Showing posts with label Morbidity. Show all posts
Showing posts with label Morbidity. Show all posts

Wednesday, 28 March 2012

Smoking deaths triple over decade - tobacco report

A man lights a 'bidi' at a wood logging mill on the outskirts of Jammu October 31, 2011. REUTERS/Mukesh Gupta/Files
A man lights a 'bidi' at a wood logging mill on the outskirts of Jammu


By Kate Kelland | Reuters

LONDON (Reuters) - Tobacco-related deaths have nearly tripled in the past decade and big tobacco firms are undermining public efforts that could save millions, a report led by the health campaign group the World Lung Foundation (WLF) said on Wednesday.

In the report, marking the tenth anniversary of its first Tobacco Atlas, the WLF and the American Cancer Society said if current trends continue, a billion people will die from tobacco use and exposure this century - one person every six seconds.

Tobacco has killed 50 million people in the last 10 years, and tobacco is responsible for more than 15 percent of all male deaths and 7 percent of female deaths, the new Tobacco Atlas report found. (www.tobaccoatlas.org)

In China, tobacco is already the number one killer - causing 1.2 million deaths a year - and that number is expected to rise to 3.5 million a year by 2030, the report said.

That is part of a broader shift, with smoking rates in the developed world declining but numbers growing in poorer regions, said Michael Eriksen, one of the report's authors and director of the Institute of Public Health at Georgia State University.

"If we don't act, the projections for the future are even more morbid. And the burden of death caused by tobacco is increasingly one of the developing world, particularly Asia, the Middle East and Africa," he said in an interview.

Almost 80 percent of people who die from tobacco-related illnesses now come from low- and middle-income countries. In Turkey, 38 percent of male deaths are from smoking-related illnesses, though smoking also remains the biggest killer of American women too.

WLF's chief executive Peter Baldini accused the tobacco industry of thriving on ignorance about the true effect of smoking and "misinformation to subvert health policies that could save millions".

The report said the industry had stepped up its fight against anti-tobacco policies, launching legal challenges and seeking to delay or stop the introduction of plain packaging, legislation banning smoking in public places, advertising bans and health warnings on packets.

The world's six biggest tobacco firms made $35.1 billion in profits in 2010 - equal to the combined earnings of Coca-Cola, Microsoft and McDonald's, the report said.

Smoking causes lung cancer as well as several other chronic pulmonary diseases and is a major risk factor in heart disease, the world's number one killer.

More than 170 countries have signed up to a World Health Organisation-led convention committing them to cut smoking rates, limiting exposure to second-hand smoke, and curbing tobacco advertising and promotion.

WHO director general Margaret Chan said thanks in part to that convention, 1.1 billion people have in the past two years become covered by at least one measure designed to curb tobacco use. She added, however, that the battle was far from over and urged more countries to fight the industry.

"We must never allow the tobacco industry to get the upper hand," she said in a foreword to the report. "Tobacco is a killer. It should not be advertised, subsidised or glamorised."

(Reporting by Kate Kelland; Editing by Ben Harding)

Tuesday, 27 March 2012

Is it Time for a Heart Health Screen?

Source: Contributed by the National Heart Centre Singapore (NHCS), this article was first published in Asiaone as part of a series on heart health. 

In Singapore, cardiovascular disease - a class of diseases affecting the heart and blood vessels - is the leading cause of death and morbidity.


Coronary heart disease - a subset of cardiovascular disease - is the number two killer. It is the failure of the coronary arteries or vessels supplying oxygen to the heart and surrounding tissue.

Coronary heart disease (also known as coronary artery disease) is expected to afflict more people at a younger age as we become more sedentary and develop unhealthy eating habits.


Coronary heart disease is known to develop over a long time and can go undetected in the early stages as there may be no symptoms. For some patients, the onset of a major heart attack with its attendant complications is the first and only symptom of coronary artery disease. This can be avoided if more patients, especially those with known risk factors, keep track of their heart health.




What is heart health assessment?

Heart health assessment plays an important part in the early diagnosis and treatment of heart disease. This is especially important for people who do not seem ill.



"This is because cardiovascular risk factors could be detected, allowing for earlier therapy," explains Dr Paul Chiam, Consultant Cardiologist at the National Heart Centre Singapore. "Early heart problems (if any) could also be picked up. Treatment - including lifestyle modification - can help to prevent or delay complications".


A basic assessment is relatively pain-free, except for routine blood taking. The assessment usually begins with a medical history review and a detailed physical examination. It also includes tests such as the ECG (electrocardiogram), chest x-ray, and fasting lipid and glucose profiles to evaluate basic cardiac status and risk profile.


The results will help to determine if the risk factors for heart disease - such as high blood pressure, diabetes or elevated cholesterol levels - are present.


Besides cardiovascular risk factors, early heart conditions such as underlying heart artery blockages can be picked up. Early intervention can prevent the condition from becoming worse.


Who can do the screening?

A family physician or GP can provide most of the basic screening. He or she may refer patients to a cardiologist for further tests, such as an exercise stress test, based on clinical findings from the basic screening.



Who should have heart health screening?

The recommended age to start assessing heart health for most people is around 40-45 years.

For people with strong family history of heart disease, they should perhaps start earlier, at around 35 years old.
As for the frequency of the check-ups, Dr Chiam says, "Depending on the patient's clinical history and the risk profile, the doctor may recommend that a checkup be done every one to five years."


What are the tests for heart disease?
Blood testsThis analyses cholesterol levels, kidney and liver function and diabetes mellitus. It can also confirm if you are having a heart attack if you are experiencing chest pain


Electrocardiogram (ECG) Identifies abnormal heart rhythm and evaluates if symptoms of chest discomfort are due to heart disease.
The patient will be asked to lie on a bed and electrodes will be placed on his chest, arms and legs. These electrodes help to detect the electrical activity of the heart. Patient can breathe normally during the procedure, but should avoid moving or talking to prevent distortion of test results. This test takes about 5 to 10 minutes.


Chest x-ray
Diagnoses abnormalities in cardiovascular and pulmonary systems - heart, lungs and blood vessels.


Exercise stress testThis assesses the response of the heart to increased workload and demand for blood supply during exercise or exertion.
Electrodes are placed on the patient's chest for ECG monitoring before the test. The patient's ECG and blood pressure are taken at rest. The patient is then asked to walk on the treadmill machine. The speed and gradient of the slope will increase every 3 minutes to stress the heart gradually.


During the test, the patient's blood pressure, heart rate, ECG and general condition are monitored closely. The patients should inform the doctor to stop the test at any time if they are feeling tired, unwell or unable to continue. The procedure takes up to 1 hour, inclusive of preparation time.


Calcium score on CT scan
By assessing the amount of calcification in the coronary arteries, this test detects coronary artery disease at an early stage when there are no symptoms and helps to determine its severity.


The technologist begins by positioning the patient on the computed tomography (CT) examination table, usually flat on the back. Straps and pillows may be used to help the patient maintain the correct position and to hold still during the scan.
Electrodes for ECG will be attached to the chest to monitor heart beats. This makes it possible to record CT scans when the heart is not actively contracting.


Patients are asked to hold their breath for a period of 10 to 15 seconds while images are recorded. You may also feel a little warm upon injection of the contrast, which should subside after a short while.


When the examination is completed, you will be asked to wait until the technologist verifies that the images are of high enough quality for accurate interpretation.




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