News and Views
1. As per a study published in November issue of Cancer Epidemiology Biomarkers & Prevention there has been significant decline in the rates of atypical ductal hyperplasia, known risk factor for breast cancer. The decline correlates with the declining use of HRT in women.
2. 2.2 crores affected by swine flu in US : At least 2.2 crore American have come down with H1N1 swine flu since the virus first surfaced in April and approximately 3900 people have died including 540 children.
3. As per a report published in the Journal Pediatric, more than 53% of children with kidney stones do not have classical symptoms like painful bloody urination.
4. Tadelafil has been approved by US FDA in May 2009 for the treatment of pulmonary arterial hypertension.
5. Pitavastatin was approved by the US FDA in August 2009 for the treatment of primary hyper mixed Dyslipidemia.
6. Dronedarone has been approved by US FDA in July 2009 for the treatment of paroxysmal or persistent arterial fibrillation or atrial flutter.
The optimal management of ST elevation myocardial infarction patients with failed fibrinolysis has been uncertain. The REACT trial randomly assigned 427 patients with STEMI and failed fibrinolysis to conservative medical therapy, repeat fibrinolysis, or rescue percutaneous coronary intervention (69 percent with stenting) [1,2].
At more than four years of follow up, rescue angioplasty was associated with a lower rate of all cause mortality compared to repeat fibrinolysis or conservative therapy.
Rescue or salvage angioplasty is defined as angioplasty done within 12 hours of failed fibrinolysis in patients with evidence of continuing or recurrent myocardial ischemia.
If rescue angioplasty is performed, it should be undertaken quickly.
That means one should do urgent angio at 45 to 60 minutes following fibrinolysis. Go for angioplasty or bypass with less than TIMI grade 3 flow, defer intervention in patients with TIMI 3 flow who are hemodynamically stable. However, observational data suggest that even patients with TIMI 3 flow have reduced mortality if PCI is performed.
1. Gershlick, AH, Stephens Lloyd, A, Hughes, S, et al. Rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction. N Engl J Med 2005; 353:2758.
2. Carver, A, Rafelt, S, Gershlick, AH, et al. Longer term follow up of patients recruited to the REACT (Rescue Angioplasty Versus Conservative Treatment or Repeat Thrombolysis) trial. J Am Coll Cardiol 2009; 54:118.
Myths about Depression
Depression is hurtful but not a major medical condition. MYTH
Depression is not simply a temporary case of the blues. It is a common, serious medical condition that can disrupt daily functioning. At the extreme, people with depression may harm themselves. Brain imaging research shows that the brains of people with depression function differently than those of non depressed people. In depressed people, brain areas that regulate mood, behavior, thinking, appetite and sleep seem to function abnormally. Also, important brain chemicals called neurotransmitters appear to be out of balance.
If your parent and grandparent had depression, you are sure to get it eventually. MYTH.
Because depression can run in families, scientists suspect that genes play a role. You are three times more likely to develop depression if your parents suffered depression. But it is not inevitable that you will get the illness, too. Scientists believe the risk of developing depression results from a combination of genetic, biochemical, psychological, and environmental factors.
Only emotionally troubled people become depressed. MYTH
Depression affects people from all walks of life, not just people with previous emotional troubles. Depression can strike after the loss of a loved one, trauma, or other stressful situations like the loss of a job.
Most people with depression never go to a mental health professional. FACT
Only 39% of people with severe depression see a mental health professional. People with depression often see their primary care doctor. Also, many depressed patients remain undiagnosed or undertreated. Some cases of depression are tough to treat. But the vast majority of cases are highly treatable with antidepressants and talk therapy. The earlier treatment begins, the more effective it is.
Depression is most common in elderly people. MYTH
People assume the elderly suffer depression most often. In fact, middle aged people 40 to 59 have the highest rates of depression. Depression is not a normal part of aging. However, ill health, medication side effects, social isolation, and financial troubles can trigger depression in elderly people. Older people belong to a generation that often feels ashamed to admit to feelings of sadness and grief. But it's crucial that they seek help, especially because white men 85 and older have the highest suicide rate.
Depression causes physical pain. FACT
Depression causes emotional symptoms such as anxiety, irritability, and hopelessness. But it can also cause physical symptoms such as chest pain, queasy or nauseated sensations, dizziness or lightheadedness, chest pain, sleep problems, exhaustion, and changes in weight and appetite. It can also worsen back and joint pain and muscle aches.
Talking about depression only makes it worse. MYTH
Different types of psychotherapy, or talk therapy, have been proven effective in treating depression. For example, cognitive behavioral therapy (CBT) teaches people new ways of thinking to replace negative thoughts and behaviors that contribute to depression. In another approach, interpersonal therapy (IPT) helps people to understand troubled relationships and find ways to work through the difficulties.
Being optimistic can cure depression. MYTH
Depression is debilitating. Most people with the disorder will require treatment to get better. Few can will themselves to get well through positive thinking. Depressed people may need medication to normalize brain chemicals.