35 Burst results for "Hypertension"
Using a Digital Cognitive Behavior Therapy to Treat Diabetes
"David thanks for joining us. I'm happy to be here. Thanks for having me dating. We're gonna talk about better therapeutics. Its efforts to improve outcomes for patients with cardio metabolic conditions through what you call your nutritional cognitive behavior therapy and your prescription digital health products. Let's start with the diseases. you're targeting. how big healthcare problem do they represented a over half of. Us adults have one or more major cardio metabolic disease including diabetes hypertension in hybrid. Dania maids a yard. It's a we use the word epidemic for a lot of things. But i think it applies. Here it's a it's a massive problem to what extent are cardiovascular diseases and diabetes and related conditions driven by behaviors opposed to biology and perhaps more to the point. To what extent. Can these be treated by behavioral therapy rather than pharmacologic interventions so You know a fascinating a fascinating topic. So if you if you think about our evolutionary history i you know we didn't we didn't really have ancestors with cardio metabolic disease yup in in order to in order to survive and thrive and reproduce You know people were lean and fit. And and those are things that seem tend to reduce or eliminate cardio metabolic disease
Out of Sight But Center Stage, Jurors Weigh Derek Chauvin's Fate
"I'm Julie Walker jurors in Minneapolis continue to weigh the fate of former police officer Derek Chauvin charged with the murder of George Floyd what or who killed Floyd that's what both sides argued long closings yesterday defense attorney Eric Nelson told jurors Chauvin was doing what he was trained it was drugs in a bad heart disease heart hypertension all of these things existed before Mr Chauvin rocked prosecutor Jerry Blackwell argued it would show that kneeling on Floyd for nine minutes and twenty nine seconds and not an enlarged heart reason George Lloyd is dead is because Mr Schoen hard was too small jurors are being sequestered as they decide the case which could land show been in prison for up to forty years on the most serious charge audio from court TV I'm Julie Walker
Derek Chauvin's Murder Trial Heads to Jury Deliberations
"The murder case against former Minneapolis police officer Direct showman in the death of George Floyd has now gone to the jury and Ed Donahue has this report. In closing statements, Defense attorney Eric Nelson said It wasn't a lack of oxygen that killed Floyd Drug ingestion. Huh? A bad heart. Diseased heart. Hypertension. Prosecutor Steve Slater told the jury showman had to have known what he was doing to Floyd. He heard him but he just didn't listen. Continued to push him down. Slater also pointed out it's all on video that force for nine minutes and 29 seconds that killed George Ploy. He betrayed the badge tape from court TV show Bin showed little expression. He took off his mask as his attorney, presented his closing statement.
Murder case against ex-cop in Floyd's death goes to the jury
"The murder case against former Minneapolis police officer Derek show open in the death of George Floyd has gone to the jury in closing statements defense attorney Eric Nelson said it wasn't a lack of oxygen that killed Floyd drug ingestion and the bad heart the diseased heart hypertension prosecutor Steve Slater told the jury Chauvin had to have known what he was doing to Floyd she heard him but he just didn't listen he continued to push him down Fletcher also pointed out it's all on video that forced for nine minutes and twenty nine seconds that killed George Floyd he betrayed the batch tape from court TV show been showed little expression he took off his mask as his attorney presented his closing statement I'm a Donahue
Interview With Paul Farmer on Global Health Inequity
"Paul farmers it professor at harvard medical school chief of global health equity at brigham and women's hospital in boston and the co founder of the organization partners in health began by asking him to describe the global health care situation in his own words. Well right now. We could focus almost entirely on the setbacks. You know one of the biggest problems we faced all over. The world is that with a shutdown. Obviously people aren't able to readily accessed their their care. What if they have cancer. Whatever they have diabetes have severe hypertension. So those are ranking problems. I think to anybody who's involved in global health. But that's just the tip of the iceberg. A lot of the efforts that we have engaged in to address. Social determinants of health are also being set back economic educational programs cultural endeavors employment opportunities There's been a major contraction. An anti poverty efforts overall. so it's going to be Troubling reflection on what's happened this past year and a lhasa worried it's gonna be projected poured into a futures. Will
How To Work Through Pregnancy And Menopause.
"Hi and welcome to help each other hurt a podcast dedicated to uncovering many of the women's health issues many of us are wondering about but few of us are talking about my mission is to expose the current gaps in knowledge and Care on all things Women's Health. Enjoy. Welcome back to the show. So today's episode is going to be all about pregnancy and how conditions may may have affected your pregnancy can come back to play a role in perimenopause and menopause. So you may think these two are completely unrelated and I am here to let you know. There's actually some really interesting themes that we may be able to gleam from our pregnancy that we can use when we look forward to or as we're entering into perimenopause and menopause. Before we get into that let's hear a word from our sponsor from Pharma. Thank you so much for sponsoring. Today's episode film Pharma is a woman's health care company the focuses on putting women first off then Farm was established to help women who are often forgotten about the pharmaceutical industry their products address vaginal and Volvo dryness itching and pain. We're always told how important it is to moisturize our face, but our intimate areas just as important many women have trouble talking about dryness with their doctors and do not know where to turn them far. My mom is here for you. This company feels women should feel comfortable making intimate skin hydration a part of their daily skincare routine try their products today for relief from vaginal and Volvo, dryness wage and pain check them out at fem pharma.com. That's, you are not going to be disappointed. All right, so here comes a fun job. Moment of Truth one of the reasons I wanted to do this episode today is because I am expecting and I've been hiding this fact for a pretty long time. I am in my third trimester and so far pregnancy has gone just fine. I'm not one of those people who really enjoys being a pregnant. I know many women who do simply not one of them. So I have been trying to hide it and I guess that's my way of not focusing so much on it. Thankfully. I'm lucky to be pretty healthy during this pregnancy. And this will be my third child is a surprise. We don't know yet if it's going to be a boy or a girl so it'd be really fun if you want to stick around and see I'm due in early June and not anything like my last baby. This baby might be a little early. So if there is a little break in podcast episodes, it's probably because I just had a baby now you also log I love working and I love what I do is I'll probably be back pretty quickly. And at this point I've gotten really efficient at getting podcast episode out to you. So I wanted to let you know because I do not feel like I was being honest hiding this any longer and I am really excited but it really led me to think about let's talk about how pregnancy relates to. Pause and menopause now. I just said I'm one of those people who loves being pregnant. That's mostly because I'm uncomfortable a lot. However, I have been really blessed to have healthy pregnancies, but every single pregnancy can be thought of as a stress test. So do you know what a stress test is if you don't we typically think about cardiovascular stress tests where they put the little leads you and you have to walk or run on the treadmill and they're looking at the EKG to see when you're under stress what happens to your body and this is gleaming information about future cardiovascular or current call log. Vascular risks that you may have and pregnancy is a very similar. It's a, you know, forty weeks stress test to see when we put your body under a little bit of stress or conditions that arise that may play a role in your health as we go down the line and we're starting to clean so much more information about what we can take from our state and as pregnant women into our health as we go forward, for example, if you had gestational diabetes or gestational hypertension preeclampsia, a preterm birth postpartum depression off or any of these other complications, and I'm going to talk to you about what all those could mean and we're still Gathering a lot of this data. So more and more is to come now what you've never had a baby or you haven't had a pregnancy in your lifetime. I think this episode will still be really interesting because we're learning so much about maternal health and female birth. Factors that are completely independent or different from the traditional and I'm saying those are question. You can't see me risk factors, which is based on the mail system. So thinking about these is also really interesting as well as if you have a friend or a daughter or a niece who's going to be pregnant. This is such a really interesting information to know about first. I'm going to walk you through some soft findings and soft findings means. This is just what I see clinically and I don't really know how it's going to go on to apply but one of the things that I do see a very common basis is women who have had a postpartum depression seemed to have an increased risk for either pmdd, which is severe PMS or mood symptoms in perimenopause and into
More Californians Are Now Eligible for COVID-19 Vaccine
"If you are 16 or older and you have certain health conditions you actually qualify for a vaccine Doctor. Robert Schooley is a professor of medicine in the infectious disease division at UC San Diego. He tells KOGO news. It's complicated to decide who's in the category. Some are wondering why Type Two diabetes is included, but not Type One. The reason for that is the Type two diabetes is adult onset diabetes. It's often associated with obesity and can be associated with heart disease. These patients with diabetes being in it Get her disease, the one to get into trouble with covert type One diabetes is juvenile onset diabetes, often with younger, skinnier people. Dr. Scully also says, Well, some heart issues qualify. Hypertension does not know the county says that is the number one condition among most hospitalized covert patients. Marilyn Haider KOGO News, the
DECLARE-ing Another Victory for Dapagliflozin
