobile, cumulative resource in the palm of your hand to understand heart valve technology.  Doctors can share this information with Patients during visits, as a training tool for Fellows, Residents and Medical Students; and it can be used by Patients to share details with Family members .  The ability to conduct interactive discussions through blogs and discussion boards allow for Patients and Physicians to enhance the quality of care and education for everyone involved.

iMobile Wellness…Building Communities, Removing Barriers.

aSleep
Everyone needs to get seven to eight hours of uninterrupted, restful sleep every night. Even if you’ve had a hard time falling asleep before, this iPhone app can help you out. This app creates lifelike nature sounds related to the beach, the forest, wind and rain. aSleep can soothe you into a peaceful slumber using a programmable timer.

Quitter
This app is for those who quit smoking, but are tempted to start again when their friends smoke. This app helps to keep you smoke-free by showing you how long you’ve been smoke-free and how much money you have saved during that time. Just one glance at the savings is sure to help you say ‘no’ next time someone offers you a cigarette.

PointsCalc
Ever wonder how many calories you’re about to eat? PointsCalc assigns a number of "points" to a food based on its calories, fat, and fiber. If a particular food item goes over a certain number of points, the app tells you that you probably shouldn't eat it. Sounds pretty simple, unless that donut is right in front of you!

Epocrates
This app is for healthcare pros and others who need to have the latest information on drugs, their doses, adverse reactions, formularies, pricing and images, all at their fingertips. Epocrates can check drug interactions for up to 30 drugs at a time. This app also includes a number of medical calculators, including Body Mass Index (BMI) calculator and Glomerular Filtration Rate (GFR) calculator.

Do you have a favorite health app that we did not mention? Please feel free to chime in.  We want to hear from you!

It’s no secret that mobile technology is changing the way people communicate, connect and learn in myriad industries, professions, and personal pursuits. Global mobile phone service usage went from 1 billion people in 2001 to 4.1 billion estimated in 2008. Many people are forgoing their “personal computers” in favor of their mobile device. 

In the world of medicine, the territory is especially ripe for mobile takeover because the hunger is there for patients and doctors alike to find better ways to communicate and make better health decisions together. This is why iMobileWellness was founded. 

Formally endorsing and requiring mobile devices is a great move toward encouraging a future of better patient-doctor interactions, and we will be keeping our eyes peeled to see if more schools follow suit. 

Know of any other examples of mobile devices being required either in schools or in medical organizations? Please post a comment.

As stent graft procedures become more prevalent, doctors and patients can use the iPhone application to access critical aortic stent graft information and make better health decisions

PHOENIX (Dec 28, 2009) – iMobileWellness today announced the launch of the iStentGraft application for the iPhone.  Designed to give doctors and patients quick and easy access to stent graft information, the app puts critical knowledge at the user’s fingertips in a mobile form, helping to facilitate better treatment decisions. 

“Stent graft implantations are a relatively new and increasingly prevalent procedure, and this application is a great technical reference for cardiac and vascular surgeons, radiologists and other referring specialties,” said Patrick Kullmann, chief executive officer (CEO) of iMobileWellness. “It is also a great resource for those going through the procedure, or those watching a parent or grandparent go through the procedure.”

Stents grafts are scaffold tubes, often made of synthetic polyester materials reinforced with metal mesh, which can be inserted less invasively through the blood vessels to reinforce the diseased aorta in a patient, thus preventing a vessel rupture that could be deadly.  The iStentGraft application will feature:

• Searchable database: Doctors and patients can find comprehensive information about all thoracic and abdominal stents grafts available in the marketplace, searchable by device name or company
• My Profile creation: Doctors can enter specialties, specific procedures and stent grafts they’ve used; patients can enter their condition(s), procedures and other details; both can enter contact information in order to facilitate patient-doctor connections and quick access to experts
• Physician information: Users can access a comprehensive listing of experts, which will also contain a searchable map of all physicians that perform these procedures, information on their experience and specialties, and contact information
• Blog: Users can access to recent news related to aortic stent grafts, as well as original content, including articles, interviews, comments and questions
• PubMed: Doctors can get direct access to white papers on health-related topics through pubmed.gov, a service of the U.S. National Library of Medicine and the National Institutes of Health

