April 29, 2011 (New York, NY) -- Gastric-bypass surgery may provide benefits to patients with type 2 diabetes beyond the benefits that can be directly attributed to weight loss, a new study finds .
According to Dr Blandine Laferrère (St Luke's Roosevelt Hospital, New York, NY) and colleagues, recent studies that show a strong correlation between the concentrations of plasma branched-chain amino acids (BCAAs) and related metabolites with insulin resistance and loss of insulin sensitivity raise the possibility that the rapid remission of diabetes seen in many diabetic patients after gastric-bypass surgery may be related to the pronounced changes in BCAAs or other metabolites and not the weight loss alone.
In a study published in the April 27, 2011 issue of Science Translational Medicine, Laferrère et al found the total amino acids and BCAAs decreased in the gastric bypass surgery group but not in a similar group of patients who lost the same amount of weight (10 kg) with diet alone. Also, the metabolites derived from BCAA oxidation decreased only in the surgery group. Levels of acylcarnitines and BCAAs and their metabolites were inversely correlated with proinsulin concentrations, C-peptide response to oral glucose, and the insulin-sensitivity index after weight loss, whereas the BCAAs and their metabolites were uniquely correlated with levels of insulin resistance.
Washington, DC - Predicting the future is a fool's game, and predicting successful drug and device therapy in cardiovascular medicine is just as tricky.
When bioabsorbable stents emerged on the radar of interventionalists this past decade, some dared to dream that they might one day have a stent that would do its job, then disappear, eliminating the long-term use of dual antiplatelet therapy, without a subsequent risk of stent thrombosis. In addition, bioabsorbable stents wouldn't interfere with diagnostic evaluations using noninvasive imaging, such as MRI and computed tomography (CT). Equally important, the technology offered the promise of doing away with vessels loaded up with multiple stents, the so-called full metal jacket, which has the potential to interfere with future coronary surgery.
After a number of years, one stent, a fully bioabsorbable everolimus-eluting stent (BVS, Abbott Vascular) shows promise and is furthest along in clinical development, but not everybody is sure of the role the vanishing scaffolds will play in everyday practice. Some experts see a more expansive role for the devices, even implanting the stents into vulnerable arteries that are not yet significantly closed, with the intention of making an unhealthy vessel healthy again. Others, however, see interventionalists implanting the stents only in a minority of patients.
Dr James Otton (St Vincent's Hospital, Sydney, Australia) and colleagues presented results from theirProspective Evaluation of an Algorithm for Coronary Calcium Estimation, a study of their algorithm for quantifying extraluminal coronary calcium in the major epicardial vessels from a contrast-enhanced CT scan.
Measuring calcium score from a single contrast CT has been tried before, but it has usually been impossible to accurately measure calcium across the whole range of Agatston scores, Otton told heartwire. "The key to [our] success was realizing, first, that it is not possible to adequately separate contrast from arterial-wall calcium using solely the traditional axial measurement approach, and second, that traditional calcium-score thresholds don't apply to high-resolution contrast-enhanced coronary CT."
Instead, Otton et al tested coaxial analysis—looking at the coronary artery in short axis—which allows for precise separation of the contrast-filled lumen and the vessel wall and can be mostly automated with standard software tools, he explained. The researchers also found that a lot of noncalcified material appears in the Hounsfield range of 130 to 200 Hounsfield units (HU) on high-resolution coronary CT scans, while the true calcium generally greatly exceeds 200 HU. This finding is supported by previous intravascular ultrasound (IVUS) studies.
Simple facts about saturated / unsaturated / transfatty acids (TFA)
SATURATED FAT CAUSES ARTEROSCLEROSIS
Beef, Beef fat, veal, lamb, pork, lard, poultry fat, butter, cream, milk, cheeses and other dairy products made from whole and 2 percent milk
coconut, coconut oil, palm oil and palm kernel oil (often called tropical oils), and cocoa butter
TRANS UNSATURATED FATTY ACIS (TFA) CAUSES ATHEROSCLEROSIS
beef, pork, lamb and the butterfat in butter and milk
making margarine, shortening, cooking oils cookies and white bread
TFA IS MORE ATHEROGENIC THAN SATURATED FAT (CAUSES MORE DAMAGE)
UNSATURATED FAT DOES NOT CAUSE ATHEROSCLEROSIS
salmon, trout, herring, avocados, olives, walnuts and liquid vegetable oils such as soybean, corn, safflower, canola, olive and sunflower
Unsaturated fat = polyunsaturated fats + monounsaturated fats
Replacing saturated and TFA with unsaturated fat helps reduce blood cholesterol levels
American Heart Association recommends
Choose a diet rich in fruits, vegetables wholegrain, high fibre foods and fat free and low fat diary most often
Keep total fat intake between 25 to 35% of calories (mainly mono and poly unsaturated fats)
TFA less than 1% Calories
To reduce TFA in diet
Look for food labeled ZERO TFA
Use unhydrogenated vegetable oils (canola, sunflower or olive oil)
Soft margarine instead of harder stick forms and butter
Limit Saturated Fats = Limit TFA
Limit commercially fried foods – has large amount of Saturated Fats and TFA
Barbershops a cut above for BP checks in African American menOCTOBER 28, 2010 | Steve Stiles
Chicago, IL - In the Texas of 150 years ago, the town barber was probably also the guy who pulled an aching tooth. A cadre of barbers in today's Texas were true to their healthcare-provider heritage by participating in a hypertension-screening outreach experiment that helped many of their customers with hypertension to get their blood pressures under control.
In a unique randomized trial , African American men who were patrons of black-owned barbershops in Dallas County, where they had their BP regularly measured and were encouraged to contact a physician when it was elevated, showed a mean 7.8-mm-Hg drop in systolic pressure over 10 months.
That was only 2.5-mm-Hg more of a drop (p=0.08) than seen in a comparator group of men who had received standard educational pamphlets on high BP in African Americans, but no BP checks or other encouragement to assess blood pressure, at the barbershops.
"That doesn't sound like much of a blood-pressure fall for any one person, but at the population level it's a very large effect," lead author Dr Ronald G Victor (Cedars-Sinai Heart Institute, Los Angeles, CA) observed for heartwire.