"Well hello and welcome to the i former x podcast where we explore the evidence that informs aleatory care pharmacy practice. This is stuart hanes the host of the i former x podcast in about a year ago we reviewed and discussed the data h f study which evaluated the benefits of the sodium glucose transporter two or s. l. t. two inhibitor. Adaptable flows in in patients with reduced ejection fraction. Heart failure even in patients without diabetes. And if you are not familiar with a data h f study. I strongly encourage you to read the original study. And the i former x commentary of course. The data regarding the use of the sglt two inhibitors to prevent cardiovascular events and to treat heart failure or quite compelling but can they also slow the progression of renal complications in patients with chronic kidney disease. Well i was excited to see the much anticipated data. Ck d. study published in the new england journal of medicine a few weeks ago. And i knew just the right people. I wanted to review this study for i former expert. Dr jennifer clements dr stephanie. Nitro jennifer and stephanie are no strangers to i former x. They are members of the i former x oriel board and have been frequent contributors over the years. That clements is clinical pharmacy. Specialist in diabetes transitions at spartanburg regional health. Care system in spartanburg south carolina indoctrinate grow is associate professor of pharmacy practice at the university of connecticut. Stephanie jennifer it's great to welcome you back on the i former x podcast. Thanks for the invitation stewart. Thank you for having us back so before we get started per usual. I'd like to get your thoughts on a patient case. A i think that is not unlike. What many of our listeners encounter in their practices and want to imagine. You're seeing k t a sixty one year old african american female in the primary care clinic today. The patient has a longstanding history of hypertension type two diabetes dyslipidemia and. She's morbidly obese. She also has osteoarthritis internees. She recently was diagnosed with chronic kidney disease in her primary care physician referred her to you to make certain quote. We are doing everything we can to protect your kidneys. According to her medical record katie has been prescribed lysenko pearl twenty milligrams twice daily resume astatine twenty milligrams daily metformin thousand twice daily and insulin Twenty it's bedtime and in addition over the counter. She takes aspirin eighty-one milligrams and naproxen sodium for arthritis pain. She currently weighs two hundred sixty four pounds of bmi forty point. Nine blood pressure today when thirty. Eight over seventy six and her most recent labs yesterday include a fasting glucose of eighty seven and a one c of six point seven percent. Sam crat nin of one point seven milligrams per deciliter and an estimated. Gfr of thirty seven seven potassium of four point seven. Ldl cholesterol fifty six hdl cholesterol. Forty eight triglycerides of one. Oh seven in addition. The patient had a timed urine protein tests performed and the album into creating ratio was three hundred fifty. So stephanie. Before we talk about the study that you reviewed in your i former x commentary. I'm wondering what's going through your mind in this case What are some of the key questions you ask this patient during the encounter and what additional apps if any might you want to obtain and is there any additional treatment options. Who'd be considering at this point to stewart. I would agree that. Kt really does mirror. Many of the patients that are encountered in clinical practice. And i think this case excites me because there are many opportunities for the pharmacists to intervene here and if we're going to utilize the ppc process. I would. I want to collect additional information from kt. for example. Does she smoke. How often is she using her naproxen. And at what dose. I'd also want to collect possible. Her a. one c. Blood pressure and serum craton and trends and we know how important it is to not evaluate labs in isolation so seeing her patterns would provide additional insight or care planning. It's really important to know. Kt's renal function is stable or if it's consistently fluctuating as this information would help our assessment of how we can manage. Her current metformin does since her egfr is approaching the cutoff for continue at minimum. She needed both reduction. And also story the for thinking about the potential use of sglt two inhibitors for katie ensuring that arena function is stable. What help us feel more comfortable recommending. Its use since we know that there have been reports of a two kidney injury and volume depletion upon initiation of these drugs. I don't want wanna collect a bit more information about her. Lifestyle habits including a general understanding of her dietary choices notably her sodium and protein intake and see if she is engaging in any physical activity given her need when the patient and osteoarthritis. I'd also wanna know her insurance provider and learn if she's burdened by any of the cost of her current medications in case we want to add anything in the future cd management perspective. I'm really happy to see that. She's on than a pro because she has albumin. Urea but further management is needed to help delay rano progression and when we think of good. Ck d. management. We need to consider it. I optimizing her glycemic control which looks really good for. Kt at this point and also painting and maintaining a blood pressure will have less than one thirty over eighty if we can do that safely
Mexican president tests positive for COVID-19, symptoms mild
"Of consistently downplaying the pandemic. Mexico's president contracted the virus, making him the latest world leader to fall ill from covert 19. His government says he has mild symptoms and is running the country's affairs from the National Palace. As NPR's Carrie Kahn reports, the Mexican leader is sick at a time when the country is witnessing a record number of coronavirus deaths. For many, it was just a matter of time before president and dress Manuel Lopez Obrador would contract the virus. He's rarely seen in public, using a mask and throughout the pandemic has kept up a grueling schedule, touring the country, flying commercial airlines and interacting with many people like he did just this past weekend. The military band played the national anthem, Lopez Obrador inaugurated new basis for his National Guard troops. He told a small crowd that the pandemic yes has been rough on Mexico. But it needs to be put into perspective. Lack is masking a panda Mia. There's been a basically, corruption has done more damage to Mexico. It's worse than a pandemic. It's a plague, he said. On Saturday, Lopez Obrador's underplayed the spread of covert in the country even as the death toll is approaching 150,000, the fourth highest in the world. More than 1.7 million people have tested positive for the virus. But officials admit that is an undercount since only the sickest are tested, and his ambitious vaccination plan is stalled recently after Fizer temporarily halted shipments of its vaccine to the country, do the logistics problems. Critics of the president's handling of the pandemic say they're not surprised. He himself has now fallen ill. Let's face it, The odds were increasingly against him Kindness. Bravo is a political analyst and teaches at sea. They in Mexico City University does not even try to be a social model. In terms of basically taking precautions. Early on in the pandemic, Lopez Obrador famously held up religious ambulance declaring that they along with his good morals. Would protect him from the virus and the cool protector. It is. Alone 80 that the best shield against the virus is to be honest, not to steal and not to betray. His comments, made back in March, are now being rebroadcast continually on TV and social media. For now, Officials say. President Lopez Obrador is isolating in his quarters at the national Palace and has only mild symptoms at 67, though he suffers from hypertension, and he had a heart attack in 2013. His Interior minister, Olga Sanchez, oversized morning press conference today, but kept it far under the two hours the president usually takes sink winter studly, pronto pronto Sirica Pereira, especially the president is stable and will recuperate very soon. I'm sure of it, she said. Soon after the morning conference, the president's office sent out pictures of Lopez over door in a suit behind his desk, taking a call with Vladimir Putin. Russia will reportedly send 24 million doses of its but make the vaccine over the next two months to Mexico.
"hypertension" Discussed on Cardionerds
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"hypertension" Discussed on Cardionerds
"How do you approach the choice of initial blood pressure. Medication in general. And what would be your top choices for this patient in particular so You know looking at his overall picture suggests that he's at a high risk for cardiovascular. Disease is still primary prevention patient but but pressures are elevated in the clinic and he's got a lot of risk factors. He's got past three c. K. d. he's got known diabetes sleep apnea obesity. So the american guidelines recommend typically in these folks that are in that stage to hyper-tension ranges. Everyone gets the lifestyle that we talked about. But then what we want to be. Starting with is fixed. Dose combination therapy. And so when you're when you're have lower blood. Pressure's it's reasonable to start with single agent therapy. Interestingly the european guidelines really unless there's overwhelming circumstances were worried about side effects really push fixed combination therapy as the first thing that you add in american guidelines. They give you a little bit of leeway so if you're twenty over ten above where we need to be then we should be starting fixed dose combination therapy and these folks in this guy. I definitely would start fixed us combination therapy right off the bat now. There's a few factors that we have to take into consideration here. The accomplish trial published back in. I believe it was two thousand eight looked at combination of a ac a statistic and so we know in that trial acc be tend to do a little bit better in terms of cardiovascular events but a couple things and keep in. Mind here one. He's african american gentlemen. Just in general to african americans tend to have more of a low green and hypertension so have a little bit less efficacy with ace inhibitors. Entry attention receptor blockers in the absence of a diuretic. So those medications work but we gotta get people on a diabetic so for someone like him. We'd probably go with combination. Enter tencent receptor blocker and fis type. Diuretic would be the best choice for him and typically affixed dose combination pill. Now the one problem with that when we think about it is a lot of the fixed dose combination pills. Don't come with a real good design tech. They come with hydrochlorothiazide and they don't come with napa my salad really. The most significant fixed those combination that comes with valid on is still brand name. It's asil certain and so it will be a good choice when it comes off patent but it's really unaffordable for most patients. And if you can't do that then what i would ultimately recommend in this gentleman is thinking about something like cloth or dabba might for his. I type diabetic particularly with his. Ckd because we know a lot of resistant hypertension is driven especially in kidney disease by volume. We know that at lower fires we're going to see a little bit less efficacy of hydrochlorothiazide. Then i would add on an ngo tencent. Receptor blocker can got a little bit of kidney protective effects without lower. Gfr i probably screen them for albumin. Urea as well because that can impact some of our choices in terms of blood pressure. Medications about really are cutoffs. Typically if are under forty five. I won't use hydrochloride. I don't use it very much anyway. But i i will more go with clark alanon. It has a more consistent affect all the way down to. Gfr thirty once we get into those. The stage four chronic kidney disease. Then you really looking at either sequential nefer on blockade. So if i type anna loop diuretic which can have a good blood pressure lowering effects particularly resistant hypertension but in your primary hypertension which we don't know if this guy's resistant pretension because we don't i don't have any medicine right now but we'd probably think about just their clark owner that might and if you were under thirty for gfr so stage four chronic kidney disease. Then we'd be thinking about adding a loop diuretic as well if he were caucasian than i probably be more likely to go with a die..
