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Caring for Older Adults: Managing heart attack treatment and follow-up care

As the proportion of older adults in the U.S. continues to increase, appropriate care for older people becomes increasingly important. In fact, caregivers and loved ones should be aware of age-appropriate care for heart attack or chest pain.

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(Family Features) As the proportion of older adults in the U.S. continues to increase, appropriate care for older people becomes increasingly important. In fact, caregivers and loved ones should be aware of age-appropriate care for heart attack or chest pain.

The first step is to call 911. Once medical care is started, age-related changes in general health and in the heart and blood vessels require consideration, and likely modifications, in how people age 75 and older are treated, according to a scientific statement from the American Heart Association, published in its flagship, peer-reviewed journal “Circulation.”

The statement, “Management of acute coronary syndrome (ACS) in the older adult population,” highlights evidence to help clinicians better care for older patients. According to the statement, 30-40% of people hospitalized with ACS, which includes heart attack and unstable angina (heart-related chest pain), are age 75 or older.

“Older patients have more pronounced anatomical changes and more severe functional impairment, and they are more likely to have additional health conditions not related to heart disease,” said Abdulla A. Damluji, M.D., Ph.D., FAHA, chair of the scientific statement writing committee, director of the Inova Center of Outcomes Research, and an associate professor of medicine at Johns Hopkins School of Medicine. “These include frailty, other chronic disorders (treated with multiple medications), physical dysfunction, cognitive decline or urinary incontinence.”

Normal Aging and Age-Related Changes in the Heart and Blood Vessels
Cardiovascular changes that occur with normal aging make ACS more likely and may make diagnosing and treating it more complex. These changes include large arteries becoming stiffer, the heart working harder but pumping less effectively, blood vessels becoming less flexible and less able to respond to changes in the heart’s oxygen needs and an increased tendency to form blood clots. Sensory decline due to aging may alter hearing, vision and pain sensations. Kidney function also declines with age, with more than 1/3 of people ages 65 and older having chronic kidney disease.

Multiple Medical Conditions and Medications
As people age, they are often diagnosed with health conditions that may be worsened by ACS or complicate existing ACS. As these chronic conditions are treated, medications prescribed may result in unwanted interactions or medications that treat one condition may worsen another.

“Geriatric syndromes and the complexities of their care may undermine the effectiveness of treatments for ACS, as well as the resiliency of older adults to survive and recover,” Damluji said. “A detailed review of all medications – including supplements and over-the-counter medicines – is essential, ideally in consultation with a pharmacist who has geriatric expertise.”

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Steps for Heart Attack Care and Follow-Up for Older Adults

  • Call 911 if you notice someone experiencing heart attack warning signs. These include chest discomfort, discomfort in other areas of the upper body (one or both arms, back, neck, jaw or stomach), shortness of breath or other symptoms such as a cold sweat, nausea or lightheadedness.
  • Consider treatment needs for co-existing conditions. An individualized, patient-centered approach is best for older adults.
  • Get input from multiple specialists, including a pharmacist, to manage care and medications.
  • People with cognitive difficulties and limited mobility may benefit from a simplified medication schedule, with fewer doses per day and 90-day supplies of medications so fewer refills are necessary.
  • The goals of care for older people with ACS should extend beyond clinical outcomes and focus on quality of life and the ability to live independently.
  • Do-not-resuscitate orders should be discussed before any surgery or procedure.

For more information about managing ACS in older adults, visit Heart.org.

Photo courtesy of Getty Images


SOURCE:
American Heart Association

Health

Observing World Cancer Day

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World Cancer Day is an international day marked on 4 February to raise awareness of cancer and to encourage its preventiondetection, and treatment. World Cancer Day is led by the Union for International Cancer Control (UICC) to support the goals of the World Cancer Declaration, written in 2008. The primary goal of World Cancer Day is to significantly reduce illness and death caused by cancer and is an opportunity to rally the international community to end the injustice of preventable suffering from cancer. The day is observed by the United Nations.

World Cancer Day targets misinformation, raises awareness, and reduces stigma. Multiple initiatives are run on World Cancer Day to show support for those affected by cancer. One of these movements are #NoHairSelfie, a global movement to have “hairticipants” shave their heads either physically or virtually to show a symbol of courage for those undergoing cancer treatment. Images of participants are then shared all over social media. Hundreds of events around the world also take place. (wikipedia)

https://stmdailynews.com/category/lifestyle/health-and-wellness/health/

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FDA CDC News

Food Safety Tips for Game Day

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/PRNewswire/ — Super Bowl Sunday is coming up and you may be planning a party with friends and family. These parties often involve finger foods, communal dishes, and treats that are left out for long periods of time—which can lead to foodborne illness (also known as food poisoning).  Don’t let foodborne illness ruin the fun. Check out these tips from the U.S. Food and Drug Administration and learn how you can keep your food safe.

