Thursday, August 13, 2009
Rx: Chill out and eat chocolate.
Hospitalists may someday prescribe chocolate bars and tickle therapy in their discharge orders to patients with heart problems, if the results of two studies are any indication.
In one, patients who were hospitalized for MI between 1992-1994 were less likely to die of heart disease over the next eight years if they ate chocolate at least twice a week vs. never eating chocolate, the study of middle-aged Swedes found. Check out these hazard ratios that compare never eating chocolate with:
--Eating chocolate less than once per month: 0.73 (95% confidence interval, 0.41-1.31)
--Eating chocolate up to once per week: 0.56 (CI, 0.32-0.99)
--Eating chocolate twice or more per week: 0.34 (CI, 0.17-0.70)
The poor souls who favor candy over chocolate are out of luck, however: consumption of other kinds of sweets had no effect on cardiac mortality, the researchers found.
A second study from the Women's Health Initiative found that women who were cynical and hostile toward others had higher rates of incident coronary heart disease (CHD) and mortality over 8 years than less cynical and/or hostile women. Likewise, optimistic women had lower rates of CHD and death than pessimists.
Together, these studies beg the question: Might we someday prescribe hugs, feel-good movies and daily Dove bars along with the statins? Seems like it couldn't hurt...
Labels: cardiology
posted by Jessica Berthold at
4:01 PM
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Saturday, April 25, 2009
Highlights from Internal Medicine 2009
At a Thursday afternoon session, Jason Persoff, MD, reminded his audience of the high stakes involved when dealing with cardiac resuscitation. Even when CPR is done perfectly, he noted during "Shocking Developments in Resuscitation: Cold Compressions and Clinical Updates," it yields only one-third of the normal cardiac output, 10% to 15% of normal cerebral blood flow, and 1% to 5% of normal cardiac blood flow. And perfect CPR is rare: Dr. Persoff cited a study showing that chest compressions are too shallow about 63% of the time and too slow about 72% of the time. As for defibrillation, it's often not done quickly enough, Dr. Persoff said. He advised attendees to shock first, ask questions about rhythm later.
On Friday, Dennis G. Maki, MACP, delivered a lecture on "Emerging Infectious Diseases" that focused in part on C. difficile-associated disease (CDAD). Rates of CDAD are increasing "precipitously," he noted, because of more variable strains and an older, more susceptible population. He also pointed to another possible culprit: alcohol-based handrubs. Because spores can't be killed by alcohol gels, Dr. Maki recommends good old-fashioned handwashing instead.
Finally, at a Saturday afternoon session on "Pain Management in the Hospitalized Patient," Eva H. Chittenden, FACP, offered attendees a thorough review of best practices, including appropriate use of opioids and other medications. Although completely relieving pain isn't always possible, Dr. Chittenden said, clinicians can focus on reducing it to a level that's tolerable for the patient. "We have to believe our patients when they say they have pain," she said, "because they're the only ones who can tell us."
For more in-depth coverage of Internal Medicine 2009 sessions, check out the June issue of ACP Hospitalist.
Labels: cardiology, infectious diseases, Internal Medicine 2009, pain management, palliative care
posted by Jennifer Kearney-Strouse at
12:23 PM
1 Comments
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