Echo Predicts Mortality in Aortic Stenosis

from AMERICAN SOCIETY OF ECHOCARDIOGRAPHY - 22ND ANNUAL SCIENTIFIC MEETING

Population: Elderly patients with normal LV function & did not undergo Aortic Valve Replacement

Poor survival with

Greater LV concentric remodeling

Lower stroke volume

Elevated LV filling pressures

Elevated PA pressure

Gastric Bypass Does More Than Just Reduce Weight

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 [1].

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.

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Now you see me, now you don't: The bioabsorbable stent in clinical practice

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.

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New CT method gets calcium score and coronary anatomy in a single scan

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.

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SIMPLE FACTS ABOUT SATURATED / UNSATURATED / TRANSFATTY ACIDS (TFA)

Simple facts about saturated / unsaturated / transfatty acids (TFA)

SATURATED FAT CAUSES ARTEROSCLEROSIS

SOURCES

ANIMALS	PLANTS
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

SOURCES

NATURAL	PROCESSED FOOD
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

SOURCES

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 these

High TFA

French fries

Doughnuts

Cookies

Muffins

Pies

Cakes

Limit Saturated Fats = Limit TFA

Limit commercially fried foods – has large amount of Saturated Fats and TFA

HYPERTENSION

Barbershops a cut above for BP checks in African American men

OCTOBER 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 [1], 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.

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LIST OF MUSLIM FOOD OUTLET IN HONG KONG

ISLAMIC CENTRE CANTEEN

5th floor Masjid Ammar and Osman Ramju

Sadick Islamic Centre

40 Oi Kwan Road

Wan Chai Hong Kong

EBENEEZER'S KEBAB

Shop No G04

Wan Chai Central Building

89 Lockhart Road

Wan Chai Hong Kong

EBENEEZER'S KEBAB

Ground floor

52 Lockhart Road

Wan Chai Hong Kong

EBENEEZER'S KEBAB

Ground Floor

California Place

25 D'Aguilar Streeet

Lan Kwai Fong

Central Hong Kong

EBENEEZER'S KEBAB

G01C

Astoria Building

32 Ashley Road

Tsim Sha Tsui

Kowloon

EBENEEZER'S KEBAB

Shop No 2,3 & 5

Ground Floor

Multifield Plaza

5-7A Prat Avenue

Tsim Sha Tsui

Kowloon

EBENEEZER'S KEBAB

Shop 11 & 12

Ground Floor

Hong Kong Gold Coast

No 1 Castle Peak Road

Tuen Mun

New Terrritories

EBENEEZER'S KEBAB

Shop G03A

Discovery Bay Plaza

Discovery Bay

Lantau Island

ISTANBUL KEBAB

Shop F-1

Ground Floor

Rose Mansion

1 Hart Avenue

Tsim Sha Tsui

Kowloon

ISTANBUL KEBAB

Ground floor

34A Lock Road

Tsim Sha Tsui

Kowloon

MUGHAL CLUB

Room 211 2nd Floor

Hai Phong Mansion

53-55 Hai Phong Road

Tsim Sha Tsui

Kowloon

THE GREAT INDIAN KEBAB FACTORY

Shop 8

Level 2

Miramar Shopping Centre

132 Nathan Road

Tsim Sha Tsui

Kowloon

SPICE RESTAURANT

2nd Floor

Prosperous Centre

No 1 Knutsford Terrace

Tsim Sha Tsui

Kowloon

ZIAFAT RESTAURANT

6th Floor

Harilela Mansion

81 Nathan Road

Tsim Sha Tsui

Kowloon

THE NEW SANGEET INDIAN RESTAURANT

Shop UG06 - 08

Upper Ground Floor

Toyo Mall

Intercontinental Plaza

94 Granville Road

Tsim Sha Tsui

Kowloon

JOJO INDIAN CUISINE

2nd Floor

David House

37 - 39 Lockhart Road

Wan Chai Hong Kong

RANG MAHAL

Flat B 1st Floor

Percival House

83 Percival Street

Causeway Bay (near Times Square)

Hong Kong

JANSHAN CELEBRATING INDIAN CUISINE

1st floor

Amber Lodge

23 Hollywood Road

Central

Hong Kong

SHAFFI'S INDIAN RESTAURANT

Shop 7

Ground Floor

Fau Tsui Street

Yuen Long

New Territories

POPEYE'S CHICKENS AND BISCUITS

7T103 & 7E161

Level 7

Passenger Terminal 1

Hong Kong International Airport

Lantau Island

HABIBI RESTAURANT

1st Floor

Grand Progress Building

15 - 16 Lan Kwai Fong

Central

Hong Kong

HABIBI CAFE

112 - 114

Wellington Streeet

Central

Hong Kong

WARUNG MALANG

Flat B2

2nd Floor

Dragon Rise Building

9-11 Pennington Streeet

Causeway Bay

Hong Kong

BLITAR CAFE

201 Causeway Bay Centre

19 - 23 Sugar Street

Causeway Bay

Hong Kong