Fauci: Up to 90% of population needs vaccine for herd immunity
"The cdc is now requiring a negative test for any travelers coming from the uk but officials had been downplaying the threat of these of these new strains that we are seeing these variations in the uk. I think you had said earlier this week. That a mutation doesn't mean the virus more dangerous or more deadly. Dr fauci said that these these these variations may already be here in the united states. So why why this new step. Why this new restriction important for people to know that we're layering protection on top of protection on top of protection. No individual protection is going to be one hundred percent. A lot of americans don't know that back in march through the presidential To twelve f authority we restricted. The ability of people to come to the united states from the uk and travel is down ninety percent even pre knowledge about this new variant from the uk. So we've already had severe travel restrictions from the uk. testing within seventy. Two hours isn't one hundred percent. It's not perfect but it does. Further decreased the number of people who will come in and then what we recommend to people according to the. Cdc is that once you get here you still isolate for seven days if you've had a negative test or for further longer than that if you don't get a test on this end ten to fourteen days so those things layer together. We'll significantly decrease chance of exposure to a new variant. But here's what the american people most need to know. Mitigation works the shows that it works. So if you're worried about a new potentially more contagious variant. It that much more important that we follow the four ws. Where a mask wash your hands. Watch your distanced and the fourth one is weight on gatherings especially with one last holiday coming up new year's we need to be very careful. You said that you understand the skepticism. From many african americans about the vaccine obviously given the history of medical racism in this country and you of course got vaccinated on camera to to to to send a message. What else needs to be done to convince people including some of those most vulnerable that this vaccine is not only safe but it's effective and necessary. Well we need to continue to acknowledge what's happened in the past. And i've talked about ski. Talked about henrietta lacks but they were real issues going on today right now in this country when you look at seven hundred women dying pregnancy related complications. Most of them black and brown in the united states. When you look at not just cova hypertension and cancer disparities. We need to acknowledge these things. And we need to show people meaningfully in a real sense what we're doing to improve on these measures and that's why a surgeon general before covid health equity was a critical part of everything that i did. And then we need to engage with trusted influencers. We need to make sure our pastors in e moms in rabbis. All of whom. I'm working with. Have the facts so that they can spread it to to their congregants and we need to walk the talk and that's why i got vaccinated on live tv. I want people to know that as a scientist at the doctor. I've looked at the data. I know the protections that are in place. I know an african american female helped. Develop this vaccine and tony foul. She and i made sure that the trials were were enrolled with diverse participants. And i got vaccinated because i trusted and how we end this pandemic
How to Improve Cultural Competence in Dermatology and Skincare with Dr. Susan Taylor
"Okay. So we're here with Dr Taylor, don't worry we gave a nice bio on you before you came on the line do truly one of the most amazing dermatologist in the United States like I'm so excited you're here we want to hear about your career little bit before we start talking about the issues of the day that we brought you on to talk about. So first off what made you want to become dermatologist well, you know. When I went to medical school, I. wanted to be an interest and I wanted to treat people from the inner city with hypertension and diabetes and cardiovascular disease. But then during my fourth year medical school did my very first dermatology rotation and I loved everything about the specialty The fact that he could range from Piatra patients to you know those in their eighties and nineties the fact that there was a little bit of surgery. Pediatrics was cosmetic. Dermatology in general dermatology. The fact that you could actually see in feel in touch the pathology as opposed to like pretending, you can hear it you know through the stethoscope so that really changed my whole focus. Now when I graduated I decided nonetheless to do a internal medicine residency. But halfway through I said, you know you've got to remain true to yourself and what are you gonna be happy you know thirty years from now practicing so I went back and did another residency in dermatology in here we are. Also, that added a little bit of time onto your career. It did. Yes it was so worth it. Yeah, and so you I know you're the founder of many amazing things that I've gotten many resources from one of the things that you're known for is. Working at the skin of Color Center can you and you co-founded that ready did yes. So I'm back with that is when that started back in nineteen ninety eight I did my dermatology residency at Columbia. Presbyterian. Medical Center in about ten years after I had finished I got a call from one of my professors who said you know here in New York, there's the need for a center that specializes in skin disorders for people with darker skin tones, and he said, this was my my mentor. Dr Deleo. He says, you know they say to me you're a nice guy but I want someone who looks like made and so he called me one day and said, would you be interested in coming to New York in creating some type of center and for me it was an incredible challenge an incredible need. This type of center didn't exist anywhere in the world and my mandate was to name it started to figure out what the mission was and that was a wonderful wonderful challenge. So what I decided was. This would be a center for. Instance in clinical dermatology, we would also perform clinical trials, research trials, and at that point, many dermatologists were very afraid of doing any types of cosmetic procedures on people with darker skin tones. So we wanted to really gorge path that. So that's Why we created the skin of Color Center, I am delighted to report it still in existence. Now, it's now affiliated with Mount Sinai and there's a new wonderful director WHO's there? Can, I just ask Dr Leo was he a White Guy? Dr Dalil I didn't know you. Know can Dr till now goes bad. You know I'm a tall white guy and they don't want to see a tall white guy. They want someone who looks like you and you know he's just been a wonderful inspiration over all of these years I'm very fortunate to have had him as a mentor Academic Sense. So when you let your medical residency, did you feel like you were prepared to treat all the patients that you were about to say is at the level of care that they are. Yeah. So I had the distinct honor and privilege of a doing my dermatology residency New York City in Manhattan like one of the most diverse places on earth. So from the time I was the first year. Dermatology residents I saw people with all skin tones. And all ethnicities and racial groups. So when I completed three years of residency, I did indeed the very prepared in diagnosing and treating disorders in people with darker skin tones. Then I opened up a private practice in Philadelphia, which is my hometown and I found that over time many women and men of color sought me out because you know it's not just the skin tone, but it's also the customs habits. Women did not have to explain to me what they do with their hair because I have the same hair and so there is a cultural competence and we wanted to create a center were all the doctors no matter what their race or ethnicity was culturally competent.
COVID-19: ‘little or no’ benefit from remdesivir: WHO
"Results from a UN coordinated international trial looking at four cave nineteen therapeutics have shown little or no positive impact on preventing death in patients infected with new corona virus, the Solidarity Therapeutics Trial, overseen by the world. Health Organization who found that REMM disappear hydroxy chloroquine, Lapenne Aveer. Rootin- and Interferon. appeared to have little or no effect on twenty eight day mortality or the hospital course of covid nineteen among hospitalized patients. The study involved more than thirty countries and investigated the effects of the treatments on mortality ventilation and length of stay in hospital. It did not examine other uses of the drugs such as preventive treatment, which would. Require further trials in a related announcement. The WHO said that Covid nineteen had also highlighted the increased vulnerability of people with high blood pressure to the coronavirus. The warning is based on data for more than one hundred twenty countries showing significant caveat related disruption to treatment for people suffering from chronic health conditions with findings showing these patients make up fifty to sixty percent of all deaths through covid. Dr Bent Mickelson director of WHO's Department of noncommunicable diseases said that more than one point one, billion people around the world suffer from hypertension mainly in low and middle income countries when it comes to call it nine, thousand, nine, hundred, hypertension, one, hundred and twenty two countries that has reported. US that in over fifty percent of the country's the healthcare services disrupted fully or partially fifty percent of the country's, and in addition we see a high number of is we don't have global figures yet, but we see in the rain show fifty, sixty percent of the people that are severely ill and died in hospitals from code have hypertension diabetes, and so forth and the working on the global targets.
