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One of the most time-consuming tasks in clinical medicine is seeking the opinions of specialist colleagues. There is a pressure not only to make referrals appropriate but also to summarize the case in the language of the specialist. This book explains basic physiologic and pathophysiologic mechanisms of cardiovascular disease in a straightforward manner, gives guidelines as to when referral is appropriate, and, uniquely, explains what the specialist is likely to do. It is ideal for any hospital doctor, generalist, or even senior medical student who may need a cardiology opinion, or for that ma.
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).
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.
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.
Federal policy toward Native Americans has fluctuated wildly in the twentieth century. Washington long envisioned that Indians would be assimilated into American culture—until FDR's New Deal introduced tribal self-government. Then, during the Truman and Eisenhower administrations, its goal became the termination of federal wardship status for Indians. This book considers the changes in attitude that began in 1960 and culminated in the Indian Self-Determination Act of 1975. Drawing on personal interviews with key players, George Castile goes behind the scenes in Washington to reveal what motivated policy makers—and who really shaped policy—from the Kennedy to the Ford administrations. To Show Heart is a detailed and unbiased account of one of the least understood periods in Indian affairs. It tells how "termination" became a political embarrassment during the civil rights movement, how Lyndon Johnson's War on Poverty prompted politicians to rethink Indian policy, and how championing self-determination presented an opportunity for Presidents Nixon and Ford to "show heart" toward Native Americans. Along the way, Castile assesses the impact of the Indian activism of the 1960s and 1970s and offers an objective view of the American Indian Movement and the standoff at Wounded Knee. He also discusses the recent history of individual tribes, which gives greater meaning to decisions made at the national level. Castile's work greatly enhances our understanding of the formulation of current Indian policy and of the changes that have occurred since 1975. To Show Heart is an important book not only for anthropologists and historians but also for Native Americans themselves, who will benefit from this inside look at how bureaucrats have sought to determine their destinies.
#1 NEW YORK TIMES BESTSELLER • In her latest book, Brené Brown writes, “If we want to find the way back to ourselves and one another, we need language and the grounded confidence to both tell our stories and be stewards of the stories that we hear. This is the framework for meaningful connection.” Don’t miss the five-part HBO Max docuseries Brené Brown: Atlas of the Heart! In Atlas of the Heart, Brown takes us on a journey through eighty-seven of the emotions and experiences that define what it means to be human. As she maps the necessary skills and an actionable framework for meaningful connection, she gives us the language and tools to access a universe of new choices and second chances—a universe where we can share and steward the stories of our bravest and most heartbreaking moments with one another in a way that builds connection. Over the past two decades, Brown’s extensive research into the experiences that make us who we are has shaped the cultural conversation and helped define what it means to be courageous with our lives. Atlas of the Heart draws on this research, as well as on Brown’s singular skills as a storyteller, to show us how accurately naming an experience doesn’t give the experience more power—it gives us the power of understanding, meaning, and choice. Brown shares, “I want this book to be an atlas for all of us, because I believe that, with an adventurous heart and the right maps, we can travel anywhere and never fear losing ourselves.”
Ideal for cardiologists who need to keep abreast of rapidly changing scientific foundations, clinical research results, and evidence-based medicine, Braunwald’s Heart Disease is your indispensable source for definitive, state-of-the-art answers on every aspect of contemporary cardiology, helping you apply the most recent knowledge in personalized medicine, imaging techniques, pharmacology, interventional cardiology, electrophysiology, and much more! Practice with confidence and overcome your toughest challenges with advice from the top minds in cardiology today, who synthesize the entire state of current knowledge and summarize all of the most recent ACC/AHA practice guidelines. Locate the answers you need fast thanks to a user-friendly, full-color design with more than 1,200 color illustrations. Learn from leading international experts, including 53 new authors. Explore brand-new chapters, such as Principles of Cardiovascular Genetics and Biomarkers, Proteomics, Metabolomics, and Personalized Medicine. Access new and updated guidelines covering Diseases of the Aorta, Peripheral Artery Diseases, Diabetes and the Cardiovascular System, Heart Failure, and Valvular Heart Disease. Stay abreast of the latest diagnostic and imaging techniques and modalities, such as three-dimensional echocardiography, speckle tracking, tissue Doppler, computed tomography, and cardiac magnetic resonance imaging. Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
How do you fight despair and learn to meet the world with a loving heart? How do you overcome shame? Stay faithful in spite of failure? No matter where people live or what their circumstances may be, everyone needs boundless, restorative love. Gorgeous and uplifting, Tattoos on the Heart amply demonstrates the impact unconditional love can have on your life. As a pastor working in a neighborhood with the highest concentration of murderous gang activity in Los Angeles, Gregory Boyle created an organization to provide jobs, job training, and encouragement so that young people could work together and learn the mutual respect that comes from collaboration. Tattoos on the Heart is a breathtaking series of parables distilled from his twenty years in the barrio. Arranged by theme and filled with sparkling humor and glowing generosity, these essays offer a stirring look at how full our lives could be if we could find the joy in loving others and in being loved unconditionally. From giant, tattooed Cesar, shopping at JCPenney fresh out of prison, we learn how to feel worthy of God’s love. From ten-year-old Lula we learn the importance of being known and acknowledged. From Pedro we understand the kind of patience necessary to rescue someone from the darkness. In each chapter we benefit from Boyle’s wonderful, hard-earned wisdom. Inspired by faith but applicable to anyone trying to be good, these personal, unflinching stories are full of surprising revelations and observations of the community in which Boyle works and of the many lives he has helped save. Erudite, down-to-earth, and utterly heartening, these essays about universal kinship and redemption are moving examples of the power of unconditional love in difficult times and the importance of fighting despair. With Gregory Boyle’s guidance, we can recognize our own wounds in the broken lives and daunting struggles of the men and women in these parables and learn to find joy in all of the people around us. Tattoos on the Heart reminds us that no life is less valuable than another.
In Edgar Allan Poe's "The Tell-Tale Heart", the narrator tries to prove his sanity after murdering an elderly man because of his "vulture eye". His growing guilt leads him to hear the old man's heart beating under the floorboards, which drives him to confess the crime to the police.
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.