November 2017


it might help men with existing heart disease


When it comes to men with coronary artery disease, there may be no such thing as lowering total blood cholesterol levels too far. A study in the current issue of the journal Circulation found that the arteries in male patients with a cholesterol level as low as 155 milligrams per deciliter_a figure many Americans would envy_benefited from cholesterol-lowering medication as much as those with higher levels.

For perspective, the National Cholesterol Education Program’s guidelines for adults recommend that heart disease patients aim for a cholesterol level of about 160 mg/dl. For adults without heart disease, anything below 200 mg/dl is considered desirable. While some research has raised questions about the safety of very low cholesterol levels, no danger has been proved.

The new report fuels an ongoing debate about how aggressively to treat heart disease patients whose cholesterol is already fairly low. Dutch scientists studied 885 men under age 70 with total blood cholesterol levels ranging from 155 mg/dl_lower than patients in other studies of cholesterol-lowering drugs_to 310 mg/dl. All of the men had symptoms such as a previous heart attack or angina pain. After meeting with a dietitian to discuss a lower-fat diet, about half the men received the drug pravastatin and the others got a placebo. Pravastatin, sold in the United States by

Bristol-Myers Squibb as Pravachol, belongs to a class of drugs that includes simvastatin (Zocor) and lovastatin (Mevacor).

Good numbers. After two years, the pravastatin group’s cholesterol levels had improved, while the placebo group’s hadn’t markedly changed. In the pravastatin patients, total cholesterol dropped 20 percent and LDL_or “bad”_cholesterol fell 29 percent. In addition, their HDL_or “good”

cholesterol, thought to have a protective effect_rose 10 percent.

Beyond the numbers, artery-clogging deposits actually shrank in 54 of the men who received the drug, compared with only 30 of those on the placebo. Arteries continued to narrow in 142 of the pravastatin-treated men but 181 of the placebo patients. About an equal number in each group saw no change. Only 20 pravastatin patients needed an unanticipated angioplasty to unclog an artery, compared with 47 in the placebo group.In each of the groups, about two dozen men had to undergo unexpected heart-bypass surgery. Study co-author Albert Bruschke, a cardiologist at the University Hospital Leiden, says he and his collaborators plan to study women next.

Some leading U.S. cardiology researchers note that coronary artery disease is relatively uncommon in people with very low cholesterol levels. In the United States, only about 20 percent of first-time heart-attack patients fall below 200 mg/dl.

But Bruschke points out that even people in China, where a total cholesterol of 155 mg/dl is considered above normal, develop heart disease. Whatever the definition of high cholesterol, Bruschke’s study is one of several that underscore the need to treat it_a message that still hasn’t gotten across to all cardiologists and patients. In that light, observes Scott Grundy, chairman of the American Heart Association’s cholesterol task force: “I don’t think we ought to quibble over exactly what number we should start with.”







Suffering from a heart attack can be scary and deadly. However, heart attacks can be prevented. Here are a few tips to help you reduce your risk of heart attacks and heart disease.

Tips To Prevent Heart Attacks
healthy-food-stocksEat Healthy

Cut out foods high in cholesterol. Bad cholesterol create heart attacks by blocking arteries. Promote heart health by cutting out trans fats and too much sugar. Add omega-3 to your diet. Also eat more fruits and vegetables. The best foods to eat for heart health are the following:

Leafy Greens
Lean Beef
Dark Chocolate
Whole Grains

Regular exercise can prevent heart disease. If you have heart disease, it can slow down its progression. Exercise is more about promoting cardiovascular health than it is about losing weight. Exercise improves your overall health. If you walk a mile a day, you are decreasing your risk of a heart attack.

Reduce Stress

Stress can cause heart attacks. Reduce your stress by practicing relaxation techniques or removing stressful situations from your life. If your job is stressful, try to find another job that is not. If your schedule is stress, try to eliminate some items or delegate.

Lower Blood Pressure

Keep your blood pressure below 130/80. Low blood pressure can help prevent a sudden heart attack. High blood pressure do not have obvious symptoms. It is best to measure your blood pressure daily at home. Foods such as white beans, tilapia, pork tenderloin, kiwi, bananas, kale, peaches and broccoli can naturally lower blood pressure.

Lower Cholesterol

You can improve your cholesterol by eliminating foods high in LDL. LDL is bad cholesterol that leads to heart attack. You should eat foods that have more HDL. HDL is the good cholesterol that protects you against heart disease. If your total cholesterol is high, the chances of you suffering from a heart attack is increased. Ideally, your total cholesterol ratio divided by HDL should be 3.0.

