The science behind “broken heart syndrome” // La ciencia detras del "Sindrome de Corazon Roto"

The science behind “broken heart syndrome”

Posted By P.J. Skerrett On February 14, 2012

http://www.health.harvard.edu/blog/the-science-behind-broken-heart-syndrome-201202144256/print/ 

During Valentine’s season, it’s not hard to run across articles on what’s come to be called broken-heart syndrome. These often open with a touching story of a long-married couple that died within days of each other.
Many of these articles lump two completely different conditions under the “broken heart” heading. One is stress cardiomyopathy, sometimes known as takotsubo cardiomyopathy. The other is myocardial infarction, better known as a heart attack.
A huge sudden stress—like news that a loved one has died, experiencing an earthquake, or learning that your accountant has stolen all of your retirement savings—unleashes a torrent of stress hormones. Most of us weather this storm just fine. Others don’t.

Stress cardiomyopathy

Stress cardiomyopathy is a weakening of the left ventricle, the heart’s main pumping chamber. The bottom portion of the left ventricle balloons out each time the heart beats. It was originally called takotsubo cardiomyopathy because the shape of the left ventricle resembles the tako-tsubo, a Japanese trap used to catch octopi (see image). Exactly how stress makes this happen isn’t yet known.
Calling this “broken-heart syndrome” is cute, but limited. In addition to happening after news of unexpected loss, stress cardiomyopathy can be caused by an accident, episode of severe fear or pain, fierce argument, or even something that’s supposed to be pleasurable, like a surprise party or winning the lottery.
Stress cardiomyopathy feels like a heart attack—pain in the chest, left arm, jaw, or upper back; feeling short of breath or lightheaded; the sudden onset of nausea, dizziness, or a cold sweat. It even looks like one on an electrocardiogram. But none of the coronary arteries are blocked, the hallmark of a heart attack.
Treating stress cardiomyopathy generally involves the use of heart-protecting medications such as beta blockers, ACE inhibitors, and diuretics. Over the course of a week or longer, the ballooning tends to fade and the left ventricle usually recovers its pumping power.
(You can read more about stress cardiomyopathy in this article from the Harvard Women’s Health Watch.)

Myocardial infarction

Plaque is the cholesterol-filled gunk that builds up inside arteries throughout the body. Small plaques are silent; large ones can cause angina—chest pain or pressure brought on by physical activity or emotional stress. A big, sudden stress can lead to a heart attack two ways: by causing plaque to burst, or by triggering a dangerous heart rhythm.
When a plaque bursts, it spews a mixture of activated cholesterol, white blood cells, and other debris into the bloodstream. A blood clot forms to seal the leak and contain the damage. If the clot is so big that it completely blocks the artery, blood stops flowing to a section of heart muscle. Without oxygenated blood, that area of the heart begins to die. That’s a heart attack.
A surge or stress hormones can also interfere with the precisely timed signals that keep the heart beating steadily. It can make the left ventricle beat so fast and so erratically that it never has time to relax and fill with blood. Circulation to the brain and body stops. This situation, known as ventricular fibrillation, is a common cause of sudden (and deadly) cardiac arrest.
Over the years, a number of studies have shown that sudden stress from earthquakes, wars, sporting events, and more are followed by a spike in heart attacks. It happens with sudden loss and grief, too. A new study from Harvard-affiliated Beth Israel Deaconess Medical Center showed that the risk of having a heart attack is 21 times higher than normal within the first day after a loved one dies. The elevated risk drops as the days pass. The report was published in the journal Circulation. (You can read more about sudden stress and heart attack in this article from the Harvard Heart Letter.)

Prevention is tricky

There’s no way to steel yourself against the shock of bad news. All you can hope for is that your heart can handle it. The best way to get it ready is by making the kinds of healthy daily choices that protect the heart and prevent the buildup of plaque. You know which ones I mean—exercising, eating a healthy diet, not smoking, and the like.
If your heart has been broken and you are in mourning or grief, take care of yourself, advise the Beth Israel Deaconess researchers. Try to eat and sleep, don’t forget to take any needed medications, and take seriously symptoms such as chest pain.

Antidepressants: can they cure tiredness or premenstrual tension? / Los antidepresivos pueden curar el cansancio y la tension pre menstrual?