The Pandemic Behind The Pandemic
"This episode, we're going to be talking about the most pressing issue of our time, and there's a statement that you cannot solve a problem that you don't understand. You cannot solve a problem that you don't understand and to take that a step further, you cannot solve a problem you don't know you have. Right now we're dealing with a worldwide pandemic and there are many pieces of this situation that are not being analyzed. It's such a broad wide ranging issue with many components and today when a break some of those things down in a reminded me of a statement and this was published in the journal Invention intelligence referring to Albert. Einstein. Stating that quote often the problem as given is misleading. And you have to work through a mass of data to define the real problem. Often this step consumes more time than deriving the solution. Einstein was quoted to have said if I were given an hour in which to do a problem upon which my life depended. I would spend forty of those minutes studying the problem fifteen minutes reviewing the problem. And just five minutes solving it. So today we're going to get a better understanding of the underlying problem the pandemic behind the pandemic. and. This starts for me with the report that I talked about back in April when this situation really began to kick off and it really was alarming and I wanted to make sure that people knew about this data. Now, here in the US, we had early access to some data because several other countries had experienced the ramifications of covid nineteen being spread throughout the population most notably Italy was really hit the hardest and their data really gave us an opportunity to be aware of our. Underlying susceptibility. To, Cope in nineteen to infectious diseases of really all types but specifically and looking at the data with covid nineteen after thousands of people lost their lives. The Scientific Advisor to Italy's Minister of Health stated that quote on re evaluation by the National Institute of Health only twelve percent of the death certificates have shown a direct causality from corona virus alone. While eighty eight percent of patients who have died have at least one pre morbidity in many times two or three. Pre existing chronic diseases that have become absolute pandemics in our today themselves have really left susceptible. And we had this data and even take it a step further and I talked about this the very beginning of the pandemic. This was published the Journal of the American Medical Association in April. This was back in April. This analyze data hospitalized Kobe nineteen patients in New, York City, which was really the epicenter of a lot of the the turmoil, the fallout. In an covered that already approximately ninety percent of people having severe reactions to Kobe nineteen or those with pre existing chronic diseases with the most common co morbidity is being hypertension, obesity and diabetes. And now in the real reason that this show is happening today, the just published a report. Updated on September thirtieth twenty. Twenty. Reiterated with the data has been showing us from the very beginning their official report stated that ninety four percent of the lives loss from covid nineteen. When people who had additional diseases they stated that for each death noted to be related to cope nineteen, there were on average two point, six additional conditions or causes for each death. Most notably type two diabetes and hypertension. This is not to say that covid nineteen has not been absolute destructive force. In our society. This is to say. That, these chronic diseases loaded the gun. In Cova nineteen pulled the trigger. Our susceptibility. Our underlying pre existing health conditions as a society sets up when I saw that data coming out of Italy, I was like all we're in trouble. We're in trouble here in the United States we're in trouble. And this is why today we're going to take a deep dive and really look at this issue we're going to get a face to face good look in the mirror at the issues that are underlying. So many of the problems experiencing. As. A culture, we cannot turn a blind eye to this stuff anymore. This is our opportunity to change things right now but we need to get face to face with this problem and we need to understand truly how bad it is in all the different components so that we can come to a solution because as Albert. Einstein. And by the way with all the quotes that might come from Albert Einstein or from Abraham Lincoln or whatever we don't know who said it whoever did is pretty SMART But in that statement of like if you've got. An hour for problem spending forty minutes on the problem itself studying the problem looking at all angles of it then reviewing your study of that problem. Right and then you spending five minutes on solution this because the solution will be much more effective. Much more poignant. When. You actually understand what you're trying to do. You actually understand the problem.
Why Dr. Kumar is Changing The Wellness Game
"Welcome back once again, see the outcomes, rocket podcasts where we chat with today's most successful and inspiring health care leaders. I really WANNA. Thank you for tuning in again and I welcome you to go to outcomes rocket dot health slash reviews where you could rate and review today's podcast because he is one outstanding individual and healthcare is name is Dr Rajiv Kumar he's the president and chief medical officer at Virgin Pulse during medical school he realized that many of the worst health problems we face as a nation diabetes heart disease cancer hypertension. Et, CETERA. I related to the collective unhealthy lifestyle, and so he has pledged to make a difference in this industry. He's done and as a frontline physician and now through various different companies, some amazing things and so what I WANNA do is open up the microphone to Raji to fill in any of the gaps of the introduction and then a so we could get into the podcast. Reggie welcome to the PODCAST. Think saw glad to be here. So Rajiv, what would you fill in in your intro that I that I left out? I think that was pretty comprehensive. Just, a little bit about virgin pulse. You know what? I think that may not be familiar name to a lot of folks on your that are listening to your podcast. We are an employee wellbeing company. We work with large employers all around the world, and our goal is to help them activate their employees to lead healthier lifestyles which had to kind of go around the healthcare system a little bit, and go direct to the employees and figure out ways to motivate them to inspire them and to help them sustain behavior change over time, and it's not just about healthcare cost reduction. It really is about how do we help people be? Healthier, happier and more productive at work in their personal lives. So that's really what our mission is. That's beautiful and listeners for those of you who haven't connected the DOTS virgin pulse. One of Sir Richard Branson's Virgin Group companies. So you know with the gentleman like that behind something like this and and Rajiv as part of the executive leadership team, you can imagine some great things are happening. It's an exciting time for us. We definitely are inspired by Sir Richard Branson leadership in his philosophy is if you take care of your employees, they'll take care of your business, and so we're trying to empower employers to take better care of their employees. So strong, and and you know it's really interesting that you guys are tackling this employer perspective of the entire health career equation because costs are soaring and aside from labor costs, it seems like healthcare cost is oftentimes double digits in that front. What are your thoughts on what should be on every medical leaders agenda today? Well, I'm biased but I think it has to be a behavior change remember too often looking for a magic pill or magic device or something to kind of stem the tide of rising obesity, diabetes and heart disease in our country and at the end of the day, there's so much. We can do to actually change people's behavior a lot of what we're facing as a result of our diet, our physical activity or lack thereof the stress that we have in our lives just how we how we treat ourselves and how we don't take care of ourselves, and so I think it's not necessarily a hot topic I. Think it should be and and I wish there was more focus on it is the perennial that if we can change behavior, we can prevent a lot of disease and we can produce significantly greater outcomes and Reggie. What would you say right now at at at Virgin? Pulse. Is an example of how you guys are improving health outcomes. Well, I think we really tried to think outside of the box I think traditional health interventions and and health and wellbeing platforms have largely been ineffective and they've been around for decades. So we sat around and we said what if we took a different approach rather than making people feel like they're failures rather than telling them that they're sick what if we actually make them feel successful what if we make them feel good about themselves right off the bat what would that do for self esteem for their motivation and for their ability to change. Most of what we see in our industry is a heavy focus on screening, and so employers asked their employees to take health risk assessments and do biometric screenings and so forth, and the problem with that is they take a health risk assessment tells them you're sick. You know you have high risk, your unhealthy needs to do more change your lifestyle, get your biometric screening results and you have high blood pressure. You may not like the results that you get back and that can be very demotivating, and so we've said is, is there a scientist out there? Is there a behavior change model that focuses on success? We found a scientist by the name of Dr Bj fog out of Stanford University and Dr Fog is sort of a new guru of behavior change and he's come up with a behavior change model that he caused the fog behavior change model and it's very simple as model is is a formula to it is called B. Equals M. A. T.. Equals motivation times, ability times a trigger, and so what he means by that is to get somebody to do a behavior that we want them to do or they want to do. First of all, they have to have the motivation to do it. Second is they have to have the ability to do it, and a third is you have to trigger them. To trump to do that behavior and too often in the in the kind of behavior change space, we ask people to do things that require either too much motivation or too much ability. So we say something like go to the gym four times a week and exercise for sixty minutes. Each time you go that takes a lot of motivation and some people may not even have the ability a really know how to do that where to get started so forth so Dr Fog says, well, motivation is hard to change. Your motivation waxes and wanes on a daily basis on an hourly basis, we can't really change somebody's motivation that easily what you can do is changed the behavior you're asking them to do to make it easier. You can change the ability to perform the action, and so the idea is if you take a behavior like washing your teeth and you break it down to the smallest tiniest thing that somebody could possibly do like floss one tooth and you ask them to do that they can actually do. That very easily, it doesn't take a lot of motivation is very quick to do, and if they do that and you celebrate the fact that they did it, you can help them build what we call success momentum, and then they're going to feel better about going to the next step and try something harder and so in our entire approach to behavior change, we break behaviors down into their simplest most basic action we ask people to do that would trigger then and then when they do it we. Reward them make them successful. We give them social status. They might get some kind of points or some kind of reward, and then we ask them to do something harder the next time around and stuff feedback loop that builds up momentum, and it changes behavior in a very sustainable way in a very habitual way, which is really the key to behavior changes creating habits.