Benefits-of-Quitting-SmokingQuit Smoking or Using Tobacco Products

Smoking and using tobacco products such as chewing tobacco can increase your chances of developing a heart disease. Nicotine is bad for your blood vessels. It restricts and narrows them. This makes it easier for them to be blocked and cause a heart attack.

Maintain Healthy Weight

Maintaining a healthy weight helps to prevent heart attacks and diabetes. Obesity can lead to other health related diseases that can cause a heart attack. If you are overweight, diet and exercise can help. However, it is best to consult with a dietitian or your doctor to figure out what works best for you.

Take Diabetes Seriously

People with diabetes have an increased risk of developing heart disease. Regulating your sugar by taking your medicine, exercising and sticking to your doctor recommended diet can prevent diabetes causing a heart attack. So take responsibility for your diabetes and do not take unnecessary risk. An A1C reading that is lower than 7% is your goal.

Understanding Heart Failure
Many people do not have a fundamental understanding of heart failure. The name itself almost implies that the heart has completely stopped working, but that is not necessarily the case. What it does mean is that it is no longer able to pump effectively as it was designed to do. In other words, it has to work harder to pump blood throughout the body. Eventually, it becomes more and more inefficient as it stretches and stiffens over time. Typically, the heart beats faster and harder than normal during the beginning stages of heart failure, and as the disease progresses, it grows weaker and weaker. In more advanced stages, it is unable to contract with the force that is needed to sufficiently pump blood throughout the body and it continues to grow weaker still. Eventually, it can cause severe arrhythmia. People that live with advanced heart failure typically die because of heart rhythm disorders, because blood has backed up into the lungs and they are no longer able to breathe, or because the heart itself is simply no longer able to put up with the strain and stops functioning.

HN_BB_Heart_Disease_3_prevent-img_1280x720Habits That Lead to Heart Failure
What are some of the most common habits that lead to heart failure? Without a doubt, one of the most frequent behaviors is leading a sedentary lifestyle. People that fail to get the exercise that they need and who eat unhealthy foods that are packed with fat, preservatives and sugar have a higher incidence of heart failure than those that refrain from these habits. Typically, any type of lifestyle that is unhealthy, such as smoking or drinking, also can be related to heart failure. Many of these lifestyles lead to an increased possibility of suffering a heart attack, which can easily cause heart failure as a complication. Of course, there are times when it simply exists through no fault of the individual involved. This happens when there is some structural problem with the heart or there is a pre-existing condition that could not be averted through changes in lifestyle.

Managing Your Life While Living with Heart Failure
When people initially get the diagnosis of heart failure, they typically feel like their entire life has come to an abrupt end. However, the disease can be managed, sometimes for years. Mild cases can even be reversed in some instances. For those who are unable to reverse the disease, medication and lifestyle changes can make a huge difference. In many cases, they are able to lead relatively normal lives, even do mild exercise. Eventually, the disease will take its toll but many people can live it for up to a decade. In fact, those who are suffering from the disease must make the lifestyle changes in order to manage it effectively. It makes it even more important to eat healthy, get exercise and get plenty of rest, not to mention managing stress. By doing all of these things and taking medication, the disease can be kept at bay for some time.


The causes of pituitary apoplexy is unknown, possibility is caused by the following factors.

1. Ischemic factors:
1) When the pituitary adenoma growth faster than the capacity of the blood supply, the tumor tissue area appear avascular necrosis, and subsequent bleeding.

2) The pituitary gland has a unique vascular supply, only through supply from the the pituitary portal system on the pituitary stalk, when the suprasellar pituitary adenoma growth, it can embed incisure diaphragma sellae and the pituitary stalk in the middle of the narrow site, blocking the pituitary pars distalis of nutrition and tumor blood vessels, lead to anterior leavess and the whole tumor ischemia, necrosis and hemorrhage. Pituitary adenoma side growth to suppression cavernous sinus, and make to raise the pressure of cavernous sinus. Cause increased venous pressure within the tumor so that tumor supply artery damage and infarct.

2. Vascular factors: pituitary adenoma with abundant blood vessels, forming irregular sinusoids, thin-walled sinusoids, tumor volume increased pressure to cause blood vessel bursting and bleeding. Modern angiography confirmed that blood vessel in pituitary adenoma is smaller than normal blood vessels and diameter mixed. Electron microscopy in these blood vessels do not fully mature, the membrane was ruptured or segment-shaped, perivascular space has been compressed plasma protein and red blood cells, which are the basis of pituitary adenoma hemorrhage.

