Health
Largest U.S. Cardiac Database Shows Excellent Long-term Survival After Surgical Aortic Valve Replacement
Study in Low-Risk Patients Reveals 5-year Survival Rate of 93%
Newswise — A study published today in The Annals of Thoracic Surgery demonstrates outstanding long-term survival following low-risk isolated surgical aortic valve replacement (SAVR).
The study reviewed 42,586 patients who underwent low-risk isolated SAVR between 2011 and 2019 at 981 different cardiac surgery programs across the U.S. Conducted by eight leading national investigators, the assessment relied on evidence from The Society of Thoracic Surgeons (STS) National Database, with linkage to the Centers for Disease Control and Prevention’s National Death Index (NDI).
The STS National Database, with nearly 10 million patient records, is the nation’s largest and most comprehensive clinical registry for cardiothoracic disease. The linkage to the NDI has permitted highly accurate survival information to now be available following heart and lung operations performed in the U.S.
All patients in the study were classified as low risk for SAVR mortality as defined by the STS predicted risk of operative mortality (PROM ≤ 4%). Overall, 92.9% survived after five years, and the eight-year survival was close to 90%. The study matched the criterion used in the current low-risk trials evaluating SAVR with transcatheter aortic valve replacement (TAVR). The average age of patients was 74.2 years with a mean PROM of 1.92%
“This study sets a benchmark for outcomes for management of aortic valve stenosis,” said Vinod Thourani, MD, Bernie Marcus Chair of Cardiovascular Surgery and the Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia. “This analysis is significant because of the longitudinal follow-up with very large numbers of patients, and it is an important complement to results from randomized clinical trials that are commonly measured over just one year.”
Recent evidence has revealed that SAVR following failed TAVR requiring explant of the TAVR valve, has been the fastest-growing cardiac procedure over the last five years, associated with worse outcomes than those expected following primary SAVR surgeries.
The most recent mid-term results from the PARTNER 3 and Evolut Low-Risk trials comparing risk of death and stroke from SAVR and TAVR are expected to be released in fall 2023. As there have been some concerns raised regarding the representativeness of these trials, the current study was performed to establish real-world long-term results from SAVR to serve as a benchmark for outcomes.
“There remains absolutely no doubt that TAVR is an excellent primary option for patients of higher risk or advanced age. The aim of this study was to specifically evaluate patients of low risk, and this revealed that longitudinal outcomes of SAVR in this specific population are outstanding. As surgeons are consistently performing these surgeries with excellent outcomes, and now in minimally invasive fashion, these data should give providers of valve therapy, including cardiologists and surgeons, a point of reflection when it comes to deciding what the best option is for their patients,” said senior study author Vinay Badhwar, MD, Professor and Chairman of the Department of Cardiovascular and Thoracic Surgery of West Virginia University, and Executive Chair of the WVU Heart and Vascular Institute.
The STS National Database includes 97% of all cardiac operations performed in the U.S. with precise and validated statistical models for patients receiving adult cardiac, general thoracic, and congenital operations.
Study authors also included Robert H. Habib, PhD, Wilson Szeto, MD, Joseph Sabik, MD, Jennifer Romano, MD, MS, and Thomas MacGillivray, MD.
Link to “Survival Following Surgical Aortic Valve Replacement in Low-Risk Patients: A Contemporary Trial Benchmark:” https://www.annalsthoracicsurgery.org/article/S0003-4975(23)01064-0/fulltext
Journal Link: The Annals of Thoracic Surgery, Oct-2023
Source: The Society of Thoracic Surgeons
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Lifestyle
Keep Cold and Flu Season at Bay
During cold and flu season, preparation and proper treatment are crucial for recovery, minimizing illness spread, and maintaining overall health.
(Family Features) It doesn’t take much for cold and flu symptoms to take over. Even a mild case of the sniffles can make it difficult to navigate the demands of everyday life. It’s virtually impossible to avoid germs altogether, but you can make sure you’re ready to fight off an infection, whether it’s a minor cold or a full-blown case of the flu.
Cold and Flu Tips
“I always share a few easy and simple methods with my patients when cold and flu season comes back around to keep them in the best shape,” said Dr. Tim Tiutan, board-certified internal medicine physician. “Not only does getting ahead offer protection, but knowing what to do when symptoms start to come on, and what to have in your medicine cabinet, can help ease the burden of an oncoming illness.”
Preparation and prevention play important roles before a bug hits, but it’s also valuable to know how to effectively treat an illness and keep your loved ones from getting sick.
