HealthWatch July 28, 2013

CARDIAC SCORING An approach to determining the condition of your heart

North Georgia’s Health & Prevention Magazine July 2013

IN THIS ISSUE

• Digital Xrays

New technology with a lot less radiation... page 2

• Back to School

What this time of year means to the local Health Department... page 8

• Women’s Health

NGMC earns national consecutive top awards... page 14

FEATURING

GAINESVILLE HEART AND VASCULAR GROUP PAGE 12

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Sunday, July 28, 2013

The Times, Gainesville, Georgia |

Dental X-rays going digital

gainesvilletimes com

The Longstreet Clinic, P.C. is pleased to welcome two highly trained surgeons to Gainesville.

Suman Annambhotla, M.D. SCOTT ROGERS | The Times Michelle Saco prepares to take a digital X-ray of Elizabeth Crawley’s teeth at The Gainesville Dental Group. The digital process uses the same imaging equipment as with film, but uses smaller doses of radiation

By Meredith Pruitt

of access and the equipment that mpruitt@gainesvilletimes.com you use, not to mention that it is stored in the computer,” said Donna While the medical field constantly Shewbert, a registered dental hygienworks to advance technology, the ist at Gainesville Dental Group. dental field is doing the same.

“If you move and change dentists, Many dental offices now use only or if you have to go to a specialist, digital X-rays to examine patients. (your X-rays) don’t have to be copThe use of digital X-rays is proven to ied. They’re right in the computer in expose the patient and staff to half your chart.” the radiation of a regular X-ray.

Shewbert said Gainesville Dental According to a study by Dentsply, a Group only uses digital X-rays and company that provides dental prod- has done away with the film and ucts and educational resources inter- hassle that goes along with convennationally, a modern digital dental tional X-rays.

X-ray exposes a patient to only half “In our office, we don’t give a the radiation to which the average choice. The digital X-rays are just person is already exposed on a regu- easier,” Shewbert said. “It’s basically lar day. the same as using a digital camera.

Gainesville Dental Group is one There’s no film involved.” office that uses digital X-rays and The technology also processes prefers them for a variety of reasons. everything faster. While a regular “They’re easier to use, they’re X-ray would take up to 20 minutes safer for the patient, they’re kinder Please see X-ray page 7 to the patient as far as the ease

Vascular & Vein Specialists

Dr. Annambhotla is a graduate of the Georgia Institute of Technology and earned his medical degree at the University of Alabama School of Medicine.

He completed his General Surgery Residency and participated in the vascular research program at Baylor College of Medicine before entering Vascular Surgery Fellowship training at Northwestern University.

To schedule an appointment, call (770) 534-0110.

Betsy H. Grunch, M.D. Department of Neurosurgery

Dr. Grunch is a graduate of the University of Georgia and earned her medical degree at the Medical College of Georgia.

She completed her Neurosurgery Residency at Duke University Medical Center in Durham, N.C. To schedule an appointment, call (770) 533-7288.

Gainesville | www.longstreetclinic.com Since 1995, The Longstreet Clinic has grown to include more than 150 providers in some 16 specialties. By embracing compassionate, evidence-based quality standards of care, TLC consistently receives recognition from national organizations that measure and certify practices in key areas of clinic performance.

The Times, Gainesville, Georgia |

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3

Phone: 678-430-3110 678-825-3160 www.cvcng.com The best place for Heart and Vascular Care and prevention in Gainesville and Northeast Georgia.

Our physicans have been presented with numerous awards including the prestigious Patient Choice Award in 2012, Compassionate Care Award and have been nominated to be among America’s Top Cardiologists.

Dr. Salman Ashfaq is also rated as one of the top rated Cardiologists in the Atlanta Metro area based on patient satisfaction surveys on HealthGrades.

We combine the latest medical treatments with leading edge technology at the Cardiovascular Clinic of North Georgia.

We provide our patients with individualized programs and services to improve their overall health and quality

We are always available for our patients 24/7. Same day and urgent appointments available.

of life. We work closely and in tandem with the primary

MEET OUR PROVIDERS:

possible is provided.

care community of physicians to ensure that the best care • Adult Consultative Cardiology

Salman Ashfaq MD FACC FSCAI

Dr. Salman Ashfaq (Dr. Ash) received his medical degree from King Edward Medical University. He completed his Internal Medicine internship and residency at Barnes-Jewish Hospital and Washington University School of Medicine in Saint Louis, where he was also selected to be Chief Resident. He completed his fellowship in Cardiology and Interventional Cardiology at Emory University School of Medicine in Atlanta, Georgia. After completion of his training, Dr. Ashfaq worked as an Assistant Professor of Cardiology at the University of Kansas. He also served as Director of the Cardiac Catheterization Lab at the Robert J. Dole Veteran Affairs Medical Center and also was part of a busy private practice. Since 2010, Dr. Ashfaq has served the patients of North Atlanta and Northeast Georgia. Dr. Ashfaq has a special interest in the treatment and eradication of heart attacks. He also has special expertise in Nuclear Cardiology and Cardiac and Vascular interventions including angioplasty, stents, and atherectomy procedures. Dr. Ashfaq has made several presentations at the American College of Cardiology Scientific sessions and also has authored numerous scientific publications and is a reviewer for renowned Cardiology journals. In addition to his passion for the care of heart patients, Dr. Ashfaq enjoys watching all kinds of sporting events, football, soccer and playing golf. He and his wife are the proud parents of a seven-year-old daughter and a baby boy.

• ECG • Holter & Event Monitoring • Exercise Treadmill Testing • Echocardiography • Transesophageal Echocardiography • Stress Echocardiography • Myocardial Perfusion Imaging (Nuclear Scans) • Peripheral Vascular (Claudication) Testing • Cardiac Catheterization (Leg & Wrist Access)

Saurabh Dhawan MD

Dr. Dhawan received his medical degree at Seth G. S. Medical College. He completed his Internal Medicine Internship at Albert Einstein Medical Center in Philadelphia, Pennsylvania and completed an Internal Medicine Residency at University of Tennessee in Memphis. He then went on to do Post-doctoral Fellowship Vascular Biology and Atherosclerotic Plaque Imaging and completed Fellowship in Cardiology, Echocardiography, and Nuclear Cardiology at Emory University School of Medicine in Atlanta, Georgia. Dr. Dhawan is Board Certified in Internal Medicine, Vascular Ultrasonography, and Nuclear Cardiology. He is also Board eligible in Cardiovascular Diseases and Echocardiography. He also has obtained special training in use and interpretation of Cardiac CT imaging. Dr. Dhawan has made several presentations at various national Cardiology conferences and also has authored numerous scientific publications. He is a member of the American College of Cardiology. Dr. Dhawan has lived in the Atlanta Metro area since 2007. He enjoys running and watching cricket. He and his wife are proud parents of a four year old boy and a baby girl.

