What happens when you faint?

What happens when you faint? - You were watching the news on CNN recently, when the anchor Poppy Harlow collapsed during a live? She spoke in a graphic on the screen at the time, over a period of 10 seconds or more, his speech was halting and paste - and then there was silence.

With the schema in the approval rate of President Obama is on the screen, the issue moved to a commercial.

After a brief stuffed CNN colleague, Ms. Harlow, who is pregnant, has reappeared and assured his audience that was fine.

She explained that she was a little hot, fainted briefly, and now it felt good. She closed the show and quickly informed his doctor. Soon after, she tweeted that she and her baby were fine. The video series was widely distributed. It is not every day that you can see (or hear) someone low on live television. But have you ever wondered exactly what is fainting?

Fainting is not just one thing

As the term is commonly used, fainting is a sudden and temporary loss of consciousness. The medical term is "syncope" which comes from "syncope" Greek meaning "contraction" or "cut". 

It is an appropriate term because syncope occurs due to a sudden reduction of blood flow to the brain. Syncope is common: nearly a third of people report having at least one episode of loss of consciousness during his lifetime. 

But while "fading" is commonly used to describe people in good health low may be due to a number of conditions, ranging from harmless to life threatening.

Some of the most common causes of fainting include:

    * Vasovagal syncope. The name of the report refers to increased activity of the vagus nerve which signals the heart to slow down and blood vessels ("vasopressin") to open. This combination of effects results in a drop in blood pressure and too little blood flow to the brain.

The sight of blood or emotional or physical stress are common triggers of this condition. Straining during defecation or even strong cough can also cause vasovagal syncope. And therefore can a hot or a sense of panic or claustrophobia.

   * Abnormal heart rhythm. If the heart rate is significantly slower or faster, blood pressure and fainting can fall may follow. Among the many triggers an abnormal heart rhythm are heart disease itself, certain medications, or an overactive thyroid gland.

    * Orthostatic hypotension. This term means a drop in blood pressure that develops during the movement of the supine to standing or sitting. Dehydration, medication or drugs (including alcohol) and blood loss are common culprits underlying. The condition also becomes more common with age.

There are many other causes of fainting, such as blood sugar or seizures. But in many cases you can not find the cause. 

Although nearly 75% of people who do not have anything serious vanish as the cause, it is important to have controls to ensure that you are in that 75%. And even when he did not find anything serious, many people get injured if they fall when they lose consciousness.

People who lost consciousness and occupations involving passengers or heavy machinery operation may be recommended to restrict activities that could themselves or others at risk if they are still missing. 

Pregnancy is another condition that can make it more likely fainting. Blood vessels tend to dilate during pregnancy and blood pressure is usually on the low side. Not much to drop enough to cause fainting blood pressure.

When fainting is fashionable 

In some circumstances, fainting in a specific signal - "fade" or "fail" - has become a cultural expectation. For example, it was common for aristocratic women of Victorian England for a low particularly dramatic moment.

Examples abound of "hysterical fainting" where a lot of people close to each other begins to fail due to a common illness or exposure to a toxin or even a curse. And then there is the game we played in the gentle district intentionally: we breathe deeply and rapidly for some time and then hold our breath and push. It has never worked for me - which is fortunate, because it can be dangerous.

The bottom line 

The circumstances of the disappearance of Poppy Harlow - a warm atmosphere under the studio lights, pregnancy and stressful job - seem more than enough to trigger an episode of fainting. But it was the right thing to be checked by your doctor. In fact, perhaps the only surprise of fainting - including recent event Poppy Harlow in the air - is that this does not happen more often. 
By: Robert Shmerling, M.D.  

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Caesarean section rates: Consider this when deciding where to take your baby

Caesarean section rates: Consider this when deciding where to take your baby - There have been criticisms that the caesarean rate is very high because the highest rates are not translated into improved maternal and child health for many years. 

Many moms feel strongly to have a natural vaginal birth and want to do everything possible to avoid a C-section. But for some, a cesarean section may seem a good choice for a variety of reasons. And for others, a cesarean section may be essential to protect the health - or life - mom and baby. 