With mobile usage increasing dramatically from 1 billion in 2001 to 4.1 billion estimated in 2008, this application comes at a time when there is a high demand for information accessibility via mobile device.  “At iMobileWellness, we leverage mobile technology not only to make this information more readily available, but to also to connect doctors, patients and the entire healthcare community,” said Kullmann.

The iStentGraft application is the second for iMobileWellness, following the successful launch of the iAorticValve application a month ago.  Like all of the ten-plus applications iMobileWellness plans to release, the applications are designed to remove barriers and provide access to valuable and reliable health information.

The iStentGraft application will be available for download in Standard and Professional versions, for $39.99 and $59.99 respectively.  Any user can experience a free trial of the application for 48 hours prior to purchase.  You can download now by visiting www.imobilewellness.com, or by searching iStentGraft in Apple’s Application Store from your iPhone.

About iMobileWellness

iMobileWellness is a company dedicated to transforming health and wellness by putting the power of information into the hands of physicians, patients, health professionals, care givers and consumers. Through its two subsidiaries—iMobileWellness and iMobileWellness—iMobileWellness strives to eliminate barriers so that people around the world can make the best health-related decisions possible.  For more information, visit www.imobilewellness.com.

Technology empowers us to be educated consumers and doctors. Still, the sheer amount of health information and self-diagnostics available on the Internet can make it difficult to decipher what is truly important.  

Have you ever tried to diagnose yourself using the Internet?  If you have, you’ve probably figured out that it’s not exactly scientific.  Plug in symptoms such as a headache or dizziness and you could get a range of possible “conditions.”  Of course, this phenomenon has given birth to a new form of the hypochondriac: the cyberchondriac.  A cyberchondriac turns to the Internet at the first sign of minor pain or ache and diagnoses himself or herself with the worst possible disease that collates with those symptoms, and then falls into a state of hysteria.

Though a cyberchondriac is a fairly extreme example of self-diagnosis, it is true that the way we find health information is changing — and doctors are seeing more patients who bring up results of online searches or self-diagnostics.  And ultimately, isn’t it better if we’re all part cyberchondriac? Although a Web site or application should never be trusted in the same capacity as a physician, having access to information – and plenty of it – is allowing patients and doctors to have better conversations.  And better communication equals better health decisions.

According to Wikipedia:
 “a stent graft is a tubular device, which is composed of special fabric supported by a rigid structure, usually metal… the device is used primarily in endovascular surgery. Stent grafts are used to support weak points in arteries, commonly known as an aneurysm. Stent grafts are most commonly used in the repair of an abdominal aortic aneurysm, in a procedure called an EVAR. The theory behind the procedure is that once in place inside the aorta, the stent graft acts as a false lumen for blood to travel through, instead of flowing into the aneurysm sack.”

So, why does this little metal tube have the cardiac surgeons buzzing?  Well, as this NYTimes.com article notes, bypass surgery has been a typical way to treat aneurisms in the past.  Bypass surgery, where the diseased artery is “bypassed” by connecting the aorta to a healthier vessel, is an extensive and invasive surgery.  The patient’s chest is typically opened up, which makes both surgery and recovery a bit more intense and risky. 

Stent grafts, however, can be inserted non-invasively, without open heart surgery, and research is showing that the therapy can treat aneurisms just as effectively as an invasive procedure.  This is a huge benefit for patients who may not be in good enough health to undergo an invasive procedure. Surgeons who used to have limited options for treatment of these high-risk patients now have another option.