• Angioplasty & Stenting (Coronary, Renal & Peripheral Vascular) • Pacemaker Implants • Loop Recorder Implants • Pacemaker & ICD (Implantable Cardioverter Defibrillator Management • Anticoagulation Management • Lipid Management

Dawn Eckler MSN, NP-C

Dawn Eckler joined the practice in June 2013. She completed her training as a Nurse Practitioner in May 2013 from the University of North Georgia. She brings with her a wealth of experience and compassionate care from her years as a Cardiac Nurse and Emergency Room Nurse In Denver, Colorado and then at Northeast Georgia Medical Center.

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Sunday, July 28, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Vision problems may be due to astigmatism By: Charles Phelps

cphelps@gainesvilletimes.com

SCOTT ROGERS | The Times Dr. Jack Chapman Jr. meets with patient Jordan Collins for a routine eye exam at Chapman’s offices at Gainesville Eye Associates

the condition can change as the child grows, and it may decrease or worsen over time.

There are different ways to correct astigmatism, Chapman said. Glasses

Astigmatism is where the front of the eye (or cornea) is shaped more like a football than a basketball when a person is still in developmental stages as a child. Signs of astigmatism may start to show and can include weakness, pain, headaches and dimness of vision.

Astigmatism is also common with nearsightedness and farsightedness.

A lot of times, when people are younger, they just adapt and live with (astigmatism), Chapman said.

There’s no specific cause identified for astigmatism. However, it can be hereditary, said Tania Crow, certified ophthalmic assistant and team leader for Chapman.

She said if a child has astigmatism,

and contact lenses are the fastest fixes.

He said Lasik eye surgery is another way to fix astigmatism. Another surgery that corrects astigmatism is photorefractive keratectomy.

PRK removes tissue from the superficial and inner layers of the cornea.

Lasik doesn’t remove tissue from the surface of the cornea, but only from its inner layer.

Both procedures allow light to focus on the retina (of the eye) by altering the shape of the cornea.

Chapman said all the different options change the optical system of a person who has astigmatism.

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Have you found yourself squinting to see? Or, fighting a headache due to blurry vision?

If so, then you may be feeling the effects of an eye condition known as astigmatism.

Astigmatism is where the front of the eye (or cornea) is shaped more like a football than a basketball, said Dr. Jack M. Chapman Jr., physician at Gainesville Eye Associates.As light rays go into the eye, they’re supposed to focus on one place. With astigmatism, Chapman said, light rays pass through the eye and hit different spots, not the focal point.

Not only can astigmatism occur in the cornea, but it can also occur in the lens of the eye, better known as lenticular astigmatism. This leaves the cornea normal-shaped.

Chapman said there are many symptoms of astigmatism: blurred vision, headaches, sensitivity to light, excessive squinting and eye strain.

Chapman said astigmatism begins

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NGDC adds full-service pharmacy Advertorial provided by Northeast Georgia Diagnostic Clinic The Northeast Georgia Diagnostic Clinic continues to focus on providing the latest and most advanced methods of medical care to our community. We are proud to announce the addition of the Diagnostic Clinic Pharmacy.

Our goal is to have all your medical needs met in one location, which is why we have added a full-service pharmacy. Now there is no need to make an additional stop on the way home from the doctor’s office; pick up your prescriptions on your way out the door.

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To provide the needed care in all of these specialties, the physicians at the Northeast Georgia Diagnostic Clinic are supported by a staff of professionals offering the following onsite services: non-invasive cardiology services, clinical laboratory, clinical research, chemotherapy and cancer care, diabetes and nutrition education, imaging, physical therapy and pulmonary/sleep medicine in addition to our new full-service pharmacy.

The physicians and staff at the will continue to serve the adult popuNortheast Georgia Diagnostic Clinic lation of our community with com-

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Sunday, July 28, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

Biological clock could affect career paths

By Diane Stafford

owl avoids early-morning classes, and all pre-med chemistry prerequisites are taught at 8 a.m., it’s unlikely that The student who hates mornings, student will choose to become a docwho won’t sign up for an 8 a.m. class, tor. may well be forging a career path Brown had a group of students comand forecasting long-term job perfor- plete evaluations to rank their “mornmance. ingness” or “eveningness” tendencies.

A new study distributed by the It then looked at their major fields of American Academy of Sleep Medicine study. injects a new consideration into the “They end up with a declared major theory that people’s internal body that depends on what they’re interestclocks influence their “morningness” ed in, what they’re good at, what they or “eveningness.” might have fun with, and what they The study authored by Frederick might want to do for the rest of their Brown, an associate professor of lives,” Brown said in a phone interview. psychology at Pennsylvania State “But they also pay attention to when University, suggests that this “lark” ver- they’ll have to work.” sus “owl” tendency — whether caused Brown found, for example, that stuby nature or nurture — appears to dents with high “eveningness” scores, influence students’ choices of college gravitate to such majors as the permajors. formance arts, media or information And that could have long-range job systems, where work hours skew later consequences. For instance, if a night in the day or even overnight.

The Kansas City Star

A student’s “morningness-eveningness influence” involves personality traits and a built-in biological tolerance for early or late or irregular job hours, he said.

The connection between college majors and body clocks needs further investigation with larger samples, and that is beginning, Brown said.

“Some people are what we call ‘invulnerables,’ “ Brown said. “They get by on short sleep or disruptions for long periods. But one of our conclusions is that a mismatch of genetics and job characteristics is important.

“The genetic component is wellestablished,” he said. “About half the population are daytime people, about one-quarter are moderate to extreme morning types, and about one-quarter are moderate to extreme evening types.”

Knowing one’s own type is important for workers who want to maxi-

mize job performance, productivity and personal health.There’s also a safety issue. Sleepy workers can’t be as aware as they might need to be.

“It’s bad for your health and for employee engagement to have night or shift work if you’re not set up for it,” said Leigh Branham, a consultant with Keeping the People Inc. in Overland Park, Kan. “It’s a vicious cycle when sleep problems and stress interfere with job performance.”

Becky Wilson learned years ago that she can’t expect top performance from herself in the early morning. The chief visibility officer at WDS Marketing and Public Relations in Overland Park will drag herself to a breakfast meeting, but she avoids it if she can.

“I’ve been that way from the very young,” Wilson said. “It’s very challenging for me to be up and somewhere at Please see Ticktock page 11

The Times, Gainesville, Georgia |

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Sunday, July 28, 2013

7

X-ray Continued from page 2 to develop, the use of digital X-rays renders images almost instantly.