In some parts of the world where caesarean sections are not readily available, complications of vaginal delivery often lead to serious consequences, including loss of life for the mother and baby. However, the rapid access to caesarean sections has its own problems.

Especially, cesarean section is a safe procedure. But it has higher risks than vaginal delivery, including the rate is three times higher infection, bleeding and organ damage. It also has a longer recovery period.

So how many cesareans are is a number deserve attention.

Find the optimal cesarean rate 

Consequently, there is a sweet spot - a certain "type" of caesarean sections necessary to prevent the terrible suffering and consequences that can occur when a baby can not move or the birth canal, or when there is an emergency requiring immediate delivery. 

Recently, a study by researchers at Harvard Medical School and the School of Medicine at Stanford University found that the ideal rate of cesarean section appears to be about 19% of all births. This number is higher than previous guidelines have recommended, but lower than the rate in most US hospitals - which can be as high as 70%. 

How do researchers get this number? Caesarean rates of 194 countries analyzed and compared with the rates of maternal and infant mortality. Their analysis suggests that babies and mothers is not better wear when caesarean section rates are above 19%. The Caesarean section rate below 19% were associated with more complications related to childbirth and the poorest results.

This research also suggests that some of the reasons often cited for the high rate of caesarean sections - the moms who are older or obese, or who have had multiple births earlier, with the fear of being sued doctors - can not be only one small part of the bigger picture. In particular, these examples do not account for why some doctors and hospitals are simply more (or less) cesarean than others. 

Dr. Neel Shah is one of the co-authors of the study and an obstetrician in my department at Harvard-affiliated Beth Israel Deaconess Medical Center. Dr. Shah has discovered some previously unknown that help explain the variation in the factors cesarean rates.

For example, his research suggests that time pressure in some hospitals may lead to more caesarean sections compared, vaginal delivery may take a long time and staff resources. Provide the clinical team with access to better information and technology can help to make better decisions based on the volume of patients, staff and global resources to support safe care.

What this means for parents

If you are a healthy woman and have a low risk pregnancy, the hospital plans to use can determine the likelihood that you're going to have a caesarean section more than any other factor. So find out the caesarean section rate in the hospital where she will give birth. Talk to your doctor about this also. If you are early in your pregnancy, you can opt to choose your doctor on the basis that he or she exercises.

Finally, it is important to remember that there are times when a cesarean is the only sure way to give birth. When this happens, the woman may feel a sense of loss of the birth experience she had hoped for. But do your homework about the quality of care can help ensure that your delivery has been determined for the right reasons.
By: Hope Ricciotti, MD.

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New treatment for hepatitis C - but affordable?

New treatment for hepatitis C - but affordable?- The burden of hepatitis C public health is enormous. 

This viral infection causes severe liver cirrhosis, terminal liver cancer and liver failure, often require a liver transplant. Over 3 million people in the United States and 150 million worldwide, are infected with hepatitis C, resulting in 700,000 deaths annually.

People who are infected with hepatitis C often have no symptoms. The virus persists in the liver damage liver tissue slowly over a long period of time. For this reason, it is essential that the progression of liver damage before stopping advanced liver disease or liver cancer occurs.

But there is good news: in recent years we have witnessed remarkable progress in the development of new drug treatments for hepatitis C. sofosbuvir (Sovaldi) and combined with ledipasvir sofosbuvir (Harvoni) are two well known examples these new drug treatments.

Another new drug combination, and sofosbuvir velpatasvir, which was recently described in a report published in the New England Journal of Medicine, is extremely effective against most forms of hepatitis C will become the standard treatment when this combination FDA approved. 

But although the new drugs can cure hepatitis C in many cases they are not accessible to all who need it. New drugs for hepatitis C cost between $ 80,000 and $ 150,000 per year.

People with excellent insurance coverage see low-pocket costs for these drugs. But because of the cost, many insurance companies have set up systems that require high switching costs quotas of people with less robust plans make these medicines out of reach of many people.

In the US, drug hepatitis C are just one example of "specialty drugs." These new drugs for many chronic diseases - such as cancer and arthritis - that were issued to levels that are unaffordable to many people in need.

