
Your Heart In Their Hands: Surgeon Preferences & Survival Rates
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Unless you are paying entirely out-of-pocket for a heart surgery, you will not usually get final say over which surgeon you get.
The surgeon, however, will have final say over what they actually do when they open you up.
And their preferences, it seems, can make all the difference:
MAG vs SAG
When doing coronary artery bypass grafting, (CABG), surgeons may prefer to do multi-arterial grafting (MAG) or single-arterial grafting (SAG).
Recently, there was a study analysing more than a million Americans who underwent CABG on Medicare over an 18-year period, looking at outcomes for MAG vs SAG.
The superficial news: those who received MAG had much better long-term survival chances than those who received SAG.
However: this may be less to do with the relative merits of the procedures themselves, and more to do with the preferences of the surgeon.
The “eyeball test”
If surgeons look at a patient and think they will not have many years to live after surgery, they may opt for the SAG, as the long-term benefits of the MAG will only manifest in the long-term.
This may seem a little self-defeating (indeed, maybe you won’t live to see the long-term if you don’t get the surgery type with the longer-term survival chances), there can be other factors involved, that may make surgeons more interested in your short-term survival chances.
Or you might just not have enough donor artery tissue available to pick and choose; after all, a person having a coronary artery bypass quite possibly won’t have great arteries in their arm or leg, either.
Or a person could be missing limbs (a common complication, given the comorbidities of both peripheral artery disease, and diabetes).
See also: How To Stay A Step Ahead Of Peripheral Artery Disease
Why it might be ok that things are like this
When factoring in surgeon preference for MAG or SAG as an instrumental variable, no significant difference in long-term survival was observed. This may explain inconsistencies with randomized controlled trials like the Arterial Revascularization Trial (ART), which also found no survival benefit of MAG over SAG.
Also, MAG recipients were generally younger, healthier, and from more resourceful areas, which likely had a further impact on MAG-giving decisions, and/but at the same time, may also have increased survival chances for reasons other than that they got MAG rather than SAG.
Here’s a pop-science article that goes into more detail about this:
Surgeon preferences may explain differences in CABG survival rates
How to look out for yourself, and advocate for yourself
…or your loved one, of course. Now, having a coronary artery bypass surgery of any kind is not a fun activity; it will be dangerous, it’ll be stressful before and after, and the recovery will often not be an easy time either. However, it is possible to learn more about what is going on / what will happen, ask the right questions, and get the best options for you (which may not always be the same as the best options for someone else).
We wrote about that in more detail here:
Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Take care!
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Broccoli vs Red Cabbage – Which is Healthier?
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Our Verdict
When comparing broccoli to red cabbage, we picked the broccoli.
Why?
Both are certainly great! Which is usual for any Brassica oleracea cultivar (as both of these vegetables are). But there is a clear winner:
In terms of macros, broccoli has more fiber and protein, while red cabbage has more carbs. Now, nobody is getting metabolic disease from eating cabbage, but by the numbers, this is a simple win for broccoli, especially on account of the fiber.
In the category of vitamins, broccoli has more of vitamins B1, B2, B3, B5, C, E, K, and choline, while red cabbage has more of vitamins A and B6. Another win for broccoli.
When it comes to minerals, it’s a similar story: broccoli has more copper, magnesium, phosphorus, potassium, selenium, and zinc, while red cabbage has more iron and manganese. They’re equal in calcium, by the way. Broccoli wins again.
Looking at polyphenols, both cultivars have plenty, but broccoli has more in total, as well as more variety, so yet another win for broccoli here.
Now, standing next to broccoli has made red cabbage look bad, but we want to assure you that red cabbage is itself a nutritional powerhouse—broccoli is just even more so.
So of course, by all means do enjoy either or both; diversity is good!
Want to learn more?
You might like:
21 Most Beneficial Polyphenols & What Foods Have Them
Enjoy!
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Makkō-Hō – by Haruka Nagai
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We’ve all heard the claims, “Fluent in 3 Months!”, “Russian in Two Weeks!”, “Overnight Mandarin Chinese”, “15-Minute Arabic!”, “Instant Italian!”.
We see the same in the world of health and fitness too. So how does this one’s claim of “five minutes’ physical fitness” hold up?