“We use a sensor, which instantaneously puts the image up on the screen, or we use a sulphur phosphate plate and we scan it through the machine and then it scans it into the computer,” Shewbert said.“So it’s more of a permanent image.”

The images are more permanent when transmitted digitally because with film, there’s no backups that can be produced, she said.

“You know, you take a traditional film, it’s just like a traditional picture. Once you have that, it’s gone,” Shewbert said.

“But with digital, it’s backed up on your computer system. It’s in your file on the computer system.”

The dental office can email images to patients and make copies.

SCOTT ROGERS | The Times Dental Hygienist Michelle Saco processes a digital x-ray plate in the offices at The Gainesville Dental Group. The digital process uses the same imaging equipment as with film, but uses smaller doses of radiation. The patient can also easily view the X-rays on a monitor from the dental chair.

Another advantage of digital X-rays is that they allow dental offices to go green. A dental office using digital X-rays does not have to worry about disposing of hazardous chemi-

cal developers, which can harm the environment.

The hassle of paperwork in processing and sharing is eliminated by the use of digital technology

as well. The images can easily be transferred between dentists’ offices.

Digital technology has been proven to provide a better diagnosis to the patient through clearer images.

8

Sunday, July 28, 2013

The Times, Gainesville, Georgia |

gainesvilletimes com

A new school year means vaccinations

By Carly Sharec

are asked to keep additional copies remind parents,” Palmer said in referof immunization records, which is ence to upcoming vaccines. helpful in the event an official form In Georgia, immunization records are required to be filed with the July and August aren’t only for is lost or misfiled.

Typically, children need a series of school before admittance. They’re purchasing school supplies or new outfits. Parents and students need immunizations in entering school, also required for college registrato remember that certain immuniza- then again in going from grade tion, joining the military or traveling tions are required before stepping school to middle school, and then abroad, according to the state’s pubfollowing high school graduation, lic health department website. through those school doors.

Since 2010, the number of immuniThere is no official partnership particularly if they are planning to zations from the health department between the school systems and the attend college.

From birth to 5 years of age, chil- has dropped, Palmer said. In 2010, county health department, but it’s an issue that does bring the entities dren will receive a variety of vac- 9,502 immunizations were given to cinations for different illnesses, like children from birth to 18. In 2012, together.

“We work closely with the schools,” Hepatitis B, diphtheria, tetanus and that number was 6,448.

So far in 2013, 2,604 children have said Dave Palmer, public informa- pertussis. Up until 18 years of age, tion officer for Georgia’s Public additional doses or booster shots had immunizations at the health Health District 2. “By law, children are given based on factors like the department.

If everyone over oris at risk everyone over 50 or at risk ageIf or if the 50 child deemed Palmer attributed the drop to a are required to have their immuniza- child’s got screened for colon at risk forgot a particular disease. variety of factors, saying a declining screened forcancer... colon cancer... tions to be in school.”

Palmer also mentioned that it’s a birth rate may be one issue. He also Form 3231 filed with the eryone If everyone Ifover everyone over 50 or over 50 atmust or risk 50 atbeor risk at risk schools before a child attends. The good idea to get the flu vaccination, said more families may be opting to screened got screened gotform for screened colon for colon cancer... for colon cancer... cancer... is maintained by health depart- which is optional but recommended. get the immunizations at a private “Usually in April and May we try to provider. ments or licensed physicians. Parents csharec@gainesvilletimes.com

30,000 Lives 30,000 Lives Be Saved Could Be Saved 0,000 30,000 30,000 Lives Lives LivesCould If everyone over 50 or at risk

ould Could Could BeBe Saved Be Saved Saved got screened for colon cancer...

30,000 Lives

Immunizations are required but there are three recognizable exemptions to the law, according to Hall County Schools Health Services Coordinator Mamie Coker.

The state’s immunization form 3231 might be marked as “incomplete,” showing that the student is working to get up-to-date on their shots. That’s an acceptable scenario, Coker said.

Another recognizable exemption would be a doctor’s excuse. “When the child’s medical doctor for medical reasons determines they should not receive vaccines,” she explained.

One example, she said, would be if the child had low immunity due to other treatments, like chemotherapy, so a vaccination would not be advisable.

That exemption is also noted on Please see Vaccinations page 9

If everyone over 50 or at risk got screened for colon cancer...

30,000 Lives Could Be Saved

In the U.S., colorectal cancer iscancer the second in deathin death In the U.S., colorectal is the leading second cancer leadingresulting cancer resulting - but regular screenings save lives. detecting and then removing - but regular screenings save By lives.

By detecting and then removing heIn U.S., theIn colorectal U.S., the colorectal U.S., cancer colorectal cancer is the cancer is second theissecond the leading second leading cancer leading cancer resulting cancer resulting in resulting death in death in death pre-cancerous polyps in their earliest stages, an estimated 60% of deaths pre-cancerous polyps their earliest stages, an estimated 60% of deaths ut -regular but -regular butscreenings regular screenings screenings save save lives.save lives.

By lives. detecting By detecting Bycolorectal and detecting and then removing and then removing removing from cancer can be prevented. fromthen colorectal cancer can be prevented.

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Sunday, July 28, 2013

9

Vaccinations Continued from page 8 the 3231 form, and is only good for one year. It would have to be resubmitted annually if the child’s doctor continued to say a vaccine would not be advisable.

The final exemption is religious.

“We accept a handwritten, legal affidavit where the parent writes and makes a statement that immunizations are against their religious beliefs,” Coker said. The form has to be notarized.

That exemption only needs to be filed once, making it good for the student’s time spent at the school.

Coker said that “less than a handful” of students use that exemption.

The rules are the same for Gainesville schools, health services coordinator Paula Sawyer said.

“We do send out letters for sixthgrade students because that is

SCOTT ROGERS | The Times Jesus Gomes, holds his daughter Alexandra, 5, while she gets a vaccination shot from Seth Lee at the Hall County Health Department.

After her two shots, Gomez is ready to begin kindergarten

when they have a change in what is required that’s different from when the student first enters school,” she said. “We follow the state guidelines

When its your heart results matter

for immunizations.”

Both Sawyer and Coker said that the majority of students get their immunizations.

More information may be obtained from the schools, the public health department or the state’s public health website at health.state.ga.us.

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Sunday, July 28, 2013

The Times, Gainesville, Georgia |

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Apps help to keep you healthy in the heat

By Reid Kanaley

The Philadelphia Inquirer Could a smartphone application save you in a heat wave?

On the job or at play outside, look for relief to the OSHA Heat Safety

what’s important is the accompanying page of precautions to be taken.

In high to extreme heat, the app says, outdoor work should be rescheduled for a cooler day. If it must go on, there needs to be drinking water on site, and there ought

In high to extreme heat, the app says, outdoor work should be rescheduled for a cooler day.

