The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.
The magnificent anatomic presentation in this book "The Heart and Cor onary Arteries" has a unique importance for surgeons. It is a fundamental contribution to the anatomy of the heart and great arteries as well, because of the analytical, detailed, and imaginative anatomic approach of the author. While surgery from time to time is influenced by the development of new physiologic principles and techniques, methods of intra- and post-operative support, and new diagnostic methodology, the excellence of its results con tinues to be related primarily to the precision and perfection of the opera tive procedure itself. The operative procedure can be precise and perfect only if it is based upon the surgeon's profound knowledge of normal anatomy, his understanding of the alterations in this normal anatomy by the pathol ogy with which he is dealing, and his ability to use this anatomic informa tion in organizing and effecting his surgical procedure. The cardiac sur geon, therefore, will find great rewards from intense study of this anatomic atlas. The cardiologist, the pediatric cardiologist, the anatomist, the pathol ogist, and students interested in cardiac disease will benefit to almost the same degree from a careful study of this work. May 1975 JOHN W. KIRKLIN, M. D.
Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.
An atlas on coronary artery anomalies, this text provides a guide to the complex morphology that is essential to the understanding of coronary artery disease. The book features a variety of cases - with illustrative angiograms and diagrams - that demonstrates all possible anomalies and clarify what is abnormal. Each case includes clinical information, angiographic findings, other diagnostic material and a discussion.
The New York Times bestselling guide to the lifesaving diet that can both prevent and help reverse the effects of heart disease Based on the groundbreaking results of his twenty-year nutritional study, Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn illustrates that a plant-based, oil-free diet can not only prevent the progression of heart disease but can also reverse its effects. Dr. Esselstyn is an internationally known surgeon, researcher and former clinician at the Cleveland Clinic and a featured expert in the acclaimed documentary Forks Over Knives. Prevent and Reverse Heart Disease has helped thousands across the country, and is the book behind Bill Clinton’s life-changing vegan diet. The proof lies in the incredible outcomes for patients who have followed Dr. Esselstyn's program, including a number of patients in his original study who had been told by their cardiologists that they had less than a year to live. Within months of starting the program, all Dr. Esselstyn’s patients began to improve dramatically, and twenty years later, they remain free of symptoms. Complete with more than 150 delicious recipes perfect for a plant-based diet, the national bestseller Prevent and Reverse Heart Disease explains the science behind the simple plan that has drastically changed the lives of heart disease patients forever. It will empower readers and give them the tools to take control of their heart health.
This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.
Lifestyle and Heart Health and Disease provides a comprehensive evaluation of lifestyle factors that modify heart function and structure. It includes coverage of a wide range of lifestyle factors, including physical activity, alcohol, tobacco, drugs of abuse, nutrition and psychosocial factors. The book clearly presents the scientific evaluation of published research relating to general responses by scientists, physicians and patients, along with new research on the role of lifestyle in the prevention, amelioration and causation of cardiac remodeling and disease. - Explains the pathogenic mechanisms of cardiovascular diseases and the targets of therapy - Presents methods contained within the book that can be applied to the diagnosis of heart disease - Contains a concise summary with recommendations for actions and conclusions - Provides a one-stop-shopping synopsis of key ideas associated with many aspects of lifestyle
Arterial hypertension, coronary heart disease and heart fail ure are the commonest cardiovascular conditions to present in clinical practice. Over the past few years it has become in creasingly clear that they are closely and causally interrelated and that their relationship can have a significant bearing on prognosis. Epidemiological studies have shown that arterial hypertension is one of the most important risk factors for de veloping heart failure. Only one in four patients with hyper tension is adequately managed, and in 50% of cases, the hypertension has not been recognised or treated. Patients with pre-existing hypertension who go on to suffer an acute myocardial infarction have usually not previously had typi cal angina symptoms, the infarct territory is larger, life threatening arrhythmias are commoner and hence in-hospi tal mortality and long-term prognosis are markedly worse. The presence of raised blood pressure in the post-infarct phase doubles the risk of manifest heart failure. The close relationship between hypertension, coronary heart disease and heart failure makes the choice of therapeu tic strategy particularly important. Agents and classes of agents that have prognostic value in all three conditions should be considered first, as synergy might result in addi tional benefits. In such patients, this sort of therapeutic deci sion-making might have further advantages. The use of these agents may prevent complications which are not yet clinically obvious (such as heart failure).
Caffeine in Food and Dietary Supplements is the summary of a workshop convened by the Institute of Medicine in August 2013 to review the available science on safe levels of caffeine consumption in foods, beverages, and dietary supplements and to identify data gaps. Scientists with expertise in food safety, nutrition, pharmacology, psychology, toxicology, and related disciplines; medical professionals with pediatric and adult patient experience in cardiology, neurology, and psychiatry; public health professionals; food industry representatives; regulatory experts; and consumer advocates discussed the safety of caffeine in food and dietary supplements, including, but not limited to, caffeinated beverage products, and identified data gaps. Caffeine, a central nervous stimulant, is arguably the most frequently ingested pharmacologically active substance in the world. Occurring naturally in more than 60 plants, including coffee beans, tea leaves, cola nuts and cocoa pods, caffeine has been part of innumerable cultures for centuries. But the caffeine-in-food landscape is changing. There are an array of new caffeine-containing energy products, from waffles to sunflower seeds, jelly beans to syrup, even bottled water, entering the marketplace. Years of scientific research have shown that moderate consumption by healthy adults of products containing naturally-occurring caffeine is not associated with adverse health effects. The changing caffeine landscape raises concerns about safety and whether any of these new products might be targeting populations not normally associated with caffeine consumption, namely children and adolescents, and whether caffeine poses a greater health risk to those populations than it does for healthy adults. This report delineates vulnerable populations who may be at risk from caffeine exposure; describes caffeine exposure and risk of cardiovascular and other health effects on vulnerable populations, including additive effects with other ingredients and effects related to pre-existing conditions; explores safe caffeine exposure levels for general and vulnerable populations; and identifies data gaps on caffeine stimulant effects.