Well, it is 5 minutes per day. And indeed, the author writes:
❝The total time [to do these exercises], then, is only one minute and thirty seconds. This series I call one round. When it has been completed, execute another complete round. You should find the exercises easier to do the second time. Executed this way, the exercsies will prove very effective, though they take only three minutes in all. After you have leaned back into the final position, you must remain in that posture for one minute. That brings the total time to four minutes. Even when [some small additions] are added, it takes only five minutes at most.❞
The exercises themselves are from makkō-hō, which is a kind of Japanese dynamic yoga. They involve repetitions of (mostly) moving stretches with good form, and are excellent for mobility and general health, keeping us supple and robust as we get older.
The text descriptions are clear, as are the diagrams and photos. The language is a little dated, as this book was written in the 1970s, but the techniques themselves are timeless.
Bottom line: consider it a 5-minute anti-aging regimen. And, as Nagai says, “the person who cannot find 5 minutes out of 24 hours, was never truly interested in their health”.
Click here to check out Makkō-Hō and schedule your five minutes!
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The Well Plated Cookbook – by Erin Clarke
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Clarke’s focus here is on what she calls “stealthy healthy”, with the idea of dishes that feel indulgent while being great for the health.
The recipes, of which there are well over 100, are indeed delicious and easy to make without being oversimplified, and since she encourages the use of in-season ingredients, many recipes come with a “market swaps” substitution guide, to make each recipe seasonal.
The book is largely not vegetarian, let alone vegan, but the required substitutions will be second-nature to any seasoned vegetarian or vegan. Indeed, “skip the meat sometimes” is one of the advices she offers near the beginning of the book, in the category of tips to make things even healthier.
Bottom line: if you want to add dishes to your repertoire that are great for entertaining and still super-healthy, this book will be a fine addition to your collection.
Click here to check out The Well Plated Cookbook, and get cooking!
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Quit Like a Woman – by Holly Whitaker
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We’ve reviewed “quit drinking” books before, so what makes this one different?
While others focus on the science of addiction and the tips and tricks of habit breaking/forming, this one is more about environmental factors, and that because of society being as it is, we as women often face different challenges when it comes to drinking (or not). Not necessarily easier or harder than men’s in this case, but different. And that sometimes calls for different methods to deal with them. This book explores those.
She also looks at such matters as how to quit alcohol when you’ve never stuck to a diet, and other such very down-to-earth topics, in a well-researched and non-preachy fashion.
Bottom line: if you’ve sometimes tried to quit drinking or even just to cut back, but found the deck stacked against you and things conspire to undermine your efforts, this book will give you a clearer path forward.
Click here to check out Quite Like A Woman, And Take Care Of Yourself!
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Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
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Each year, more and more Victorians become sick with a flesh-eating bacteria known as Buruli ulcer. Last year, 363 people presented with the infection, the highest number since 2004.
But it has been unclear exactly how it spreads, until now. New research shows mosquitoes are infected from biting possums that carry the bacteria. Mozzies spread it to humans through their bite.
What is Buruli ulcer?
Buruli ulcer, also known as Bairnsdale ulcer, is a skin infection caused by the bacterium Mycobacterium ulcerans.
It starts off like a small mosquito bite and over many months, slowly develops into an ulcer, with extensive destruction of the underlying tissue.
While often painless initially, the infection can become very serious. If left untreated, the ulcer can continue to enlarge. This is where it gets its “flesh-eating” name.
Thankfully, it’s treatable. A six to eight week course of specific antibiotics is an effective treatment, sometimes supported with surgery to remove the infected tissue.
Where can you catch it?
The World Health Organization considers Buruli ulcer a neglected tropical skin disease. Cases have been reported across 33 countries, primarily in west and central Africa.
However, since the early 2000s, Buruli ulcer has also been increasingly recorded in coastal Victoria, including suburbs around Melbourne and Geelong.
Scientists have long known Australian native possums were partly responsible for its spread, and suspected mosquitoes also played a role in the increase in cases. New research confirms this.
Our efforts to ‘beat Buruli’
Confirming the role of insects in outbreaks of an infectious disease is achieved by building up corroborating, independent evidence.
In this new research, published in Nature Microbiology, the team (including co-authors Tim Stinear, Stacey Lynch and Peter Mee) conducted extensive surveys across a 350 km² area of Victoria.
We collected mosquitoes and analysed the specimens to determine whether they were carrying the pathogen, and links to infected possums and people. It was like contact tracing for mosquitoes.
Aedes notoscriptus was the mosquito identified as carrying the bacteria that caused Buruli ulcer.