Uncontrolled hypertension is getting worse in the U.S., study finds
"New study is showing an increasing number of people in the US are suffering from uncontrolled high blood pressure. Brian Shook has more research from Jama showed that out of 18,000 subjects who had high blood pressure in 2017 and 2018, the number of uncontrolled hypertension cases rose by 10%. Nicknamed the Silent Killer. High Blood Pressure has also been linked to be a danger to anyone infected with the Corona virus.
Dr. Philippe Friedlich On Pediatric Surgery And Neonatal Therapeutic Hypothermia
"Welcome to medicine. We're still practicing I'm Bill Curtis of course I my friend and Co host Dr Steven Tailback He's the quadruple board certified doctor of Internal Medicine Pulmonary Disease Critical Care and neuro critical care these days he continues to fight on the front lines of the COVID battle in California for which we are eternally grateful Steve How you doing I'm well thank you. It's good to be. I'm sure you've heard of children's Hospital of Los Angeles notice. Hla US News and World Report has consistently ranked the H. L. A. in the top five nationally and the number one pediatric hospital in California for thirty years. Running this remarkable nonprofit children's care hospital is nationally known for Neonatal Research and care that is funded entirely by generous philanthropists. Dr Felipe Friedli is chief of neonatologist at Children's Hospital. He is also co director of the fetal and neonatal? Institute. And he is professor of clinical pediatrics and surgery at the renowned kept school of Medicine at USC where he's published over one hundred, fifty abstracts, Peer Review Articles and book. Chapters Dr. Freedland is a rock star in one of the world's most complicated pressure filled and delicate specialties that include newborn respiratory failures newborn pulmonary hypertension even surgery on unborn babies. Can you imagine welcome Dr Felipe Free Lick? It is an honor to have you here tonight and having me. So doctor. Can you just bring our listeners up to speed on C. H. LA and your mission there? Sharon's HUSK local Sandra's mission is to care for sick children's no matter what their background cultural background or insurance they have we are. Laced to gear for family and children's in babies when there's no other place that could care for them. Are we talking about like one of the few medical specialties that truly couldn't wait for Covid to pause that's a great question fortunately or many children's covid has not been has impactful. They are some babies are insurance that are sick but by four unless we compared to adults we. Are Really lucky so far. So we're not going to spend the whole show on Kovin because frankly I think people wanted to know much more about your specialty, but maybe you could tell us a little about what kind of a regimen as C. H. L. A. Developed uniquely for this pandemic and what are some of the special things that you do at your hospital to manage this. A lot of it has to do with making sure that became screen families in staff when they arrive at the hospital in make sure that they're the environment for caring for the Germans you regardless of the reason why they're in the hospital is is optimal until the hospital has and significant resources to ensure that we screen families and visitors and parents when they arrive psychologically, how do you get your clientele to feel safe under these circumstances that has been Estonia As you can imagine a lot of families or speared to even go close to a hospital. So said, only our data's suggesting that we can provide a safest environment to bring Ren's and care for them, but it is a concern. Certainly, we can see that visit to the emergency room are significantly down obviously a lot of the outpatient clinic. I've had to restructure their environment, but I think that honest conversations with family in trying to make sure that. Children can get the care they need. So they don't have complications from their Biz orders diseases are we tried to do our best to get the message across
CDC study finds nearly half of US population at 'high risk' of severe case of COVID-19
"Study finds Nearly half of US adults are risk of covert 19 complications due to underlying medical conditions. ABC is Mark Rommel Art explains. The study estimates 45.4% of Americans are at risk of having a severe case of covert 19 due to a one arm or underlying medical conditions such as heart disease, diabetes, lung disease, hypertension or cancer. It found disparities in some racial and ethnic groups as well. The top three most at risk were American, Indian, Alaska native adults, where 55% had at least one underlying condition, followed by black adults at 52% and white adults at 48%.
Matthew McConaughey grills Dr. Anthony Fauci in Instagram interview on COVID-19
"Academy Award winning actor Matthew McConaughey cast a variety of questions about the virus to Dr Anthony Foulke, the nation's top infectious disease. Doctor. Details on their chat from ABC is Alex for Shay, the actor Ass Valachi of Sunlight kills the virus. But she said yes, McConaughey also asked if letting everyone get infected, so we all become immune is a viable strategy. No way felt, he said, particularly in America, where obesity, diabetes and hypertension are prevalent. The death toll. Would be enormous and totally unacceptable found, she said.
"hypertension" Discussed on iForumRx.org
"Greetings and welcome to the. I former ex podcast where we explore the evidence that informs Tori Care Pharmacy Practice. My name is Stuart Hanes. The host of I former ex hypertension is perhaps the most common chronic disease encountered in clinical practice and while high blood pressure does not cause symptoms at least not routinely. It leads to end organ damage to the kidneys. The eyes brain and his a major contributing factor to atherosclerotic cutting vascular disease thus helping patients achieve and maintain optimal blood. Pressure is among the most important goals that pharmacists and ambulatory and Community Pharmacy. Settings should be striving to achieve now. While optimal blood pressure is clearly important preventing cardiovascular events and organ damage is really the ultimate goal and in this regard how we achieve good blood pressure. Control may be just as important as getting to goal. That's why the recently published Hijja chromotherapy study caught my eye my guest today. Dr Joseph Sustain and Dr. Vivian Chang from the University of Colorado skaggs pharmacy and Pharmaceutical Sciences Dr Secene is professor in the departments of pharmacy practice in family medicine. And Dr Chang is a PG way to ambulatory care pharmacy. Practice resident together they authored a commentary for I former ex about the Hijra chromotherapy study entitled should bed time be mid time for hypertension Joe. It's great to have you back on the Iphone X. PODCAST and did IAN. Thank you for becoming a first time contributor. Thank you stuart. It's always a pleasure talking about hypertension at topic near and dear to my heart high. Thank you so much for having me on. I four RX. I've been a subscriber some time now and I'm excited to be here so before we get started. I want you to imagine you're seeing L. Are a fifty nine year. Old African American male in the Family Medicine Clinic today for a routine blood pressure. Follow up visit. The patient has a longstanding history of high blood pressure are L. is also overweight but is otherwise healthy. He reports no personal history of cardiovascular disease states that his sister has kidney problems and his father died at age. Sixty from stroke. The patient currently takes Lysenko Parole Twenty Daily hydrochlorothiazide twenty five milligrams daily 'em Load Pin ten milligrams daily. And last week. He was started on spiral. Aktan twelve point five milligrams once-daily now. He weighs two hundred one pounds and his team is thirty. Six point to his.
"hypertension" Discussed on Surgery 101
"Let's talk about treatment. Women with persistent postpartum hypertension should be treated because the risk of stroke or seizure is still high patient that need anti hypertensive therapy or are those with severe hypertension on those non sphere hypertension with pressures above one forty over ninety patients with prejudge stations. Diabetes should have the pressures Kapitolo one thirty thirty over eighty the Beta law. Fifteen extended release hydrology in Massell. Dope are the most common agents us. It's inhibitors such as capital. Prell and analysis krill though contraindicated in pregnancy can be used postpartum. All of these options were saved for breastfeeding liberal. which is a Beta blocker should be avoided in women with asthma or heart failure and can be given either orally or through an IV Philippine can only be given orally rallying can be prescribed the IV or intramuscularly muscular early mental Joepat can only be given orally absorbed signs of pre ECLAMPSIA? ECLAMPSIA are or help syndrome. Magnesium sulfate is given for Niro protection. Finally Wanna I treat for causes and consult other specialties. If there are signs of an organ damage most importantly patient education is required. Patients should be given teaching on how to take take a proper blood pressure at home. A blood pressure log should be given so patients can keep track of their blood pressures and cut off values on when they need to visit our family physician or present to hospital should also be given. Okay let's get back to our case you've already ordered lobs by regardless of technical diagnosis patients. Hypertensive before you had offered that c-section Russian you ask the nurse to give her Bagel and to call you urgently for pressure goes above one sixty over one ten on either systolic diastolic or develop any new symptoms dining hugo reassess. Alana her has gone away. Fenner pressures are back to normal. She's feeling much better. Her labs are also normal. And you deamer safe to go home before discharge her. Get her educational teaching on how to take our pressures you ask her to schedule a follow up appointment with her obstetrician one week from now interfere pressures go above one forty over ninety dollars diastolic. To Call Her outside attrition if it goes above the one sixty or one ten mark on other systolic or diastolic. She should come to the hospital right away. She agrees with the plan to summarize. Hypertension in pregnancy including postpartum is defined as systolic blood pressure. One forty zero grader and or a dialogue pressure ninety a crater on tour marcation at least fifteen minutes apart severe hypertension systolic pressure when sixteen greater or a diced olic pressure one hundred ten or greater signs or symptoms include a severe headache altered mental status blurry vision visual. Oh field defects pulmonary Dima right upper quadrant or stomach. Pain nausea vomiting and swelling in the legs hands for face mobile hydraulic the Filipina and method doper for the most common agencies. Thank you for listening to a podcast..