Tool, available in English and Spanish to be shade. Workers should keep to from the U.S. Department of Labor. a schedule that has them drinking The free application for Android, about four cups of water an hour.

Apple and BlackBerry devices calcuWhen things really get out of hand, lates a heat index — a combination Please see Heat page 11 of the temperature and humidity. But

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11

Heat

to deal with stress — the “psychology of survival,” as the guide puts it — and how to read the clouds to know what sort of weather is coming over the horizon.

Weather Underground, the app by you’ll want to fire up the Army the company of the same name, is Survival Guide. This free version of free for Android and Apple. Weather a recent edition of the U.S. military Underground claims to have built guide is published for Android devic- the first weather site on the Internet. es by AppOpus.com. An Apple App These days, it offers apps and gadStore search turned up several ver- gets and widgets for desktop and sions of the guide for Apple devices, mobile platforms, as well as an app but not one that is free. for Roku, a content-streaming device Included in the survival guide is for TVs. a chapter on desert survival, with In the phone app, if a red alert advice that might translate well to icon appears on the home screen, cities and towns on staying sheltered tap it to see current heat and airin the heat of the day, switching trav- quality warnings. The app will send el plans to nighttime, and looking severe-weather alerts to your device, out for mirages. It also covers warn- if you tell it to do so in the “settings” ing signs of heat exhaustion, heat screens. strokes and other ways you might Tap “more” to play National become a “heat casualty.”

Weather Service radio, read the For would-be MacGyvers, the sur- WunderBlog, tweet weather reports, vival guide is a gold mine of instruc- see a page on tropical-storm activity, tion on how to be resourceful, how or even check for ski conditions.

Continued from page 10

24-hour schedules — their circadian rhythms — aren’t exact, and they often change with age.

“The problem with sleep research is that it’s difficult to sort out what’s endogenous (regulated by the internal body clock) and what’s exogenous 7:30 a.m. I really have no say about it. (external input),” Stevens said.

It’s not something I decided. It’s the But, he said, researchers do believe way I am.“ that individuals can adjust their body Wilson has no trouble working until clocks if they’re consistent about midnight, so she has to remind herself changing sleep and wake times. That’s not to call colleagues who go to bed why changing shifts — alternating at 9 p.m. They’re the ones who bound between day and night work hours out of bed at dawn or before, ready to — is a problem.There’s no chance for start the day. consistency.

In the sleep lab at the University Nancy Spangler, a consultant with of Kansas Hospital, medical direc- Partnership for Workplace Mental tor Damien Stevens said the medical Health, said failure to get the consiscommunity continually debates the tent sleep that an individual needs can “lark” versus “owl” theories about how lead to more than physical fatigue. It much of a person’s sleep preference is can lead to stress and depression. organic and how much is volitional — “This can be a difficult problem in behavior developed by choice. people who have chronic shift work, What is scientifically known is that such as nurses, who alternate day an area of the brain, the suprachias- and night shifts,” Spangler said. “It’s matic nucleus, sends signals that keep far better to have a shift and keep it. mammals on a 24-hour schedule, influ- Fortunately, more employers are aware enced mainly by light. But individuals’ of that.”

Ticktock

Continued from page 6

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H. Keith Robinson, MD Medical Degree: Medical College of Georgia Residency: Anesthesiology - University of Alabama: Birmingham, AL Fellowship: Pain Management - Wake Forest University, Bowman Gray School of Medicine: Winston-Salem, NC Board Certifications: American Board of Anesthesiology, American Board of Anesthesiology: Subspecialty Certified in Pain Medicine

Becky Caverzasi, APRN, NP-C Education: Valdosta State University - BSN North Georgia College & State Univ - MSN Board Certifications: American Academy of Nurse Practitioners, Georgia Board of Nursing

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GAINESVILLE HEAR

At Gainesville Heart & Vascular Group, we believe that the patient is the center of our practic We are committed to providing the best possible care through diligent clinical evaluation an appropriate use of state-of-the-art technology. Guided by compassion for each individual, w strive to provide convenience and peace of mind to our patients by providing most servic under one roof. Our ultimate goal — help our patients achieve a better quality of life.

S E RV I C E S O F F E R E D • Adult Consultative Cardiology • ECG, Holter and Event Monitoring • Exercise Treadmill Testing • Echocardiography • Transesophageal Echocardiography • Stress Echocardiography • Myocardial Perfusion Imaging (Nuclear Scans) • Peripheral Vascular (claudication) Testing • Cardiac Catheterization (leg and wrist access)

• Coronary Angioplasty and Stenting • Peripheral Vascular Angioplasty and Stentin • Renal Angioplasty and Stenting • Pacemaker Implants • Loop Recorder Implants • Pacemaker and ICD Management • Anticoagulation Management • Lipid Management • Pulmonary Hypertension Testing

7 0 5 J e s s e J e w e l l P a r k w a y, S E , S u i t e 2 0 0 , G a i n

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RT AND VASCULAR GROUP Cardiovascular disease affects over 80 million people in the United States.

ce. nd we ces

Risk factors associated with cardiovascular disease include age, diabetes, high blood pressure, high cholesterol, tobacco use and family history of cardiovascular disease. Symptoms associated with cardiovascular disease include chest pain, shortness of breath, arm/leg pain, loss of consciousness and fatigue.

We at the Gainesville Heart and Vascular Group specialize in prevention, diagnosis and treatment of cardiovascular disease.

Established in 1994, the Gainesville Heart & Vascular Group, formerly known as the Gainesville Heart Group, is recognized as the first cardiology practice dedicated to the care of heart patients in Gainesville and surrounding areas.

Its founder, Dr. David P. Johnson is a Gainesville native who had a dream of providing full-time and full-service cardiac care to the community. He and his partners played an integral part in bringing the Open Heart Surgery Program to Gainesville in 2002.

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Our staff has a reputation of applying a personal touch to our care and cherishing the relationship we have with our patients. Our staff, including physicians, enjoys residing and being an active part of the Hall County community.

Our office has a wide variety of services, including general cardiology consultation, electrocardiography, echocardiography / 2-D Doppler, stress echocardiography, nuclear stress testing and ankle brachial pressure index. Our physicians are staffed round the clock, 365 days a year, at the Northeast Georgia Medical Center. Cardiac catheterizations, including coronary and peripheral artery stenting, stress testing, transesophageal echocardiography and pacemaker devices are performed at the Northeast Georgia Medical Center.

We would enjoy an opportunity to meet with you to prevent, diagnose and treat cardiovascular disease.