Cameron Webb (NSW Health Pathology)Molecular testing of the mosquito specimens showed that of the two most abundant mosquito species, only Aedes notoscriptus (a widespread species commonly known as the Australian backyard mosquito) was positive for Mycobacterium ulcerans.
We then used genomic tests to show the bacteria found on these mosquitoes matched the bacteria in possum poo and humans with Buruli ulcer.
We further analysed mosquito specimens that contained blood to show Aedes notoscriptus was feeding on both possums and humans.
To then link everything together, geospatial analysis revealed the areas where human Buruli ulcer cases occur overlap with areas where both mosquitoes and possums that harbour Mycobacterium ulcerans are active.
Stop its spread by stopping mozzies breeding
The mosquito in this study primarily responsible for the bacteria’s spread is Aedes notoscriptus, a mosquito that lays its eggs around water in containers in backyard habitats.
Controlling “backyard” mosquitoes is a critical part of reducing the risk of many global mosquito-borne disease, especially dengue and now Buruli ulcer.
You can reduce places where water collects after rainfall, such as potted plant saucers, blocked gutters and drains, unscreened rainwater tanks, and a wide range of plastic buckets and other containers. These should all be either emptied at least weekly or, better yet, thrown away or placed under cover.
Mosquitoes can lay eggs in a wide range of water-filled items in the backyard.
Cameron Webb (NSW Health Pathology)There is a role for insecticides too. While residual insecticides applied to surfaces around the house and garden will reduce mosquito populations, they can also impact other, beneficial, insects. Judicious use of such sprays is recommended. But there are ecological safe insecticides that can be applied to water-filled containers (such as ornamental ponds, fountains, stormwater pits and so on).
Recent research also indicates new mosquito-control approaches that use mosquitoes themselves to spread insecticides may soon be available.
How to protect yourself from bites
The first line of defence will remain personal protection measures against mosquito bites.
Covering up with loose fitted long sleeved shirts, long pants, and covered shoes will provide physical protection from mosquitoes.
Applying topical insect repellent to all exposed areas of skin has been proven to provide safe and effective protection from mosquito bites. Repellents should include diethytolumide (DEET), picaridin or oil of lemon eucalyptus.
While the rise in Buruli ulcer is a significant health concern, so too are many other mosquito-borne diseases. The steps to avoid mosquito bites and exposure to Mycobacteriam ulcerans will also protect against viruses such as Ross River, Barmah Forest, Japanese encephalitis, and Murray Valley encephalitis.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney; Peter Mee, Adjunct Associate Lecturer, School of Applied Systems Biology, La Trobe University; Stacey Lynch, Team Leader- Mammalian infection disease research, CSIRO, and Tim Stinear, Professor of Microbiology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Worst Cookware Lurking In Your Kitchen (Toxicologist Explains)
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Dr. Yvonne Burkart gives us a rundown of the worst offenders, and what to use instead:
Hot mess
The very worst offender is non-stick cookware, the kind with materials such as Teflon. These are the most toxic, due to PFAS chemicals.
Non-stick pans release toxic gases, leach chemicals into food, and release microplastic particles, which can accumulate in the body.
One that a lot of people don’t think about, in that category, is the humble air-fryer, which often as not has a non-stick cooking “basket”. These she describes as highly toxic, as they combine plastic, non-stick coatings, and high heat, which can release fumes and other potentially dangerous chemicals into the air and food.
You may be wondering: how bad is it? And the answer is, quite bad. PFAS chemicals are linked to infertility, hypertension in pregnancy, developmental issues in children, cancer, weakened immune systems, hormonal disruption, obesity, and intestinal inflammation.
Dr. Burkart’s top picks for doing better:
- Pure ceramic cookware: top choice for safety, particularly brands like Xtrema, which are tested for heavy metal leaching.
- Carbon steel & cast iron: durable and safe; can leach iron in acidic foods (for most people, this is a plus, but some may need to be aware of it)
- Stainless steel: lightweight and affordable but can leach nickel and chromium in acidic foods at high temperatures. Use only if nothing better is available.
And specifically as alternatives to air-fryers: glass convection ovens or stainless steel ovens are safer than conventional air fryers. The old “combination oven” can often be a good choice here.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- PFAS Exposure & Cancer: The Numbers Are High
- It’s Not Fantastic To Be Plastic ← for the closely related topic of microplastics and nanoplastics
Take care!
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