"hypertension" Discussed on Surgery 101
"Let's move on and to develop differential diagnoses so honor last. We have new onset hypertension or pre ECLAMPSIA persistent hypertension or pre eclampsia Hope Syndrome which is characterized by Mall low platelets and increased liver enzymes and lastly pre existing hypertension or resistant. Hypertension were treatment. This can further be categorized as a secondary hypertension with a known cause such such as endocrine disorder or primary hypertension also known as essential hypertension with no known cause in our case Alana husband complaining of a headache and her the pressure has been around one fifty over ninety eight. She has no history of hypertension or elevated. Blood pressure's on her prenatal sheets. So Alana's likely experiencing a new onset. He's had hypertension. Let's move onto diagnosis. That diagnosis of postpartum hypertension is relatively straightforward. You take a blood. The pressure blood pressure should be checked. After fireman's arrest patients should be sitting down the arms should be at the level of the heart feet on the ground back supported inappropriate cough and our arm arm should also be supported. The COP line should be about one point five times the circumference of the arm. The final blood pressure is consistently higher in one arm usually use a higher value hypertension in pregnancy including the postpartum period. It's defined as Stolac blood pressure of one forty or greater and or diastolic blood pressure ninety or greater on two or more occasions at least fifteen minutes apart using the same arm severe hypertension as its Stolac pressure. Sure one sixth grader or diastolic pressure of one hundred ten or greater again at least too much romance fifteen minutes apart using the same arm severe hypertension and postpartum pardon puree can cause maternal throw. It should be treated immediately at translated. Hypertensive effect is when you get high blood pressure but it's within a normal range offer rest risk for repeated measurement on the same or subsequent visits white coat hypertension pressures that are elevated in office but our normal home blood pressure monitoring tossed hypertension. It's the opposite of white coat hypertension. It's when pressures are elevated at home but are normal in the office you confirm with the nurse than a lot of blood pressure. Were properly done while she was resting in fifteen minutes apart. The nurse also tells you there are no labs on files so pre-columbian Help Syndrome are stolman differential. So you get verbal verbal order Turner's Hypertensive lops does include the CBC urine protein to create an ratio also known as a urine AC are serum creatine in urea acid elti ast all the HVAC Ruben ankle socks so p t t irr..
"hypertension" Discussed on Veterans Helping Veterans
"Certain aircrafts and stuff like that. That were transporting each and orange so so when we're talking about Agent, Orange exposure and a diagnosis of hypertension. That's another big one because if they ever add hypertension as presumptive to to Agent, Orange exposure that open up so many other avenues for veterans to be service connected for because as many people know, you can have hypertension it can be controlled medication, but there's so many offshoots. Hypertension that can happen stroke, heart disease, things of that sort self and those are all service connected as well. So if you have a disability that that's secondary to hypertension that's open for service connection. So it just kind of keep in mind. If you're exposed to Agent Orange, and you have through tension get the claim in because 'cause that claims should warrant benefits down the road if they ever. Our ad hypertension. Well, I thought I'd pretend too much one of the empty John. But I would not know. Oh, man. Hard about as man. Yeah. Ski mccart this use coronary artery disease, heart conditions like that. Yeah. Yeah. But, but hypertension is it's a very how should I say, it's a type of disability that many many people have including a number of veterans in and the bean counters at the department of extra terrorist are just terrified here that they're gonna have to add. 'cause it's no it's not so much. Hang ten percent. Disability for hypertension, which is usually qualified when you're on prescription and your diastolic, and let's call up and hypertension or above a certain level. Even if it's controlled you can get a ten percent disability. What the afraid of is paying out for the severe chronic does not that calm innate as a result of hypertension, especially stroke cause heart disease. I already be service connected on presumptive to Agent Orange. But but any other disability that's not an already on the presumptive list, like stroke or any other? Residual shoot a hypertension would be service connected as well. Yes. So. Involved in that, it's it's more complex and people realize just keep an eye on the oaks. And like like, we said that if he had it, especially if you're blue water navy bathroom, and you had Mitch us or if your spouse and and. Surviving spouse get climbing get in there and talk to to metrics rep or someone like John Dory here, he's a certified metrics claim agent. And I don't know how many or cross country, you know, Dionne. You know, I looked at the website one time. So I was kinda curious how many people are there that do what I do on a claims agent level and the credits that appearance age if he's not including Ernie's there's a lot of attorneys. That are authorized and do what what we what we do is claims agents. I think there's only a couple of hundred throughout the country, maybe to two hundred fifty throughout the country, and and I would recommend guest of those two hundred hundred fifty accredited appeal to agents maybe half on some trade on time. I'm just guessing at that. But I know for the state of Minnesota, we've got three, and and I'm fulltime the other guy is that I know of John Brown was sitting on this show years ago. He's still fulltime. And I think there's two others that are registered I know one to do it full time. But I guess the point being is this Gerald what I guess plan. So the question eight I would reckon to guess credited appeals agents at do it fulltime, and it hit me maybe a couple of hundred safety somewhere around there. Well, we're many veterans all in claims, that's not very many. Well, I tell you there's a lot of work out there to be had. I sometimes I rubbed shoulders with threes. Co workers, and tears that have run into from previous jobs and still this is the job you gotta get into. I if you wanna make a difference. You wanna, you know, make a living doing it, your old boss, and you're good at what you do. It's a perfect job. It's best thing. I ever did..