A rise in prescribing of antidepressants by doctors who are not psychiatrists, often for uses other than depression/anxiety, has helped build what is now a massive market. According to IMS Health, sales of antidepressants in the United States alone surpassed $11 billion in 2010. Antidepressants are now the third most commonly prescribed drug class in this country. Four out of five physicians prescribing antidepressants are not psychiatrists, and antidepressants are commonly prescribed by primary care doctors. Between 1996 and 2007, the percentage of doctor visits during which antidepressants were prescribed but no psychiatric diagnosis was noted increased from 59.5% to 72.7%, according to the study. Antidepressants have been demonstrated to be clinically effective for only a limited number of psychiatric conditions: major depressive disorder, chronic depression, some anxiety disorders, and a few other well-defined conditions, but antidepressant use is becoming concentrated among people with less severe and poorly defined medical conditions and even problems such as tiredness, nonspecific pain, smoking problems, headaches, abnormal sensations and premenstrual tension. What’s the reason behind this?

CLICK HERE 

El incremento en la prescripción de antidepresivos por médicos que no son psiquiatras, a menudo para usos diferentes a los de tratar Depresión/Ansiedad, ha contribuido en la construcción de un Mercado masivo en esta industria. De acuerdo con IMS Health, las ventas de antidepresivos en Estados Unidos solamente ha sobrepasado los $11 billones de dólares en 2010. Antidepresivos son la tercera prescripción mas común en el país. Cuatro de cada cinco médicos que prescriben anti depresivos, no son psiquiatras y los anti depresivos son recetados por médicos primarios. El porcentaje de visitas a estos doctores mientras no existía un diagnostico psiquiátrico se incremento de 59.5% hasta 72.7% de acuerdo al estudio. Este tipo de drogas han demostrado que son clínicamente efectivas únicamente en un limitado numero de condiciones psiquiátricas: depresión mayor, depresión crónica, algunos desordenes de ansiedad, y algunas cuantas condiciones bien definidas, pero el uso de antidepresivos se ha ido concentrando en personas con diagnósticos menos severos o incluso pobres diagnósticos como cansancio, dolores inespecíficos, problemas para dejar de fumar, dolores de cabeza, sensaciones anormales y síndrome pre menstrual entre otros. Cual es la razón detrás de esto?   

CLICK AQUI

Are you more stressed than you think? // Esta usted mas estresado de lo que piensa?

Stress is considered as a psychological and physical response of the body that occurs whenever we must adapt to changing conditions, whether those conditions be real or perceived, positive or negative. Although everyone has stress in their lives, people respond to stress in different ways. Some people seem to be severely affected while others seem calm, cool, and collected all the time. Regardless, we all have it. However, a stage of continues stress could lead to serious health problems and is the door to many of the most common preventable chronic diseases. Here are NINE signs that revel that you are more stressed out than you think. 

Estrés es considerado como una respuesta psicológica y fisiológica de nuestro cuerpo que ocurre cada vez que nos debemos adaptar a condiciones cambiantes. Condiciones reales o percibidas, positivas o negativas. Aunque todas las personas tenemos estrés en nuestras vidas, cada persona responde al estrés de diferentes maneras; algunas personas se pueden percibir severamente afectadas mientras que otras se ven calmadas, tranquilas y contenidas todo el tiempo. A pesar de esto, todos tenemos estrés. Sin embargo un continuo estado de estrés podría conducir a serios problemas de salud y es la puerta para muchos de las más comunes enfermedades crónicas prevenibles. Aquí están NUEVE señales que revelan si usted estaría más estresado de lo que pensaba.

Test to Understand Cancer Risk

This test was developed by the Harvard School of Public Health and evaluates risk factors of the most common types of cancer.  This interactive tool estimates the risk of cancer and provides personalized tips for prevention. Anyone can use it, but it's most accurate for people age 40 and over who have never had any type of cancer.
This tool takes only few minutes to be answered and helps you understand your risk so you can MODIFY them and focus on your prevention efforts. 

Because the best way to fight cancer is to stop it before it starts!

CLICK HERE TO GO TO THE TEST 

Este Test fue desarrollado por la Escuela de Salud Publica de la Universidad de Harvard, evalúa los factores de riesgo de los más comunes tipos de Cáncer. Esta herramienta interactiva estima el riesgo de desarrollar Cáncer y provee consejos personalizados para iniciar la prevención. 

Esta herramienta toma únicamente unos pocos minutos para ser respondida y produce una enorme ayuda para entender SU riesgo de tal manera que usted puede modificarlo y centrarse en los esfuerzos para prevenir.

Porque la mejor manera de combatir el cáncer es detenerlo antes de que comience. 

CLICK AQUI PARA IR AL TEST 

Do you wanna get rid of your belly fat? Start exercising.