3. Certain Tumor: more see in prolactinomas, not only because it is more see in pituitary adenomas, and in general due to the larger tumor size, easy to cause the obstacles of local blood circulation and blood supply. Pituitary apoplexy was particularly prevalent in the larger adenomas, but that may also occur in small adenomas, and many small adenoma post-stroke, no significant clinical symptoms, known as subclinical pituitary apoplexy.

4. Induced factors:
1) trauma: in suffering from pituitary adenoma, if the head by the external force, tumor and neurocranium occurred extrusion or stretch moment in sports, causes tumor vascular hemorrhage, especially in tumor blood vessels.

2) radiation therapy: Radiation therapy of pituitary adenoma can increase tumor blood vessels bleeding.

3) estrogen: estrogen can lead to pituitary hyperemia, prone to pituitary apoplexy.

4) upper respiratory tract infection, sneeze that increased pressure within the cavernous sinus, such as the adenoma into the cavernous sinus, the tumor is increased venous pressure, cause insufficient blood supply to tumor or artery embolization.

5) certain drugs and other: such as bromocriptine, chlorpromazine, anticoagulant therapy, alcoholism, angiography, dynamic pituitary function checks after surgery, as well as sphenoid sinusitis, atherosclerosis embolism, thrombocytopenia can cause pituitary apoplexy .

Since the tortuous demise of healthcare giant Johnson & Johnson’s proposed $24 billion acquisition of medical device manufacturer Guidant in January 2006, the era of the mega-merger within the pharmaceutical and biotechnology industries appeared to be at an end. The last such deal took place in August 2004, when the acrimonious marriage between Sanofi-Synthelabo and Aventis was consummated.

While mega-mergers no doubt lead to increased critical mass, as demonstrated by the global rankings of Pfizer (including, for example, Pharmacia, Warner-Lambert), GlaxoSmithKline (Glaxo Wellcome, SmithKline Beecham) and sanofi-aventis, many industry executives now acknowledge that they do not always bring a solution for every problem – particularly poor R&D productivity. Indeed, mergers can actually disrupt the work of researchers as pipelines are reviewed and projects reprioritised. GSK, for one, has since split up its R&D teams into smaller groups based on therapy areas, to encourage the levels of innovation seen in smaller biotechnology rivals.

In the past two years, however, there have been plenty of other types of deal within the healthcare industry. Indeed, in the third week of March 2006 alone, three major transactions were announced, potentially worth more than $20 billion:

Merck KGaA, the German conglomerate, made an audacious €14.6 billion takeover offer for larger (in terms of pharmaceutical sales) compatriot Schering AG. It was against the deal, and a few days later accepted a friendly €16.3 billion offer from larger German rival Bayer, potentially creating a top-15 player that would overtake Boehringer Ingelheim as the country’s largest drugmaker
Californian-based Watson agreed a $1.9 billion all-cash deal with troubled Florida rival Andrx, a specialist in drug delivery and difficult-to-produce generics, saying it would create the US’ third-largest generics company
Actavis of Iceland, which has already swept up the likes of Alpharma’s generics unit and Amide, launched a hostile $1.6 billion bid for Pliva, Central and Eastern Europe’s largest generics manufacturer
The last two deals highlight one of the major trends – consolidation within the generics industry. These different types of transaction, which show no signs of abating, are outlined below.

While sales of generic drugs are flourishing world-wide in this era of healthcare cost-containment, the large volumes sold do not dispel the fact that generics are low-profit products. Manufacturers in this area really need to achieve a large enough mass to operate competitively, in terms of production, lower prices to increase market share and in particular, to have a healthy flow of ANDAs. Those that potentially have 180 days generic marketing exclusivity in the US are especially valuable, but often bring with them the threat of litigation and thus expensive legal fees.
As such, consolidation within this sector has been hectic over the past couple of years. Firstly, there was the tussle for the top spot, which Novartis’ Sandoz unit briefly held from July 2005 after it bought Germany’s Hexal and its US affiliate Eon Labs. In January 2006, however, Teva of Israel regained the no.1 position after it bought US rival Ivax for $7.4 billion. Secondly, smaller generics producers have been merging, with some deals aimed at geographical expansion (for example, Indian manufacturers buying in Europe and the US, though all-domestic deals in India are also popular).