"hypertension" Discussed on Surgery 101
"So that's intra hypnotic portal, hypertension, pre hypnotic and post hypnotic causes are a lot more straightforward when we think about pre hypnotic portal, hypertension. This would be equivalent to someone stepping on the garden hose proximal to the outlet of those again, any resistance apply to the anatomical path flow proximal to deliver can cause pre hypnotic portal. Hypertension portal or splitting vein thrombosis split omega Lee or split. Nick, atrial Venus. Fistula are three important causes of pre hypnotic portal, hypertension, moving onto post paddock port, hypertension. This is a source of resistance that is distorted liver thus the causes can be well, categorized. Into paddock means the inferior Vena Cava or the heart. So as we mentioned earlier, but Kyari syndrome can cause thrombosis of the paddock veins or the inferior Vena Cava and therefore can lead to post. Paddock portal, hypertension, cardiac diseases such as constrictive pericarditis or restrictive cardiomyopathy result in decreased filling of the right atrium ventricle this ultimately translates to an increase in pressure in the IB see in the portal Venus's system by section. So that concludes the structural changes of portal, hypertension. If you're still with me, let's briefly talk about the dynamic changes, which is still an area of active research. The dynamic changes occur from increased production of Vasil constrictors such as Endo theologians agile tense into nor Ephron as well as decrease secretion of endothelial basil dilates such as nitric oxide in the liver. This causes contraction of smooth muscles of the paddock vascular to make things more complicated. The splaying blood flow, which is the circulation of the GI tract increases because of local release of vascular endothelial girl factor at Nick oxide, this alternately causes spanked Nick Vasil dilation angiogenesis increased basketball permeability and systemic Hypo tension the systemic hypertension results in activation of the Renan agile Johnson dos strong system, resulting in increase. Fluid retention which combined with the increased vascular permeability of displaying Nick circulation as well as the low albumin that is typical of nutrient deficient psoriatic patients ultimately contributes to the development of the site. He's all right. So let's simplify that the dynamic changes are caused by secretion of compounds that ultimately caused basil constriction in the and basil dilation in the slang circulation digitally, low albumin creates a low on Kartik pressure. Promoting sites development, which is worse. Invite inflammatory factors causing an increase in vascular permeability of despite Nick circulation. So that concludes our podcast on the path of Yala. The of portal, hypertension. Thank you so much for listening. Here's a summary of the key points. Number one. The portal vein is a large main that's applies liver with seventy five percent of his blood flow at about fifty percent of his oxygen. Number two sites of Puerto systemic collateralisation include cabinet Medusa, the Sauvage VERA sees gastric fair. Sees rectal. Vera sees or hemorrhoids the retro peritoneal Baynes and the veins of sappy. Number three causes of portal. Hypertension can be broken down into pre hypnotic intra paddock and posted paddock. Number four, intra paddick causes can then further be broken down into pre sign associate soil and Paul said. Number five, the most common cause of Puerto hypertension in the western world is liver cirrhosis and finally number six the dynamic changes of Puerto hypertension include Vasil constriction of deliver Vasil dilation of split Nick circulation and increased vascular permeability of the split Nick succession. I hope you enjoyed this podcast and tune into our next one on Pertile, hypertension, as we work through patient presentation of the disease. Thanks again for listening. Thanks air for this. Excellent. Overview of what can be a complicated, and sometimes confusing topic. I'm looking forward
"hypertension" Discussed on Surgery 101
"Risk number three rectal, viruses, or hemorrhoids these occur from the anastomosis between the inferior Mezin teric vein to the superior rectal vein. And then lastly to the middle and inferior rectal James causing hemorrhoids. Number four gastric. Vera sees these occur from the anastomosis between the portal vein and sledding gain, which sent an ASOs. He's to the short gastric lanes. Number five, the retro peritoneal veins or the veins of recipes these occur from the anastomosis between the inferior Mezin teric main on the veins of Retzias. And lastly, number six the die for Matic veins or the veins of sappy this occurs directly from the anastomosis between the portal vein and the veins of sappy. Okay. So far, we've covered the anatomy of portal, hypertension. The definition of portal pretension and the concept of porta systemic collateralisation. Now, let's address the causes of Puerto hypertension. So Ohm's law defines pressure as the product of volume of blood flowing through a system and the resistance of that system to flow in portal, hypertension. There is both an increase in the volume of blood flow Annan increase in resistance, and this is due to both structural changes as well as dynamic changes. Let's talk about the structural changes. I you can classify portal hypertension, into pre hypnotic intra paddock or post about it causes. Let's begin with intra paddick the most common intra hypnotic cause of portal. Hypertension is liberty roses liver cirrhosis is defined by paddock fibrosis which causes a distortion of cell architecture. A ceramic liver has increased resistance of imagine that the portal vein is a garden hose. Intra hypnotic portal. Hypertension would be analogous. Someone pressing thick piece of cheesecloth to the outlet of the hose the hose becomes pressurized proximity. And we will see less output from those when we look at intra paddock causes of portal, hypertension. We can further apply cheesecloth analogy to specific locations within liver. Simply put the cheesecloth could be located anywhere along the anatomical path flow. Remember, the paddock science soy's mentioned earlier as you now know they are essentially small canals which allow for. Passage of blood from the portal triads to the central veins in broad terms are cheesecloth can be located before the paddock sides. It can be located within the paddock sinus olds or it can be located after paddock sides, respectively referred to as precise oil, sinus oil or poll side Soto. Precise soil portal, hypertension, develops proximal to deliver sinus waves and can be due to number one congenital malformations such as polycystic liver disease number two year diseases such as primary bilious roses or primary Slough rose in college Itis, number three neoplasm such as them Volmer or Colegio carcinoma number four granular liver lesions such as sarcoidosis or she still foam ICES. Sinus oil portal, hypertension, develops due to a problem with the liver, sinus oil itself or the surrounding structure of that sign swayed the space of this is the common culprit, this is the space between the sinus, Lloyd and the hip paddle sites, which is actually where the exchange of nutrients into the liver actually occurs. Fibrosis of the space of this is an important cause of sinus sorrel, portal, hypertension, and this can occur from metabolic causes such as non alcoholic fatty liver disease inflammatory causes such as viral hepatitis. She still so myositis cytomegalovirus or chronic. Uber and drugs are talks in said his EMMY odor on methotrexate, alcohol, vinyl, chloride or copper. Lastly post sinus, oil portal, hypertension, develops distant to deliver sinuses. Causes include a sinus Loyd obstruction from vino Occlusive disease, but Kyari syndrome, which is the clues in of the paddock veins or the inferior Vena Cava can also be considered posted Babic as well as primary vascular malignancies such as epithelial you'd Emmanuel Indo THEO while that's a mouthful, okay..
"hypertension" Discussed on Surgery 101
"The paddock artery proper flowing inward as well. As the car. Unbowed duct flowing outward after entering deliver the left and right portal vein. Contribute to portal triads which made a portal vein branch had a gain anabol- duct. These portal triads make up part of the functional unit of deliver known as agonize or lobbies, and the labile is made up of several portal triads arranged around the periphery of a central vein blood flows from the terminal Puerto vein in the portal, triad to the central through a structure called a sinus lining the outside of these signs are Pata sites, which absorb nutrients from the blood as flows through the sinus sinuses to the central vein, the central vein, then go on to form left right and middle hypnotic veins, which then flow into the interior via cable now that can be quite complicated to visualize. So I suggest looking at a diagram online of the labeled anatomy, if the billiards system would also be helpful to look at a labeled cross-sectional view of deliver to get a sense of the portal triad. Adds a assign a soybeans and the central veins. All right. That's nothing Adamy for now. So how do we define portal? Hypertension portal. Hypertension is technically defined by portal vein pressure that is higher than five millimeters. Mercury. However pressures of eight to ten moments of mercury are usually required for the development of Puerto systemic collateralisation. So what is that what is part of collateralisation while let's break down Porto systemic means that it involves both the portal circulation as discussed above, and this is stemming circulation collateralisation means that there is development of collateral flow or an alternate flow, Pat for the blood under normal circumstances. The blood in the portal circulation does not make the blood in the systemic circulation. However, a basic understanding the laws of physics tells us that flow tends to follow the path of least resistance. So if we create resistance in the portal circulation, we will see elevation portal pressure and the flow of blood will. Preferentially pass through areas of low resistance, hence the term porting systemic collateralisation porta systemic collateralisation occurs, where the Puerto Vena system Nassim sees with stem Akina system as the pressure in the portal vein increases, these anastomosis become engorged dilated Enin some cases become a concern for bleeding. There are six major sites of Porto systemic collateralisation, which are highly pimple. They are number one captured Medusa recalculation of the Bill Bain and engorgement of the para umbilical veins this occurs from the anastomosis between the left portal vein and the obliterated umbilical vein. Which runs inside ligament Terry's number two is often you'll Veira sees this occurs from the anastomosis between the portal vein and the coronary thing, which is also known as the left gastric way this drains into the Asaf Venus plex side as mentioned. Earlier bleeding from an esophageal disease is associated with fifteen to twenty percent mortality.
"hypertension" Discussed on KIRO Radio 97.3 FM
"Thing which is what you talked about where you're increasing your fitness and the the byproduct is happiness but if your main goal is happiness than doing a little bit hopefully will then lend itself increase i was getting a lot of anxiety because i've shared this story i felt like one day i was just gonna have a heart attack and i was two hundred thirty pounds and got my cholesterol numbers back yesterday here i am fifty one year old dog assure my cholesterol numbers were there they were to eleven they were high and that's when i decided one hundred four days ago that was gonna change my diet drastically that i was going to go plat base stop eating meat along the way very limited dairy i was going to drink a salad in the morning which is what i do i'm going to exercise sixty to ninety minutes a day i'm gonna take my fitness outside i'm not going to be locked into a gym somewhere i'm not gonna limit alcohol i'm gonna quit alcohol which is what i did one hundred and four days ago and i got my numbers back from my doctor yesterday and michael cholesterol numbers plummeted to one hundred thirty six i had hypertension where sometimes i would come to work in my hypertension might numbers my top number on my blood pressure be between one forty and one sixty so i take a hypertension medicine for that and i recently went to see my doctor after making these changes and my blood pressure was one oh five over sixty eight so i share this with you because your body really can't heal it so if you take the time no matter how much you've abused your body if you really take the time and take care of it and think about what you're putting into your body and it doesn't mean you have to be planned base it doesn't mean you can't eat meat it doesn't mean you can't have a beer but you just pay more attention you pay more attention and you wake up with intention just wake up with intention pay more attention your body will heal itself and you can live a great life time for texts it's all right here we go at tax time nine eight nine seven three tracey's here brought to you by wrench mobile mechanics will check the cars here in a moment but right.