Prevent
Short of stashing yourself away in a bubble, there aren’t many failsafe ways to fully avoid germs. However, some basic hygiene and preventive care can go a long way toward minimizing your risk. Regularly washing your hands can help get rid of germs before you accidentally introduce them to your eyes, mouth or nose. Be especially diligent after spending time in crowded places.
Maintaining an overall healthy lifestyle also helps ensure you’re in optimal condition if you do get sick. That means eating a nutritious, well-rounded diet and keeping up with your exercise routine. Also be sure to talk to your doctor or pharmacist about getting a flu shot; while it may not fully prevent you from getting sick, in most cases it helps your body fight back and keeps your symptoms manageable.
Prepare
Knowing you can’t completely eliminate your exposure to germs, it’s a good idea to ensure you have everything you need to fight a cold or flu on hand. At least once a year, give your medicine cabinet a thorough cleaning. Discard any expired medications and replace products that have run low, especially those designed to help fight symptoms like pain relievers, fever reducers, decongestants, antihistamines and cough syrups.
It’s also a good time to restock items like tissues, cough drops, hand sanitizer and antibacterial soap. Medical supplies like thermometers and humidifiers also come in handy when you’re under the weather; check to be sure yours are in good working order and consider adding any supplies you don’t already have, such as a blood pressure cuff or home oximeter.
Treat
Once you’re sick, sleep is one of the best remedies. Your body can redirect energy toward healing when you’re sleeping, which helps boost your immune system, so give yourself permission to rest when you’re feeling down.
In addition to getting enough rest, it’s important to treat your symptoms, not just mask them. Because symptoms like fever, runny nose, chest congestion, cough and more can indicate a more serious problem, finding the root cause of the symptoms can be a more effective treatment strategy.
For example, some common remedies for chest congestion only mask the symptoms. Many doctors recommend an option like Mucinex 12-Hour because it treats the cause of chest congestion by thinning and loosening excess mucus. One dose lasts up to 12 hours, helping you clear mucus and relieve chest congestion.
Contain
Getting rest and managing your symptoms are easier when you stay at home, but it’s also the best way to prevent spreading germs to others. It’s not always practical, but if you can, limit yourself to one area of the house, away from family members. Cough into your elbow or a tissue, never your hands. Use antibacterial hand sanitizer and wipe down surfaces to minimize others’ contact with your germs.
Be especially wary of spending time with anyone who has a compromised immune system while you’re contagious, including those with pre-existing conditions, older adults and pregnant women. Take advantage of delivery or curbside services for essentials like groceries and talk with your employer about working remotely or using sick time until you’re feeling better.
Find more advice to help fight this cold and flu season at Mucinex.com. https://www.youtube.com/embed/zUpFn6VhRTM?feature=share/?utm_source=familyfeatures&utm_medium=referral&utm_campaign=#17187-Mucinex
When to Call for Help if You’re Feeling Lousy
If you’re experiencing cold symptoms, you might wonder when it’s appropriate to see a doctor for further evaluation. While most colds resolve on their own within a week or two, there are certain instances when seeking medical attention is advisable.
High Fever: If your fever persists for more than three days or reaches 102 F or higher, consult a health care provider.
Persistent or Severe Headaches: If you experience persistent or severe headaches that are not alleviated by over-the-counter medication, it’s advisable to consult a health care provider, as this could indicate a more serious underlying issue.
Persistent Symptoms: If your symptoms worsen or don’t improve after a week, seek medical advice.
Unusual Symptoms: If you experience uncommon or concerning symptoms during a cold, such as extreme fatigue, confusion, dehydration or a high fever that doesn’t respond to treatment, consult your doctor promptly for a proper diagnosis and treatment plan.
Trouble Breathing: Difficulty breathing, chest pain or wheezing can indicate a more severe respiratory condition and warrant medical attention.
High-Risk Individuals: For individuals at high risk of complications from colds, such as pregnant women, the elderly or individuals with conditions like diabetes or heart disease, it’s important to seek advice early to prevent any potential complications.
Remember, your health care provider can offer guidance tailored to your specific situation, helping you manage your cold effectively and ensure optimal recovery.
Photos courtesy of Shutterstock
SOURCE:
Mucinex
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Visit our Food & Drink section to get the latest on Foodie News and recipes, offering a delightful blend of culinary inspiration and gastronomic trends to elevate your dining experience.
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Lifestyle
Self-forgiveness is more than self-comfort − a philosopher explains
Self-forgiveness requires confronting negative emotions, acknowledging wrongdoing, and is essential for moral growth and healthier relationships.