Up to medicines for hepatitis C, and other drugs are sold at affordable levels, some people without sufficient funds being left behind and can not benefit from modern advances in drug therapy. 

As a society, we must find ways to make these drugs available to all who need it and at the same time compensate pharmaceutical companies for its fresh research and high development. It is a difficult balance, but in a society based on justice and equity, is that we must achieve. For those who have hepatitis C should go without treatment.
By: Gregory Curfman, MD

  

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Can your coffee habit that allows you to live longer?

Can your coffee habit that allows you to live longer? - Taking hot or cold, black or "regular", many people say they can not live without: coffee.

The dark and seductive drink that has become a staple in the American diet. But when did we become so obsessed with coffee, and our obsession is actually bad for us?

Researchers have some revealing answers.

Coffee origins are unclear. A legend goes back centuries in the forests of Ethiopia, where a goat herder discovered that their animals are activated after eating the red berries of the coffee bush. 

But wherever you started from, the popularity of coffee spread rapidly around the world and eventually Europe and the "New World" by the 17th century. 

Although tea was the first drink of choice for the American colonists, coffee has finally replaced after the rebellion against the tea tax by King George III, leading to the Boston Tea Party in December 1773. According to the National Association coffee, coffee would Thomas Jefferson once described as "the favorite drink of the civilized world."

In modern times, a cup (or more) of beer has become a daily ritual in the United States - with meals, office, coffee shops, and at home. It is available in all possible combinations of the size and flavor without much caffeine. But for years, experts have debated whether coffee or threat to health promotion.

In search of the effects of coffee on health 

Coffee contains antioxidants that may help protect cells against damage. In some studies, coffee has been shown to have a protective effect against some cancers as well as chronic diseases such as type 2 diabetes, Alzheimer's disease, Parkinson's disease, and gout. The caffeine in coffee is a stimulant and can help mental alertness and fatigue. 

However, too much coffee can make you nervous, leading to sleep problems, give you headaches, increased blood pressure, and trigger cardiac arrhythmias, and may even promote bone loss. But it is really dangerous coffee? Coffee lovers are putting their lives on the line when they reach for that next cup of coffee? 

To deepen, scientists from Harvard University School TH Chan of Public Health analyzed data from three ongoing studies involving nearly 300,000 men and women up to 30 years. The research results were recently published in the journal Circulation. 

They found that moderate coffee consumption was actually associated with a lower risk of overall mortality and a lower risk of death from cardiac and neurological diseases.

Both caffeinated and decaffeinated coffee had a protective effect, suggesting that something other than caffeine is at stake - perhaps these antioxidants. The heavy coffee drinking still seemed to reduce the risk of death beyond moderate consumption, but does not appear to increase the risk, either.

Ultimately, the researchers concluded, "coffee consumption can be incorporated into a healthy lifestyle." Good news for the millions of Americans who just need to be "dying" for coffee in the metaphorical sense - and can live happily with her.

By: Mallika Marshall, MD.

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The truth about altruism

The truth about altruism - Credit people like Eleanor Roosevelt asking, "When will our consciences grow so tender that we will act to prevent human misery rather than avenge it?" Unfortunately, tenderness is not a characteristic of all human consciousness. So the violence continues, often rationalized as revenge in response to the misery of others.

While altruism is often understood as rooted in tenderness, scientific research suggests otherwise. Rather, altruism may have evolved with the desire to condemn and even punish those who act solely in their own interests. We can be motivated to do good, to avoid being rejected by our community.

The function of altruism

These impulses to act for the good may have helped our early ancestors enforce social norms, in an earlier era formal laws, contracts and courts have forced cooperation.

A few years ago, an international group of researchers led by anthropologist Joseph Henrich from Emory University in Atlanta, tested this theory. They created three experimental games and they played with people who lived in Africa, South America, New Guinea, the South Pacific and the US Midwest.

In these games, players were anonymous to each other. All received real money (or "game") to operate:

        *  The dictator Thurs. The player to decide how much your participation to give the player B. Player B must accept any amount offered. If player A is stingy, no fault.
 
        *  The ultimatum game. Player A decides how much to share with the player B. Player B, before hearing the amount, deciding which offer is acceptable. If B rejects A's offer, both players receive nothing.
 