"hypertension" Discussed on 1150 AM KKNW
"'cause you do oh i know my wife at least twice a week looks at me when i'm asleep going at kill you retina i know she won't do it because you'll get caught she watches a lot of i am married to a marriage and family therapist imagine that combo platter i feel your pain i laugh at your pain when the kids went off to college she joined them because she was in college for therapy we had to take therapy i did not want to take therapy because i handle my problems the old fashioned way you hold them internally and you express them in all sorts and hypertension that's the way i deal with it so put my foot down i said no therapy here's what i learned about therapy pretty much every conversations going on man woman goes like this why do you keep trying to solve my problems because you're talking to me tried to solve my problems quit talking to me and this is why my wife will never be out of work i got to tell you when she was in school all the test we had to do i would actually dreading her becoming a therapist but compared to the people that she deals with now on a daily basis i look fantastic hulan i wish you would have done this years ago save me so much trouble i can do whatever i want carte blanche because she can't horse me it'd be bad for business her business cards would have to read do as i say how do you get any driver's license to man the last time you've done that got new drivers license.
"hypertension" Discussed on WDRC
"Been to a couple daca than indicated that they need the fog you know the evening actress thaw ldl though fat then of the weird a health warning what who is it is a bit where but you know uh we tend to demonize salt you know everybody's must have been an ultra low sole diet and yes that the big since people with congestive heart failure and a certain percentage of people not all but a certain percentage of people with high blood pressure they benefit from a low sodium diet however it's actually have been shown that uh for some peop people with high blood pressure uh you get a paradoxical reaction like a backwards reaction from restricting sodium you've actually can sometimes send your blood pressure up uh when you're sodium declines so uh for some people who have hypertension or low blood pressure or weak adrenal function uh they may require more salt and sodium to maintain their fluid volume uh and in the absence assault they feel low weaken can woosie and so i am a partial myself to salt consumption by part of it has to do with my genetics and part of it has to do with the fact that i don't have any conditions which cause you to have to avoid salt i don't have hypertension uh but also exercise lawn they when you exercise on you do lose sodium you sweat and so you need to replete that and and and at just the way is for some people so i i would say uh that's not necessarily a problem so we're going to convert a potential problem into a nonproblem and i should reassure your friend the uh you know as long as everything's okay as sodium consumption has not been shown to be uh a problem in of itself a one way to mitigate the effects of taking a lot of sodium is makes you taking a lot of potassium it's more about the a sodium to potassium ratio uh because americans consume much too much sodium and not enough potassium from fresh fruits and vegetables a gave of sodium from salty foods junkfood snack foods uh and you know that is what creates the problem but if the ratio of sodium to potassium remains good then it's less of a problem as a nonproblem for worry about it keep on consume an assault or eight uh this item if you're suffering from fatigue uh let me suggest.
"hypertension" Discussed on AM 870 The Answer
"More than twenty percent for you to qualify and this that one luke well i sometimes don't understand how things happen but they happen in a very miraculous way and i became a kidney dr because i'm supposed to come here on this radio and say i love you and i know how to protect your kidneys so ckd is the area of my attention and i know how to stop its chronic kidney disease is a very scientists these most patients who end up on dialysis have no clue about their kidney disease according to alatas studies one third of patients who end up on dialysis until d us and another thirty percent until a week both four initiation other dialysis have no clue that anything is wrong with their kidneys civil coming from the rest in modern medical world i have this question what has happened why is that so that so many people are getting on dialysis we have about seven hundred thousand people on the other series and of course many of them have gone that way because diabetes because diabetes is the number one cause of kidney failure in our country and the second most titled an cause is hypertension a lot of times diabetes and hypertension are together and her you have to stop diabetes hypertension if you wanna stark kidney disease and this is why we are conducting this study on the six self march next tuesday and i want to see all of you and i want to make sure that you all come people who don't want to get on they the alice's who don't want to go there out that everybody else has hey can i want you to be there because your haning dancing doctor no said it all so between eleven and twelve on tuesday he had the registration time and i wanna see everybody in chester please make sure you ask about your egf are if you're a number is less than thirty more than fifteen you are in stage four if it's less than fifteen you are in stage five ckd.
"hypertension" Discussed on KQED Radio
"Where most of our providers are and so from children all the way up to our seniors and really we see a lot of adults and chronic diseases hypertension diabetes um north carolina still has a lot of smoker so we see a lot of uh chronic upset djoric pulmonary disease and asthma so those folks would lose the access to that and trying we do a really good job with our um with our diabetics we have you know sixty over sixty percent of our diabetics of hemoglobin a 1 sees that measures other diabetes are doing london under seven i wish was really difficult for folks of low income and your it sounds like you're their lifeline in a in a in a very serious way and so i'm curious if if this funding does not come through and i know that is not the purpose of this programme to predict that it's not going to come through its to say that this is up in the air were in limbo but if it does not come through our eu facing closures of some of the clinics that you're running oh absolutely um we are we would end up closing at least two clinics um and that also would then mean also lane off a significant portion of our staff and so that would billy be a hardship especially four roanne county where there is not as much access i wanna share some more of what you are listener said about this issue here's what one of you left in our inbox my name is dr george garo i'm a chief medical officer or federally qualified health centre in western pennsylvania i wanted to talk with you about community house center mission.
"hypertension" Discussed on Code Switch
"Rain and we've been experienced and racism didn't get i want to go back to your agenda metaphor really quickly so you said it weathering is like a game agenda in which you know you routinely have these blocks removed from one level moved up to a different tear into everything becomes more and more unstable in a lot more tenuous to stay with metaphor for a second is there any way to put the bloc's back it it's it's it hard to say but i don't think it's sort of the complete gun repeal i certainly don't believe there isn't anything that can be done one thing that can be done is done and it you know benefits in particular people who are weathered but in the middle class or more highly educated is access to healthcare so you might be hypertensive from weathering fight if you have good access to healthcare you get it diagnosed early you get it treated you know you learn what you need to do with your diet to make it a little less likely to be turned into its most pernicious and lifethreatening formed a we've seen evidence for instance in some of our studies were we've compared lax in very highpoverty areas too lax in more middle class neighborhood and what we've seen is that those in the higher class neighborhood do have much longer life expectancy than those in the poor neighborhood but they send most of that extra life with chronic conditions and possibly disabled there with a variety of morbidity uh than whites with the same incomes and education floating in the same neighborhood so certainly having the longer life expectancy in averting death and averting the worst versions you know of hypertension or diabetes or or their complications you know avoiding educations and strokes et cetera those are good things fight without dealing with the kind of more structurally routed factors that lead to weather across class.
"hypertension" Discussed on KPAM 860
"Oh the booklovers heart his two healthy for words and the nature leprous heart it flies high return but the heart of some pulmonary hypertension often misdiagnosed as as is unbearably stressed in can fail at the former neary hypertension association we onepage nations a high mass foreign live including our heart into finding a cure here png association dot org that's ph association dot org two two two.
"hypertension" Discussed on Road To Ripped
"The american culture house the station to reduce heart disease patient's lives the incidence of hypertension and diabetes or talent they actually get reduced as you go higher higher and turns to restrict what about so this is a the cause asian thing what about calories sufficiently low calorie sell on to talk about the what about being active excise say what about you know what about being at and healthy weight food quality a so nutrient you're the one thing we know is that when they do these studies these big sample size studies with thousand people those that eat more meat tend to be the looking at a lot of times of fastfood meat processed me those eat more meat smoke cigarettes though the more likely to not excise the more likely be over way the more likely to over conceicao is more likely to go on bayala's pop and so they try and use that meat as the link they could pick anything has the lake any figure rigs like so many different variables in that study yeah use son and those that are that are tend to be vegan there are more likely to be more healthconscious they'll be doing though magazine more abiyan calorie yeah though they won't be exactly they'll be slimmer leaner and then it's like get a controlled study will you have you know two dietrich of two people want other being dr for seen calories or whatever went on macronutrients on a diet with some meat yes saint that you know and then excising doing all that and see the how the bloodmarkers change and author even really that different i wouldn't think there would be like you had the same mac rose and you had very similar people that were going in with similar blood work unless they get unless there all on do a gin the protein from soy protein because that independent berlin's of estrogen yahya i'll outside but if they were doing something like rice protein it probably be just fine right and because i don't think vegans alpha gets necessarily like a terrible diet for you we're trying to be antivehicle but i just think that the way that they bash they do like these totally bad straw man arguments all anal is cool they did a documentary which actually pretty good called fat head.