Dr. David Johnson

Dr. Bernardine King

Dr. Nayyar Shamsi

Dr. Martin Siegfried

Lauren Beebe, PA-C

e s v i l l e • P h o n e 7 7 0 . 5 3 4 . 9 0 1 4 • w w w. g h v g . n e t

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Hospital recognized for women’s health care

By Meredith Pruitt

mpruitt@gainesvilletimes.com Northeast Georgia Medical Center has been recognized for its commitment to providing exceptional health care for women.

Healthgrades, the largest independent hospital rating company in the country, gave NGMC its Women’s Health Excellence Award for 2013.

The Gainesville hospital was one of four total hospitals in the nation to receive the award and was one of two hospitals chosen in Georgia.

The problems associated with women’s health have become important at Healthgrades due to its recent study on mortality and complication rates in women.

According to a press release from NGMC, the study found that from the years 2009 to 2011, if all hospitals in the country had performed at the same level as the award winners, 46,317 women’s lives could potentially have been saved, and 21,285 women would have most likely been spared from suffering hospital-related complications.

Healthgrades took this into account and looked at mortality and complication rates in women treated at NGMC related to 15 main conditions and procedures. These include heart attacks, stroke and procedures such as heart valve replacement, hip replacement and spinal fusion.

The company compared these to the rates of more than 4,500 hospitals nationwide in order to consider NGMC for the award. The hospital placed in the top 4 percent of hospitals in the nation.

“I think a lot of people think of women’s health as referring almost exclusively to child birth and things of that nature that we would handle over in our Women and Children’s Pavilion,” said hospital spokesman Sean Couch.“You would think that a women’s health award might apply

SCOTT ROGERS | The Times Cardiologist Allison Dupont MD, prepares to examine patient Janet Bedsole at the Northeast Georgia Heart Center. NGMC has earned a top national award for two consecutive years for exceptional health care for women

to that when, in actuality, it does not.”

Dr. Alison Dupont, with Northeast Georgia Heart Center at NGMC, knows that women’s health issues have much to do with the heart, she said. As one of only four female cardiologists at the hospital, she said she understands why women’s heart health should be a main focus.

“It kind of hits home because there’s so many women that are not recognized as having heart disease despite the fact that it’s the No. 1 killer of women,” Dupont said.

Dupont is an interventional cardiologist. Her female patients usually come in with heart attacks or need an angioplasty procedure done. She

says the need for women’s health care is not always reflected well in medical research.

“Women sometimes are underrepresented in study populations,” Dupont said. “When we look at the cardiology studies that are published, there’s hardly ever any women in these studies, so we have to kind of extrapolate what we do into the female population even though it hasn’t really been thoroughly studied.”

Dupont also said that heart catheterization has been changed in the hospital to better meet the needs of women specifically.

“The one thing that I think is an

important change in our practice is that we’ve started doing a lot more radial access procedures during our heart catheterization,” Dupont said.

This involves using access in the wrist instead of the leg in order to reduce the risk of severe bleeding since women are at a higher risk of bleeding during major procedures.

Dupont said major risk factors for heart diseases are the same in both women and men. Smoking, diabetes, high blood pressure, high cholesterol, family history of heart disease and obesity are all factors.

She also said the most important Please see Women’s health page 15

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Women’s health Continued from page 14 thing is recognizing the symptoms of heart disease in women.

“There have been studies actually that have shown that women who have heart attacks don’t do as well,” Dupont said. “The prognosis is poor in women.”

Women will sometimes either ignore their symptoms or simply develop heart disease later in their lives, particularly after menopause, she said.

“Whatever we can do to reduce the risk of death in women with a heart attack is what we aim to do,” she said.

Another major field determining excellence in women’s health care for the hospital is its performance in orthopedic surgery for women.

Dr. Charlie DeCook, an orthopedic surgeon who operates at NGMC but has an office at The Longstreet Clinic, is a hip replacement specialist. He uses something called an anterior approach when performing a total hip replacement surgery.

“What led to the (Healthgrades) award was the results we got from (hip replacement surgeries on women),” DeCook said.

“Anterior hip replacements is a different way of doing hip replacements. We make our incision from the front of the hip and not the back of the hip, and because of that we don’t cut muscle, so there’s less pain and quicker recovery.”

DeCook said there is less risk of complications and the patient’s hospital stay can be shortened with an anterior hip replacement. Anyone in need of hip surgery may have this procedure done, he said.

“Anyone with hip arthritis is a candidate for an anterior hip replacement, so anyone that would have any

SCOTT ROGERS | The Times Cardiologist Allison Dupont MD, discusses medical care with Janet Bedsole at the Northeast Georgia Heart Center.

kind of hip replacement would be a that our caregivers — including phy- all they can to save women’s lives, candidate for the anterior approach,” sicians, nurses, techs, EMS and other they’re doing it as well as the other clinical staff — are not only doing best hospitals in the nation.”

DeCook said.

“A lot of women when they get older develop that hip arthritis, and it significantly affects their quality of AINESVILLE EUROLOGY ROUP LLC life. Everything they do, they’re moving their hip and it’s painful.”

He said the concentration on womOver 34 Years of Service en’s health care has been advanced, to Northeast Georgia but they have always had the same consideration for the health of Leading Board Certified Neurologists in female patients.

Northeast Georgia Since 1979 “I think there’s always been a • ALL physicians board certified in Neurology commitment to women’s health,” • ALL physicians dedicated to providing compassionate and comprehensive DeCook said. “I think we’re just recneurological care ognizing and clarifying it more. So I • ALL physicians hold academic appointments think the types of procedures have at Medical College of Georgia • ALL physicians dedicated to the teaching and changed. I think that’s what’s helped Clinton E. Branch, Jr., M.D., FAAN; Michael S. Baugh, M.D. and Daniel L. Cobb, M.D. training of future physicians the most.”

This is the second consecutive Since 1979 Gainesville Neurology Group If you need a neurologic evaluation, has helped patients in Northeast Georgia year the hospital has earned the with neurologic problems: ask your physician for a referral to award. The hospital staff is proud to • Migraine • Sleep Disorders Gainesville Neurology Group • Vertigo • Neuropathy/Radiculopathy earn this award, said Brad Nurkin, or call our office at 770-534-7885 • Dementia • Parkinson’s Disease president of NGMC, in a statement • Seizures • Myasthenia Gravis for information and appointments. released by the hospital this month.

“Northeast Georgia Medical Center 1240 Jesse Jewell Parkway GAINESVILLE recognizes the unique health care Suite 400 needs of women across all of our Gainesville, GA 30501 N EUROLOGY services, not just the ones reviewed p: 770-534-1117 f: 770-503-7285

by Healthgrades,” Nurkin said. “We’re GROUP, LLC www.gainesvilleneurology.com proud that this award recognizes

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Researchers link ‘obesity gene’ to hunger hormone

By Melissa Pandika

Los Angeles Times Researchers have further unraveled how a version of a gene linked to obesity risk causes people to gain weight — it makes them more likely to feel hungry after a meal and to prefer high-calorie foods.

