Closed-heart aortic valve replacement, good surgery and good science

Here is an article from a San Antonio, Texas paper about replacing the aortic valve in the heart without cracking the chest, but instead using a minimally-invasive catheter technique:

http://www.kens5.com/news/New-heart-valve-replacement-doesnt-involved-open-heart-surgery-146475805.html

This is absolutely thrilling news. Open-heart surgery is one of the most inherently worrisome and fraught forms of surgery, with an unbelievably painful post-op recovery phase. Simply cracking the chest is a big deal, and anything they do after that might be tricky but it's not nearly as shocking to the body.

Taking the chest-cracking out of heart surgery is the single biggest change we can make to safer, saner, faster-healing, less complicated heart surgeries. We WANT people to survive the experience intact, we really do!

Aortic valve issues are, as I recall from my ICU/Telemetry nursing, one of the more common heart issues; although it's not often life-threatening, it is often life-limiting, because without that "aortic kick" that the heart gets from a good, solid snapping-closed of the aortic valve during a heartbeat, the pumping action just isn't as good, and that has knock-on effects that can pile up over time.

Weak aortic valves can contribute to everything related to an impaired heartbeat, including blood pressure, vessel competence (think of congestive heart failure and tissue swelling/edema), and most obviously to cardiac hypertrophy, where an underpowered heart grows extra muscle to try to push blood around. What that really does is create more demand for blood from the heart itself, and push more blood back out the incompetent aorta!

Now that surgery can correct aortic valve issues without open-heart surgery, watch the medical news over the next 2-3 years: you're going to see a lot more studies directly relating aortic valve problems to other conditions, like those mentioned above. Why now? Because, once a problem can be solved, physicians are much more willing to look at the problem directly.

Just like the rest of us. :)

It's important to note that, for people with CRPS who have to avoid surgery as much as is compatible with life, and for those with dysautonomia for other reasons, this surgery is a game-changer. No longer do we have to choose between increasingly incompetent valves and a lifelong upsurge in agony, disruption, and dysregulation. Now, we can have a surgery that goes near two major nerve bundles but, if properly done, touches neither; solves the problem and gives us our hearts back; and lets us get on with making the best of our lives.Talk about a win/win!

Link between fast food and depression confirmed, not clarified

This article states that around 5% of non-depressed people go on to develop depression when they eat junk food of the baked-goods variety (like croissants, pecans spins and Twinkies) or fast food.

Link between fast food and depression confirmed

The authors assume the link is causal (fast/junk food causes depression), but I don't see why. Many people only eat fast food and carb-rich junk food when they're already depressed and want the temporary solace (and serotonin/insulin hit) of comfort food. It might be smarter to eat more trail mix, olives and avocados when we're depressed, and leave out the Twinkies, but the fact is they cost more.

So, is the fast food/junk food self-medication for depression, contributor to depression, or both? It makes more sense to view it as a sign that something is amiss, rather than leaping to the conclusion that fast/junk food itself is the problem.

When people need to self-medicate, they're going to find a way. And at least fast food is not going to cause as many accidents as alcohol, as much ruin as harder drugs, or as much disease as compulsive sex -- all of which are popular forms of self-medication for depression.

Something to consider... We need not leap right to the blaming mentality. We can treat these changes in habits as useful clues instead.

Repeated stress knocks out the prefrontal cortex

... In a number of ways.
This article describes a new finding which relates memory loss and cognitive dysfunction to a loss of glutamate receptors in the prefrontal cortex (PFC):
body=http%3A%2F%2Fwww.sciencedaily.com%2Freleases%2F2012%2F03%2F120307132202.htm&subject=How+repeated+stress+impairs+memory
They state that this is why the PFC tends to falter in the face of repeated stress: the receptors for one of the key neurotransmitters become depopulated, leaving fewer sites to accept the glutamate and allow that part of the brain to do its job.
Cognitive impairment in the face of repeated or chronic stress is not a monolithic problem, though. Memory and decision-making are probably the most complex of brain tasks, and there are plenty of things that go wrong when memory and cognition fail.
Other factors include dopamine depletion, leaving less of that transmitter to carry messages back from the PFC, thereby making executive decisions harder to make and still harder to follow through on. (I wrote a previous post on dopamine and decision making. I'll dig it up and link over.)
And then there's the adrenaline overproduction and overuse that characterizes chronic and repeated stress, leading to disruption of the hypothalamic-pituitary-adrenal axis (the body's entire signaling structure for body processes) which contributes to brain dysfunction in still more ways: by disrupting sleep, which disrupts memory formation and impedes logic; and by contributing to the rise of metabolic syndrome, creating less stable blood sugar -- which, in the brain, adds considerable insult to injury: a hungry brain is a low-functioning brain.
Take your vacations. Simplify your life. Move your body around regularly. Meditate early and often. If you cherish your brain, you might as well let it work -- and that means getting a half-Nelson on stress before it gets one on you.

Links:
The article on overuse of dopamine (on my Living Anyway blog): http://livinganyway.blogspot.com/2011/03/dopamine-poverty-and-pain-lighter-side.html
Another Biowizardry entry on neurotransmitters: http://biowizardry.blogspot.com/2011/08/scared-of-wrong-things-role-of-mao-in.html

Numeracy: The educational gift that keeps on giving?

This is about what we used to call numeric literacy:

http://www.sciencedaily.com/releases/2012/02/120210133346.htm#.TzdCY4vl1xg.mailto

I have problems with using the word "numeracy" to mean "numeric literacy", but I can adapt. To me, the word "numeracy" means "of or relating to numbers"; therefore, to be numerate means to be of or relating to numbers, and that doesn't make sense. 

This spasm of reflexive linguistic conservatism will pass and then we can get to the point...

Numeric literacy (however you name it) results in better decisions. Those who are numerically literate are better able to understand information that's represented by quantities and numbers, and not be confused by sloppy descriptions and poor representations. They have better outcomes in health care, work and other areas where decision-making really pays off. 

The fun part is, that this article's writer makes the point that the spin doctors are gonna pounce on this, as if they haven't already:

"This has implications for how policy makers and others should communicate about the risks of medicines, earthquakes, climate change, and the stock market."

Caveat emptor, from here on out!

Make your decisions emotionally if you must, but get the data first, so at least you can really see what you're risking. 

Then, remember your fifth grade math and see how the numbers add up. (The kinds of statistics that get published in the news rarely require anything more, so don't let the math intimidate you.) That intellectual integrity can save your life.