Jogging Beats Weight Lifting for Losing Belly Fat

Compared with resistance training, aerobic exercise burns 67% more calories, research shows.

By Robert Preidt, HealthDay News

FRIDAY, Aug. 26 (HealthDay News) — Aerobic exercise is better than resistance training if you want to lose the belly fat that poses a serious threat to your health, researchers say.

That's the finding of their eight-month study that compared the effectiveness of aerobic exercise (such as jogging), resistance training (such as weight lifting), or a combination of the two activities in 196 overweight, sedentary adults aged 18 to 70.

The participants in the aerobic group did the equivalent of 12 miles of jogging per week at 80 percent maximum heart rate, while those in the resistance group did three sets of eight to 12 repetitions three times per week.

The Duke University Medical Center researchers looked at how these types of exercise reduced the fat that's deep within the abdomen and fills the spaces between internal organs. This type of fat — called visceral and liver fat — is associated with increased risk of heart disease, diabetes, and some types of cancer.

Aerobic exercise significantly reduced visceral and liver fat and improved risk factors for heart disease and diabetes, such as insulin resistance, liver enzymes and triglyceride levels. Resistance training didn't deliver these benefits. Aerobic exercise plus resistance training achieved results similar to aerobic exercise alone, the investigators found.

"Resistance training is great for improving strength and increasing lean body mass," lead author and exercise physiologist Cris Slentz said in a Duke news release. "But if you are overweight, which two-thirds of the population is, and you want to lose belly fat, aerobic exercise is the better choice because it burns more calories."

Aerobic exercise burned 67 percent more calories than resistance training, the researchers found.

The study was published in the Aug. 25 issue of the American Journal of Physiology.

Why Boozing Can Be Bad for Your Sex Life

Sure, you're more likely to ask for her phone number after throwing back a few. But when it comes to your sexual health, alcohol can be one big turn off. Here's why.

By Chris Iliades, MD

Medically reviewed by Farrokh Sohrabi, MD

http://www.everydayhealth.com/erectile-dysfunction/why-boozing-can-be-bad-for-your-sex-life.aspx?xid=tw_everydayhealth_20120106_boozesex

Drink a little alcohol; kiss your bedroom jitters goodbye: Anyone who’s transformed into Don Juan after a couple of cocktails knows that. But beyond that newfound confidence, is alcohol good for your sex life?
Actually, the effect can be the opposite as your blood alcohol level increases. Alcohol is a depressant, and using it heavily can dampen mood, decrease sexual desire, and make it difficult for a man to achieve erections or reach an orgasm while under the influence. In fact, overdoing it on booze is a common cause of erectile dysfunction.
That doesn’t mean you need to cut back completely — most experts say moderation is key. But what's “moderation” exactly? According to the U.S. Centers for Disease Control and Prevention (CDC), moderate drinking is no more than two drinks a day for men (and one drink a day for women). The liver can only break down the amount of alcohol in about one standard-size drink an hour, so regularly drinking more than that means that toxins from alcohol can build up in your body and affect your organs, including those involved in sex.
Here’s why you should think twice about tossing back too many.

5 Ways Alcohol Can Wreck Your Sex Life

For men, heavy drinking can lead to:
Temporary erectile dysfunction. Researchers have found that too much alcohol affects both your brain and your penis. In one University of Washington study, sober men were able to achieve an erection more quickly than intoxicated men — and some men are unable to have an erection at all after drinking.
That’s because pre-sex boozing decreases blood flow to your penis, reduces the intensity of your orgasm, and can dampen your level of excitement (in other words, even if you are able to have sex, it may not be nearly as pleasurable as it would be without the excess alcohol).
Long-term erectile dysfunction. The risk for long-term erectile dysfunction has been linked to chronic heavy use of alcohol. In fact, studies show that men who are dependent on alcohol have a 60 to 70 percent chance of suffering from sexual problems. The most common of these are erectile dysfunction, premature ejaculation, and loss of sexual desire.
Ruined relationships. According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use beyond moderation is associated with relationship problems that include conflict, infidelity, economic insecurity, and divorce. In addition, 90 percent of all sexual assaults involve alcohol consumption.
The sexual repercussions of smoking. If you are someone who tends to light up while drinking, you could be further increasing your risk for ED. For men under the age of 40, smoking is the biggest cause of erectile dysfunction — and studies show that men who smoke more than 10 cigarettes daily are at an increased risk for erectile dysfunction.
STDs. Another big risk when combining sex and alcohol? Getting exposed to a sexually transmitted disease. Studies show that almost 50 percent of unplanned sexual encounters involve alcohol, and 60 percent of STDs are transmitted when alcohol is involved. Young adults who use alcohol are seven times more likely to have unprotected sex.