Although stent grafts are still relatively new, we look forward to following the new developments in this technology in 2010.  Post a comment if you have any articles or research to share!

Although much was known about the structure and purpose of a human’s aortic valves dating back to the 1400s, according to the Cleveland Clinic, it wasn’t until the 1950s that significant developments were identified in heart valve surgery. Marked by the initial use of heart-lung machines, bioprosthetic (pig and calf) valves and the first aortic valve repair surgery, the dawn of these techniques was revolutionary. Since then, the surgical industry as a whole has seen improved diagnostic techniques including imaging, better timing for surgical intervention, and improvement in surgical techniques – most notably, the introduction of minimally invasive surgery.

Since the late 1990s, minimally invasive procedures have received a fair amount of buzz because they are much easier on patients than invasive, open-chest procedures. At this point, non-invasive surgery is not an option for aortic valve repair and replacement, but that could be the next big breakthrough that we all rave about.  Still, patients today have an unprecedented amount of choices in the way care is administered: the patient can choose the type of incision they’d prefer to get, the type of valve that should be used, and the type of procedure (valve repair or valve replacement) to be performed.

• Difficulty breathing
• Fever over 100 degrees
• Black, tar-like stools
• Pain that sharply increases, or becomes uncontrollable
• Wound drainage problems; redness, bleeding or opening at the incision site
• A decrease in ability to function (ex: cannot walk to the bathroom)
• A change in level of consciousness or ability to wake
• Persistent diarrhea, constipation, nausea, or vomiting
• Inability to tolerate food or drink
• Unexplained pain in one or both legs

As we noted, if you were having any of the complications above, we hope common sense would tell you that something is amiss.  As always, remember that you should never hesitate to call your doctor or surgeon to simply check on something that you are worried about.

What’s better than a 2-D image? A 3-D image. Medtronic partnered with an imaging software firm to introduce 3D Recon, which provides three-dimensional images of veins to help surgeons treat aortic aneurysms. This service can also convert two-dimensional computed tomography images to three-dimensional images, and remove bone and anatomy from those images. Our guess?  3-D imaging will soon become the standard.

New study: Although CT scans are associated with an immense amount of radiation, a new study finds that they can also be a faster and more cost-effective way of diagnosing a heart attack in the emergency room. Instead of taking the risk of sending someone home with no clear signs of a heart attack, emergency room doctors can run a CT scan for a deep, detailed view inside the body that helps them make an accurate diagnosis.

Fitness magazine has gathered a list of the best iPhone apps to help you eat healthy. These apps will help you make healthy choices at the grocery store, count calories and select nearby healthy restaurants. Read the full article and see the list of apps here.

And don’t forget about exercise after you’ve used your iPhone to count calories.  About.com has a great list of fitness applications that can help you get through your workout.

If you don’t find any iPhone apps that grab you from these two lists, don’t give up yet. There are hundreds of other health and fitness apps in the Apple app store that will motivate you to lead a healthy lifestyle.  Do you have a favorite fitness/healthy eating app?  Be sure to leave us a comment.

In an increasingly online and mobile world, one of the biggest concerns with the flow and availability of health information is the reliability of it.

Speed vs. accuracy has always been a concern with reporting, and it is a struggle to strike a balance in providing information that is quick yet quality.  Take the recent “balloon boy” story, a case in which media outlets spent a significant amount of time reporting inaccurate information, simply because of the demand to get the story out quickly for their audiences. 

Accuracy becomes a bigger deal, however, when you’re relying on that source for information related to something a bit more important: your personal health care.  Aside from specialized applications and company tools such as the iAorticValve application from iMobileWellness, many people rely on non-commercial informational aggregate sites such as WebMD or HealthCentral.  But with online resources and Web sites growing exponentially, how can you know when to trust the Web sites and articles that come up in your Google search?