Their study, published Monday in the Journal of Clinical Investigation, found that individuals who inherited the high-risk version of the FTO gene from both of their parents have higher levels of the appetite-stimulating hormone ghrelin in their bloodstream, which leaves them hungry even after eating. Real-time brain imaging also revealed that the FTO gene regulates the brain’s responses to ghrelin and to images of food.

“This possibly explains why some people are more sensitive to overweight and obesity than others,” said Dr. Jeremy Korman, a bariatric surgeon at Marina Weight Loss in Marina Del Rey, who was not part of the study.

A 2007 study found that people who have two copies of the “obesityrisk” version of FTO weighed about 6.5 pounds more, on average, than those who didn’t have any copies of the variant. Other studies have shown that people who had the high-obesity-risk gene variant ate more those who didn’t.

But exactly how FTO affected appetite and weight gain remained a mystery. Batterham’s group hypothesized that gut hormones that regulate appetite_and the brain’s responses_ might be the missing link.

Their study marks the first examination of how FTO variation in humans regulates ghrelin and leads to obesity, said study coauthor Rachel Batterham, an endocrine and obesity researcher at University College London.

Batterham’s group recruited 359 healthy, normal-weight European

men. Among them, 45 had two copies of the obesity-risk version of FTO, while the rest carried the low-risk variant.The researchers matched the participants for body weight, fat dis-

ing differences in the brain’s reward regions, as well as the hypothalamus, which controls appetite. For example, low-risk participants preferred high-calorie foods before the meal,

It makes them more likely to feel hungry after a meal and to prefer high-calorie foods tribution and social factors such as educational level, to make sure that any differences they saw were because of FTO and not to other physical or psychological characteristics.

A group of 10 men with the highobesity-risk variant of FTO and 10 men with the normal version were asked to rate their hunger before and after a standard test meal. Highrisk men felt hungrier than low-risk men after eating a meal, while blood tests revealed that they also had higher levels of ghrelin circulating through their bodies. Levels of ghrelin_secreted by stomach cells_normally peak right before a meal and subside immediately afterward.

The research team then used functional magnetic resonance imaging, or fMRI, in a different group of 24 subjects to measure their brain activity in response to images of highcalorie and low-calorie foods, as well as non-food items, before and after a meal. They asked the participants to rate the appeal of each image and measured their blood ghrelin levels.

Compared with their low-risk counterparts, subjects with the highrisk version of FTO found the images of high-calorie foods more appealing_even after a meal. The fMRI tests revealed that the brains of the two groups also responded differently to images of food before and after a meal and to circulating levels of ghrelin.

Researchers saw the most strik-

but preferred low calorie foods after eating. Researchers didn’t observe this shift in obesity-risk individuals, who preferred high-calorie foods before and after eating.

The researchers also looked at mouse and human cells to tease out what was going on at the molecular level. Normally, FTO makes changes to ghrelin mRNA, which carries instructions for “building” the hor-

mone. When FTO was produced at high amounts in these cells, ghrelin levels were higher. They also found that blood cells from people with two copies of the high-risk version of FTO had more ghrelin mRNA than people with the low-risk versions of FTO. The study results could have important clinical implications, Dr. Korman said. For example, it could prompt pharmaceutical companies to develop drugs that help regulate ghrelin signaling.

But “the problem is that it’s not as easy as it sounds,” he said. Besides ghrelin, the gut releases other hormones that send “an opposite signal” that tell us that we’re full and satisfied. “There are so many other signals interacting with the brain.”

Batterham agreed. “This is one piece of a jigsaw,” she said.

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Survey: Most doctors say they don’t have ‘major responsibility’ for cutting costs

By Eryn Brown

Los Angeles Times Physicians are concerned about skyrocketing health care costs — but most don’t think they have “major responsibility” for reducing those costs, according to survey results released Tuesday.

Mayo Clinic researcher Dr. Jon C. Tilburt and colleagues polled 2,556 doctors on health care costs in 2012, asking them to gauge their level of responsibility for controlling costs — as well as others’ responsibility. More than half of respondents said that trial lawyers, health insurance companies, hospitals and health systems, pharmaceutical and device manufacturers and patients had a major responsibility for cutting costs. But only 36 percent said that physicians themselves had major responsibility. More than half said that doctors bore “some responsibility.”

The team also asked doctors to describe how enthusiastic they were about various approaches to cost-containment. Most were very or somewhat enthusiastic about reforms such as promoting quality of care and improving the quality of the data doctors have at their disposal to make better informed treatment decisions.

But “respondents’ ratings for changing how care gets paid for were more mixed,” the team wrote, reporting that physicians were loath to endorse “more substantial financing reforms” such as eliminating fee-for-service reimbursement, cutting Medicare pay or imposing penalties when patients have to be readmitted to the hospital.

The researchers called the doctors’ opinions about cost-containment “complex” and “nuanced,” noting that 85 percent agreed that “trying to contain costs is the responsibility of every physician,” even as 78 percent agreed

with the statement that they “should be solely devoted to my individual patients’ best interests, even if that is expensive.”

A report summarizing the survey results was published in the Journal of the American Medical Association.

In a related editorial, University of Pennsylvania researchers Dr. Ezekiel J. Emanuel and Andrew Steinmetz called the physicians’ reported attitudes “a denial of responsibility,” writing that many doctors seemed enthusiastic only about cost-cutting efforts that “relieve the physician from being the decision maker.”

“If there ever was an ‘all-hands-ondeck’ moment in the history of health care, now is the time ... physicians must lead,” they wrote.

But, they added, “in the face of this new and uncertain moment in the reform of the health care system, physicians are lapsing into the wellknown, cautious instinctual approaches humans adopt whenever confronted by uncertainty: blame others and persevere with ‘business as usual.’ “

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Medicare chief confident health care reform is on schedule

By Pamela Yip

we launched our new call center information, both in English and in The Dallas Morning News Spanish, and then we have a translaOpen enrollment for the health tor for up to 150 other languages, insurance exchanges created by the with the idea of starting to get peoAffordable Care Act is less than three ple excited or energized about what months away, and Marilyn Tavenner is comes next.

(The toll-free number for the call busily trying to spread the word.

Tavenner manages the Centers for center is 1-800-318-2596.)

Q: In your marketing, you obviously Medicare & Medicaid Services, the $820 billion federal agency charged want to convince young people to with implementing the rollout of the sign up for health insurance to balance out the insurance risk pool. How exchanges.