Food Safety Tips for Game Day

CLEAN

  • Wash your hands with warm water and soap for at least 20 seconds before and after handling food and after using the bathroom, changing diapers, and handling pets.
  • Wash your cutting boards, dishes, utensils, and counter tops with hot soapy water after preparing each food item.
  • Rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten. Scrub firm produce with a clean produce brush.

SEPERATE

  • Separate raw meat, poultry, seafood, and eggs from other foods in your shopping cart, grocery bags, and refrigerator.
  • Use one cutting board for fresh produce and a separate one for raw meat, poultry, and seafood.
  • Never place cooked food on a plate that previously held raw meat, poultry, seafood, or eggs unless the plate has been washed in hot, soapy water.
  • Don’t reuse marinades used on raw foods unless you bring them to a boil first.
  • If baking, make sure that no raw flour is on surfaces that contact other foods.

COOK

  • Use a food thermometer to ensure the safety of meat, poultry, seafood, and egg products. These foods must be cooked to a safe minimum internal temperature to destroy any harmful bacteria.
  • When cooking in a microwave oven, cover food, stir, and rotate for even cooking. If there is no turntable, rotate the dish by hand once or twice during cooking. Always allow standing time, which completes the cooking, before checking the internal temperature with a food thermometer.

CHILL

  • Refrigerate or freeze meat, poultry, eggs, seafood, and other perishables within 2 hours of cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90° F.
  • Divide large amounts of leftovers into shallow containers for quicker cooling in the refrigerator.

SERVE

  • Keep cold foods chilled to 40 °F or below and hot foods heated to 140 °F or above.
  • If you’re planning a buffet and aren’t sure how quickly the food will be eaten, keep serving portions small. Prepare a number of small platters and dishes ahead of time and replace the serving dishes with the fresh ones throughout the party.
  • Don’t add new food to an already filled serving dish. Instead, replace nearly empty serving dishes with freshly filled ones.
  • Watch the clock with leftovers. Whether you’re sending “doggie bags” home with guests or are saving them for yourself, leftovers should be refrigerated as soon as guests arrive home and/or within 2 hours!

Learn more at:
http://www.fda.gov/Food/FoodborneIllnessContaminants/BuyStoreServeSafeFood/ucm328131.htm

SOURCE U.S. Food and Drug Administration

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FDA CDC News

FDA Concludes that Existing Regulatory Frameworks for Foods and Supplements are Not Appropriate for Cannabidiol, Will Work with Congress on a New Way Forward

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Statement From:Janet Woodcock, M.D.
Principal Deputy Commissioner – Office of the Commissioner

January 26, 2023

Given the growing cannabidiol (CBD) products market, the U.S. Food and Drug Administration convened a high-level internal working group to explore potential regulatory pathways for CBD products. Today we are announcing that after careful review, the FDA has concluded that a new regulatory pathway for CBD is needed that balances individuals’ desire for access to CBD products with the regulatory oversight needed to manage risks. The agency is prepared to work with Congress on this matter. Today, we are also denying three citizen petitions that had asked the agency to conduct rulemaking to allow the marketing of CBD products as dietary supplements.  

The use of CBD raises various safety concerns, especially with long-term use. Studies have shown the potential for harm to the liver, interactions with certain medications and possible harm to the male reproductive system. CBD exposure is also concerning when it comes to certain vulnerable populations such as children and those who are pregnant. 

A new regulatory pathway would benefit consumers by providing safeguards and oversight to manage and minimize risks related to CBD products. Some risk management tools could include clear labels, prevention of contaminants, CBD content limits, and measures, such as minimum purchase age, to mitigate the risk of ingestion by children. In addition, a new pathway could provide access and oversight for certain CBD-containing products for animals.

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The FDA’s existing foods and dietary supplement authorities provide only limited tools for managing many of the risks associated with CBD products. Under the law, any substance, including CBD, must meet specific safety standards to be lawfully marketed as a dietary supplement or food additive. 

The working group, which I chair, has closely examined studies related to the CBD-based drug Epidiolex, published scientific literatureinformation submitted to a public docket, as well as studies both conducted and commissioned by the agency. Given the available evidence, it is not apparent how CBD products could meet safety standards for dietary supplements or food additives. For example, we have not found adequate evidence to determine how much CBD can be consumed, and for how long, before causing harm. Therefore, we do not intend to pursue rulemaking allowing the use of CBD in dietary supplements or conventional foods. 

CBD also poses risks to animals, and people could be unknowingly exposed to CBD through meat, milk and eggs from animals fed CBD. Because it is not apparent how CBD products could meet the safety standard for substances in animal food, we also do not intend to pursue rulemaking allowing the use of CBD in animal food. A new regulatory pathway could provide access and oversight for certain CBD-containing products for animals.

The FDA will continue to take action against CBD and other cannabis-derived products to protect the public, in coordination with state regulatory partners, when appropriate. We will remain diligent in monitoring the marketplace, identifying products that pose risks and acting within our authorities. The FDA looks forward to working with Congress to develop a cross-agency strategy for the regulation of these products to protect the public’s health and safety.

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