This site, found through Google, lists out the top 20 sites for medical information.  Still, there is nothing on the site that gives any reliable reason why this information should be trusted.  In the “About,” there are no names given, and there is no indication of staff or funding for this operation.  It simply says:

“The most linked to, and most popular sites for a category are short-listed, then visited and evaluated for relevance and content for the category being reviewed. The whole process is human-edited.”

Granted, WebMD, perhaps the most widely known and trusted health information Web site, is first on the list; but how do we know why the other sites are ranked where they are?  Why is HealthCentral second, and Mayo Clinic ninth?

One source that we found for accreditation and reliability was the Utilization Review Accreditation Commission (URAC), which is an independent, nonprofit organization that promotes health care quality through certification and accreditation programs.  They accredit organizations – but have also started to accredit Web sites, such as Web MD. 

In addition to accreditation by URAC, another indication of reliable content on a Web site is when a name and contact are given along with the information that is put forth.  This can be in the form of referencing links to credible organizations, whether academic institutes, hospitals or government agencies like the FDA.

When it comes down to it, even the information on the most reliable Web site might not speak directly to your personal situation and health care needs.  This is why, ultimately, no matter how much Web research you do, we recommend always consulting your physician when making a decision about your health care.

• Do I have to go through open heart surgery, or is minimally invasive surgery an option for me?
• What type of valve will be implanted? Is the valve mechanical or biological? What are the benefits and risks of each?
• Who manufactures the valve and what is the product name? – This will be helpful if doing additional research using the iAorticValve application.
• How long will the surgery take?
• Should I donate and store my blood in the blood bank? Can I also have my family members donate blood before the surgery?
• Which medicines can I still take and which ones will I have to stop taking prior to surgery? Can I continue taking vitamins and supplements that were not prescribed?
• Do I need to change my diet in any way?
• Is there anything special that I need to do on the day of the surgery?
• How long will I be in the hospital after the surgery?
• What should I expect to see and feel after my surgery?
• What are some of the most common side effects or complications of aortic valve replacement surgeries?
• Do you have any additional advice that would help me prepare for and recover from this surgery?

Remember, there are no bad questions, so don’t hesitate to ask. For additional questions, look here.

Absolutely.

Just knowing the most common fears and anxieties that a patient might feel before surgery is useful for both the patient and the doctor.  The mere act of monitoring and determining factors affecting anxiety can decrease pre-operational fear.  

There are many different articles and studies on the most common fears that people encounter prior to surgery, and specifically with cardiac surgery.  Here, gathered from various sources, are what we found as the five most common triggers:

1. Timing of surgery – This study found that many patients who are waiting for surgery experience some anxiety due to the uncertainty around the date of their surgery.  For your own peace of mind, talk to your doctor about a realistic timeline for the surgery.

2. Experiencing pain/discomfort – While there will be some pain and discomfort after the surgery, there is no need to panic. Your doctor can prescribe pain medication that will effectively treat any pain and discomfort that you feel.

3. Anesthesia – It is very common for people to have some concerns about anesthesia. It dulls our senses and takes us out of control of what’s happening to our bodies. However, no one could realistically put his or her body through cardiac surgery without anesthesia. Rest assured, anesthesiologists will monitor every heart beat and every breath to make sure your body has no trouble with the anesthesia.

4. Complications – Every surgery is different.  The good news is that heart surgeries are common procedures.  According to Adam Pick, author of The Patient’s Guide to Heart Valve Surgery, each year, over 700,000 heart surgeries take place across the world. That’s over 1,900 surgeries per day. And with technologies increasing in sophistication day by day, the tools available to your doctor in avoiding complications are also increasing.  Trust your doctor to make the best decisions, but never hesitate to ask questions about the process and about recovery.

5. Resuming lifestyle – Going back to “the way it was” may seem overwhelming.  The uncertainty with the length of recovery can make it difficult to plan ahead. Family support is crucial to a successful recovery period for any patient. It is wise to ease into full recovery, and your doctor can help advise you of the best process.