Mylan, which called off a merger with King, and Barr are now viewed as potential players in the US in light of the deals involving Ivax, Watson and Andrx, and IMS expects consolidation to continue in this sector, not least as all-generics mergers have some of the most guaranteed returns in terms of shareholder value thanks in part to their virtually instant economies of scale (for example, in administrative and manufacturing functions). Some recent transactions:

Leciva + Slovakopharma (= Zentiva)
Par + Kali Labs
Stada + Nizhpharm, Ciclum
Glenmark + TASC Pharma
Aurobindo + Able Labs (pending)
Dr Reddy’s + Betapharm (pending)
At the other end of the healthcare lifecycle, many of the biotechnology companies founded in the 1980s and early 1990s have struggled to survive as pipeline projects failed, IPO windows closed, and venture capital proved hard to come by. Many have sought to cut administrative and other expenses, and to acquire more promising products and technologies, through mergers. Some companies, like Acambis, have expressed an interest in M&A as a way of moving into new areas, while others have done deals to progress their development into commercialisation. There have been fewer mergers between the larger biotechs, with the marriage of Biogen and Idec in 2003 being a noticeable exception. Some recent examples of smaller transactions include:

MorphoSys + Biogenesis
Antisoma + Aptamera
GPC Biotech + Axxima
IDM + Epimmune
EpiCept + Maxim
EntreMed + Miikana
As the huge detailing teams of Big Pharma have come to dominate the primary care market, more small firms have evolved that focus on the specialty area. In these niche markets, older products coming towards the end of their lifespan are often acquired from larger manufacturers, or drug delivery technologies are applied to create new formulations with their own periods of exclusivity. Some biotechnology firms have also moved in this direction, buying already marketed drugs that can bring in immediate revenue to fund the development of innovative new therapies. Examples of these types of transaction include:
Bradley + Bioglan
QLT + Atrix
Protein Design Labs + ESP Pharma
Jazz + Orphan Medical
MGI Pharma + Guilford
OSI + Eyetech
The business operating environment in Japan has historically made mergers difficult, and it is not unusual for them to be cancelled at a relatively late stage. As Western firms have moved into their domestic market, however, Japanese pharmaceutical manufacturers have had to look elsewhere for revenue growth. Larger players, led by Takeda, have been successful, and in the past few years there have been a number of all-Japan deals, some involving companies ranked in the top 30:
Kowa + Nikken Chemicals
Yamanouchi + Fujisawa (= Astellas)
Nichiiko + Nippon Galen
Daiichi + Sankyo
Dainippon + Sumitomo Pharma
Teikoku Hormone + Grelan (= Aska Pharma)
IMS does not expect to see many Western companies buy out Japanese manufacturers, though they have been taking over full control of former joint venture subsidiaries in the country (e.g. Merck & Co with Banyu), and many multinationals are keen on expanding their presence in the world’s second-largest single market for pharmaceuticals. Most observers view Roche’s buying of a 50.1% stake in Chugai in late 2002 as unusual. A more common occurrence has been for Japanese firms to expand their geographical presence and technology bases through the acquisition of overseas companies. Examples include:

Kyorin + ActivX Biosciences (USA)
Takeda + Syrrx (USA)
Sosei + Arakis (UK)
One of the most common type of deal recently has been a larger firm filling a gap in its pipeline or technology base with the targeted acquisition of a smaller company. Some of these transactions occur after a licensing deal, and others have replaced them:
J&J: OraPharma, 3D Pharma, Scios, Transform, Peninsula
Pfizer: Esperion, Angiosyn, Idun, Bioren, Vicuron
Genyzme: SangStat, Ilex Oncology, Verigen, Bone Care International
GSK: Corixa, ID Biomedical
Amgen: Tularik, Abgenix (pending)
AstraZeneca: KuDOS (pending)
Large firms have also been rearranging their portfolios, with deals in the over-the-counter sector growing; in early 2006, Pfizer was the latest to announce its intention of a “strategic” development for its consumer health unit. Previously, Reckitt Benckiser had bought Boots’ Healthcare International unit, Bayer Roche’s OTC division, and Novartis BMS’ North American consumer health business. Overall, geographical targets are likely to remain popular, while some regional players may also combine with each other to become a more dominant force in a particular country.

As seen by the announcements in March, the pace of consolidation in 2006 shows no sign of slowing. Serono is looking for a buyer, SkyePharma received a takeover offer, Altana is seeking a partner for its pharmaceutical unit, and Novartis is buying out the remaining 58% of its US affiliate Chiron, thereby entering the growing vaccine market. Other companies, such as Pfizer and Amgen have said they are looking for suitable deals, and a number of US firms have had a windfall thanks to the repatriation of overseas profits. There are continuing rumours and speculation about mega-mergers, involving the likes of AstraZeneca, GSK, Merck & Co, Novartis, Schering-Plough and Wyeth, but even if these fail to materialise, bankers in the life sciences sector look set to have plenty of business coming their way in the near future.

