Another Fascinating U Shaped Mortality Curve

Medical News: Tight Glucose Control Raises Mortality Risk in Heart Failure – in Cardiovascular, CHF from MedPage Today

To look farther down the disease spectrum than the analysis in ACCORD, Dr. Aguilar’s group retrospectively examined outcomes for a national cohort of 5,815 ambulatory diabetic patients with established heart failure who were treated in ambulatory clinics at VA medical centers.

During two years of follow-up, mortality rates were:

* 25.0% in the bottom quintile with hemoglobin A1c levels of 6.4% or less.
* 23.0% in the group with A1c levels of 6.5% to 7.1%.
* 17.7% in the middle quintile with glycosylated hemoglobin levels above 7.1% but no more than 7.8%.
* 22.5% in the group with A1c levels of 7.9% to 9.0%.
* 23.2% in the top quartile with hemoglobin A1c levels above 9.0%.

This is must-have information for all the life settlement underwriters out there.

Electronic Cigarettes

Electronic Cigarettes

FDA notified healthcare professionals and patients that a laboratory analysis of electronic cigarette samples has found that they contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze. Electronic cigarettes, also called “e-cigarettes,” are battery-operated devices that generally contain cartridges filled with nicotine, flavor and other chemicals. The electronic cigarette turns nicotine, which is highly addictive, and other chemicals into a vapor that is inhaled by the user. These products are marketed and sold to young people and are readily available online and in shopping malls. They are also available in different flavors, such as chocolate and mint, which may appeal to young people.

The FDA’s Division of Pharmaceutical Analysis analyzed the ingredients in a small sample of cartridges from two leading brands of electronic cigarettes. In one sample, the FDA’s analyses detected diethylene glycol, a chemical used in antifreeze that is toxic to humans, and in several other samples, the FDA analyses detected carcinogens, including nitrosamines. These products do not contain any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. Because these products have not been submitted to the FDA for evaluation or approval, at this time the agency has no way of knowing, except for the limited testing it has performed, the levels of nicotine or the amounts or kinds of other chemicals that the various brands of these products deliver to the user.

Health care professionals and consumers may report serious adverse events (side effects) or product quality problems with the use of e-cigarettes to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail, fax or phone.