Why Less Is More

The relaxing effect of alcohol and the feeling of well-being that comes with a drink or two have made alcohol humans’ favorite beverage for about 10,000 years. Though some studies confirm that alcohol (in moderation!) is good for your heart and circulation (which can work against erectile dysfunction), it’s important to remember that sex and alcohol are a delicate balancing act.
If you've experienced a lack of sexual desire, premature ejaculation, relationship problems, or erectile dysfunction because of mixing alcohol and sex, you may be letting alcohol get the best of your sex life.

Last Updated: 01/04/2012

PSA Test for Prostate Cancer Doesn't Save Lives But findings are irrelevant, one expert says.

FRIDAY, Jan. 6, 2012 (HealthDay News) — Annual screening for prostate cancer doesn't save lives, finds a new study that is unlikely to quell the controversy surrounding routine prostate specific antigen (PSA) screening.
"Organized prostate cancer screening when done in addition to whatever background testing exists in the population does not result in any apparent benefit, but does result in harm from false positives and over-diagnosis," said lead researcher Philip Prorok, from the Division of Cancer Prevention at the U.S. National Cancer Institute.
"Men considering prostate cancer screening should be fully informed of the implications of such testing before making a decision," he added.
Experts have disagreed for some time on whether the blood test saves lives or results in over-diagnosis and over-treatment. The new findings, which extend prior results out to 13 years of follow-up, are published in the Jan. 6 online edition of the Journal of the National Cancer Institute.
The study followed men enrolled in the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) Trial from 1993 to 2009, comparing results for a group of men who had undergone screening with those for men who hadn't had testing. The men were 55 to 74 years old.
One group had PSA screening every year for six years and a digital rectal examination every year for four years. The other men had regular care, which in some cases included screening if requested by the patient or doctor.
Compared to men getting usual care, the screened men had a 12 percent relative increase in prostate cancer but a slightly lower rate of high-grade cancer.
However, no difference in deaths was seen between the two groups.
This finding held true even after age, screening before the trial and other medical conditions were taken into account, the researchers said.
Prorok said that better treatment for prostate cancer may explain the similar mortality results.
Among prostate cancer patients, death from other causes was somewhat higher in the screened group (10.7 percent of 4,250 men with prostate cancer) compared to the usual care group (9.9 percent of 3,815 men with prostate cancer).
This indicates men who underwent PSA screening were over-diagnosed, meaning the test picked up slow-growing tumors that probably weren't lethal, the researchers said.
"PSA testing and digital rectal examination screening as conducted in this trial did not reduce prostate cancer mortality, but there was a persistent excess of prostate cancer cases in the screened arm, suggesting over-diagnosis of prostate cancer," Prorok said.
Some prostate cancer experts disagree with the authors' conclusions.
Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, said the results are invalid because the trial was flawed.
According to D'Amico, 52 percent of those who received usual care had a PSA screening. "That's a serious issue which makes it very hard for the study to show if any benefit exists for PSA screening," he said.
Also, 15 percent of those who were supposed to get PSA screening never did, D'Amico said. "So what you've got is a screening study in which 85 percent of the people got PSA screened on the screening arm and 52 percent got screened on the control arm, which makes it impossible to ever measure a difference," he said.
Men should ignore this study, "because it has no relevance to PSA screening," D'Amico said.
D'Amico said he has more confidence in the results of a European study published in 2009 in the New England Journal of Medicine, which showed a 20 percent reduction in cancer mortality with PSA screening.
Men who can benefit most from screening are those at risk for prostate cancer, particularly men who have a family history of prostate cancer, African Americans and men over 60, D'Amico said.
Prorok acknowledged that the PLCO trial wasn't perfect. "Nonetheless, the contamination was not enough to eliminate the early diagnosis of prostate cancers nor the persistent excess of cancers," he said.
PLCO provides information about over-diagnosis, Prorok added. "Even if the contamination did dilute a benefit compared to no screening, the result of no mortality difference between the arms in PLCO could be interpreted to suggest that more intensive screening is not beneficial but does result in harm," he said.
 Found in:
http://www.everydayhealth.com/prostate-cancer/0106/psa-test-for-prostate-cancer-doesnt-save-lives.aspx?xid=tw_everydayhealth_20120106_psatest