The state-based exchanges will are you going to approach that with enable individuals and small busi- young people?

A: Media are targeted at different nesses to shop for health plans. The exchanges, or marketplaces, will help age groups, but there’s a big section consumers and small businesses to that’s targeted to folks between 18 compare and purchase qualified and 35, or really 26 and 35.

We’re trying to do it through sports, health plans. through media applications — your The exchanges of 26 states will be Marilyn Tavenner iPhone, iPad — the types of things operated by the federal government.

Tavenner sat down with the Dallas that younger individuals tend to use. but obviously, we’re going to try and We also have external marketing steer away from that because the Morning News for an interview. Her groups who are focusing energy on comments are edited for brevity.

Q: Will you be ready when open what’s appealing to a young person.

It’s not the idea of cancer or a heart enrollment starts Oct. 1?

A: We’re now at what I call the final attack; it’s the idea of a sports injury.

How do you get protected around touches in testing. We will be ready.

There’s the internal part, which is these things?

For young couples, it’s about talkthe technology and the testing and getting all the information loaded, ing about their family and taking care particularly if you’re in a federally of their children. We’re (also) trying to appeal to parents. Parents tend to facilitated exchange.

We’re in the process of working influence their children about having with insurers, loading data, check- health care.

We are also trying to work with ing that data for completeness, accuracy. That data will become public. individual sports teams inside marPeople will actually be able to look kets.

Q: What’s the biggest challenge in at rates across the federally facilitated all this for you? exchanges around Labor Day, which is A: It’s getting consumers comfortanother step in making it more meanable with what’s going to be available ingful for consumers.

So even before they sign up, they and helping to manage their expeccan actually look and see, if I’m a tations. It’s making people aware of single person or if I’m a person with how you get started.

You can go online, you can comtwo dependents, what kind of rates, what kinds of plans, are going to be plete your own application, you can dial the 1-800 call center number, available in my hometown.

The external mechanisms are really which will be available 24 hours a day, preparing consumers. At the end of seven days a week.

Then we will always have a paper June, we launched our new website (at http://www.healthcare.gov), and application that folks can complete,

more we automate it, the quicker the process, the easier it is.

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Nation faces acute shortages of some medications

By Marie McCullough

survey.

Why aren’t patients and families up in arms?

They may not realize their care was Rationing medical care is denounced as immoral in the United States, yet it compromised or complicated by a goes on daily in hospitals, clinics, shortage unless their caregivers are nursing homes, ambulances and phar- unusually candid.

“Patients in an intensive care unit macies.

Since 2006, this country has had often don’t know they’ve been worsening shortages of sterile generic injectables — drugs given by shots or intravenously. Currently, more than 300 medicines crucial to treating cancer, infections, cardiac arrest, premature infants, pain and more are in short supply.

The reasons for this predicament are complex, and the fixes, elusive.

The scope, however, is clear from surveys of medical and trade groups. The impacted,” said pharmacist Erin Fox, latest, a University of Pennsylvania who tracks shortages as manager of poll of oncologists released last the University of Utah’s drug-informamonth, found 83 percent had dealt tion service. “And the hospitals don’t with shortages by delaying cancer want folks to talk about it. They don’t treatments, omitting doses, using sec- want to admit, ‘We had a patient who ond-choice drugs or sending patients died because we didn’t have this drug.’ “ elsewhere.

The secret human toll is rising. In “Oncologists are facing wrenching decisions about how to allocate life- the last three years, dozens of deaths saving drugs,” said cancer specialist due to contaminated drugs have been Keerthi Gogineni, who led the Penn linked to producers and vendors who The Philadelphia Inquirer

have capitalized on shortages. The Institute for Safe Medication Practices (ISMP) in Horsham received hundreds of reports of medication errors, near-disasters, and 15 deaths related to shortages when it surveyed 1,800 health-care practitioners in 2010.

“This is the worst I’ve ever seen in over 40 years as a pharmacist,” said

Of 142 respondents with a shortageprevention program, more than half said “the company was still unable to prevent a drug shortage.

Michael Cohen, ISMP president, who contributes to The Inquirer’s Checkup blog. “It’s truly a public health crisis.”

One group of patients has been acutely aware and outspoken about the crisis because it threatens their health every day.

These 30,000 Americans cannot eat by mouth, usually from digestive diseases. They must get all nourishment — from vitamins to fat — in a customized, sterile solution pumped into

a heart vein.

Total parenteral nutrition, or TPN, is also vital temporarily for premature newborns and hospitalized patients who can’t eat.

“We were very vocal in outlining for (government officials) what we think needs to be done,” said Joan Bishop, director of the nonprofit Oley Foundation in Albany, N.Y., a TPN support network. “You can’t just let people starve.”

Among the group’s stalwart activists is Bettemarie Bond, 42, of Levittown.

She suffers from rare digestive and metabolic disorders and has been on TPN since 1990. A single bite of, say, pizza, would set off excruciating inflammation in her pancreas and gut.

In her teens, doctors told Bond to prepare to be an invalid. Instead, helped by her parents and TPN specialists, she graduated from college, bought a house, and became a pediatric occupational therapist. She works with autistic preschoolers and hides her infusion pumps in a snazzy backpack.

To do all this, Bond has to conPlease see Drug shortage page 21

Entertainers asked to help promote health care law

By Noam N. Levey

Tribune Washington Bureau Stepping up efforts to enroll young Americans in health insurance this fall, the Obama administration is enlisting the help of actors and entertainment industry officials to educate 20-something consumers about the need to get covered.

Senior administration officials met Monday morning with a group of entertainers to talk about media campaigns to reach young Americans about the Affordable

Care Act, according to a White House official.

Among those at the meeting were actors Jennifer Hudson, Kal Penn and Amy Poehler; Mike Farah of the website Funny or Die; Daniel Kellison of YouTube Comedy; Royal Pains sitcom creator Andrew Lenchewski; songwriter Bruce Roberts; and Troy Carter of the entertainment agency Atom Factory.

Also in attendance were representatives for Oprah Winfrey, Alicia Keys, Bon Jovi, the Latin Recording Academy and the National Academy

of Recording Arts and Sciences, which produces the Grammys.

The president stopped into the meeting, according to the White House.

The Obama administration is working with scores of community groups, health care companies, foundations and others to publicize the president’s 2010 health law, which will make guaranteed health coverage available to all Americans for the first time next year and also require most consumers to have health coverage or pay a fine.

Sufficient enrollment -- particularly of young, healthy consumers -- is viewed as critical to keeping premiums affordable next year; the administration is aiming to get about 2.7 million currently uninsured young consumers enrolled in 2014.