As with any concern or fear, never hesitate to consult your doctor prior to surgery.

iAorticValve will help radiologists by saving time, according to Pat Kullmann, CEO of iMobileWellness. A patient who needs an MRI or CT scan, for example, may have a mechanical prosthesis specified in his or her chart. The technician or radiologist can use the iAorticValve app to explore the prosthesis the patient has and identify any imaging concerns that may be associated with it, he said.

"They can look up the different brands of valves, and, in some cases, it may preclude the technician or radiologist from needing to call a cardiologist, or hunt down the information on multiple websites from multiple sources," Kullmann said.

H1N1 is all the chatter on social media platforms, and news outlets can’t cover it enough. Harvard recently came out with an H1N1 app for $1.99. Users can check symptoms, map outbreaks and clinics, call a hotline, and get up-to-the-minute updates from the CDC. Not convinced you need the app? Neither are we, but as Information Week’s Marianne McGee notes, “…Harvard Medical School reminds us that there have been 180,000 cases of H1N1 flu worldwide so far this year, according to the World Health Organization, and that the White House has predicted that 160 million infections and 90,000 deaths are ‘plausible’ this winter.” 

With the recent unveiling of a new Verizon platform for mobile technology, the battle for mobile users continues. Up to this point, Apple has been fairly dominant in maintaining their loyal iPhone users. Should Apple be worried? Can the Android really unseat the iPhone? Regardless of the platform, we’re guessing that the mobile migration of information (and the importance of its availability) will not change, especially when it comes to health care.

iMobileWellness’ iAorticValve Application is a tool for doctors, patients, to access information that is critical to care decisions

MINNEAPOLIS (October 19, 2009) – In years past, the stethoscope has been the quintessential object in a doctor’s toolkit. Today, in the age of the internet and fast-moving technologies, iMobileWellness has announced the launch of a Web site and iPhone application that will be the stethoscope of the 21^st century. 

The iAorticValve application will allow doctors and patients to access and use critical aortic valve information—and have it at their fingertips in a mobile form. The application will take information spread across different sources and create a portal for connection, feedback and better health decisions. Like all of the ten-plus applications iMobileWellness plans to release, the application is designed to remove barriers and provide access to valuable and reliable health information for doctors, patients and the entire healthcare community.

Features of the iAorticValve application will include:

• Searchable database: Doctors and patients can find comprehensive information about all percutaneous, tissue and mechanical aortic valves available in the marketplace, searchable by valve name or device company
• My Profile creation: Doctors can enter specialties, specific procedures and valves they’ve used; patients can enter their condition(s), procedures and other details; both can enter contact information in order to facilitate patient-doctor connections and quick access to experts
• Physician information: Users can access a comprehensive listing of experts, which will also contain a searchable map of all cardiac surgeons or cardiologists, information on their experience and specialties, and contact information
• Blog: Users can plug in to recent news related to aortic valves, as well as original content including articles, interviews, comments and questions
• PubMed: Doctors can get direct access to white papers on health-related topics through pubmed.gov, a service of the U.S. National Library of Medicine and the National Institutes of Health

It’s not just doctors and patients who will be impressed with the iAorticValve application. With navigational features that push the envelope, such as the new “wheel of fortune” navigation featured in no other iPhone application to-date, mobile technology buffs will appreciate the application at interface level.

The iAorticValve Application will be available for download in Standard and Professional versions, for $29 and $49 respectively. Any user can experience a free trial of the application for 48 hours prior to purchase. You can download now by visiting www.imobilewellness.com, or by searching iAorticValve in Apple’s Application Store from your iPhone.

About iMobileWellness

iMobileWellness is a company dedicated to transforming health and wellness by putting the power of information into the hands of physicians, patients, health professionals, care givers and consumers. iMobileWellness strives to eliminate barriers so that people around the world can make the best health-related decisions possible. For more information, visit www.imobilewellness.com.