Mordechai Gordon, Quinnipiac University
As the Jewish High Holidays approach, which begin with Rosh Hashanah and continue with Yom Kippur, the theme of forgiveness keeps coming to my mind.
The 10 days from Rosh Hashanah to Yom Kippur are referred to in the Jewish tradition as the days of repentance, or the days of awe. During this period, Jews who observe the holidays implore God to respond to their sins with mercy, while also requesting forgiveness from anyone those individuals may have wronged in the past year.
Most conversations about forgiveness focus on the meaning and value of forgiving others. Douglas Stewart, a philosopher of education who has researched forgiveness extensively, writes that to forgive implies a willingness to let go of our negative emotions or hard feelings and to adopt in their place a more generous and compassionate attitude toward our wrongdoers.
Other philosophers have pointed out that the benefits of forgiveness include overcoming resentment, restoring relationships and setting a wrong to rest in the past – without vengeance. As such, to forgive should be considered morally valuable and admirable.
But what about self-forgiveness? Is it morally valuable, or just something we do to make ourselves feel better? And what is self-forgiveness, anyway?
As a philosopher of education, some of my own research has wrestled with these questions.
Defining self-forgiveness
Self-forgiveness means managing to work through painful feelings such as guilt, shame and deep disappointment with ourselves. It entails transforming negative attitudes, such as contempt, anger and shame, into more positive emotions such as respect and humility.
It is important to recognize, however, that a wrongdoer cannot simply reject shame: They must confront it. Moral philosophers such as Byron Williston assert that people who have deeply wronged others, such as betraying a loved one, need to experience shame and take responsibility for their actions – such as asking for forgiveness. Otherwise, an attempt at self-forgiveness is not likely to be meaningful.
Finally, we need to keep in mind that self-forgiveness does not imply someone has extinguished all the negative feelings directed at themselves or is done with self-reproach. This would amount to an impossible goal.
Rather, as philosopher Robin Dillon pointed out, self-forgiveness suggests that someone is no longer being consumed or overwhelmed by those negative feelings. In short, it is possible to forgive ourselves and still view ourselves with a demanding and critical eye.
Moral development
Getting there, though, is not easy. Self-forgiveness entails working through a rigorous process of coming to terms with wrongdoing.
According to ethicist Margaret Holmgren, that process includes at least four steps: acknowledging that what we did was wrong; coming to terms with why it was wrong; allowing ourselves to experience grief and self-resentment at having injured another person; and, finally, making a genuine effort to correct the attitudes that led to the harmful act and making amends to the victim.
In other words, confronting negative emotions, attitudes and patterns is essential prior to attempting to restore relationships with others. Only once we are able to relax the preoccupation with guilt and shame, and to genuinely forgive ourselves, can we meaningfully contribute to relationships as liberated and equal partners – especially in ongoing ones, such as with family and friends.
Of course, there are cases in which the offense is so vast, such as genocide, that no individual can make full restitution or provide an adequate apology for the wrong.
There are other times when an apology is impossible. Perhaps victims are dead; perhaps a direct apology would retraumatize them or do more harm than good.
In those cases, I would argue, an offender can still attempt to work toward self-forgiveness – acknowledging not only the victim’s intrinsic worth but their own, regardless of their ability to make amends. This in itself is moral growth: appreciating that neither is a mere object that can be manipulated or abused.
The take-home point, I would argue, is that going through the process of self-forgiveness is morally beneficial. It can not only liberate people who tend to reproach themselves incessantly, but it can enhance their ability to relate ethically toward others – to acknowledge wrongdoing, while simultaneously affirming their own value.
Most people have experienced at least one situation in which they inflicted pain on someone else and recognized that their words or actions caused harm. In such situations, we also often feel ashamed of ourselves and attempt to apologize or make amends.
Yet I hope that during this High Holiday season we keep in mind that self-forgiveness should also be considered essential. If moral development means a process in which our self-awareness and character mature, then acknowledging wrongdoing and experiencing shame, followed by self-forgiveness, are indispensable for that process.
Mordechai Gordon, Professor of Education, Quinnipiac University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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health and wellness
Protecting Your Lung Health at Any Age
(Family Features) Chronic obstructive pulmonary disease, or COPD, is a serious lung condition that makes breathing difficult. Whether you’re a younger adult, middle-aged or over 60, you can take steps to protect your lungs or manage your COPD to feel better, be more active and breathe easier. Follow these tips from the National Heart, Lung, and Blood Institute to bring your lung health into focus – at any age. Learn more at nhlbi.nih.gov/BreatheBetter.
SOURCE:
National Heart, Lung, and Blood Institute
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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