        *  The third game of repression. Player A decides how much to share with the player B. Player C is given an independent participation. If C feels was too stingy A, C can be punished by reducing the benefits of, but C should pay part of their participation for the privilege. 

The interest dictates that all players must have all the money they receive, because it is a time that the anonymous meeting and reputation does not matter.

In fact, the interest does not govern the results. Few have acted purely selfish. Overall, there was an almost universal to act altruistically and share the trend of play.

Player A is usually offered something that the player B and frequently gave media. In the third game of the punishment, Player C was generally willing to sacrifice some money to punish selfishness. A player, when you know that the punishment was possible, tended to be more generous.

Since Player A has more stingy, most players have chosen to punish him if they were the target of selfishness A player or just a spectator. Local customs affect the amount of trade and the punishment threshold.

Human values and standards

The studies do not show whether it was induced by a desire for revenge or feelings of envy or competition. In any case, people can be more generous when they expect to be punished by selfishness which is outside the cultural norm or when behaving fairly is a high value of the community.

What this means for Eleanor Roosevelt's desire for a tender of universal human consciousness? Human beings with a greater capacity for altruism may have had a survival advantage in primitive societies. 

But it was the people who were good with a spear and had a talent for looking for food or agriculture. In evolutionary terms, being the time both strong and selfless seems to be the winning combination. 

If it is pure altruism, Heinrich study provides no evidence. But it supports the idea that even if we are being "unselfish", we serve our own interests.

Mrs. Roosevelt could argue that society becomes more bearable when people feel good to be kind and generous, rather than the harsh and unforgiving heart. And if I could look around today, she would probably not think of tenderness flourished worldwide since his death in 1962.

But it can be encouraged to know about research showing "altruism" or consciousness as a natural emergent property of human societies. We humans seem to have the ability to play clean, though we sometimes fear of punishment that can help us do that.

By: Michael Craig Miller,M.D.

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4 new recommendations for adolescent health

4 new recommendations for adolescent health - The annual "check-up" is (perhaps only) perfect for not only how children develop and provide the necessary vaccines, but to see how they are generally time - and help ensure they turn into happy, healthy adults. After all, prevention is really what is pediatrics.

That's why the American Academy of Pediatrics (AAP) has a checklist for pediatricians called "Recommendations for pediatric preventive health care." These recommendations, which are updated every few years, based on the update on child health research now - and in the future.

 

While the latest version which includes new recommendations for younger children, like putting fluoride varnish on the teeth of children under 5 years and make a simple test of heart defects in newborns, most changes this occasion relate to teenagers. Here is what the AAP thinks pediatricians should do with their pre-teen and adolescent patients:

 

Detection of the lipids. Sometimes high cholesterol runs in families - but parents and other family members can not have checked your own, or may not be aware of the results of other family members tests.

 

Because high cholesterol can cause real damage to blood vessels over time and lead to heart disease and stroke, it is recommended that all young people have their cholesterol between the ages of 9 and 11. Doctors can before or again it is based on risk, but the AAP wants to be sure that everyone is checked at least once.

The detection of drugs and alcohol. As we all know, teenagers usually experience with drugs and alcohol. For some young people, this may be difficult or even fatal consequences.

 

The AAP recommended six simple questions (called the CRAFFT screen) that the really important information became apparent - and allow important discussions.

 

Depression screening (eg, a questionnaire). Suicide is the leading cause of death among teenagers - and depression is a treatable illness. But to treat it, we know it's there.

 
HIV testing between the ages of 16 and 18. This is important because one in four new HIV infections occur among young people aged 13-24, and 60% of all young people living with HIV do not know that they are infected. 

 

If you do not know, they not only can not help, but they can pass the infection to others. 

 

I guess some parents say, "My son did not need these. - Our family is healthy and my son is a good boy, happy to know stay out of trouble" But the truth is that we never can Learn everything about the history of our family or our children - and when it comes to health and well-being of our children is always better to be safe than sorry.

If you have questions about these recommendations or whatever you do - or not - happening at the check-up of your child, talk to your doctor.

By: Claire McCharty,MD. 

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