But polls show many Americans still do not know about the law. And Republican critics of the Affordable Care Act have repeatedly attacked efforts to educate the public and pressured groups not to participate, including sports leagues such as the National Football League.

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Drug shortage Continued from page 20 serve energy; even taking a shower can exhaust her. The shortages add needless stress. Consider that severe selenium deficiency can cause heart damage, yet she has not had the trace element for almost a year. She has gone without IV multivitamins for months at a time. She also worries that her infusion pharmacist will run out of the only pain medication she can tolerate. “Without it, the pain would be unbearable,” she said.

Still, she considers herself lucky.

“Some friends have had it much worse,” she said. “They’ve gotten lipids (fats) just once a week instead of daily. It’s affected their health.”

Though shortages occur in other developed countries, the U.S. is especially vulnerable, experts agree.

In a recent analysis, Food and Drug Administration officials cited a root problem: U.S. factories that make sterile injectables are few, aging and inadequate, and manufacturers have no economic incentives to upgrade.

When equipment breaks or inspectors find problems, it’s often easier to quit making the injectables — which have high production costs and low profit margins — and divert the capacity to more lucrative products.

Only seven companies now make virtually all sterile injectables in the U.S., their plants running round the clock. Six have received repeated FDA warnings about safety lapses.

Experts cite other factors behind shortages, including hospital group purchasing contracts that drive down prices, hoarding, and low insurance reimbursements.

“In Britain, prices are more regulated,” said Michael Link, a Stanford University pediatric oncologist. “The reimbursement rate for generics is higher, and on-patent drug reimburse-

ment is lower.”

The FDA cannot order firms to make drugs, but recent legislation and a presidential order gave the agency more muscle. Last year, it began requiring companies to give early warnings of permanent and temporary drug discontinuations.

The agency also allowed temporary importation of a key ovarian cancer chemotherapy, as it did the year before for a leukemia drug.

But importation is not ideal. Many foreign factories do not meet FDA standards. And global transport of heavy glass vials adds to costs.

Last month, an industry group, the International Society for Pharmaceutical Engineering, released the first global survey of companies and others. The intent was to see if steps already taken by industry and regulators were working.

The answer was not so well.

Of 142 respondents with a shortageprevention program, more than half said “the company was still unable to prevent a drug shortage.”

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Cardiac scoring reveals calcium buildup in arteries

By Meredith Pruitt

arteries.

The high-resolution CT scan used in cardiac scoring is performed Out of all baby boomers of both with no contrast and lets you see sexes, 39 percent have cardiovascu- the calcium in your arteries. It is lar disease.This is caused by a silent fast and painless.

“You just stand in the scanner and problem — calcium buildup in the it just takes a few seconds really to arteries.

The awareness factor can deter- scan,” said Dr. Brian Gay, a radiolomine how harmful heart conditions gist at MRI and Imaging of Georgia. can be, and awareness is gener- “Then it gives an image and the ally low. In fact, only 13 percent of computer will analyze the image, women see heart disease as a seri- and it will tell you the amount of ous threat, even though statistically, calcium in the coronary arteries.”

The comparison given by the it is the No. 1 killer of women.

Fortunately, radiologists can now computer can determine how high perform a relatively low-cost pro- one’s risk is for coronary problems, cedure to determine exactly how including heart attacks. The score much calcium a given person has can be defined as good or bad in his or her coronary vessels and based on a person’s age and gender.

Calcium level norms usually go how that number compares to othup the scale with age, but the ers in their age range.

In this case though, a higher score increase would be abnormally high is not good.A young, healthy person for someone with heart issues. The would have no calcium in their baby boomer age bracket is normpruitt@gainesvilletimes.com

mally the target market for this procedure.

“The calcium can start even at a young age, but typically we see people that are older, in their 50s, 60s, who want to know if they have calcium in their arteries,” Gay said.

He said insurance doesn’t usually cover this procedure, but it does give some added peace of mind to patients who believe they may be at risk for heart problems.

There is also a typical correlation with how wide or narrow blood vessels are and how much calcium is in them. The narrowing of blood vessels can lead to serious and even fatal heart conditions.

“You want to make sure your vessels aren’t getting so narrow that they would cause a heart attack, and the calcium scoring shows you how much calcium is there, but it doesn’t really show you how narrow the vessels are,” Gay said.

Cardiac scoring uses a scale that mentions narrowing of the vessels as a possibility because of this correlation. A scale of 0 indicates no calcium and likeliness for no narrowing or plaque buildup.

Someone with a score numbered up to 10 is still highly unlikely to have any calcium or plaque in the arteries. However, if the score is in the 11-100 range, mild coronary calcium and/or narrowing may be possible.

From the range of 101-400, coronary artery disease and narrowing of the arteries both become a significant possibility and a concern.

Any score higher than 400 is considered serious, and further consultation from a physician would be recommended.

The availability of the scoring system is hoped to boost awareness and provide easy access for a more informed heart patient.

Skipping breakfast linked with heart disease

By Mary MacVean

at night had a 55 percent higher risk of coronary heart disease. They didn’t find an association with the Even Elmo knows that breakfast is number of times a day a person ate.

Those associations were true the most important meal of the day in his world, but there hasn’t been — if somewhat less so — when enough scientific evidence for the other habits and conditions that federal government to recommend would cause coronary heart disease were factored in, said the researchit for grown-ups.

Still, it sounds like it might be a ers, from Harvard University and wise move to stock up on oatmeal Brigham and Women’s Hospital.

Snacking and skipping breakfast and the like. In an article released Monday in the journal Circulation, are common among Americans, the researchers found that men who researchers noted. And such habits skipped breakfast had a 27 percent have been associated with weight higher risk of coronary heart dis- gain, high blood pressure and diabeease than men who ate their morn- tes, they wrote.

So they looked at the Health ing meal though we imagine that big daily plates of bacon and pan- Professionals Follow-up Study, an ongoing look at 51,529 men who cakes with syrup are not the ideal.

The researchers also found, using are questioned every two years a large ongoing study of mostly about their health and habits.

The men who did not eat breakwhite men, that those who ate late Los Angeles Times

fast were younger, more often single and more likely to smoke and less active than the other men. The latenight snackers were also more likely to smoke and to have hypertension and sleep less than seven hours a night, the researchers wrote.

But the quality of the men’s diets was on average very high.

“The timing of the meal may be directly responsible for the metabolic effects that may lead to CHD, or alternatively, eating habits may be a proxy for specific foods more likely to be consumed at breakfast or late at night such as breakfast cereals high in dietary fiber and fortified micronutrients like folate or latenight snack foods high in calories,” the researchers wrote.

They said they would like to see additional studies looking at women and ethnic groups.

The Times, Gainesville, Georgia |

gainesvilletimes com

Sunday, July 28, 2013

23

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