A swell in reported cases of mumps has Iowa health officials on the lookout. According to the Iowa Department of Public Health (IDPH), the state typically has an average of seven reported cases per year. As of March 16, 67 cases have been reported since the start of 2006 in 15 Iowa counties. That number has since grown.
The virus affects secreting cells at the back of the mouth and glands, and the response to infection produces swelling and pain mostly in the salivary ducts and glands found in the cheeks in front of the ear.

About 18 days after infection, symptoms such as earache, jaw tenderness, bodily discomfort, headache, low fever and anorexia begin. Many infected with the mumps virus show no symptoms or signs that would point to mumps infection. In 80 percent of the symptomatic cases, mumps clears up within 10 days and leaves only a hard immunity that lasts a lifetime. Approximately 20 percent of cases will be associated with some complications of nervous tissue or testicular tissue in males past puberty.

The virus is transmitted in saliva and can be transferred three to five days before symptoms even begin.

Mumps transfers between individuals via respiratory secretions like sneezing, coughing and even talking.

As for how the virus started spreading in Iowa, many scenarios are possible. An unvaccinated child visiting a country where vaccination is uncommon can bring back the virus and spread it to siblings, unvaccinated parents or classmates. Foreign college students are often implicated in campus outbreaks.

With the recent outbreak, the average age of the infected is 22, but seven cases involved children younger than 15 and 13 cases were reported for the over 40 age bracket.

Those who are 50 years old or younger should know their vaccination status. Children who attend Iowa schools should have proof of vaccination presented during enrollment, but there are estimates that 10 to 20 percent of the population has not received the recommended vaccinations. Those who do not remember being vaccinated may wish to discuss this with their health care provider.

The MMR vaccine has been available for nearly 40 years and remains at least 95 percent effective in preventing mumps. There are sub-strains of the mumps virus but this vaccine has been demonstrated to prevent each of the sub-strains. It is unlikely that those who have been vaccinated will be susceptible to this outbreak.

The CDC has determined that the strain spreading in Iowa is similar to the 2004-05 mumps outbreak in the United Kingdom and is covered by the MMR vaccine. In addition, the IDPH has formed a mumps sentinel surveillance network to detect cases quicker and ensure appropriate labs and paperwork are completed.

Some tests use to diagnosis for Mitral stenosis include:

1. X-ray examination: the first change is that left heart obvious curvature of the left atrium, pulmonary trunk prominent widened pulmonary vein, right anterior oblique perspective barium can be seen expanding esophageal left atrial compression. Severe lesions, the left atrium and right ventricle increased significantly, after the front shows the right edge of the heart shadow was a double shadow of hilar shadow deepened smaller aortic arch. Left ventricular generally do not. After long-term pulmonary congestion hemosiderin deposition, under double-lung field may be scattered in the shadow of the point. Often occur in elderly patients with mitral valve calcification.

2. ECG: electrocardiogram may be normal in mild mitral stenosis. Changes characteristic is that P-wave peaks were widened and shaped, suggesting that increased left atrium. With pulmonary hypertension, the increase shows that the right ventricle, the right side axis. Often combined with advanced disease with atrial fibrillation.

3. Echocardiography: is the most common diagnosis for Mitral stenosis, to determine valve area and cross-valve pressure gradient to determine the extent of lesions, surgical methods as well as evaluating the decision of the efficacy of surgery are of great value. Two-dimensional echocardiography before and after mitral valve can be seen on leaf reflectance increased, thickening, activity rate decreased diastolic body forward before the leaf was bulging like a balloon, before and after the flap tip distance was significantly shorter leaves, orifice area reduced. M-mode ultrasonography can be seen the rate drop in diastolic filling, the normal two peaks disappeared, E slow post-peak decline curve, mitral anterior leaflet, diastolic posterior lobe in the former was subordinate to the movement with the leaf, the so-called change-like battlements . Expansion of the left atrium, right ventricular hypertrophy and right ventricular outflow tract widening. Doppler ultrasound showed a slow and decreasing blood flow through the mitral valve.

4. Inspection of radionuclides: radionuclide blood pool imaging showed expansion of the left atrium, and concentration imaging agent through time, left ventricular not. Pulmonary hypertension, the pulmonary trunk can be seen and the expansion of the right ventricle.

5. Right heart catheterization: right ventricle, pulmonary artery and pulmonary capillary pressure increased, pulmonary vascular resistance increases, reducing cardiac output. After atrial septal puncture can be directly measured left atrial and left atrial pressure, early diastolic mitral stenosis inter-valve pressure gradient normal, with the condition worsened, the pressure gradient increased.